Ampoules with the Covid-19 vaccine on a laboratory bench. Editorial Credit: M-Foto, Shutterstock.
Surprisingly enough, the world’s second-largest continent has been less hard hit by the COVID-19 pandemic than others around the globe. Africa has about 2.7 million coronavirus cases to date, though the World Health Organization has said it's difficult to know how widespread the virus is on the continent, as testing levels remain relatively low in most African countries.
Prioritizing the need to secure vaccines for their populations has been a high agenda item in the past few months for many African governments. While the process has not necessarily been as swift and systematic as it is in developed economies, Africa needs to secure at least 1.5 billion vaccine doses to reach 60% of the continent's 1.3 billion people, according to the Africa CDC, given that each person requires two doses of the vaccine to obtain full protection from the virus. It is estimated that for a country to achieve herd immunity, 60-70% of its population needs to be vaccinated with a dose that is as close to 100% efficacy as possible.
While countries like Egypt have made progress in rolling out vaccines within the same time frames as developed countries like the UK, South Africa might have to wait until the second quarter of this year to secure supply, given the affordability spectrum of the vaccines available. Most countries on the continent have on average sub-tropical weather, and some of the current vaccines available have to be shipped and stored in sub-zero temperatures. Those associated costs are a factor for rollout. The WHO states that about 50% of vaccines distributed globally go to waste, primarily because of a failure to properly control storage temperatures.
The Org looked into the vaccine rollout strategies for five of the largest economies in Africa to better understand how countries might continue to wage the fight against COVID-19.
The largest economy and most populous country in Africa, Nigeria is home to about 200 million people. Statistics show that case numbers have been relatively low, with close to 101,000 cases in total and less than 1,400 fatalities to date. But only 810,000 residents have been tested, meaning case numbers could actually be significantly higher than what's been recorded.
The country's health minister announced in late November 2020 that Nigeria would expect to receive its first doses of vaccines in early 2021. The National Agency for Food and Drug Administration and Control (NAFDAC) has been in direct discussions with several vaccine manufacturers to procure doses for its population. The country is also participating in the COVAX facility, a global initiative that brings pooled funding from developed and developing economies to vaccine manufacturers to ensure equitable access to COVID-19 vaccines in poorer countries. The COVAX facility will supply vaccines for 20% of the Nigerian population.
What's evident is that Nigeria does not have sufficient facilities to store one of the most readily available and effective vaccines — the shot from Pfizer + BioNTech - which must be stored and administered at minus 70 Celsius. Whichever option they decide on needs to take into account the high weather temperature Nigeria experiences throughout the year, as well as the sporadic power outages common in the country which might impact the cold chain infrastructure requirements. Cold chain logistics in Sub-Saharan Africa have historically been more expensive than anywhere else in the world. The need to cater for storing and transporting vaccines could bring about significant opportunities for logistics investment that could benefit other sectors, like agriculture, beyond the pandemic.
The second-largest economy in Africa has one of the most progressive vaccine strategies on the continent. Egypt received its first batch of the Chinese manufactured vaccine, Sinopharm, in December 2020, sufficient to inoculate about 50,000 people in the country with the aim to increase this to 10 million doses within a short timeframe. What's appealing about this vaccine is that it requires storage at the standard 2C-8C, but it´s efficacy rate is 86%, less than the ones needing below zero temperature storage such as the Pfizer / BioNTech vaccine. The country has less than 152,000 cases of the virus and about 8,300 fatalities so far.
With over 1.2 million recorded cases of COVID-19 and over 33,000 fatalities, South Africa has the highest number of infected citizens on the continent. The third-largest African economy has been in the spotlight recently for having a highly contagious variant of the virus, which has accelerated the number of people infected during the second coronavirus wave. It remains unclear whether the currently available vaccines can withstand this mutation.
The South African Minister of Health, Dr. Zweli Mkhize, announced the country's vaccine rollout strategy on January 3, outlining how they will implement a phased approach to ensure that at least 67% of the population achieves herd immunity through vaccinations. About 40 million people will need to obtain doses for this to happen.
So far, the country has managed to procure vaccines to the value of $19.2 million, enough for 10% of the population, funded by the Solidarity Fund through the WHO's COVAX facility. The government will also source vaccines through the African Union Vaccine Initiative. They are hoping to make these available as in the first quarter of 2021 and will prioritize 1.25 million healthcare workers, essential workers, and the most vulnerable members of the population. Through direct consultation with several vaccine manufacturers, some doses will be sourced from AstraZeneca, which has been cited as offering the most cost-effective vaccine relative to other options currently available in the market. The government has already ordered 1.5 million doses of the AstraZeneca vaccine, which they expect to arrive in the first quarter of 2021.
Through public-private partnerships, the government is also hoping to procure more vaccines through co-financing them with medical aid schemes and funds from blue-chip companies in South Africa. The CEO of Discovery Health, Ryan Noach, recently said that they are evaluating a funding model where 7.1 million of their medical aid scheme members could pay double the price for the vaccine and donate 50% of the cost to a funding vehicle such as the Solidarity Fund, in order to provide vaccines to the portion of the population who don't have access to medical aid.
Algeria is hoping to start rolling out vaccines to the majority of its 42 million inhabitants later this month, which will be available at no cost and will also not be mandatory for its people. The Algerian government signed a bilateral agreement with a Russian laboratory that produces the Sputnik V vaccine and are hoping to receive an initial shipment of 500,000 vaccine doses this month. The country has about 102,000 cases and less than 3,000 fatalities so far.
The fifth-largest economy in Africa has procured 65 million doses of vaccines, which they have yet to receive from Sinopharm and AstraZeneca. The Sinopharm vaccine was initially trialed on 600 people in the country to test its efficacy and Morocco will opt for three to four more vaccine options despite already building infrastructure and facilitating a technology transfer to manufacture the Sinopharm vaccine locally.
The health ministry in the country will run a 12-week campaign to mobilize healthcare workers across the country, who can each administer 150 to 200 vaccinations per day. The Minister of Health announced that 2,888 vaccination centers, including mobile units, will be set up across the country, with the hope of vaccinating 80% of its population - 25 million people. The country has about 450,000 coronavirus cases and almost 7,750 fatalities.
All data pertaining to coronavirus cases and fatalities per country can be found through the WHO Coronavirus Disease Dashboard. The numbers published in this article may not be the most recent at time of publication.
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