As Nigeria Runs Out of Vaccines, US Dose Donations Start to Arrive in Africa 
On 2 March, Nigeria received a delivery of vaccines from COVAX which landed in Abuja.

IBADAN – Africa’s most populous country, Nigeria, has officially exhausted all the doses of Oxford/AstraZeneca COVID-19 vaccine it received in March from COVAX, according to Dr Faisal Shuaib, CEO of Nigeria’s National Primary Health Care Development Agency (NPHCDA).

Twenty-one African countries have seen COVID-19 cases rise by over 20% for at least two weeks running, and the current peak is 80% higher than Africa’s previous peak when data from South Africa (which accounts for 37% of cases) is excluded, according to the World Health Organization (WHO) Africa region.

“Be under no illusions, Africa’s third wave is absolutely not over.  Many countries are still at peak risk and Africa’s third wave surged up faster and higher than ever before. The Eid celebrations which we marked this week may also result in a rise in cases. We must all double down on prevention measures to build on these fragile gains,” Dr Matshidiso Moeti, WHO Regional Director for Africa, told the regional media briefing on Thursday.

Vaccine doses are slowly inching upwards. One million Johnson & Johnson COVID-19 vaccine doses – part of approximately 25 million doses donated by the US government to Africa – were delivered this week, according to Jessica Lapenn, US Ambassador to the African Union.

The doses had gone to Burkina Faso, Djibouti, Ethiopia, the Gambia and Senegal. An additional 1.2 million vaccine doses will soon be delivered to Cameroon, Lesotho, Niger republic, Zambia and the Central African Republic, Lapenn told an Africa CDC press briefing on Thursday.

“These deliveries are the first tranche of approximately 25 million COVID-19 vaccine doses being donated to Africa. That’s out of 80 million doses that the Biden administration announced for global donations last month. In the next coming weeks, we’ll continue to see additional deliveries to reach this 25 million,” Lapenn said.

Jessica Lapenn, US Ambassador to the African Union

 

 

This comes as WHO urges African countries to urgently ramp up COVID-19 vaccinations as the squeeze on vaccine shipments eases.

“Around 60 million doses are set to arrive in the coming weeks from the US, Team Europe, the United Kingdom, purchased doses and other partners through the COVAX Facility. Over half a billion doses are expected through COVAX alone this year,” according to the WHO.

“A massive influx of doses means that Africa must go all out and speed up the vaccine rollout by five to six times if we are to get all these doses into arms and fully vaccinate the most vulnerable 10% of all Africans by the end of September,” said Dr Moeti.

Nearly 70% of African countries will not reach the 10% vaccination target for all countries by the end of September at the current pace. Around 3.5 million to 4 million doses are administered weekly on the continent, but to meet the September target this must rise to 21 million doses at the very least each week, according to the WHO.

Just 20 million Africans, or 1.5% of the continent’s population, are fully vaccinated so far and just 1.7% of the 3.7 billion doses given globally have been administered in Africa.

US assists African Union to achieve vaccine target

The African Union (AU) has a target of vaccinating at least 60% of people on the African continent, and Lapenn confirmed that the US government is engaging with the Africa CDC and the Africa Vaccine Acquisition Task Team (AVATT) to coordinate the allocation of the vaccine doses to African countries. 

A breakdown of the shipments provided by the Africa CDC showed Burkina Faso, Djibouti, Senegal, Gambia, Zambia, Niger and Cameroon got 151,200 doses of J&J vaccine while Ethiopia received 453,600 doses.

In addition to these deliveries, Health Policy Watch recently reported the US government will also donate an additional 500 million Pfizer vaccine doses globally starting in August, as committed by US President Biden before the recent G7 Summit.

While Africa’s share of this donation, which will be delivered through COVAX, has yet to be determined, Strive Masiyiwa, the AU Special Envoy and coordinator of the AVATT, requested half of the total donation – 250 million doses.

The US government has also pledged its support to the local manufacture of COVID-19 vaccine doses in Africa with its recent contribution, through the US International Development Finance Corporation (DFC), to a $700 million loan being made to expand Aspen pharma in South Africa. It has also signed an agreement with Senegal and other partners for production of COVID-19 vaccines in Senegal. 

DFC said the technical assistance will help mobilize technical and financial resources from public and private entities to contribute to the development of Fondation Institut Pasteur de Dakar (IPD), a vaccine manufacturer in Dakar, Senegal, to bolster the production of COVID-19 vaccines in the country.

