Less than 10 per cent of African countries to hit key COVID-19 vaccination goal

Amalendu Upadhyaya
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BRAZZAVILLE – 29 October – Just five African countries, less than 10% of Africa’s 54 nations, are projected to hit the year-end target of fully vaccinating 40% of their people unless efforts to accelerate the pace take off. This comes as the Region grapples to meet the rising demand for essential vaccination commodities, such as syringes.

Three African countries, Seychelles, Mauritius and Morocco, have already met the goal that was set in May by the World Health Assembly, the world’s highest health policy-setting body.

At the current pace, just two more countries, Tunisia and Cabo Verde will also hit the target.

In addition, limited access to crucial commodities such as syringes may slow the rollout of COVID-19 vaccines in Africa.

UNICEF has reported an imminent shortfall of up to 2.2 billion auto-disable syringes for COVID-19 vaccination and routine immunization in 2022. This includes 0.3ml auto-disposable syringes for Pfizer-BioNTech COVID-19 vaccination. 

There is no global stockpile of the 0.3ml specialized syringes, which differ from the 0.5ml syringes used for other types of COVID-19 vaccines and routine vaccination.

The market for 0.3ml auto-disable syringes is tight and extremely competitive. As such, these are in short supply and will remain so through at least the first quarter of next year.

Already some African countries, such as Kenya, Rwanda and South Africa, have experienced delays in receiving syringes.

“The looming threat of a vaccine commodities crisis hangs over the continent. Early next year COVID-19 vaccines will start pouring into Africa, but a scarcity of syringes could paralyze progress. Drastic measures must be taken to boost syringe production, fast. Countless African lives depend on it,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.

The COVAX Facility is working to address this threat by securing deals with syringe manufacturers, and through better planning to avoid deliveries outpacing the supply of syringes.

In October to date, around 50 million COVID-19 vaccine doses have arrived in Africa, which is almost double what was shipped in September. COVAX, the global platform to ensure equitable access to vaccines, has delivered almost 90% per cent of the vaccines deployed this month and has accelerated its shipments since July. However, at the current pace, Africa still faces a 275 million shortfall of COVID-19 vaccines against the year-end target of fully vaccinating 40% of its people.

Africa has fully vaccinated 77 million people, just 6% of its population. In comparison, over 70% of high-income countries have already vaccinated more than 40% of their people.

Countries still need to improve their readiness for COVID-19 vaccine rollouts. Forty-two per cent of countries in the African Region have not yet completed district-level plans for their campaigns, while nearly 40% have not yet undertaken intra-action reviews which are key to refining and improving their vaccination campaigns.

“In Africa, planning must become much more granular. This way we can spot challenges before they arise and nip any problems in the bud. WHO is supporting African countries in developing, improving and implementing their National Vaccine Deployment Plans and continually refining their COVID-19 vaccine rollouts as they proceed,” said Dr Moeti.

WHO is conducting emergency support missions to five African countries to help support, speed up and improve their COVID-19 vaccine rollouts, with plans for missions to another 10 countries this year.

WHO experts are working with local authorities and partners on the ground to analyze the reasons for any delays, and how best to address them. In South Sudan, authorities aim to ensure that the WHO mission will help the country meet its goal of achieving a tenfold increase in the daily COVID-19 vaccination rate, from 2 000 to 2 5000.

Nearly 8.5 million COVID-19 cases and more than 217 000 deaths have been recorded in Africa. In the week ending on October 24, there were more than 29 300 new cases, a drop of nearly 30% compared with the previous week. But 10 African countries are still in resurgence, including four with the upward trend or high plateau: Gabon, Congo, Cameroon and Egypt. The Delta variant has been found in 41 countries, the Alpha variant in 47, and Beta in 43.

Dr Moeti spoke during a virtual press conference on 28th October, facilitated by APO Group. She was joined by Dr Sabin Nsanzimana, Director-General, Rwanda Biomedical Centre, and Mr Sibusiso Hlatjwako, Director of External Affairs for PATH in the Africa Region & PATH Country Representative, South Africa.

Also on hand to respond to questions were WHO’s Dr Phionah Atuhebwe, New Vaccine Introduction Officer, and Dr Thierno Balde, Deputy Incident Manager for COVID-19 response.

Opening statement, COVID-19 Press Conference, 28 October 2021

Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti

“Good morning and good afternoon, bonjour and bom dia to all the journalists joining this press conference on the COVID-19 pandemic, where we will look at the complete package of supplies and resources needed to roll out the vaccines. There are critical areas where countries and partners should work together, and as an example, syringes are very very important

I’m pleased to be joined for this conversation by Dr Sabin Nsanzimana, who is the Director-General of the Rwanda Biomedical Centre, welcome Dr Nsanzimana, and he will share with us the challenges Rwanda has faced with securing syringes and the country’s efforts to successfully procure them.

