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22 February 2021updated 28 Aug 2021 9:02pm

How Africa is being left behind in the Covid-19 vaccine race

Proposals to address disparities in global vaccine distribution may not be enough to avoid what one UN official has termed “vaccine apartheid”.

By Ido Vock

The Africa Centres for Disease Control and Prevention (Africa CDC) says it expects to receive its first million doses of AstraZeneca’s coronavirus vaccine this week, which will be distributed to some 20 countries around the continent. The first shots will go to healthcare workers, with six million more doses of the vaccine, manufactured by India’s Serum Institute, expected to be delivered in the coming weeks. 

While this appears to be good news, the arrival of the doses to the Africa CDC highlights just how dire the distribution of vaccines to the world’s second most populous continent is. Africa has so far inoculated around 0.15 per cent of its population of some 1.3 billion, the second-lowest rate of any continent behind Oceania, according to figures collated by Our World In Data, a project at the University of Oxford. India, with a similar population, has vaccinated more than four times as many. The only exception to this trend is the Seychelles, the rich island country off the coast of Somalia, which has administered 60 doses per 100 people, one of the highest rates in the world. 

 

While Africa’s official tally of cases and deaths is relatively low, at around 3.8 million confirmed cases and 100,000 deaths, the real figures are likely to be significantly higher. Although the continent’s youthful, often rural population (the median African is 18 years old, less than half the age of the average European) was speculated to have helped the continent avoid the worst of the pandemic, low rates of testing and poor data collection mean that official figures are likely a significant underestimate of the real toll of the pandemic.

South Africa, which tests more than most countries on the continent, accounts for nearly half of the coronavirus deaths recorded in Africa, despite being home to just 5 per cent of its population. Extrapolated to the continent as a whole, the South African figures imply that the Covid-19 pandemic is much more widespread than official figures would suggest. As my colleague Jeremy Cliffe wrote towards the beginning of the pandemic, poor sanitation, dense cities and less effective state machineries were likely to mean that Covid would hit the Global South hard. 

As one South African politician put it to me, hygiene basics such as masks and handwashing are a luxury for many in sub-Saharan Africa, a region where around 300 million people live without access to a decent water source.  

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All of which means that Africa is in dire need of vaccines, which it is not getting. The WHO’s Covax scheme expects to distribute enough doses by the end of the year to immunise just 27 per cent of the population of 92 of the world’s poorest countries, many of them in Africa. Worryingly, the Africa CDC’s current target is to vaccinate just a third of the bloc’s population this year.

Complicating the picture is the issue of how effective existing vaccines would be even if they did arrive, with both AstraZeneca and Pfizer reporting that their jabs are less effective against mild and moderate disease caused by a variant of coronavirus widespread in South Africa. (The companies do, however, believe that the vaccines still prevent serious disease and death.) 

Russia and China are sensing an opportunity to fill the vacuum left by the West. The Chinese company Sinopharm has already sent hundreds of thousands of doses of its vaccine to countries including Zimbabwe and Egypt. Several others such as Kenya are reportedly in talks with Russian suppliers to obtain doses of the Sputnik-V jab. 

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Last week, French president Emmanuel Macron suggested Western countries should send about 1/20th of the doses they have bought to developing countries, citing the importance of humanitarianism and a geopolitical imperative to counter a “war of influence” over vaccines fought by Russia and China. The US has apparently rejected even that modest proposal, instead pledging some $4bn in funding for Covid vaccines for poor countries. Neither (or even both) would be sufficient to avoid developing countries falling far behind richer nations. The UN official Winnie Byanyima’s recent warnings of global “vaccine apartheid” between rich and poor nations may not be an overstatement. 

[See also: How Russia’s vaccine diplomacy echoes the Soviet-era smallpox initiative]