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9 June 2021updated 21 Jul 2021 12:36pm

“It’s not fair”: Rwanda’s health minister on vaccinating G7 children ahead of Africa’s elderly

Daniel Ngamije discusses his country’s human rights record, the Covax scheme and why the G7 should back vaccine patent waivers.  

By Ido Vock

Daniel Ngamije, Rwanda’s minister of health, has warned that Western countries vaccinating their teenagers against Covid-19 ahead of vulnerable and elderly people in developing countries such as his is unfair. In an interview with the New Statesman, Ngamije said that rich countries will not be safe as long as coronavirus continues spreading among unvaccinated populations, potentially causing dangerous new variants to emerge.

Rich countries such as the US and those within wealthy blocs such as the EU are now vaccinating teenagers against Covid-19, bringing them closer to the threshold for “herd immunity”. While teenagers are at low risk of being made seriously ill by Covid-19 themselves, they can transmit it to people who are at a higher risk.

Some are now arguing, however, that such doses should instead be given to older people in poorer nations. “Starting to vaccinate kids of 12 in developed countries while in Africa and other developing countries, you have elders with co-morbidities without access to vaccines… It’s not fair,” Ngamije said.

Covax, the vaccine-sharing scheme spearheaded by the World Health Organisation, was intended to help ensure a more equitable distribution of vaccines to developing nations, including Rwanda. Yet the bulk of the doses it was supposed to distribute were contracted to be manufactured by the Serum Institute of India. In the face of a devastating wave of Covid-19 this year, the Indian government banned the export of most vaccines, leaving the countries reliant on Covax facing a disastrous shortfall.

In May, Rwanda was forced to suspend its vaccination programme because of a lack of doses. “[The Indian government’s decision] affected our trend,” Ngamije said, adding that his government is now looking to secure alternative deals through regional body the African Union, and with vaccine manufacturers.

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Rwanda’s current target, similar to many other developing countries, is to vaccinate 60 per cent of its population by the end of 2022 – over a year later than many developed countries expect to reach similar immunity figures. This is in part because richer nations have near-monopolised the initial supply of vaccines produced by companies such as Pfizer and Moderna.

In order to speed up immunisation drives in the developing world, Ngamije argued that the G7 countries, which are meeting this week in Cornwall, England, should support vaccine patent waivers, which would make it easier to produce generic versions. “[Patent waivers] are a wise decision that countries should be taking,” he said. In addition, he said that the club of rich economies should offer technology transfer to Rwanda and other countries, which would involve manufacturers sharing knowledge on how to produce vaccines that rely on complex processes. Many experts believe that without knowledge sharing, patent waivers will not be enough to kick-start the production of generic vaccines. 

“International solidarity in making vaccines accessible to everybody is a scientific and human rights decision,” Ngamije added.

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On issues of human rights and freedom of the press, Ngamije was less forthcoming. When questioned over whether press restrictions in Rwanda might have allowed the government’s coronavirus response to evade scrutiny, he demurred, insisting: “Journalists are free to express the whole story about Covid-19. We didn’t try to hide anything.”

According to the rights group Human Rights Watch, journalists reporting on the impact of Rwandan government policies for limiting the spread of Covid-19 were in March 2020 arrested “in circumstances that appeared retaliatory”. Rwanda is ranked as “not free” by the watchdog Freedom House, which notes that President Paul Kagame’s administration continues to repress journalists and opposition politicians, including through at least two “apparent assassinations” in 2019.

In August 2020, Paul Rusesabagina – the former hotel manager who sheltered thousands during the 1994 genocide, who vociferously opposes the Kagame government – was tricked into boarding a plane he believed was heading to Dubai but which landed in Rwanda, where he was arrested on arrival. He has been charged with terrorism-related offences. 

The case has drawn comparisons with the brazen arrest of Roman Protasevich, a dissident blogger, by the government of Belarus in May. “What’s wrong in tricking a criminal you are looking for?” Kagame has argued in respect to the case.

[see also: Autocrats around the world are watching to see how the West responds to Belarus’s air piracy]

Rusesabagina’s family claim he is being denied food and medicine in prison in an attempt to force him to cooperate with his trial, which he stopped attending in March, saying the proceedings were biased. 

Ngamije offered little comment on Rusesabagina’s case. “I just want to reassure you that Rwanda is a country which respects human rights with institutions that are there, especially justice… [Rusesabagina] will be fairly treated in the justice system.”