The World Health Organization (WHO) warned on Friday that the COVID-19 pandemic in Africa was expected to get worse, as 22 countries are facing surges and less than 1% of the continent’s population is vaccinated against the virus.

“Cases have increased by 52% just in the past week, and deaths have increased by 32%, and we’re expecting things to only get worse,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told the global body’s weekly COVID-19 press briefing.

“Vaccines donated next year will be far too late for those who are dying today, or being infected today, or at risk,” he added.

Earlier in the week, Health Policy Watch reported that only two African countries – Morocco and the tiny island of Seychelles – have vaccinated more than 10% of their populations, while vaccination rollouts are faltering on the continent because of dose shortages.

“The brutal reality is that, in an era of multiple variants with increased transmissibility and potentially increased impact, we have left the vulnerable population in Africa unprotected by vaccines in a context where health systems are already weak,” said Mike Ryan, Executive Director of WHO’s Health Emergencies Programme.

Ryan added that this was “the consequence of the current unfair distribution of vaccines”. 

“If we had been distributing vaccines fairly and equitably, we may by now have protected those people most vulnerable on the African continent. We simply have not done that,” added Ryan.

Negotiations with AstraZeneca

Bruce Aylward, WHO’s lead on COVAX, told the briefing that “30 or 40 countries”, particularly in sub-Saharan Africa, have had to suspend their vaccine rollouts and were unable to provide their citizens with their second doses of AstraZeneca vaccines. 

This follows the decision by the Serum Institute of India (SII) in late March to stop supplying COVAX with the AstraZeneca vaccine it was manufacturing and redirect its doses for domestic use in India.

“We are now urgently trying to work with AstraZeneca itself, as well as SII and the government in India, to restart those shipments so that we can get those second doses into those populations because we are running to a longer interval than we would have liked,” said Aylward.

He stressed that it was hard for countries to deal with this stop-start dynamic as it disrupted systems and undermined public confidence.

“It takes a long time to get the logistics in place to operate at scale,” said Aylward. “When countries with weak systems are forced to continually interrupt, reorganise and redirect their programmes, they are going to have real trouble as additional doses arrive.”

In addition, he said, because rollouts have been “interrupted, staggered and slowed”, this undermined community mobilisation. 

“We hear this repeatedly from political leaders who are so keen to mobilise their populations, but so concerned that they are having to do that prematurely” because of supply problems.

Kate O’Brien, WHO’s director of vaccines, said that it had taken the most successful countries with secure supplies around four months to get to their peak pace.

“Those are countries that had clarity on what their supply was going to be, could mobilise demand, could communicate with their populations and their communities what the order is going to be, where you go for vaccination,” said O’Brien. “One of the worst things that you can do in an immunisation programme is to be communicating out to the community that doses will be available, and then you cannot deliver.”

Vaccine Inequity is ‘Fuelling Two-track Pandemic’

“The global failure to share vaccines equitably is fuelling a two-track pandemic that’s now taking its toll on some of the world’s poorest and most vulnerable people,” said Tedros.

“More than half of all high- and upper-middle-income countries and economies have now administered enough doses to fully vaccinate at least 20% of their populations. Just three out of 79 low and middle-income countries have reached the same level,” said Tedros.

This week, New York lifted almost all COVID-related restrictions as 70% of adults in the state have been vaccinated.

Aside from Africa, many Latin American countries have rapidly increasing epidemics while Indonesia is also facing a surge in cases.

Tedros reminded the briefing that the WHO had set the global targets of vaccinating at least 10% of the global population by September, at least 40% by the end of the year, and 70% by the middle of next year. 

“We very much appreciate the vaccine donations announced by the G7 and others. And we thank those countries including the United States that have committed to sharing doses in June and July. We urge others to follow suit. We need vaccines to be donated now to save lives.”

Tedros added that the WHO would make an announcement on Monday about plans to increase vaccine production in Africa.

Image Credits: EAC, Western Cape government, WHO.