Ursula von der Leyen, President of the European Commission, announcing the Digital Green Certificate proposal at a press conference on Wednesday.

The European Commission has released a proposal establishing a framework for a “Digital Green Certificate”, clearing the way for a vaccine certificate system to be set up by the summer. 

The proposal comes as many European countries are witnessing a third wave of infections and as the region’s vaccination campaign is lagging from vaccine shortages and the suspension of the AstraZeneca vaccine, a key vaccine in the inoculation effort – with only 10% of EU residents vaccinated. 

European Commission and WHO Encourage Trust in AstraZeneca Vaccine

President of the European Commission, von der Leyen, announced the moves  in a press conference – whrere she also stressed her confidence in the safety of the AstraZeneca vaccine, echoing the same message sent by the European Medicines Agency and the World Health Organization. 

“I trust AstraZeneca, I trust the vaccines,” said Von der Leyen. 

WHO’s expert safety team called the investigation into the thromboembolic events “good practice,” but stressed that there is currently no causal link to the vaccine. 

“At this time, WHO considers that the benefits of the AstraZeneca vaccine outweigh its risks and recommends that vaccinations continue,” said WHO in a statement released on Wednesday.   

The EMA is expected to publish its assessment of the vaccine on Thursday in a statement that Von der Leyen said would “clarify the situation.” 

Certificate System to Support Free Movement and Revitalize Economy

The Digital Green Certificate is designed to facilitate the safe and free movement of citizens in the EU during the COVID-19 pandemic. It will provide proof that an individual has been vaccinated against COVID-19, has received a negative test, or has recovered from COVID-19. 

Mock-ups of a paper and digital vaccination certificate, proposed by the European Commission on Tuesday.

“The Digital Green Certificate offers an EU-wide solution to ensure that EU citizens benefit from a harmonised digital tool to support free movement in the EU,” said Vera Jourová, Vice President for Values and Transparency at the European Commission, in a press release. 

“Our key objectives are to offer an easy to use, non-discriminatory and secure tool that fully respects data protection,” Jourová added. 

Several EU member states that rely heavily on tourism, including Greece, Spain, and Italy, were strong proponents of a common approach to such a system to revitalize air travel and ease the pressure on economies. Airlines and the travel industry also put pressure on EU politicians to implement a standardised travel solution. 

“We aim to help member states reinstate the freedom of movement in a safe, responsible and trusted manner,” said Ursula von der Leyen, President of the European Commission, at a press conference on Wednesday. 

Certificate System Won’t Be Discriminatory, Say Commission Officials

The proposed system will benefit everyone travelling within the EU and won’t discriminate against those who have not been vaccinated, emphasised the Commission in a statement. This comes after several countries and experts raised concerns about the ethics of such a system. 

National authorities in EU member states will be responsible for issuing the certificate, meaning it could be issued by hospitals, test centres, or health authorities. The certificate will include the individuals’ name, date of birth, date of issuance, information about the vaccine, test or recovery status, and a unique identifier. 

A QR code will be used to authenticate the certificate, ensure the security of data, and protect against falsification. According to the Commission, no personal data will be retained by the visited countries. 

The stages of the Digital Green Certificate System in practice.

The rights of individuals falling within the three categories on the Digital Green Certificate will be equal and member states will be required to waive the same public health restrictions, such as testing or quarantine, for all travellers with a certificate. 

“The Digital Green Certificate will not be a pre-condition to free movement and it will not discriminate in any way,” said Didier Reynders, Commissioner for Justice. “A common EU-approach will not only help us gradually restore free movement within the EU and avoid fragmentation. It is also a chance to influence global standards and lead by example based on our European values like data protection.”

Free movement is a fundamental right for EU citizens and the certificate system will “make it easier to exercise that right,” said the Commission. Those without a certificate will be able to travel, but may be subject to testing or quarantine. 

Commission officials have made a point to avoid the term “passport,” instead describing the Digital Green Certificate as a common system to help EU member states coordinate travel measures.

The certificate will be available to EU citizens and their family members, non-EU nationals who reside in the EU, and visitors who have the right to travel to other member states. It will be valid in all EU member states and Iceland, Liechtenstein, Norway, and Switzerland will be able to decide whether or not to introduce it. 

There will be no difference in the treatment of citizens and eligible non-EU citizens, said the Commission. 

The European Commission will develop a gateway for all certificates to be verified across the EU, assist member states in the technical implementation of the certificates, and support member states to develop software to scan and check the QR codes.

Vaccines Included Under Certificate System

The COVID-19 vaccines that have received EU marketing authorization will automatically be recognised on the certificate, but member states will be able to accept vaccine certificates issued for other vaccines, specifically ones that have been granted authorization by a member state’s regulatory agency or ones that have received WHO Emergency Use Listing. 

This is particularly an issue for the countries – Hungary, Slovakia, and Czech Republic – that have rolled out the Russian Sputnik V and Chinese Sinovac and Sinopharm vaccines before they have been approved by the European Medicines Agency (EMA). 

It is unclear if the proposed system will automatically be updated with the vaccines currently under rolling review by the EMA, including the Sputnik V vaccine, once they receive authorization.

The proposed system leaves the door open for updates based on new scientific evidence on the efficacy of vaccines in halting the transmission of SARS-CoV2 and the duration of protective immunity from prior infection. 

Currently the framework sets the maximum validity period of the certificate of recovery from a previous COVID-19 infection at 180 days. 

Next Step for Approval of Proposal

The Commission’s proposal is subject to approval by the majority of member states and the European Parliament before it can be implemented across the region. The proposal will be discussed at the next European summit, which is set to take place in late March. 

Member states will have to implement the trust framework, which defines the rules, protocols, and standards to ensure that the certificates are interoperable, verifiable, and trusted, in order to take a common approach to the certificates. 

The system could be implemented within three months EU officials said in February during the virtual summit of the European Council.

The Digital Green Certificate system will be temporary, “it will be suspended once the World Health Organization (WHO) declares the end of the COVID-19 international health emergency,” said the Commission. 