“These commitments are part and parcel of the US’ historic leadership on humanitarian and health assistance across the continent, including our support to combat COVID-19,” said Lapenn.

“Since the outbreak of the pandemic, the US has provided roughly $541 million, and health humanitarian and economic support assistance to sub-Saharan Africa for COVID response. This follows a roughly $100 billion worth of investment in Africa’s public health over the last two decades.”

Urgently refilling Africa’s vaccine stocks

Dr John Nkengasong, Director of the Africa CDC

Dr John Nkengasong, Director of the Africa CDC, said the vaccines donated by the US government will help to ensure that vaccination continues or resumes in African countries that are either running out of doses or had already exhausted the doses received even though only 1.3% of people in Africa have been fully immunised.

“As of today, the continent has acquired 82.7 million COVID-19 vaccine doses among 51 Member States. Of that number, 61.3 million doses have been administered, representing about 74%. In order words, doses are not being wasted as up to about 75% of the doses have been used,” Nkengasong said.

According to the Africa CDC, Morocco has used up about 80% of its supplies. South Africa has also exhausted 64% of its supplies, Egypt (68%), Nigeria (99.97%) and Algeria (68%).

In Nigeria, Shuaib announced on Wednesday that the country had used 3,938,945 doses of Astrazeneca vaccines across 36 states and the country’s capital city, representing 98% utilization of the 4,024,000 doses of Oxford/AstraZeneca vaccine it received from COVAX. 

“This comprises 2,534,205 people who have been vaccinated for the first dose, and 1,404,205 who have received their second dose of the vaccine. This is to say that all vaccines given to Nigeria in this first phase have been exhausted,” Shuaib said.

He also announced that during the vaccination exercise, Nigeria recorded 14,550 cases of mild to moderate side effects out of which only 148 cases were considered to be severe and no deaths. 

“As plans and preparation for the second [vaccination] phase commences, ‘a whole family approach’ vaccination mechanism would be utilized. This is because Nigeria is plagued with other preventable and treatable diseases. We will use the opportunity of COVID-19 vaccination to integrate with other health systems,” he added.

J&J vaccine delivery timeline emerges

Elaborating on a recent deal struck between AVATT and Johnson & Johnson for 400 million doses, Masiyiwa confirmed that at least 45 African countries will be receiving the J&J vaccine through COVAX in two phases. 

In the first phase, J&J will ship six million single doses of its COVID vaccine to 27 African countries that have already paid for their vaccines. 

By the end of August, 45 African countries will have received their first shipment. Thereafter, J&J will ship an average 10 million doses per month from the Aspen facility in South Africa to African countries till the end of the year.

“In January, we would have moved to 20 million doses a month and we will continue exponentially increasing that until all 400 million doses have been delivered by September next year,” Masiyiwa said.

Strive Masiyiwa, the AU Special Envoy and coordinator of the AVATT

More local COVID-19 vaccine production deals

On Wednesday, Pfizer-BioNTech announced a deal with South Africa’s Biovac Institute, which will see the African company helping manufacture about 100 million COVID-19 vaccines for the African Union in the coming year.

“The deal is to ‘fill and finish’ the vaccine, the final stages of manufacturing where the product is processed and put into vials. It does not cover the complicated processes of mRNA drug substance production, which Pfizer and BioNTech will do at their own facilities in Europe,” Nkengasong said.

Under the deal, Biovac will get the ingredients for the vaccine from Europe, blend the components, put them in vials and package them for distribution. This deal is similar to the arrangement between South Africa-based Aspen and Johnson and Johnson.

Morocco has also signed a Memorandum of Understanding with Swedish company Recipharm to establish and scale-up COVID-19 vaccine manufacturing capacity in the country while South Africa has also signed an agreement between Biovac, Afrigen Biologics & Vaccines, a network of universities, WHO, COVAX, and Africa CDC for the establishment of the first COVID-19 mRNA vaccine technology transfer hub in Africa. 

In April 2021, Egypt also signed two agreements between Holding Company for Biological Products and Vaccines (VACSERA) and Sinovac for COVID-19 vaccine manufacturing in the country. Algeria has also announced production of the Sputnik V COVID-19 vaccine in partnership with Russia.

Masiyiwa described local production of COVID-19 vaccines in Africa as an effective opportunity for the continent to tackle “vaccine nationalism” that had largely limited the continent’s ability to quickly access and roll out COVID-19 vaccines even though it is willing to pay for the doses. 

“The countries with the production assets control the release of vaccines. So we at least could rely on production assets on African soil,” he said.

 

Image Credits: NPHCDA.

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