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COVID-19 vaccine rollout in Africa

Suhayl Omar and Wanjiku Kariuki

The COVID-19 Vaccines Global Access (COVAX) Facility was established by the World Health Organization in collaboration with the ACT-Accelerator vaccine partners the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, the Vaccine Alliance. COVAX is bringing nations together, regardless of their income level, to ensure the procurement and equitable distribution of COVID-19 vaccines (GAVI, 2020).

 

For participating countries, the COVAX facility’s principle is to maximize the chances of their populations getting access to the vaccines as quickly and safely as possible regardless of whether they are high, middle- or low-income countries.

 

This paper seeks to explore the distribution plan in place for the COVID 19 Vaccine to Africa in comparison to other continents.

 

Distribution of COVID 19 Vaccine

There are 240 million doses of the AstraZeneca/ Oxford vaccine, licensed to Serum Institute of India (SII) termed as “AZ/SII” and 96 million doses of the AstraZeneca/ Oxford vaccine under the advance purchase agreement between Gavi, the Vaccine Alliance and AstraZeneca – termed as “AZ/SKBio”. In addition to these, there are 1.2 Million doses of the Pfizer- BioNTech vaccine.

 

Proportion of types of vaccines in percentages

 

The distribution of the Vaccine has been allocated to 47 out of the 54 countries in Africa with an estimated population of 1.2 Billion in the 47 countries. 86,732,760 out of the 337.2 (25.72%) Million doses of the vaccine have been estimated to be distributed to Africa. This distribution is indicated in Appendix 1 (GAVI, the Vaccine Alliance, 2021).

 

The distribution of the vaccine therefore caters for about 3.6% of the whole population of Africa with the assumption that this population are considered the most vulnerable groups such as the health care workers.

 

Distribution of vaccine between Africa and everywhere else in percentages

 

The following countries have either exercised their rights to opt-out, have not submitted vaccine requests, or have not yet been allocated doses;

  1. Burundi
  2. Equatorial Guinea 
  3. Eritrea 
  4. Gabon 
  5. Madagascar
  6. Seychelles
  7. Tanzania

 

WHO advised that countries that are members of the COVAX Facility would have access to enough vaccines to immunize their population’s groups.  In the first phase of allocation, doses would be made available to participating countries simultaneously until they can cover approximately 20% of the population of every country (WHO, 2021). 

 

Kenya’s allocation for the vaccine stands at 4,176,000 doses (GAVI, the Vaccine Alliance, 2021). This would cater for 2,088,000 Kenyans as the vaccine is given at two doses per person, representing 3.97% of the total population whereas the phased approach targeting vulnerable groups estimated at 15.85 Million Kenyans (Anadolu Agency, 2021).

 

Conclusion

According to worldwide statistics of Covid-19 vaccine distribution, more than 100 million doses of the vaccines have been administered globally to date, however only about 0.2% of the vaccines have been administered in Africa (The Conversation, 2021). Globally, 130 countries still haven’t received a single dose of the vaccine, while ten ‘developed’ countries have administered 75% of all Covid-19 vaccinations. United Nations Secretary General has declared this act as “wildly uneven and unfair”. 

 

Even with the continued demand for vaccine equity, the COVAX facilities caveats have enabled the exclusion and delay of access to vaccinations in these countries. According to the COVAX facility interim distribution forecast, a key caveat is the prioritization of self-financing countries. A key example is, Canada which has been reserved for 1,903,200 AZ/SKBio vaccine doses within the COVAX facility but according to the Canadian government data on 4th February 2021, Canada has already vaccinated 2.43% of its population which includes 55.35% of healthcare workers with the first dose, which culminates the denials of vaccine equity at a global level (Public Health Agency of Canada, 2021). While, countries like South Africa and Kenya, actively engaged with vaccine efficacy trials, there has been no imperative post-trial access and benefit sharing in research achievements.

 

Quite visibly, the distribution of the COVID-19 vaccine is proven to be quite low in Africa and its countries in comparison to other countries in the global scale with a key stressor on African countries mostly being middle- or low-income countries with large populations. Whereas the role that the WHO COVAX facility plays is vital, the predominant risk exists in undersupplying the continent with doses that can adequately cover at least, the vulnerable groups.

 

Appendix 1

 

Country

Population 

WHO Region

Vaccine

Quantity 

Algeria

    43,050,000 

AFRO

AZ/SKBio

                  141,600 

Angola

    31,830,000 

AFRO

AZ/SII

              2,544,000 

Benin

    11,800,000 

AFRO

AZ/SII

                  936,000 

Botswana

      2,304,000 

AFRO

AZ/SKBio

                  117,600 

Burkina Faso

    20,320,000 

AFRO

AZ/SII

1,620,000

Cabo Verde

          549,935 

AFRO

AZ/SII

                  108,000 

Cameroon

    25,880,000 

AFRO

AZ/SII

              2,052,000 

Central African Republic (CAR)

      4,745,000 

AFRO

AZ/SII

                  372,000 

Chad

    15,950,000 

AFRO

AZ/SII

              1,272,000 

Comoros

          850,886 

AFRO

AZ/SII

                  108,000 

Congo, Dem. Rep.