EU Threatens to Halt Vaccine Exports to UK, If Vaccine Exports to the Continent Aren’t Reciprocated

Meanwhile, in vaccine rollout news, the EC President threatened to curb the export of COVID-19 vaccines produced in the EU to countries that have higher vaccination rates, referring to the United Kingdom and the United States, both of which have been restrictive in their export of vaccines manufactured locally. 

“We want reliable deliveries of vaccines, we want to see increases in the contracts, we want to see reciprocity and proportionality in exports,” said Von der Leyen at a press conference. “We are ready to use whatever tool we need to deliver on that.”

“This is about making sure that Europe gets its fair share,” she added. 

The EU has exported 41 million doses of vaccines manufactured in the region to some 33 countries over the past six weeks – including 9.1 million Pfizer/BioNTech vaccines to Britain and one million to the US – and is the largest funder of the WHO co-sponsored COVAX global vacccine facility, which aims to share vaccines more equitably with low- and middle-income countries too.

But the bloc of 27 member states has not received its “fair share” of vaccines in return, particularly from the UK, Von der Leyen stressed, referring to the AstraZenec/Oxford vaccine produced there. 

“It is hard to explain to our citizens why vaccines produced in the EU are going to other countries that are also producing vaccines, but hardly anything is coming back,” said Von der Leyen. 

The EU is “still waiting for doses to come from the UK,” produced by AstraZeneca, said Von der Leyen. 

According to the Commission, two factories manufacturing the AstraZeneca vaccine in the UK are mentioned in the EU’s contract with the pharma company as sites for the production of vaccines designated for the EU.

The irony is that at the same time that the EU is clamouring for the UK to permit more AstraZeneca exports, some 17 countries have suspended its use due to about 30 reports of blood clots and abnormal bleeding in recipients of the jab. 

EU is “Not Ruling Out Anything” to Secure Vaccines

“We need to ensure that there is ‘reciprocity’ and ‘proportionality,’” said Von der Leyen. “If the situation does not change, we will have to reflect on how to make export to vaccine-producing countries dependent on their level of openness.”

When asked about potentially seizing production or waiving intellectual property rights to secure vaccine supplies for member states, von der Leyen said that “all options are on the table.”

“We are in the crisis of the century and I’m not ruling out anything for now because we have to make sure that Europeans are vaccinated as soon as possible,” Von der Leyen said.

Her comments contrasted sharply with the EU’s longstanding opposition to an IP waiver on COVID-19 tools and technologies at the World Trade Organization (WTO). The EU has joined several high income countries in blocking the proposal, arguing that WTO rules are flexible enough to address the vaccine access issues faced by low- and middle-income countries.

The export restrictions could also extend to countries “who have higher vaccination rates” than the EU, which could apply to Israel, Chile, the United Arab Emirates, Bahrain, Serbia, Qatar, Turkey, and Morocco.

UK Defends its Use of the “UK-Funded” Vaccine

In a rebuke to Von der Leyen’s comments, Matt Hancock, the British Health Minister, said that the UK had the legal right to prioritize doses of the AstraZeneca vaccine, developed with government support, to its citizens. The government has repeatedly prioritised UK citizens but continues to say it has not imposed an export ban on doses. 

“We legally signed a contract for delivery of the first 100 million doses here for people in the UK, as you would expect, both to ensure that people in the UK can get their jab and also because this is a UK-funded, UK-delivered vaccine,” Hancock said at a press conference on Wednesday. 

Matt Hancock, the UK’s Health Minister, at a news briefing on Wednesday.

“It remains the case that we expect the EU to stand by its commitment,” said a spokesperson for the UK government. “Putting in place restrictions endangers global efforts to fight the virus.”

“We’ve, all of us, including with our European friends, been saying throughout the pandemic that you’d be wrong to curtail or interfere with lawfully-contracted supply,” Dominic Raab, the UK’s Foreign Secretary, said on Wednesday. “I’m surprised we’re having this conversation. It is normally what the UK and EU team up with to reject when other countries with less democratic regimes than our own engage in that kind of brinkmanship.”

The decision to fulfill the UK’s vaccine needs before exporting to the EU coincides with an announcement on Wednesday that there will be a significant reduction in the amount of vaccines available in the UK from 29 March. 

This is due to “reductions in national inbound vaccines supply,” said a letter from the National Health Service, conveying information it received from the government’s vaccines task force. 

The EU has faced vaccine supply issues for several months now. AstraZeneca has underproduced and underdelivered doses to the EU, which has slowed the speed of the regional vaccination campaign. Initially the pharma company was expecting to deliver 90 million doses in the first quarter, but this has dropped to 30 million doses.

Despite the struggles the EU has faced with their rollout of vaccines, Von der Leyen said that she remains optimistic that the target of having 70% of the adult population fully vaccinated by the end of the summer could still be reached. 

Image Credits: Twitter – Ursula von der Leyen, European Commission, European Commission, Sky News.

 

Dr John Nkenkasong, Director of the Africa CDC says negotiations to secure COVID-19 vaccines are out of their hands.

Africa’s goal of achieving herd immunity against COVID-19 hangs in the balance as 270 million doses of vaccines are yet to arrive in the continent despite being secured three months ago by the African Union (AU) and African Centres for Diseae Control (ACDC).

Mid-January 2021, Health Policy Watch reported that the Africa CDC had pre-ordered millions of much-needed vaccines from various suppliers. But to date not even the centre’s leadership knows when the first set of shipment is due to arrive – or which country will be the first to receive the doses.

With two weeks to the anticipated April roll-out of the vaccine, Dr John Nkenkasong, Director of the Africa CDC, told Health Policy Watch that the finalisation of the process, by which Member States of the African Union (AU) can confirm and obtain their doses, is yet to occur. This includes the negotiations with the Afreximbank which is providing African countries with credit facilities, with which they can procure doses of the vaccines from the manufacturers.

