In a recent interview, Akuna Cook, United States deputy assistant Secretary of State for African Affairs, emphasized the US’ ongoing commitment to deploy over 25 million doses to African countries, calling it a “top priority” of the Biden-Harris administration. The interview, hosted by Voice of America’s Hayde Adams, focused extensively on the vaccine shortages in Africa, the reasons for these shortages, and the United States’ ongoing initiatives to aid African countries in their efforts to increase vaccination rates.
Cook details the Biden administration’s expansive plan to help mitigate the spread of COVID-19 and increase inoculation rates. The plan includes an initial donation of over 25 million vaccines, investment in vaccine manufacturing in South Africa and Senegal, and the provision of over $541 million in response to the catastrophic after-effects of the pandemic. She emphasizes that “this is just the beginning,” calling it “the initial tranche” of COVID mitigation efforts to come.
These initiatives cannot come soon enough. Currently, about 1% of the entire African population has been vaccinated. The low inoculation rate comes as a result of an amalgam of factors: delays in Covax vaccine acquisition and distribution, lack of healthcare infrastructure and staff, and vaccine hesitancy. Further deepening the crisis, World Health Organization (WHO) guidelines issued in May suggested many African countries administer as many first doses as possible, forgoing stockpiling for the second and inadvertently generating a significant vaccine shortage. The WHO reports that at the current pace of inoculation, only eight of Africa’s 54 nations are set to vaccinate at least 10 percent of their country’s population by September.
Currently, the United States is the largest contributor to Covax, a multibillion-dollar alliance backed by the WHO and composed of other international health bodies and nonprofits. Covax’s mission is to ensure that low-income countries receive vaccinations at the same rate as higher-income countries. Despite good intentions, the program has struggled with fulfilling its dose delivery goals to countries in need, encountering hurdles with funding and shortages in vaccine supply.
Options for African countries to acquire vaccines through purchase appear increasingly limited as the vast majority of vaccines to be produced in the remainder of 2021 have been sold, according to data from Airfinity, an analytics firm. “The world is making a couple hundred million doses a week, so there’s not a supply problem,” said Dr. Bruce Aylward, a senior adviser to the WHO. Instead, he said, vaccine manufacturers and world leaders of high-income nations have elected to put themselves first: “There’s a choice problem.”
The race between rich countries to create, and then buy up, vaccines left many low-income countries struggling to obtain enough to vaccinate even 20% of their populations. Meanwhile, some rich countries have bought up enough to vaccinate their own populations several times over. The surplus is such that unused vaccines risk expiring, as the quantities are too large to balance out with decreasing vaccine demands. “While many countries outside Africa have now vaccinated their high-priority groups and are able to even consider vaccinating their children, African countries are unable to even follow up with second doses for high-risk groups,” says WHO Africa director Dr. Matshidiso Moeti. The lack of vaccine equity is apparent and a solution is in dire need.
Posing additional difficulties for vaccination efforts is a lack of accessible healthcare infrastructure. Further compounded by the shortage of healthcare workers, a lack of refrigeration units has made long-term vaccine storage and administration difficult for some nations.
As Covax’s leading vaccine donor, the United States should appeal to allied nations by encouraging them to provide sufficient aid to Covax recipient countries through funding or direct provision of healthcare infrastructure and vaccines. One such initiative could be an investment in vaccine manufacturing centers based in African countries, as the US has in Senegal and South Africa. This would lower transportation costs, cut down on shipping times, and provide more immediate access to vaccines. Additionally, supporting funding for grassroots movements providing vaccine information, dispersion, and incentivization may be beneficial in combating vaccine hesitancy.
Finally, accountability must be taken by rich countries as to why Covax has experienced so many challenges since its establishment. Acting with national interest and enforcing protectionism in the face of a global pandemic is counterproductive. It serves to perpetuate inequities and prolong the very thing we’re aiming to overcome. A global vaccine purchasing cap, one which takes into account population size and imposes limitations on the number of excess vaccines a country can stockpile at any given time, could be a beneficial tool in ensuring lower-income nations are guaranteed access to vaccines as they become available.
As the Delta variant spreads at an unprecedented pace, the international community must act with renewed urgency toward increasing vaccination rates. It is critical to ensure lower-income countries and rural communities have access to vaccines and sufficient healthcare infrastructure. While higher-income nations shift back to a sense of normalcy, the pandemic ravages communities elsewhere. It’s imperative to realize that this pandemic will remain a global ordeal until it has been dealt with on a global scale. We must continue to build upon our Covid mitigation efforts, as we cannot truly “end this pandemic anywhere until we’ve ended it everywhere.”
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