Mr Sibusiso Hlatjwako, the Director of External Affairs for the Africa Region for the non-profit PATH. Welcome to you Mr Hlatjwako, we were just together in the DRC Kinshasa for the vaccination forum last week led by the President. So I’m very pleased to be with you again. Mr Hlatjwako will tell us about research on the availability of syringes globally.

Just to say, syringes sound like a very small item in the big picture of rolling out vaccines, but we know very well if you don’t have syringes you cannot put shots into people’s arms so it’s a very important topic.

There have now been more than 8.4 million COVID-19 cases in Africa and sadly 217,000 lives have been lost. New cases and deaths have continued on the decrease observed in recent months, but in a few countries, such as the Republic of the Congo and Gabon, there is an upward trend in the past weeks.

With just 5.7% of the continent’s population being fully vaccinated, COVID-19 still poses a very real risk to populations in Africa, and therefore globally. Vaccine shipments are ongoing, with COVAX deploying more than 40 million doses to African countries so far in October.

The African Union has announced this week that it will buy 110 million Moderna doses with 15 million due to arrive before the end of 2021.

We observe that the absorption rate is also good. African countries have administered just over two thirds of the doses that they have received so far. 

Yet just five Africa countries – less than 10% of the continent’s 54 countries – are projected to hit the year-end target of 40% of their people fully vaccinated unless there are efforts to significantly accelerate the pace. To reach this target, African countries need to be receiving 30 million doses a week, which is almost double the current 17 million they are receiving from all sources.

In addition to vaccines, the supplies and resources needed to roll them out are critical and must be addressed through a comprehensive approach. There is a looming threat that syringe supplies will dry up. UNICEF predicts for example, a global shortage of around two billion of the auto-disposable syringes needed for COVID-19 vaccine and routine immunizations.

Already, some African countries, like Kenya, Rwanda, and South Africa, have experienced delays in receiving syringes, and unless drastic measures are taken to boost syringe production, Africa faces a crisis.

Vaccine shipments to the continent have already ramped up and are expected to increase into next year, but the scarcity of syringes could paralyse progress, for the COVID-19 vaccine and routine immunization.  So, syringe production both globally and locally in Africa must be stepped-up fast. Countless African lives depend on it.

The COVAX Facility has been working to address this threat by securing agreements with manufacturers for the needed syringes and through better planning to avoid deliveries outpacing the supply of syringes.

As WHO, we are supporting countries on all aspects of readiness to speed up and expand the COVID-19 vaccine rollout, including action to encourage communities to get vaccinated, to expand vaccination sites and to expand the age range of people eligible for vaccination, as well as ensuring the needed operational financing, the human resources, and cold chain capacities are in place.

Ghana, for example, has made vaccines available in all districts and to all people over 18 years. They have pivoted from a campaign approach so that people can now go to their closest health centre to get the jab. This kind of action to integrate COVID-19 vaccine delivery as part of the essential services provided by health systems will be a key approach going forward.

South Africa has expanded vaccination to people 12 years and older, and there are now more than 800 private vaccination sites, in a bid to reach 70% of the population by the end of the year. So partnership with the private sector, with their capacity for delivery, is a key strategy for countries to follow.

Lesotho, with its vast remote areas, uses both fixed vaccination sites and mobile outreach services to offer vaccination to people who may not be able to travel to clinics.

Liberia has conducted vaccination at high-volume traffic sites – churches, mosques, banking facilities and markets – and also reached refugees on its borders.

There are many good examples across the continent and as WHO we are helping to share these experiences between countries so that best practices can be adapted to different contexts.

For several countries, planning must become much more granular. This way we can spot challenges before they arise and nip any problem in the bud.

WHO is conducting emergency support missions to help support five African countries that are lagging behind to speed-up and improve their COVID-19 vaccine rollouts, with plans for missions to another 10 countries this year.

Our experts are working with local authorities and partners on the ground to analyse the reasons for any hold-ups and how best to address them. For instance, with WHO support, South Sudan is aiming to raise its daily COVID-19 vaccinations tenfold from 2000 to 25,000 in order to fully vaccinate 10% of its population by the end of the year. WHO is supporting the country to run targeted and tailored campaigns, using single-dose vaccination to reach as many people as possible.

I urge all countries, and companies manufacturing essentials like syringes, to take a holistic view of the end-to-end process of the vaccine rollout so that countries receiving doses are enabled and empowered to plan their rollouts effectively and to proactively address bottlenecks like syringe shortages.

In closing, I would like to commend Burundi for starting their COVID-19 vaccine rollout in the past week and commit our full support as WHO to enabling the country to catch up.

So, I look forward very much to our discussion today, thank you once again for joining us, and I’d like to warmly greet and welcome our two panellists.”

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