“Most of the processes and negotiations are work in progress,”  said Dr Nkenkasong.

In the statement in January announcing the acquisition of the 270 million doses, the African Vaccine Acquisition Task Team (AVATT) established by African Union Chair President Cyril Ramaphosa, said the doses will be supplied by Pfizer, Johnson & Johnson and AstraZeneca (through an independent licensee, Serum Institute of India).

“From the onset of this pandemic, our focus as a continent has been on collaboration and collective effort. We have held steadfastly to the principle that no country should be left behind,” Ramaphosa said at the time.

AVATT officials said at the time that all 270 million vaccine doses will be made available this year with at least 50 million being available for the crucial period of April to June 2021.

Africa CDC then asked African countries to order doses through the African Medical Supplies Platform and when the deadline for the expression of interest expired in mid-February, Nkenkasong revealed that only about 26 countries (less than half of the countries in Africa) had expressed interest in securing doses through the platform.

But less than two weeks to April, there is no clear indication of whether the doses will be available by April or not.  And any delays would threaten the goal of achieving herd immunity for COVID-19 in Africa within one year, as AU and Africa CDC officials aim to do.  

 

Africa’s Long Road to Herd Immunity
Vaccinations in Kenya: about a dozen African countries have now launched vaccine drives in priority groups like health workers, older people and teachers, with the support of the WHO co-sponsored COVAX global facility. But supplies available through COVAX fall far short of demand. 

Last week, the president of the African Development Bank, Dr. Akinwumi Adesina called for vaccine justice for Africa. Speaking at the launch of the Bank’s African Economic Outlook 2021 report on Friday, Adesina decried the lack of Covid-19 vaccines reaching Africa.

“So far, 14.6 million vaccines have been delivered in Africa, but many people still cannot get shots in their arms. That is only 1% of what we need. We are way off the mark in terms of getting to 60% of herd immunity, and sadly, I do not see that happening for another year or two at this rate— not unless things change,” Adesina said.

According to him, there is a need to improve Africa’s access to vaccines. But so far, the COVAX Facility has been the major source of vaccine doses available to African countries, beginning with Ghana in late February.   However, the COVAX supplies would cover only about 20% of the population, at most, by the end of 2021. 

“COVAX is doing a great job but still, we need more. We need them in adequate quantity. We need them quickly and we need them at an affordable price,” Adesina said.

Negotiations to Secure Vaccine Doses “are really out of our hands”

Nkenkasong is a major proponent of African countries accessing vaccine doses through multiple means considering COVAX will only provide doses for one in five of those needing jabs. But he told Health Policy Watch that several aspects of the processes involved in securing the doses of the various COVID-19 vaccines are beyond the control of the public health agency.

“Our own role is to say to the continent — this is the kind of vaccines we should get, this is exactly why we should get this vaccine and these are the targets that we are trying to achieve. The rest of the back end negotiations are really out of our hands. So be patient with us,” Nkenkasong told Health Policy Watch.

But the non-arrival of the doses of COVID-19 vaccines, which have been expected through AVATT,  has not stopped Africa CDC from getting involved in the roll-out of COVID-19 vaccines in the tens of African countries where COVAX-supplied doses are available. 

“What we are doing is to collect all those vaccines that are coming in, in a dashboard, project them and show where each country is with respect to getting to 60%. That is our role and we will use that to catalyse the process and advocate for more partners,” Nkenkasong said.

 

Image Credits: Wish FM Radio.

Vaccinated: Sister Amanda Swartz believes the vaccinations will give South Africa a fighting chance against COVID.

South Africa’s vaccination programme for health workers is inching forward, fuelled by small deliveries of the Johnson & Johnson vaccine every two weeks.  However, overall supplies remain far short of the needs – even for the health sector. 

The country has an estimated 1.25 million health workers in public and private health to serve its population of 60 million – but by 15 March, slightly fewer than 148,000 had been vaccinated due to a dearth of vaccines.

A looming third wave of COVID infections, predicted in June when the country’s winter forces people indoors, and the more infectious B.1.351 variant now dominant in the country, are two big anxieties facing health workers.  There is also hesitancy with some health workers believing that there is insufficient safety and efficacy data for most vaccines so far approved.

But Sister Amanda Swartz did not hesitate when offered a vaccine in late February. At the very front of the ‘frontline’ against the pandemic, Swartz works at Brackengate Intermediate Care Facility,  a 300-bed facility set up specifically for COVID-19 patients in Cape Town. A nurse for 30 years who has worked with HIV and tuberculosis patients, Swartz says she has never experienced anything like the second wave of the pandemic, which hit the country in December and January. 

At its zenith, South Africa was recording 22,000 new cases per day, and Swartz says the Brackengate facility was overwhelmed with patients: “We lost 20 patients in one day. Young people with no comorbidities were coming in scared because they have never been sick in their lives but they couldn’t breathe,” says Swartz. 

Swartz felt sickly on Christmas eve and spent the next 10 days in isolation. Sick with COVID-19, she had to self-isolate from her three children.

Covid is a Lonely Disease
Health workers in the Western Cape province of South Africa getting their Covid vaccination.

Describing COVID-19 as a “lonely disease”, Swartz said the nights she spent alone and struggling to breathe were the worst – but hearing her family in the house kept her going.

“It made me think about my patients differently. How they were all alone in the hospital and scared, and we are the only people that can motivate them and keep them in touch with their families.”

Returning to work was “scary”, admitted Swartz. She was still tired, suffered shortness of breath and feared being reinfected. 

When she was offered the vaccine, she grabbed the opportunity and was one of the first to be vaccinated at her facility on 24 February.

“I couldn’t actually wait for us to start with vaccinations in the country because this gives us a fighting chance against the disease,” said Swartz. “I didn’t only do it for myself. As I’m working with COVID patients, I also put the people that I love at risk. So by protecting myself, I’m also protecting my family.”

