“If we put an end to inequality (vaccine), we can end the pandemic. If we allow this inequality to persist, we allow the pandemic to continue “, launched on December 14, 2021 the Managing Director of the World Health Organization (WHO), the Dr Tedros Adhanom Ghebreyesus.
If we end vaccine inequity, we can help end the # COVID19 pandemic together. If we allow inequity to continue, we allow the pandemic to continue. #VaccineEquity pic.twitter.com/SJiF7m10Ke
– Tedros Adhanom Ghebreyesus (@DrTedros) December 15, 2021
It has become a mantra that the boss of the WHO has been repeating for months. If the question of vaccine inequity illustrated by Africa has a moral dimension, it has above all a scientific justification and is once again tangible with the appearance of the Omicron variant which is spreading at full speed.
“The link between the occurrence of new variants and vaccine inequality is no longer to be demonstrated”, explains to franceinfo Africa Dr Richard Mihigo, Coordinator of the Immunization and Vaccine Development Program at the WHO Regional Office for Africa. “We already knew that with the other forms of viral diseases. The more you let a virus circulate in a population which is not vaccinated, which is not protected – we have experience with measles in children – the more you (him) give the possibility to change and mutate. Seasonal flu is also a telling case. ”
Ten months ago, the first doses arrived in African countries, mainly via the Covax solidarity mechanism. With the exception of Eritrea, all are now deploying the range of authorized vaccines. To date, over 250 million doses have been administered on the continent. Unfortunately, according to the WHO, they only represent “3% of the approximately 8 billion doses ” injected into the world. Results : “Only about 8% of Africans are fully immunized, compared to over 60% in many high-income countries.”
Speaking on November 29 on the occasion of the extraordinary session of the World Health Assembly, the Director-General of WHO explained that the worst-case scenario imagined had taken shape. “A year ago, we started to see some countries making bilateral deals with manufacturers, and signaled that the poorest and most vulnerable would be sacrificed in this global vaccine rush. And that’s exactly what it is. it has happened. Over 80% of the world’s vaccines have been allocated to the G20 countries “, Dr. Ghebreyesus regretted then. He also pointed out that some countries were starting to “to vaccinate groups at very low risk of contracting a severe form, or to give booster doses to healthy adults” while in Africa “only one in four health workers has been vaccinated”.
December 1, World AIDS Day – the other pandemic that has raged for 40 years – was an opportunity for many to draw a parallel between the unequal treatment Africans were subjected to in the early hours of the pandemic and that of which they are today victims in the face of that of Covid-19. Winnie Byanyima, Executive Director of the Joint United Nations Program on HIV / AIDS (UNAIDS), has stepped up to the plate again by lending her voice, alongside Prince Harry, Duke of Sussex, to an awareness video by The People’s Vaccine , a coalition of NGOs and activists campaigning for vaccines accessible to all.
The responsibility of laboratories is pointed out as is the monopolization of vaccines by the most affluent nations. An attitude castigated for the umpteenth time by South African President Cyril Ramaphosa, champion of the fight against Covid-19 of the African Union (AU), during his trip to Senegal on December 7. The leader, who is currently suffering from Covid-19, recalled that the rich countries had ordered “more vaccines than their population needed”.
“Pharmaceutical companies continue to prioritize supplying high-income countries which also stockpile more doses than they can use, while blocking attempts to increase supply by supporting temporary waiver of rights of intellectual property and the increased sharing of technology and know-how “, Amnesty International summed up on December 14 in a report on vaccine inequality in East Africa.
As Africa faced a shortfall of 470 million doses for 2021, the WHO Regional Director for Africa, Dr Matshidiso Moeti, invited countries “who have reservations” at “release their doses so that other countries can buy them”. She also urged those “who promised doses ” to hold “urgently” their promises. The United States, the European Union and France have made announcements in this direction.
From now on, the continent is no longer in the situation of shortage of the first months of 2021 when the acceleration of the epidemic in India had forced the country to reserve its production capacities for itself while it ensured the manufacture of the AstraZeneca vaccine for Covax. “About 20 million doses are sent per week to the continent today” through Covax, Avat (AU vaccine procurement program) and bilateral agreements signed by states, Dr Phionah Atuhebwe said on December 14, responsible for the introduction of new vaccines at the WHO regional office for Africa.
In order to optimize their deployment, the African Center for Disease Control and Prevention (Africa CDC), WHO, Unicef, the Vaccine Alliance-Gavi, among others, have advocated for better predictability of donations. . “The majority (of those) carried out so far have been ad hoc, provided with little notice and with a short retention period. It is therefore extremely difficult for countries to plan vaccination campaigns “, specifies a press release published at the end of November. Lack of funds, shortage of syringes, absence of qualified personnel or even poor planning to determine priority targets are all obstacles to be overcome in some countries to inject serums.
Added to this is the vaccine reluctance that affects the whole world. On November 24, Reuters reported that South Africa had asked Johnson & Johnson and Pfizer to delay deliveries because vaccine mistrust was slowing its campaign. The country is the most affected by Covid-19 in Africa, but is also one of the few on the continent to approach the vaccination rate of 40% set by the WHO for the end of the year. This mistrust, partly fueled by disinformation, is often linked to “an inadequate response” concerns about the safety and side effects of vaccines, analyzes the Dr Phionah Atuhebwe. “In some countries we have also found that religious leaders are very popular and what they say (on this subject) is very important to their followers, contrary to what science has to say. “ The involvement of these opinion leaders “very important” is a data to take into account, notes the expert. “But with the third wave that we are seeing in most countries and the arrival of the fourth, she adds, hesitation tends to decrease. ” Because, we found at the WHO, vaccine hesitation is often swept away by the waves of the epidemic.
All in all, the logistical difficulties, vaccine mistrust or even the presumed waste of doses appear secondary in understanding the vaccine inequality. “There is a need to dispel the impression that (…) millions of doses are lost, expiring in Africa. This is not the case. The main challenge in African countries is vaccine supply“Dr Moeti said on December 14 at the Regional Office press conference.
If she is lagging behind for vaccination, “Africa has resisted rather better (to) different waves ” than predicted by statistics at the start of the pandemic, said Dr Richard Mihigo in early December. There are many reasons for this, but seroprevalence studies revealed “that between 40% and 60% of the populations” had come into contact with the virus in some countries. “The vast majority of infections, and it has been known for a long time, remain asymptomatic”, he adds. However,“it is important to avoid severe forms, especially in vulnerable populations” – the elderly, those with comobirdities and immunocompromised – “that the only protection should not be passive protection but rather active protection, with vaccination.”
With the approach of the end of year celebrations, conducive to gatherings, and while waiting to reduce their dependence on vaccines vis-à-vis the outside world, WHO encourages Africans to observe barrier gestures. The “winning” equation against SARS-CoV-2 being: vaccination (when available) + barrier gestures. The continent faces “officially” its fourth wave. As of December 14, it had nearly 9 million cases and had recorded more than 225 000 deaths since the start of the pandemic.