A delivery delay explains a two-month shortage of tuberculosis vaccine. According to experts, in order to end the frequent shortages, this vaccine must be manufactured in Africa.
The Cameroon experiences a breach of BCG vaccination against Tuberculosis for seven weeks. This deficiency affects all ten regions of the country, confirms the Extended Immunization Program (EPI), the public body responsible for managing routine vaccinations under the Ministry of Health’s oversight. Health Public.
According to the explanations provided by this ministry department, Cameroon was to receive a stockpile of 300 000 doses of BCG vaccine in June to protect against a possible shortage.
Only this inventory did not arrive in time. As a result, the country is facing a second tuberculosis vaccine shortage in a year.
According to Shalom Tchokfe Ndoula, permanent secretary of the EPI, the problem mainly lies in the procedures for acquiring vaccines. In fact, Cameroon pays for tuberculosis vaccines in advance and from its own resources.
In addition, “only when manufacturers collect the money do they start manufacturing the vaccines that will be delivered later.”, indicates the latter.
However, the delivery times within which orders must be placed do not always coincide with the availability of the necessary public funds.
In other words, “If Cameroon has a delay in starting the budget, we may not have the vaccines on time,” adds a GAVI (Vaccine Alliance) executive who asked not to be identified.
This situation has been further complicated by the global pandemic COVID-19points out the head of the EPI.
“It should be noted that BCG manufacturing has taken longer since the onset of COVID-19 as a majority of manufacturing units have been converted to manufacturing vaccines against COVID-19. And that’s how you line up. Which is therefore taking longer than usual,” says Shalom Tchokfe Ndoula, also a vaccination specialist.
An argument that was dismissed by Benoit Bissohong of Cameroon’s Civil Society Coalition AIDSthe Malariatuberculosis and hepatitis. The latter argues that the real problem in Cameroon lies in the vaccine supply chain.
Basically, “the distribution always takes place after the occurrence of the Illness and its severity from one area to another. It is this prevalence that guides vaccine distribution in general,” he argues.
Therefore, if the incidence is high, there will be more need for drugs or vaccines, he says. If this is not the case, the demand is reduced. This therefore determines how many doses should be used for each area.
However, according to Benoît Bissohong, the EPI does not take such parameters into account. As a result, vaccines are plentiful in some areas and not in others. This leads to leakage, then bottlenecks.
aftermath
The BCG vaccine is used to prevent severe forms of tuberculosis in infants. That is, from birth up to two years. According to health professionals, not taking this vaccine has no effect on the health of infants up to 11 months of age.
“A shortage of less than 12 weeks for a vaccine doesn’t have a big impact. Especially since BCG can be taken between birth and the 12th month. So that can be caught up on very well,” says Shalom Tchokfe Ndoula.
But for Jean Louis Abena, a public health consultant and former permanent secretary of the National Tuberculosis Control Program, the direct result of this shortage is “popular dissatisfaction with vaccination and an unmet demand for vaccines.”
Which “leads to a drop in performance of the program, which will be forced to organize itself Communication to catch up with those lost from sight. It should be noted that achievement is related to people’s trust in the system health,” he added.
Faced with this shortage, doctors are content to advise mothers on how to protect their babies.
“Because the BCG vaccine is designed to protect newborns from severe forms, not to prevent infection, the first thing to do is contain the newborn environment own ; Avoid contact with suspicious people, i.e. those who mainly cough,” orders Patrick Ndoudoumou, the general practitioner on duty at the Meyomessala district hospital in southern Cameroon.
Then “you need to protect them from inclement weather, which can weaken your respiratory system, the main gateway to the bacillus. It needs to be nursed properly to give it maximum immunity to aggression. After all, if the newborn’s health deteriorates, it must be taken to the doctor,” he adds.
emergency protocol
The 300 vaccine doses, ordered as an emergency procedure and awaiting delivery, were due to arrive in Cameroon on September 000. They will make it possible to meet demand over three months.
A process to procure 1.6 million cans is now underway. This stockpile is expected to cover a six-month period, including part of 2023. In the meantime, the EPI is hoping the emergency regulation will contain shortages pending delivery of the 1.6 million doses ordered.
Will the arrival of this new stock definitely protect Cameroon from a potential stock shortage? No, Shalom Tchokfe Ndoula replies.
In his view, economically weak African countries such as Cameroon, which order these vaccines from Indian companies, remain at high risk of bottlenecks given their rigid payment terms.
In the long run, “The only ideal solution is to produce BCG in Africa. There we will be sure that we will not lack, ”he concludes.
This article was published on the French version of SciDev.net and is reproduced with their permission.