While there is still “negativity” about the vaccine on Facebook and other social media platforms, most of Swartz’s colleagues who were afraid to be vaccinated have come around:

“They see that those who have taken the vaccine didn’t have side-effects or, if we did, they were very mild like a headache or fatigue – just like if you have Hepatitis B vaccine. So most of them say they are prepared to take the vaccine now.”

Swartz believes that a third wave is inevitable in the country as people have become lax about wearing masks and physically distancing.

The Western Cape government on Thursday said that to date 27 570 healthcare workers in the province had been vaccinated,  urging others to register and get the jab to “shield each other”.

“The vaccine is currently being rolled out to healthcare workers, but not enough of us have been vaccinated at this stage to stop the spread of the virus,” the province said in a statement.

Relaxed Lockdown Regulation Could See Spike in New Cases 
On 1 March, most pandemic-related restrictions were relaxed in South Africa in the face of falling caseloads and the devastating economic impact of lock-downs. 

But with the curfew eased, alcohol on sale again over weekends, bars and restaurants open and people allowed to mingle, health experts warn that new cases are soon going to rise again –  although, for now, new infections remain under the bar of 700 a day in a country of 60 million people.

In the face of another wave of infections, Swartz said: “What I would really like to see is that each and everyone in our country takes the vaccine if the world will give it to us. We had too many losses in the second wave. If we can prevent that by taking the vaccine, I think that will help a lot.”

South Africa’s vaccine procurement, like that of other African countries, is slow and uncertain. 

Shortly after securing 1.5 million doses of the AstraZeneca/ Oxford vaccine in a bilateral deal with the Serum Institute of India for health workers in early February, a small study, just now published in the New England Journal of Medicine, showed that the AstraZeneca vaccine was not effective in preventing mild and moderate infection against the B.1.351 variant prevalent in the country.

The government decided instead to offer the Johnson & Johnson vaccine to health workers. Although the vaccine is not yet registered for use in the country, a clinical trial on efficacy had just been completed – so scientists expanded the terms of the trial to encompass an implementation study for health workers.  Since then, the J&J vaccine has been approved both by the US Food and Drug Administration and the European Medicines Agency. 

South Africa Sells AstraZeneca Vaccine Doses Despite Calls for Roll-Out


The government, however, generated a controversy when it resolved to sell its 1.5 million AstraZeneca doses to the African Union. A number of leading scientists condemned this decision, particularly Professor Schabir Madhi, dean of the Faculty of Health Sciences at the University of the Witwatersrand and Director of the SA Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit.

Madhi was the principal investigator on an AstraZeneca efficacy trial being run in South Africa.

Writing in Business Day earlier this month, Madhi argued that “there remains a strong biologically plausible reason to expect the AstraZeneca vaccine will protect against severe disease due to the B.1351 variant, likely to a similar magnitude as the J&J vaccine”.

The World Health Organization also recommended in mid-February that the AstraZeneca vaccine should still be rolled out, even in countries where the B.1.351 variant was circulating, said Madhi.

He and other health professionals, including infectious diseases expert Professor Francois Venter, believe that the AstraZeneca vaccine should have been rolled out to high-risk South Africans who have no other protection against severe illness and death.

“Every additional day of procrastination lends itself to much of the R75m [75 million Rand/$US 4.87 million] used to procure the vaccine going to waste, while the elderly and other high-risk individuals would certainly remain unprotected as opposed to being offered a fighting chance of being protected against Covid-19 severe disease and death,” wrote Madhi.

The AstraZeneca vaccine is the backbone of the global COVAX vaccine platform’s vaccination programme and it also makes up a large portion of the African Union’s vaccine procurement.

Unlike many other African countries, South Africa has yet to receive a COVAX vaccine delivery. According to the COVAX allocation plans published on 2 March,  South Africa is still due to get over 2.4 million doses of the AstraZeneca vaccine and 117 000 Pfizer doses.

However, given the government’s decision to return its own AstraZeneca purchases and a global shortage of vaccines, it is going to take a while before the country’s citizens get the jab.

Image Credits: Western Cape government, Kerry Cullinan , Western Cape Provincial Government, South Africa .

AstraZeneca vaccine

Major European nations remain divided over the use of Oxford/AstraZeneca’s COVID-19 vaccine, while the pharma company said there was no evidence of increased risk of blood clotting and abnormal bleeding among people who get the vaccine.    

AstraZeneca’s review of all the safety data of more than 17 million people vaccinated in the European Union (EU) and the United Kingdom (UK) has shown no increased risk of pulmonary embolism, deep vein thrombosis (DVT) or thrombocytopenia in any particular age group, gender, or country, the company said on Sunday. 

Across the EU and the UK, there have been 15 cases of DVT and 22 cases of pulmonary embolism reported among those given the AstraZeneca vaccine. Five deaths have also been reported – two dying from brain hemorrhages.

The reports have prompted more than a dozen countries to either partially or fully suspend the vaccine’s use while cases are being investigated. Some 17 countries, including Spain and Sweden have joined France, Germany, and Italy in suspending use of the vaccine. 

“The nature of the pandemic has led to increased attention in individual cases and we are going beyond the standard practices for safety monitoring of licensed medicines in reporting vaccine events, to ensure public safety,”  AstraZeneca said in its statement on Sunday. Ann Taylor, Chief Medical Officer, added:

 “number of cases of blood clots reported in this group is lower than the hundreds of cases that would be expected among the general population,” but she said that the company will continue to closely monitor the vaccine rollout.   

UK’s Boris Johnson Issues Strong Defense – Australia, and Thailand Also Remain Confident in AstraZeneca 

Outside of Europe, however, the AstraZeneca vaccine rollout through the WHO co-sponsored COVAX initiative was continuing in most countries – although the Democratic Republic of Congo said they had postponed an immunization launch that had been planned for this week. 

And Australia, India and Thailand were moving ahead with the vaccine as well as the UK. 

UK Prime Minister Boris Johnson issued a series of strong statements in defense of the vaccine – whose R&D the UK also supported. “The vaccine is safe and works extremely well,” Johnson wrote in an article published on Tuesday in The Times.

