Why is there a vaccine shortage in Africa?

The African Union on Wednesday revived the critical debate on vaccine access even as the continent continues to receive donations from ‘friends’ across the globe.

But just what is the politics behind vaccine access and distribution?

Since Covid-19 vaccines were first administered, Africa has relied heavily on the Covax facility of the World Health Organization, as well as the continental purchasing initiative known as the African Vaccine Acquisition Taskforce (Avat).

Avat was set up as a pooled procurement mechanism for AU member states to buy enough vaccines for at least 50 percent of their needs.

Managed by the Africa Centres for Disease Control, the United Nations Economic Commission for Africa (Uneca) and the African Export-Import Bank (Afreximbank), it was meant to provide the funding for acquiring vaccines, and works closely with the Covax, which seeks to provide the other 50 per cent through donations.

On Wednesday, it turned out that even with these structures, Africa has been unable to access the targeted amounts. The initial source of Covax doses, India, was forced to reduce production as it fought a deadly wave over the last three months.

The Indian government has since announced that it is resuming full capacity and exports, but that may be late. Meanwhile, Africa continues to rely on donations, in spite of an elaborate plan to buy vaccines.

“Vaccine sharing is good but we shouldn't have to be relying on vaccine sharing, particularly when we can come to the table, put structures in place and say, ‘We also want to buy’,” Strive Masiyiwa, the African Union’s special envoy on Covid-19, said at a virtual press briefing organised by the WHO. 

"American taxpayers, European taxpayers, they financed some of this intellectual property (IP) and it should be for the common good. So, it is not wrong that we say there should be waivers, it was for the common good. So, we ask for this IP to be made available because it was a great miracle to have these vaccines, now let this miracle be available to all mankind.”

Mr Masiyiwa, a Zimbabwean businessman whose company, Econet Wireless, supports a Covid-19 travel certification system in Africa, says Africa’s low vaccination has little to do with hesitancy but lack of adequate doses.

How we got here

So how did we get here? As early as June last year, South African President Cyril Ramaphosa, then chairman of the African Union, joined hands with countries like India, Kenya and Senegal to push for a waiver of intellectual property rights so that manufacturers in Africa could copy the technology used to make the vaccines and produce them locally.

That debate went on at the World Trade Organization but was routinely vetoed by the rich. As a practice, WTO decides by consensus, which means that a single opposing member state nullifies any decisions.

That waiver has not been granted, but countries like Senegal, Rwanda and South Africa have announced plans to manufacture vaccines under licence from the makers. Kenya, too, on Wednesday said it will launch production next year. The actual distribution may, however, come later.

But Africa’s present problem, Mr Masiyiwa argued, was that rich countries also restricted pharmaceutical countries from selling to certain regions, including Africa, which meant that even those with money could have no doses to purchase.

“They are not selling to us, which is why we will now have to solve this by manufacturing our own.”

The WHO briefing came two days after intense discussions that saw Dr Tedros Adhanom Ghebreyesus, WHO director-general; Dr Seth Berkley, CEO of  Gavi;  Mr Masiyiwa; Dr John Nkengasong, the Africa CDC director; Prof Benedict Oramah, president and chairman of the board of directors of Afreximbank; and Dr Vera Songwe, UN undersecretary-general; Dr Matshidiso Moeti, the secretary of the Economic Commission for Africa and WHO regional director for Africa deliberate and review the state and uptake of Covid-19 vaccines in the region.

More than 5.7 billion doses have been administered globally, but only 2 per cent of those were in Africa, a continent of 1.2 billion people.

“This doesn’t only hurt the people of Africa; it hurts all of us. The longer vaccine inequity persists, the more the virus will keep circulating and changing, the longer the social and economic disruption will continue, and the higher the chances that more variants will emerge that render vaccines less effective,” Dr Tedros pointed out.

Prof Oramah assured the world that the continent has money to buy the jabs.

“Africa did not want to once again be at the bottom of the queue in regard to vaccines, because it was well known to everybody that economic recovery meant bringing the virus under control.”

The African body has acquired enough vaccines for African countries to vaccinate 400 million people, one-third of the African population, by September next year. It will cost $3 billion in a programme sponsored by the World Bank.

In July this year, Covax and the World Bank announced a programme to supply vaccines to developing countries.

Countries will have the opportunity to select and commit to procuring specific vaccines that align with their preferences. This means that countries can make orders beyond what Covax has subsidised, hence providing for situations where the Covax supply is disrupted.

But the continent by now knows that it has been a victim of the rich and Big Pharma. Will future pandemics find Africa ready? Most African leaders say so. At an Africa-Caribbean summit last week, President Uhuru Kenyatta said the two regions must “wake up” on pandemic preparedness as well as mounting debt.

“In the early days of the pandemic, we experienced serious challenges with the supply of personal protective equipment (PPEs), medical oxygen and ventilators,” he told the first African-Caricom [Caribbean Community] Summit, a virtual event, on Tuesday last week.

“This, my brothers and sisters, is a wake-up call for us in the developing world. We must do what it takes to build our own manufacturing capacity for vaccines and critical medical supplies.  In addition, we must strengthen research, surveillance, and monitoring capacity in order to mount effective responses to Covid-19 and other such pandemics.”

Additional reporting by Aggrey Mutambo