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Getting jabs in arms

More surveillance, new immunology and sequencing research spur calls for continental health security strategy

The crisis in international vaccination efforts shows no signs of abating as tens of millions of vaccines are due to expire in the coming weeks and G20 countries still resist committing to a coordinated and equitably-financed distribution plan (AC Vol 62 No 24, Jab race hits new snag).

Africa has administered just over 60% of the 474 million doses that it has received, according to the African Union.

Only seven African states: Seychelles, Morocco, Mauritius, Botswana, Rwanda, Tunisia and Cabo Verde, hit the World Health Organization's target of fully vaccinating at least 40% of their population by the end of 2021 (AC Dispatches, 27/07/21, Vaccine demand spirals as third wave hits home).

At the present rate, it will take another two-and-a-half years for Africa to reach the critical level of vaccinating the 70% of the population that should trigger herd immunity.

Ad hoc donations and uneven supply are the main causes for the vast disparities between developing countries and rich ones, but uptake has been hit by vaccine scepticism that is more prevalent in Africa and Asia than in Europe and North America.

A joint statement by international vaccine coordinator Covax, and the Africa Centres for Disease Control, complained that ad hoc donations had 'made it extremely challenging for countries to plan vaccination campaigns and increase absorptive capacity', adding that 'this trend must change'.

Nigeria has destroyed over 1 million doses of the AstraZeneca vaccine which were donated only weeks before their expiry, while Senegal announced that 400,000 doses had expired this month.

The WHO and Africa CDC, meanwhile, say that donated vaccines should have a minimum of two and a half months of shelf life on arrival, and that recipient countries should be notified of their arrival at least one month before delivery.

To push public acceptance of vaccination, an expanding group of states, now including Nigeria, Ghana, Egypt, South Africa, Kenya, Uganda, Rwanda and Zimbabwe, have made Covid shots mandatory, Meanwhile, Kenya and Uganda have introduced vaccine passports, with people required to show proof of their vaccination status, although anecdotal evidence indicates that these rules are only being enforced by some restaurants and bars.

Africa has to learn some tough lessons about health security from the way the pandemic showed  '…how easily international and multilateral agreements can dissolve, especially in the face of a global crisis' according to John Nkengasong, outgoing head of the Africa CDC, and Christian Happi, senior researcher in molecular biology, writing in Nature.

'For two years, hundreds of geneticists across the continent have worked seven days a week, often through the night, to sequence strains of SARS-CoV-2,' write Nkengasong and Happi, '…and companies worldwide have used these data (most of which are available in repositories such as GISAID) to develop Covid-19 vaccines and therapeutics. For those contributing so much to the global effort to curb this pandemic, it is galling to watch Africa continue to struggle in the acquisition and roll-out of Covid-19 vaccines.'

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