Prime Minister Boris Johnson says UK ‘very confident’ about AstraZeneca vaccine

“People should still go and get their COVID-19 vaccines when asked to do so,” said Dr Phil Bryan, UK Medicines and Healthcare products Regulatory Agency (MHRA) Vaccines Safety Lead, in a statement. 

Bryan added: “We are working closely with international counterparts in understanding the global safety experience of COVID-19 vaccines and on the rapid sharing of safety data and reports.” 

On Monday, Johnson told reporters that Britain’s MHRA is “one of the toughests and most experienced regulators in the world,” saying it’s approval signalled that the vaccine was safe. He went on to praise the UK’s vaccine rollout, one of the largest so far, which is helping to bring down COVID-19 rates. . 

More than 24 million people in the UK have received at least one dose of a coronavirus vaccine, with the UK government aiming to offer a first vaccine dose to about 32 million people in nine priority groups by 15 April.  

But Johnson reiterated, “Successful as the UK vaccination programme may be, there is little point in achieving some isolated national immunity. We need the whole world to be protected.” 

Australia will also not pause their AstraZeneca COVID-19 vaccine rollout with Chief Medical Officer Paul Kelly remaining “confident that [the vaccine] is safe.”  

“The Therapeutic Goods Administration is aware of the issue and also does not’ see any link between the AstraZeneca vaccine and blood clots,” Kelly said in a press conference on Tuesday.  

Australia’s CMO (right) Paul Kelly addresses blood clot concerns over AstraZeneca vaccine

Kelly also stated that there have been no increased incidence of blood clots among Australians who have already received the AstraZeneca vaccine. 

Thailand’s prime minister, Prayuth Chan-ocha, who received a dose of the AstraZeneca vaccine on Tuesday, urged people to “believe doctors” as other countries suspended the vaccine’s use. 

“There are people who have concerns,” Chan-ocha said after receiving the vaccine. “But we must believe doctors, believe in our medical professionals.”

Most Asian countries have continued to administer the AstraZeneca vaccine, with India the largest user. 

Thailand has ordered enough doses from AstraZeneca and China to cover around half of its population. The country has so far vaccinated around 50,000 people in high-risk groups. 

Suspensions of Vaccine is ‘Political’, Says Italy 

As many national vaccination strategies remain reliant on the vaccine made by AstraZeneca, the decision to suspend its use may slow down rollout even more, as efforts are marred by political infighting, mixed messaging, and supply shortages. 

Despite delays of the vaccine in several countries, Spain remains confident that the Spanish government’s two-week suspension will not alter the country’s vaccination calendar, government spokeswoman Maria Jesus Montero said on Tuesday. 

Spain aims to vaccinate 70% of its 47 million population by the end of the summer. 

Italy’s medicines authority director-general called the decision to delay the vaccines largely “political”.

“We got to the point of a suspension because several European countries, including Germany and France, preferred to interrupt vaccinations… to put them on hold in order to carry out checks. The choice is a political one,” Nicola Magrini told the la Repubblica daily in an interview, Reuters reported. Prior to taking on his new role,  Magrini was a former top WHO official specializing in medicines approvals and access.   

Italy has recently blocked a shipment of AstraZeneca vaccines from leaving the country, arguing that it had failed to meet its contractual obligations to provide the vaccine to the European Union. 

EMA and WHO Urge Continued Use  – WHO Data Review to be Completed on Thursday 

The European Medicines Agency and the World Health Organization have been quick to defend the Oxford/AstraZeneca vaccine – and urge its continued use. 

“I’m not here to give you the outcome of any scientific review”, said EMA director Emer Cooke at the start of a press conference on AstraZeneca vaccine safety on Tuesday. 

“I’m here to explain the steps in the process, what we’re doing, and when you can expect us to come to a conclusion.”

Experts will meet on Thursday “to come to a conclusion on the full information that has been gathered and to advise us as to whether there are further actions that need to be taken,” said Cooke. “We will inform the public of the outcome immediately after this meeting.” 

The EMA currently concludes that while the investigation is still ongoing, “We are firmly convinced that the benefits of the AstraZeneca vaccine in preventing COVID-19 with its associated risk of hospitalization and death outweigh the risk of the side effects.” 

The WHO has also issued similar messages, with the WHO’s Global Advisory Committee on Vaccine Safety saying that at the moment, “benefits of the vaccine outweigh the risks”.  The  EMA is to issue reports about the safety of the vaccine on Thursday, after examining all data. 

WHO Director General Dr Tedros Adhanom Ghebreyesus

WHO Director General Dr Tedros Adhanom Ghebreyesus said the events are not necessarily linked to vaccination, “but it’s routine practice to investigate them, and it shows that the surveillance system works and that effective controls are in place.”

–Updated 18 March, 2021

Image Credits: Flickr, gencat cat/Flickr, The Guardian, Sophie Scott/ABC.

ISLAMABAD – Pakistan authorities are threatening to fire healthcare workers who refuse to be vaccinated with the Chinese-donated SinoPharm COVID-19 vaccine. 

In a harshly worded letter, , the Directorate of Health Services in Sindh warns frontline health care workers that reluctance to get the jab will result in “strict disciplinary action” including suspension or dismissal from government services.

The letter dated 24 February and signed by Dr Nazir Ahmed Rind states that: “If any frontline health care worker refuses to vaccinate, he/ she may be terminated/ suspended from the Government Services”.

Warning letter to health workers.

The objection to being vaccinated with the SinoPharm vaccine stem from concerns raised about its efficacy and safety, particularly as a division of Pakistan’s health ministry initially declared that the vaccine was unsafe for people older than 60, pregnant women and lactating mothers. 

Although the government has since reversed its position on this, it has done little to address  health workers’ concerns. 

So far, only half of the 500,000 HCWs registered to be vaccinated have received the vaccine and the country’s health authorities are not taking kindly to their unwillingness to be vaccinated.  

