By Alexa von Ow
ResponsiBiz
25 January 2021
For a little more than a year the world has been dominated by the ongoing health crisis. SARS-CoV-2 has spread relentlessly across the globe while societies are disrupted economically and socially. The only way to render the Corona virus harmless is by developing a vaccine. Pharmaceutical companies in all parts of the world are racing to satisfy this global demand for a safe and effective immunization. A number of enterprises have managed to accomplish what typically takes years, if not decades of research, trials and testing before being approved as safe to use; twelve companies are currently at the stage of testing their product’s efficacy on a large scale (phase 3). Of these twelve, ten vaccines have been approved for either limited or emergency use by certain governments. Once a vaccine has been developed it needs to be manufactured, ideally in close proximity to where it will be used. And it needs to be purchased before making its way to health facilities where it will be administered to people. The excitement about the Hercules achievement on behalf of the pharmaceutical doers is just. However, the job is far from done while matters of pricing and equitable distribution are unresolved. Many high-income countries have allocated funds and planned the vaccine supply chain. While most of the world was in a first shut down millions of vaccine doses were being secured by wealthy nations. According to Oxfam, western countries have purchased enough Covid-19 vaccine doses to immunize their populations three times by the end of this year although accounting for only 14% of global citizens. This is not the case for middle or low-income countries, especially not for the African region.
First of all, it’s unclear who African countries will procure vaccines from. With only the US German Pfizer-BioNTech offering a supply of 50 million doses to the continent, Africa has angled its hopes eastwards. Last year, China’s Xi Jinping pledged to put its African allies first when disseminating their vaccine. A large donation of PPE and medicinal testing kits was to symbolize China’s commitment. Nevertheless, no vaccines have been delivered to the continent until today. Guinea ordered two million doses of Russia’s Sputnik V immunization. What is also known as the Gam-Covid-Vac claims an efficacy of over 91%. Considering that the medicinal product was approved without having entered into trial phase three and tested on less than 100 volunteers the reliability of this claim is rather questionable.
Secondly, the majority of African economies lack the purchasing power to match the shopping spree of wealthy nations. In anticipation of this disparity the Coalition for Epidemic Preparedness Innovation (CEPI) together with the World Health Organization (WHO) and the vaccine alliance GAVI have convened COVAX, a procurement programme for Covid-19 vaccines. This confederate is the third pillar of the Access to Covid-19 Tools (ACT) Accelerator – a framework initiated by the WHO which aims to advance diagnostics, treatment, vaccines and health system strengthening in a joint effort by relevant decision makers. COVAX’s objective is to “facilitate the equitable access and distribution” of a safe and effective corona vaccine. Operational modalities are similar to those of a multilateral organization whereas solidarity is the underlying rationale. Solidarity here means to bundle monetary resources from all participants inasmuch as high-income countries self-finance their ordered vaccines, low- or middle-income countries are eligible to be funded through the COVAX Advance Market Commitment (AMC) fund. According to GAVI, 125 wealthy economies have joined this guild and directly contributed 1.5 billion USD towards the COVAX AMC which, if hypothetically allocated to African countries only, could subsidize one shot for half of the continent’s population. 92 countries are designated eligible to be supported by the COVAX AMC. As benevolent this initiative is, again, not a single vaccine dose has been supplied to an African country. Meanwhile, 40 million individuals in high-income nations have been injected with this remedy to date.
In addition to inequitable access and lacking funds the WHO assesses that “Africa is far from ready for what will be the continent’s largest ever immunization drive”. Nations in questions are being called to “ramp up readiness” in order to accomplish mass immunization. This plea is as good as hoping an elephant learns how to ride a bicycle. It’s contradictive to imply “active leadership and engagement” where political institutions are obviously extractive. To demand Africa prepares the vaccine supply-chain- and mass immunization strategy is dismissive bearing in mind that only 28% of all health facilities have access to electricity. And it’s cynical to make membership of a club (COVAX) conditional on a preparedness which financially burdens the region heavily dependent on aid as ever. Deficient institutional capacities embedded in a post positioned democratic development will not miraculously make up for their delay. This is not to say that African countries can’t or aren’t already transforming. Even so, the continent’s trend towards advanced development needs time. More than ever the disparities between wealthy nations and Africa are blatantly obvious during this pandemic. Notions employing binary heuristics (“developed world vs. developing world”) are just partially dismantled. Yes, Africa needs to develop inclusive political institutions grown on process-focused leadership. Only then will institutional capacities master horrid crises as the current one proficiently. Only then will Africa be able to procure alternative options to COVAX as market participant at par. Supposedly, it takes two to tango (and more to line dance); high-income countries are equally compelled to contribute towards solution seeking. Western countries must think outside the aid box that sustains Africa’s recidivism into debt. Africa can wean off aid by diversified development promotion. Nigerian scientists had developed a promising vaccine candidate towards the end of last year. The corona immunization had successfully undergone pre-clinical trial. Unfortunately, missing funds interrupted the development that was supposed to be tested on humans next. Complementary to allocating funds to COVAX AMC high-income nations could have invested in African based research and development.
Inordinate pricing along with an inequitable distribution of Covid-19 vaccines across the globe will prolong human suffering and further stress economic stability. Particularly in Africa, vaccine diplomacy has been handled poorly abandoning millions of people dealing with food crisis, restricted mobility, closed schools or unemployment due to Covid-19. Only one in ten people in the African region runs a chance of getting immunized by the end of this year. This shot is most likely to be Chines or Russian infusing a hope for corona immunity and quite some risk given neither of the two nations has published any data on efficacy, user safety or adverse effects so far. But beggars can’t be chooser, right? The world can’t afford neglecting Africa’s health by virtue of punitive rankings. It’s imperative this human embarrassment is averted as a result of the public, private sectors together with civil society organisations closing ranks.
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