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Barriers and billions: the battle to vaccinate Africa


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Cassius Hynam


Sub-Saharan Africans will suffer disproportionately in the years to come unless richer nations do more to help speed up a vaccine rollout. By the end of January 2021, just 55 out of the 80 million doses available of the COVID-19 vaccine had been administered to those in lower-income countries. Not ‘55 million’, 55 people. It demonstrates the devastating juxtaposition between the abilities of nations in the Global North compared to those in the Global South to rebound from the virus. Predictions suggest Africa might not have widespread vaccination until early 2024, prolonging the economic fallout. There’s no silver bullet to catalyse a widespread vaccination program, but it can happen faster.


Africa is stuck at the back of the queue


Richer nations directly funded multiple pharmaceutical companies in their vaccine research and testing programs, under the provision they would receive vaccines first once they had approval. As a result, 60 per cent of ordered vaccines so far are heading to the world’s richest countries where just 16 per cent of people live. It is a concerning inequality. African nations simply did not have the funds to pre-order vaccines before they were proven to be effective. Countries like Canada, that have invested in multiple different vaccines, may find themselves with five times as many doses than needed.


Countries do have legitimate reasons to be desperate. World leaders are under significant domestic political pressure to vaccinate quickly, exacerbated by civil unrest. Amidst the hyper-nationalised experience of COVID-19, which has heightened the role of federal governments, we should not be surprised to see that state borders have become more defined. But Africans may feel betrayed if wealthier countries force up prices for vaccines or use their power to delay an African rollout, all while preaching the importance of an equitable recovery.


The worst is yet to come for Africa


Africa has so far managed to get through the pandemic relatively well. Despite hosting 14 per cent of the world’s population, the sub-Sahara experienced just three per cent of recorded deaths due to COVID-19. On average, GDP fell by 2.6 per cent, performing better than the global average decline of 3.5 per cent. But such statistics present a far rosier picture than reality.


Lack of widespread testing means that tens of thousands of deaths may have gone unreported, while weakened finances mean countries have less capacity to rebound economically. African governments have spent less on stimulus, allocating just three per cent of GDP compared to seven per cent in the Global North. Thirty-two million have fallen back into extreme poverty. School closures have left many in Africa’s largest ever youth cohort academically behind, with the burden worn most heavily by young girls. Most of Africa also entered the pandemic in a weaker economic position than five years earlier, driven by a pre-pandemic slowdown in mining. The need to restructure debts combined with a lack of willingness to take on more will leave vital infrastructure under-developed for years. Widespread vaccination will not only save lives, but will also allow an easing of restrictions that will boost local economies and get more young people back to school, while also providing a safe return for tourists to an economy which heavily relies on global visitors.


Is there a plan for Africa?


The COVAX program, launched by the World Health Organisation (WHO) in April 2020, hopes to deliver two billion vaccines to low-income countries by the end of 2021. However, by June this year, only 3.3 per cent of the population in poorer countries will have received a dose. The program, which has been jointly funded by 190 nations, is still $US 2 billion short in funding to reach its goals. Norway is attempting to lead the effort of richer nations to help out less-developed countries on the continent by planning to roll out vaccines concurrently in Africa and domestically. But Norway is not without faults; it has ordered three times more doses than needed. The funding shortage is causing many in the Global South, including many African nations, to enquire directly with China and Russia about their vaccines – despite these having skipped stage two of clinical trials and being as yet unapproved by the WHO. The efficacy and safety of these vaccines is questioned, potentially putting Africans at risk.


Poorer African states also face structural issues richer countries don’t face. The Pfizer vaccine must be kept at very low temperatures, making storage more difficult in nations that lack the necessary infrastructure. With production occurring almost exclusively in Europe or the Americas, transportation costs are also far higher. South Africa paid almost two and a half times the rate paid by the EU for the Astra-Zeneca vaccine.


There’s hope, but things need to change


At the end of February, Ghana became the first nation to receive a COVAX delivery, receiving 600 thousand doses of the Astra-Zeneca vaccine which can be more easily stored and transported than Pfizer. But for a population of 31 million, it is only just a start.

Structurally, there are other ways to increase vaccination rates. Public and political pressure on pharmaceutical companies to suspend patent rights and outsource production to poorer nations would be pivotal. India’s Serum Institute is manufacturing Astra-Zeneca locally but they exist as the only example in the Global South to do so. Localised production will greatly increase the speed of vaccination, with lower production and transportation costs.


World leaders also need to practice fairness. Canada, a large donor to COVAX, is accessing vaccines from the COVAX program ahead of poorer nations, despite having made multiple deals directly with pharmaceutical companies. Unilateral approaches such as this will only lead to poorer global outcomes in the long run. Many in Africa, like Tanzanian President John Magufuli, are still resentful of the US and other nations for their delayed efforts in helping stop the spread of AIDS in Africa. In order to maintain strong relationships, Western leaders must commit more than just words towards the vaccine rollout.


Cassius Hynam is the Sub-Saharan Africa Correspondent for YDS and a recent University of Melbourne graduate in Politics & International Studies and Economics. He is currently completing an internship at the Grattan Institute.