The Sindh health ministry confirmed that the notice was issued by the secretary’s office, but the provincial health minister’s PR officer failed to respond to requests for comment.

Similarly, in another letter dated 27 February, the management of the Pakistan Institute of Medical Sciences (PIMS) in Islamabad, one of the largest hospitals in the country, has issued a stern warning to employees that “all registered PIMS staff must get vaccinated as soon as possible. Otherwise, strict disciplinary action will be taken against the defaulter, as per rules”.

Flip-flopping decisions and ‘trials’  

Pakistan started vaccinating its frontline health care workers (HCWs) – including doctors, nurses and paramedics – in its federal capital and all of its federating units simultaneously in early February. 

Dr Rana Mohammad Safdar, Director General of the Health Ministry’s National Health Services Regulations and Coordination (NHSR&C), said that about 250,000 people have been vaccinated out of the 500,000 HCWs that had registered.

“The vaccine has side effects,” said Dr Yasmin Rashid, Health Minister of Pakistan’s most populous province, Punjab, in a press briefing after receiving the SinoPharm vaccines. She added that anyone getting the vaccination should do so at their own risk. 

At the time, the minister also said that it would be “premature to say how long [the vaccine] will be effective”.

 

https://twitter.com/Nadeemchisd/status/1368582866175721472

Initially, the Ministry of NHSR&C had recommended that people over the age 60, lactating mothers and pregnant women should not get this vaccine, but a month later, the Drug Regulatory Authority of Pakistan approved the vaccine for these groups.

The contradictory advice raised concerns among HCWs. Dr Tanvir-ullah, serving in the federal capital Islamabad’s Federal Government Services Polyclinic Hospital, said that he tested COVID-19 positive after getting the vaccine.

“I received the vaccine on 18 February and after that I felt body aches and later on, mild flu symptoms also developed,” he said.

On 4 March he tested positive for COVID-19.

Tanvir-ullah said that HCWs feared that the vaccine may be being tested on them. 

“Generally, HCWs are reluctant of the vaccine [and] believe they are being involved in the vaccine’s trial,” said Tanvir-ullah. “Safety and efficacy are indeed a concern of HCWs not going for vaccination.” 

Mixed Messages

Dr Qaiser Sajjad, secretary general of the Pakistan Medical Association (PMA) – a body working for doctors’ rights – said the vaccination of HCW was “slow” as doctors are ‘reluctant’ to get the Chinese vaccine.

Sajjad said that PMA has registered 189 doctors’ deaths in the fight against COVID-19 and the “unclear” message by the government regarding the efficacy of the vaccine was creating problems.

“Doctors [are] reaching out to the PMA platform and ask[ing] about efficacy, data availability, research standards, expiry and status of the donated SinoPharm vaccine,” said Sajjad. “Unfortunately, instead of convincing the HCWs, the government is trying to force them to vaccinate, which is unethical.” 

“Government must inform HCWs on how a vaccine that was not effective for people above the age of 60 years, suddenly became effective,” said Sajjad.

Public health expert Dr Zafar Mirza, who served as health minister for Pakistan and director of the Health System of World Health Organization (WHO), said that the government should have communicated to the HCWs about the safety of the vaccine in a well thought-out way.

“There is a need to correct the perception of safety and efficacy of the SinoPharm vaccine in HCWs and the public as well,” he said.

Mirza pointed out that, although no adverse case had been recorded after administering the SinoPharm vaccination, the vaccine’s safety had not been appropriately conveyed.

“Out of 500,000 HCWs the number of registered and vaccinated is very low and should have been completed so far,” said the doctor.

No Adverse Events Recorded

Akhtar Abbas, spokesperson for the Drug Regulatory Authority of Pakistan said the authority had approved the vaccine after analyzing the submitted data. He said no adverse case about safety of the SinoPharm vaccine had been reported from anywhere in the world.

Abbas said the vaccine had also been approved for people older than 60 after the expert committee reviewed the data that no adverse effect was recorded from any other country.  

According to the data released by Pakistan’s National Command and Operations Center (NCOC), a strategic forum established by the government to deal with the COVID-19 pandemic, 504,000 doses of the SinoPharm vaccine had been distributed in all federating units of the country for the frontline HCWs.

Punjab had received 118,000 doses, Sindh 102,100, Khyber Pakthunkhwa 28,000, Baluchistan 16,000, Islamabad 15 000, Azad Jammu & Kashmir 11,000 and in Gilgit Baltistan, 5 000 doses of the vaccine have been provided so far.

In the southern region, only 12,194 HCWs had been vaccinated and in north-western province, Khyber Pakthunkhwa, 26,697 HCWs had been vaccinated so far.

Rizwan Malik, Public Relations officer for the health minister of Khyber Pakthunkhwa, said that health authorities had observed an upward trend in vaccinations in the last two weeks of February, but this dropped off recently.

“Provincial government is encouraging HCWs to come for the vaccination,” he said.

Federal Minister Asad Umer, who heads the NCOC, said that around 50 percent of the HCWs had been vaccinated and “not a single case” regarding safety of the vaccine had been reported.

He agreed that there was a reluctance from HCWs to get vaccinated but that this was happening in other parts of the world as well. “Maybe HCWs are reluctant because it is something new for them,” he said.

Meanwhile, Dr Imran Sikandar of PIMS hospital, who received the first vaccine in the countrywide vaccination drive, said that he feels “perfect” after getting both doses of the SinoPharm vaccine.

“I received the first dose on 2 February and the second jab on 23 February and I am feeling healthy,” said Sikandar.

He said concerns about the vaccine were only misconceptions and needed to be eradicated. He added that vaccinations of HCWs should be made mandatory for the safety of the public.

 

Inactivated COVID-19 vaccine candidate produced by Beijing Institute of Biological Products and Sinopharm Group.

No Peer Review Study Yet

Neither of China’s two leading vaccine candidates, SinoPharm and Sinovac, have been approved by an external regulatory agency and discussions are still continuing with the WHO, according to WHO officials.

