Is Africa ready for the next pandemic?

When Covid-19 struck, Africa struggled to cope with the pandemic. What made the situation even more volatile at the time was lack of vaccines as the continent relied on unsustainable international goodwill to get its people the much crucial inoculation.

Three years on, the continent still lags behind as more than half of the population in the continent remains unvaccinated. The United Nations International Children's Emergency Fund (Unicef) has been the key delivery partner of COVAX, a global multilateral initiative aimed at making Covid-19 vaccines available equitably and to those who need them. Healthy Nation spoke to Mohamed Malick Fall, the agency’s regional director for Eastern and Southern Africa during a joint convening on Covid-19 Vaccinations in Humanitarian Settings by Unicef, WHO and Gavi, held in Nairobi last week, on what lies ahead for the continent in preparation for the next pandemic. 

Four years on since Covid was declared a pandemic and still Africa faces the initial challenge of vaccination. Is this the final fate for the continent?

I must admit that as a continent we still face the vaccine challenge, but things aren’t as they were at first. In the beginning, poor countries suffered due to what was called vaccine nationalism. There was a time when while the European countries were getting close to 75 per cent of their population getting two doses, the third world countries and particularly in Sub Saharan Africa did not have even 15 per cent of the first dose. But the game changed as the continent started witnessing an overflow of vaccines, and we were even witnessing a waste of the jabs. 

Then why is Africa still lagging behind in terms of Covid-19 vaccination?

Most of the countries are coming out of the pandemic with significant economic downtown. In our part of the world, the Covid impact was not only on the public health, but also on the economic and social front. 

The continent also continues to face humanitarian crisis driven by conflicts like those ones experienced in Somalia, South Sudan, Eriteria and Burundi. We also have climate related shocks, and as we speak now the horn of Africa is facing one of the worst droughts ever experienced in the region. In a nutshell, climate crisis is taking a toll in the region. 

Further, Africa continues to face other outbreaks. For instance,16 out of 21 countries in COVAX are facing one or more outbreaks. If it is not polio, it is yellow fever, measles or cholera. As we speak Malawi is having its worse cholera outbreak. All these factors affect the operations of health systems in the continent.

Then does it mean it is all gloom for the continent?
Not at all. Despite fragilities and challenges in some African countries, there has been significant progress in vaccination. To see a country like Somalia for example having 36 per cent coverage; or a country like South Sudan, which when the programme started was at three  per cent, but now the vaccination rate is close to 20 per cent, is an important achievement amidst all these challenges. Then there are countries which at the beginning of the programme didn’t even want to join the programme. We have countries like Tanzania which at first didn’t even recognise the disease, let alone adhere to a vaccination programme, but then has recorded a significant improvement on inoculation rates. Burundi and Madagascar were also on the same case. They joined the programme late but they have made an absolute jump in terms of coverage. This is the progress which we need to praise.

What could all this success be attributed to?
Dedication of frontline workers, community workers and the mobilisation of the community. There is also partnership from the civil society and frontline workers, which has reinforced the principle of localisation. 
This is crucial because humanitarian assistance cannot continue to rely on international support. And sometimes international support could be disrupted. Remember at the beginning of the pandemic no one could travel and most of our staff got stuck in Europe or in their countries of origin. It is only the local population that took advanced response.
Also, political commitment from the different countries played a major role. We have seen that whenever a government changes their position, the game completely changes. Countries that have multiplied coverage to three-fold are the ones where the leadership and administration has shown commitment to the drive. We are talking about countries like Zambia, Tanzania, Madagascar and Somalia. 
Moreover, international solidarity came in handy in this fight. Look at the number of dosses of vaccines, oxygen and cold chains that the continent received. All these commodities came through a mechanism of solidarity, which was based on the principle of ‘no one is safe until everyone is safe’.

What is the way forward for the continent as far as preparing for the next pandemic is concerned?
Going forward, there has to be collaboration and partnerships because if we didn’t have a programme that doesn’t bring together WHO, Unicef, GAVI, international humanitarian organisations,  professionals, and everyone else, we wouldn’t have made it. This is because everyone would be doing a parallel intervention and that would not lead us to where we want to be.

Secondly, the pandemic raised the point on localisation. When we talk about localisation, it’s not only having the local population undertaking their work, but it also means manufacturing health products. In the beginning of the pandemic, the continent didn’t even have facilities that could produce all the necessary equipment that was needed. But we were forced to learn through the process and now as a result of international appeal and pressure, some of the partners and companies are ready, for instance, to license the production of some of the vaccines in the continent. For example, I see the likes of South Africa, Rwanda and Senegal being mentioned as countries that could move or work on local manufacturing of vaccines. 

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