Should Africa make covid-19 vaccination a priority? – Community News
Covid-19

Should Africa make covid-19 vaccination a priority?

OFAR DE In the summer a lack of supplies was the main problem. Africans lined up for injections of the Covid-19 vaccine from dawn, but most of the doses went to rich countries. India, a major producer, banned exports. The results were grim. Senegal, by some estimates, saw seven times as many funerals as in normal times. Gravediggers in other African countries also worked overtime. Today, only 7% of Africans are fully vaccinated against the disease.

In recent weeks, however, vaccine shipments to Africa have increased dramatically. About 50 million doses came in in October, almost double the number that came in in September. Uganda, which has delivered 6 million doses to date, expects to have received 21 million doses by the end of this year — enough to vaccinate nearly every adult. With more shots on the horizon, the World Health Organization is calling on all countries to vaccinate 70% of their total population by mid-2022. Several African countries have set targets accordingly.

Still, the 70% target may not be achievable in much of sub-Saharan Africa, where large segments of the public seem reluctant to get the vaccine or difficult to reach. In addition, it may not be desirable to aim for it by mid-2022. The median age in the region is less than 20. Building herd immunity against covid is a worthy goal, but vaccinating masses of slender young Africans, who are at little risk of contracting covid. dying from the disease often means diverting resources from more urgent health campaigns . The target “makes little sense” for Uganda, where children make up half of the population, says Alfred Driwale, who manages the country’s vaccine program.

Health workers in Africa are already overburdened. One of their priorities is to provide catch-up vaccinations against diseases such as measles and tetanus. Millions of children missed these shots during lockdowns because their parents couldn’t travel or were afraid of getting covid in clinics. In Uganda’s Moroto district about 400 km from the capital Kampala, local health officer Hans Local says that normally about 10% of children do not return for follow-up doses. That figure has doubled since the pandemic. Kwaku Agyeman-Manu, Ghana’s health minister, says his covid program is not derived from other public health efforts. But that may be because only 8% of Ghanaians have received a shot since the vaccines started arriving in March.

Jabs against covid and those for other diseases may eventually compete for more than health workers’ time. To mount covid campaigns, some African countries have already dived into their emergency supplies of syringes, which are usually reserved for outbreaks of infectious diseases such as measles and yellow fever. Just to replenish these stocks, they will have to obtain 25% more syringes than usual, according to Unicef. That doesn’t even take into account the syringes needed for the billions of covid shots that would need to be administered to meet the 70% target. The problem is compounded by the nature of the syringes used in Africa. These are specially designed to withdraw exactly the standard covid vaccine dose and to disable the needle after a single use. Both are crucial features because shots are often given by poorly trained health professionals who can inadvertently spread infections such as: hiv by reusing old needles.

When considering priorities, some African health officials may note the growing evidence that Covid has already passed through much of the region. For example, a study in Mali found that about 60% of people were already infected in January – and thus have some degree of natural immunity. Covid may also be less deadly in Africa. Even when the outbreak in Mali was at its worst, hospitalizations among people with Covid were rare. One obvious reason is that fewer people in Mali are obese or have diabetes, two conditions that exacerbate Covid. Some studies suggest another reason: Covid appears to be less severe in people who have had malaria in the past.

Whether the 70% target is desirable or not, many countries in sub-Saharan Africa will struggle to meet it. At the beginning of November, most of them had used less than half of the doses received (see graph). One reason is that many of the doses were donated by rich countries shortly before the expiration date. “They’re bringing vaccines that expire in two weeks,” says Dr. Local. He has 2,000 doses to be administered over the next two weeks. That would require nearly 4% of adults in his district to arrive at short notice.

Outside a health center in Moroto, four people sit in the thin shade of an acacia tree, waiting for more people to come before they can get a shot. Each vial of the vaccine given here contains 15 doses. Once opened, it should be used that day. In some places, health professionals are urging people to gather friends and come as a group. A recent delivery of the vaccine from Sinovac has helped mitigate this problem as it comes in single-dose vials.

Many people in Moroto are herdsmen who regularly move in search of fresh pasture. That can make it difficult to track them down for a second dose. dr. Local hopes for a shipment of the Johnson & Johnson single-use vaccine that would solve that problem. As global vaccine stocks increase, African countries may become more selective and choose those that better suit their needs, said Unicef’s Gian Gandhi.

A prick and a prayer

A more difficult problem can be convincing people to get a shot. In surveys conducted in 15 African countries by Afrobarometer, a pollster, on average only 47% of respondents said they were likely to be vaccinated and 39% believed prayer is “much more effective” than the vaccine in preventing Covid (although some were asked before jabs were available). When health workers at Moroto’s hospital were offered injections, only half had them. Rumors that the jabs make people sterile, that Western countries send them to kill Africans and similar nonsense are circulating on WhatsApp. Even in villages without internet, the same messages are broadcast on the radio.

Low trust in government, a chronic condition across Africa, is part of the problem. Less than half of respondents to the Afrobarometer surveys said they trusted their government to ensure vaccines were safe. But many people have more prosaic doubts that can be resolved with better outreach campaigns. Sayou, a 52-year-old security guard in Dakar, Senegal’s capital, says he trusts the vaccines but isn’t sure if the clinics are open on Sunday, his only day off.

All of this helps explain why the plastic chairs outside the covid vaccination room at a clinic in Dakar are empty. There is no shortage of vaccines, but only about ten people show up a day, compared to 50 or more not so long ago. Cases of covid are low, a nurse says, “but when another wave comes, the whole world will come again.” Meanwhile, health officials must decide how best to use their limited resources.

Dig deeper

All of our stories related to the pandemic can be found on our coronavirus hub. You can also find trackers showing the worldwide vaccine roll-out, the number of deaths by country and the spread of the virus across Europe.

This article appeared in the Middle East and Africa section of the print edition under the headline “Choosing their photos”