Chinese vaccine developers have also not published peer-reviewed studies on their vaccines. Company reports show SinoPharm’s multi-country trials yielded efficacy results of 79 percent, while Sinovac trials from four different countries showed results ranging from 91.3 percent in a Turkish trial to 50.3 percent in an independently managed Brazilian trial among health care workers.

Although China has been accused of donating its COVID-19 vaccines for political power, Chinese President Xi Jinping stressed at recent meetings of the World Health Assembly that it viewed its COVID vaccines as a global “public good”.

China has also joined the global vaccine access platform, COVAX, and promised it 10 million doses. China reports that it has also offered vaccine assistance to 53 developing countries, and that it has exported or is exporting vaccines to 22 nations, according to Foreign Minister Wang Yi.

A recent preprint paper, which has not undergone peer review, suggests that SinoPharm’s vaccine held up well against a South African SARS-CoV2 variant (501Y.V2). In the analysis of blood samples from a dozen vaccinated participants, the vaccine’s neutralizing power was only reduced by a factor of 1.6 when it was exposed to the variant.   

Countries Have Autonomy to Authorise Health Products, says WHO

When asked for comment about countries using vaccines that did not yet have WHO emergency using listing, the WHO stressed that “countries have the autonomy to issue emergency use authorizations for any health product. Domestic emergency use authorizations are issued at the discretion of countries and not subject to WHO approval”.

“There are and will likely continue to be manufacturers of some vaccine candidates who may be delayed in seeking or choose not to seek emergency use listing by WHO or authorisation by a stringent regulatory authority,” the WHO told Health Policy Watch.

“The use of some of these products has proceeded in a number of countries with the agreement of national authorities. It is possible that the data required for a WHO emergency use listing assessment may not have been available at the time of national decisions to use such vaccines.”

In cases where a country’s vaccines were not requalified by the WHO but approved by a country’s national regulatory authority, it was common for the global body and UNICEF to provide technical assistance, added WHO.

“WHO’s support is provided to the immunization programme of the country, not to a specific vaccine. This support includes capacity assessments, planning, advising on delivery strategies, ensuring adequate cold chain, data monitoring, communication including raising public awareness and promoting demand for vaccination, and risk communication,” stressed the WHO.

Image Credits: Sinopharm.

WHO’s Franceso Zambon has resigned after he spoke out against the Organization’s censorship of a crucial report on Italy’s botched COVID-19 response

The WHO scientist who spoke out against the suppression of a damning report exposing key flaws in Italy’s COVID-19 response has resigned, Health Policy Watch has learned.

Franscesco Zambon, a senior figure at WHO’s Venice Office who led the preparation of the controversial report, told Health Policy Watch that he resigned over the WHO’s censorship of an “independent” report that was intended to “critically examine” both the strengths and weaknesses of Italy’s COVID-19 pandemic response. That report, said critics, contained valuable evidence that could have helped other countries in their COVID-19 response when it first hit.

But the report was removed on 14 May, just a day after it was published online on the WHO European Regional Office website – at the request of Ranieri Guerra, WHO’s assistant director-general for strategic initiatives, and former chief of preventive health at the Italian Ministry of Health from  2014 to 2017.

Strikingly, the report revealed that Italy’s national pandemic preparedness plan had not been updated for 14 years – a task that Guerra was meant to have undertaken while he was working with the Ministry between 2014 and 2017. The report also said that Italy’s initial response to the pandemic was “improvised, chaotic and creative” – which is likely to have contributed to a devastating death toll in the country in the early days of the pandemic.

The WHO’s suppression of the report adds to a growing body of evidence that has compromised the international organisation’s credibility, neutrality and transparency at a time when it is most needed, critics have said.

Read more about the report in our three-part series here.

EU Ambassador to the African Union, Birgitte Markussen.

Although the European Union (EU) is opposed to the proposal by South Africa and India urging the World Trade Organisation (WTO) to waive intellectual property (IP) rights on COVID-19 products for the duration of the pandemic, the EU will support the expansion of vaccine access in Africa.

This is according to the EU Ambassador to the African Union, Birgitte Markussen, who told a recent AU media briefing that the EU is putting its full weight behind the COVAX Facility to ensure that African countries are able to vaccines, rather than supporting the waiver proposal. 

“The universal and equitable access to safe and effective diagnosis, treatments and vaccines, is the crucial issue for us. The whole issue of intellectual property rights does not really stand in the way for the efforts. It’s rather part of the solution,” Markussen said.

WTO ‘Flexible Enough’ Without Waiver

“I know that there are many issues related to the transfer of technology and so on, and the WTO rules are already flexible enough to address the problems. So it’s not that we are against it, we just think that the solution is already there,” she said.

Markussen said there were provisions in the licensing of vaccine technology and know-how, including the granting of compulsory licenses without the patent owner’s consent, that can be fast-tracked in emergencies, such as the pandemic.

Together with the Africa Centers for Disease Control (CDC), the EU has been involved in multilateral responses to control the spread of COVID-19 in Africa, but acknowledged that there needed to be more fostering of solidarity and cooperation to tackle the threats that both Europe and Africa are facing.

Markussen also told Health Policy Watch that the EU supports calls by France and Germany for  European countries to donate substantial doses of their COVID-19 vaccines to African countries.

However, she said there is no date yet for when the donation exercise will begin although  measures are already in place to coordinate it.

“We have a mechanism whereby our member states can redistribute these types of vaccines and that’s an additional instrument to the COVAX Facility,” she told Health Policy Watch. 

Africa CDC Wants Continent to Produce COVID Vaccine

Meanwhile, Africa CDC Director John Nkengasong, Director of the Africa CDC, said the center  is keen on ensuring that African institutions including the Institut Pasteur de Dakar in Senegal are capable of producing COVID-19 vaccines to ensure that African countries are able to have quick access to the vaccines especially when additional doses are needed.

