As vaccine production expands, the continent must tackle logistical, economic and political bottlenecks to immunization, says Rabah Arezki, former chief economist at the African Development Bank (AfDB).
The average vaccination rate on the continent is disappointing, with around 8% of Africans fully vaccinated. This average hides large differences from one country to another. While Mauritius and Morocco have achieved full immunization rates of 72% and 61% respectively, this figure remains low in the vast majority of other nations, below 1% in the Democratic Republic of Congo (DRC) and Burundi for example.
The number of cases of Covid-19 infections is said to be on the rise, but the number of deaths on the continent remains relatively low. Given the weak capacity of the health sector, including in terms of intensive care management, health systems would be almost immediately overwhelmed if a variant turned out to be more harmful than what the continent has known so far. now. Vaccination is the only option available to avert a coming catastrophe on the continent.
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Unfortunately, several bottlenecks are derailing Africa’s path towards the 70% vaccination target, which will not be reached until the end of 2024 according to the World Health Organization (WHO). Beyond the consequences for the population, this failure will probably have significant and negative ripple effects on the rest of the world, particularly in terms of the emergence of new, more contagious variants.
© Provided by Jeune Afrique
July 14, 2021 – Mass vaccination tent at Treichville stadium, Abidjan, Ivory Coast. © Erick Kaglan / World Bank / Flickr / CC License
Digitization of ports
Given the rapid ramp-up of production and the slow but steady decline in demand for vaccines in advanced countries, the shortage of doses facing Africa is easing. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) said the production rate has now reached 1.5 billion doses per month. This means that more than 24 billion doses of vaccines could be produced by June 2022. This is finally good news for the continent.
Corruption at ports causes additional delays and costs, which could derail vaccination campaign
But as the pressure on production eases, bottlenecks in distribution – due to poor logistics, lack of staff to vaccinate or ordering errors – will become more apparent. With a risk of seeing, ultimately, more and more donations or purchases of vaccines returned or destroyed. The continent’s leaders must therefore be held accountable for their efforts to encourage vaccination and address these national bottlenecks.
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Beyond the need for better sharing of information on the availability and volumes of donations, it is absolutely essential to improve logistics in many regions of the continent. Corruption at ports traditionally causes significant delays and additional costs, which could derail the vaccination campaign.
In Mozambique, difficulties in Maputo’s infrastructure meant that this crucial entry point could not serve as a distribution hub for neighboring landlocked countries. Accelerating the digitization of infrastructures, in particular through the adoption of an electronic flow management system, would make it possible to monitor doses effectively.
© Provided by Jeune Afrique
With support from the German government, UNICEF delivered ultra-low temperature freezers to Ethiopia via COVAX. Each of the 26 freezers can hold more than 300,000 doses of COVID-19 vaccines, making it easier to store and administer these vaccines across the country.© UNICEFEthiopia/Nahom Tesfaye/Flickr/Licence CC
Cold chain and packaging
Another serious pitfall: the insufficiency of the cold chains, responsible for the waste of 50% of the food produced today. Considering that vaccines need to be refrigerated, at very low temperatures for some, this poses another threat to vaccination. Ghana, for example, is making drone deliveries to remote areas to reduce lead times and the need for extended refrigeration. Some experts recommend targeted and strategic investments in the cold chain but also in the optimization of packaging methods for vaccine doses.
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Furthermore, the insufficient number of workers on the front line and the inadequacy of their resources is another point of tension, which some countries have remedied by mobilizing medical personnel from the army as well as logistics experts. As a reminder, the average number of nurses in sub-Saharan Africa is one per 1,000 inhabitants, compared to ten per 1,000 in OECD countries and 15 per 1,000 in North America.
It is time to counter-attack on the communication aspect via a mobilization of the political class
While the rate of urbanization has rapidly increased on the continent in recent decades, it remains relatively low, making it more difficult to administer the vaccine. Six out of ten sub-Saharan Africans still live in rural areas compared to only two out of ten in Latin America. To reach segments of the population in remote areas, Côte d’Ivoire has innovated and sent mobile clinics, for example. Developing these initiatives on a large scale would be life-saving for the continent.
mobile payment
Action against the final barrier, vaccine hesitancy, is undoubtedly one of the most delicate. While social media has become a vector for the spread of misinformation about vaccines, this phenomenon which has not been the subject of a proportional response to reassure citizens. Worse, several leaders have contributed to increasing doubt about vaccination. It is time to counter-attack on the communication side by mobilizing the political class but also football and music stars.
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Finally, a financial incentive for the most modest households could stimulate demand for vaccination while supporting them during this difficult period. This monetary boost – financed by the richest countries, foundations and companies with commercial interests in particular on the continent – could be transferred directly via mobile phones to ensure that it benefits the intended recipient. This mechanism would be a triple win by reducing vaccine inequities, saving lives and strengthening economies.