With vaccine deliveries delayed by India’s decision to prioritise local vaccination over export requests, Africa’s leading disease control agency suggested COVID-19 could become endemic.

John Nkengasong, director of Africa’s CDC, told reporters on Thursday that Africa needs to immunise population majorities quickly, but the vaccine delays make this unlikely. 

“With the rate of immunisation in Africa, we are lagging behind in the battle against the pandemic,” Nkengasong said. He asked the global community to consider vaccine access a collective security issue that needs to be addressed everywhere.

“If we keep vaccinating at this pace, we are not going to achieve our target. And that will delay our ability to eliminate the virus from our population — and my greatest concern is that we may actually begin to move towards the endemicity of this virus,” he said.

WHO Regional Director Echoes Concerns About Eradication

At a separate briefing, Matshidiso Moeti, WHO Africa Regional Office director, also said Africa faces challenges that make it unlikely to eradicate the disease anytime soon. She said vaccine delays disproportionately affect African countries, and these point to further poor outcomes for the continent.

Moeti discussed WHO research saying Africa needs at least 20 million doses of the Oxford-AstraZeneca vaccine in the next six weeks in order to get second doses to all who received a first dose within the 8-12 week recommended interval between doses.

Compared with 1.5 billion vaccine doses already administered globally, Africa has to date administered 28 million doses, or fewer than two per 100 people. “As supplies dry up, dose-sharing is an urgent, critical and short-term solution to ensuring that Africans at the greatest risk of COVID-19 get the much-needed protection,” said Moeti. “Africa needs vaccines now. Any pause in our vaccination campaigns will lead to lost lives and lost hope.”

“We are expecting, not only in Africa, but globally, that this is a virus that we are going to live with in the future,” Moeti said in response to a question from Health Policy Watch. “ So instead of talking about quickly eradicating COVID-19, the main objective is to minimise severe illness and deaths from the virus”. She said Africa should continue to develop needed vaccines and therapeutics, and that African health systems must not be overwhelmed by the pandemic waves.

She stressed the need for more vaccine access on the continent going into 2021 to “reach that level of vaccination that’s needed to enable African countries to open up and return to a more normal life”.

While the threat of endemicity remains, Moeti said, public health stakeholders on the continent are anticipating and hoping very much that COVID-19 will not become endemic in Africa. 

France, Europe Pledge Support for Africa Vaccine Quest

The French government meanwhile, announced a new, and larger, phase of vaccine dose sharing with African countries. Speaking at the WHO briefing briefing, Stéphanie Seydoux, French Ambassador for Global Health, Seydoux said that France would now share half a million doses with six African countries within weeks. 

France was the first developed country to volunteer to share COVID-19 vaccines from domestic supplies, donating over 31,000 doses to Mauritania, with another 74,400 set for imminent delivery.

 Seydoux noted that while Africa has largely been spared from the full brunt of the pandemic, the continent and all regions should benefit from tools established to fight COVID-19. She also noted France’s commitment to Africa’s vaccine manufacturing capacity. 

France also is committed to a European Union plan to provide 100 million COVID-19 vaccine doses for low-income countries by year’s end. The United States has similarly pledged to share 80 million doses with lower-income countries.

Lesotho Explains How to Share “Half a Loaf” 

Lesotho was hoping to receive more than 130,000 COVID-19 vaccine doses through the COVAX facility. Instead, it received about 36,000 doses of Oxford-AstraZeneca vaccine on 3 March. Health Minister Semano Henry Sekatle said the country takes a “half loaf is better than none” approach in vaccination planning.

This approach allowed vaccination of 95% of health workers, he said. He then appealed to vaccine-rich countries to share with those in need: “Those who have surplus should be kind enough to return the doses. It is also quite important that all these countries that are producing these vaccines should seriously consider the liberalisation of the patents,” Sekatle said.

Added Nkengasong,“Now [it is] critically urgent for countries sitting on excess doses to redistribute — and redistribute quickly, so that we can put vaccines in the arms of the people. And the people of Africa should understand that these vaccines are safe. 

He cautioned, however, that as Africa cannot expect to receive very large quantities of vaccines anytime soon, the continent needs to continue focusing on key preventive measures such as masks and social distancing, as well as careful surveillance of hot spots in new cases and improved treatment, including sufficient oxygen supplies to treat seriously ill patients. All of those measures can help prevent health systems from getting overwhelmed.

At the same time, he noted that the public needs to do its part too: “By having safe vaccines, you’re ensuring that your neighbour is safe, your loved ones are safe. So I urge everyone that has access to getting vaccinated to quickly do so, so that we can continue to protect ourselves, and protect our loved ones.”