    86,790,000 

AFRO

AZ/SII

              6,948,000 

Congo, Rep.

      5,381,000 

AFRO

AZ/SII

                  420,000 

Côte D’ivore

    25,720,000 

AFRO

AZ/SII

              2,040,000 

Djibouti

          973,560 

EMRO

AZ/SII

                  108,000 

Egypt, Arab Rep.

  100,400,000 

EMRO

AZ/SKBio

              5,138,400 

Eswatini

      1,148,000 

AFRO

AZ/SII

                  108,000 

Ethiopia

  112,100,000 

AFRO

AZ/SII

              8,928,000 

Gambia, The

      2,348,000 

AFRO

AZ/SII

                  180,000 

Ghana

    30,420,000 

AFRO

AZ/SII

              2,412,000 

Guinea

    12,770,000 

AFRO

AZ/SII

              1,020,000 

Guinea Bissau

      1,921,000 

AFRO

AZ/SII

                  144,000 

Kenya

    52,570,000 

AFRO

AZ/SII

              4,176,000 

Lesotho

      2,125,000 

AFRO

AZ/SII

                  156,000 

Liberia

      4,937,000 

AFRO

AZ/SII

                  384,000 

Libya

      6,777,000 

EMRO

AZ/SKBio

                  343,200 

Malawi

    18,630,000 

AFRO

AZ/SII

              1,476,000 

Mali

    19,660,000 

AFRO

AZ/SII

              1,572,000 

Mauritania

      4,526,000 

AFRO

AZ/SII

                  360,000 

Mauritius

      1,266,000 

AFRO

AZ/SKBio

                  100,800 

Morocco

    36,470,000 

EMRO

AZ/SKBio

              1,881,600 

Mozambique

    30,370,000 

AFRO

AZ/SII

              2,424,000 

Namibia

      2,495,000 

AFRO

AZ/SKBio

                  127,200 

Niger

    23,310,000 

AFRO

AZ/SII

              1,872,000 

Nigeria

  201,000,000 

AFRO

AZ/SII

            16,008,000 

Rwanda

    12,630,000 

AFRO

AZ/SII

996,000

Pfizer BioNTecch

102,960

Sao Tome and Principe

          215,056 

AFRO

AZ/SII

                    96,000 

Senegal

    16,300,000 

AFRO

AZ/SII

              1,296,000 

Sierra Leone

      7,813,000 

AFRO

AZ/SII

                  612,000 

Somalia

    15,440,000 

EMRO

AZ/SII

              1,224,000 

South Africa

    58,560,000 

AFRO

AZ/SKBio

              2,976,000 

Pfizer BioNTecch

                  117,000 

South Sudan

    11,060,000 

AFRO

AZ/SII

                  864,000 

Sudan

    42,810,000 

EMRO

AZ/SII

              3,396,000 

Togo

      8,082,000 

AFRO

AZ/SII

                  636,000 

Tunisia

    11,690,000 

EMRO

AZ/SKBio

                  592,800 

Pfizer BioNTecch

                    93,600 

Uganda

    44,270,000 

AFRO

AZ/SII

              3,552,000 

Zambia

    17,860,000 

AFRO

AZ/SII

              1,428,000 

Zimbabwe

    14,650,000 

AFRO

AZ/SII

              1,152,000 

 

Works Cited 

Anadolu Agency. (2021, January 30). Anadolu Agency. From Anadolu Agency:  https://www.aa.com.tr/en/africa/kenya-announces-coronavirus-vaccination-program/2127910

GAVI. (2020, September 3). GAVI. From GAVI: https://www.gavi.org/vaccineswork/covax-explained

GAVI, the Vaccine Alliance. (2021). The COVAX Facility: Interim Distribution Forecast.

Public Health Agency of Canada. (2021, February 19). Public Health Agency of Canada. From Public Health Agency of Canada:  https://health-infobase.canada.ca/covid-19/vaccination-coverage/

The Conversation. (2021, February 9). The Conversation. From The Conversation: https://theconversation.com/south-african-covid-19-vaccine-trials-hold-key-lessons-for-future-partnerships-154676

WHO. (2021, January 12). WHO. From WHO:

https://www.who.int/news-room/feature-stories/detail/access-and-allocation-how-will-there-be-fair-and-equitable-allocation-of-limited-supplies

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