“It is so important for us as a continent to have that because we truly don’t know how these vaccines will perform in terms of the longevity of immunity,” said Nkengasong. “So if it happens that immunity wanes after two years or so, then it means you need regular additional vaccination or boosting, and that will require that we have a continental capacity so I’m really really hoping there will be the right partnerships, and then see how we can roll that across the continent,” he said.

Novavax’s COVID-19 candidate vaccine NVX-CoV2373 is administered to a health volunteer during the clinical trial.

Novavax’s COVID-19 vaccine candidate has an efficacy rate of 96.4% against the original strain of SARS-CoV2. However, the efficacy rate drops up to 55.4% against the new B.1351 variant first identified in South Africa, and also spreading globally. 

The pharma company, which has never brought a vaccine to market before, published the data from two late-stage trials conducted in the United Kingdom and South Africa on Thursday.

The Phase 3 clinical trial conducted in the UK had over 15,000 participants, including 27% over the age of 65. The efficacy rate against the original SARS-CoV2 strain is on par with results from the Pfizer/BioNTech and Moderna vaccines. 

The efficacy rate reduced to 86.3% against the B.1.1.7 variant, first identified in the UK, and declined even further against the B.1.351 variant, initially detected in South Africa. 

The South African trial included two cohorts, one of 2,665 HIV-negative adults and the other of 240 HIV-positive adults. An analysis of both groups found an overall efficacy of 48.6%, but among HIV-negative participants, the efficacy rose to 55.4%. The majority of SARS-CoV2 cases in the trial were linked to the B.1.351 variant.

Although the efficacy was lower against both widespread variants, the vaccine candidate still demonstrated  “100%  protection against severe disease, including all hospitalisation and death,” across all arms of the trial, the company stressed.   

“We are very encouraged by the data showing that NVX-CoV2373 not only provided complete protection against the most severe forms of disease, but also dramatically reduced mild and moderate disease across both trials,” said Stanley C. Erck, CEO of Novavax, in a press release. 

“Importantly, both studies confirmed efficacy against the variant strains,” he added.

Leading COVID-19 Vaccines Have Reduced Efficacy Against New Variants

Novavax announced in January, after the release of the interim trial results, that it started developing a new version of the vaccine to target the more contagious and potentially more deadly variants. Clinical testing on the new vaccine will begin between April and June of this year.

Novavax joins Pfizer, Moderna, and AstraZeneca with results showing lower efficacy against the COVID-19 variants, specifically the B.1.351 variant. Moderna found a six fold reduction in neutralizing antibodies against B.1.351, Pfizer reported lower neutralization of the variant, AstraZeneca’s vaccine was minimally protective against mild to moderate infection from the variant, and Johnson & Johnson’s vaccine efficacy rate fell from 72% in the US to 57% in South Africa. 

The B.1.1.7 variant has been detected in over 90 countries by early March and the B.1.351 variant has spread to at least 48 countries. With the increased ability for the variants to evade the immune response triggered by the vaccines, new or updated vaccines will likely be necessary for sustained protection.

Sputnik V Vaccine Developers Question EMA’s Neutrality
Healthcare worker prepares Sputnik V COVID-19 vials.

Meanwhile, the developers of Russia’s Sputnik V COVID-19 vaccine accused the European Medicines Agency (EMA) of politicizing the vaccine approval process after a senior EMA official urged EU member states to postpone national rollouts of the vaccine until the EMA had completed its regulatory review.

In an interview last week, Christa Wirthumer-Hoche, chair of the EMA managing board, likened the use of the Sputnik V vaccine without a sufficient evaluation of the safety data to “playing Russian roulette.”

In response, the vaccine developers wrote on the Sputnik V Twitter account, “demand[ing] a public apology from EMA’s Christa Wirthumer-Hoche for her negative comments…, (which) raise serious questions about possible political interference in the ongoing EMA review.”  The EMA had not made any other such comments about other vaccines that it had reviewed, Sputnik’s developers noted. 

The Sputnik V vaccine is currently under rolling review by the EMA.

The issue was quickly resolved by Thursday, but tensions are still present between the EMA, the Russian Direct Investment Fund (RDIF), the company responsible for marketing the Sputnik V vaccine abroad, and EU countries that are welcoming of the new vaccine.

Italy Becomes Latest EU Member State To Embrace Sputnik V

Italy, meanwhile, became the first country in the EU to sign a deal to produce the Sputnik V vaccine, with plans to produce 10 million doses of the vaccine in Italy by the end of the year. The deal was signed between Adienne, an Italian-Swiss pharma company, and Kirill Dmitriev, CEO of the RDIF, on Tuesday.

The production could start as early as July, if the vaccine is authorised by the EMA and Italy’s national medicines regulatory agency, AIFA. 

“The innovative production process will help create new jobs and allow Italy to control the entire production of the compound,” said the Italian-Russian Chamber of Commerce, which facilitated the negotiations. “This step will help solve the problem of the shortage of vaccine doses in Italy.”

Italy has significant business ties with China – and there has been longtime speculation that the heavy travel patterns back and forth between northern Italy and China may be one of the reasons why the Italy became the first European epicentre for the virus a year ago.

As for the Russian vaccine, a couple of EU countries have already moved forward with national approval and rollout, including Hungary, Slovakia, and Czech Republic. 

A RDIF spokesperson said on Tuesday that discussions also were underway with production facilities in Spain, France and Germany to manufacture the Sputnik V vaccine. A conversation on vaccine production cooperation was held between German Chancellor Angela Merkel and Russian President Vladimir Putin in January. 

Germany is reportedly “open to the idea of bilateral cooperation for the purpose of tapping European production capacities,” said Ulrike Demmer, deputy spokesperson for the German government. 

“Sputnik V is a very clever construct,” Thomas Mertens, head of Germany’s standing commission on vaccination, told Rheinische Post in an interview. “[It is a] good vaccine that will presumably also be approved in the EU at some point.” 

Proposed EU Vaccine Certificate Will Include Sputnik V and Chinese Vaccines

According to reports on the EU vaccine passport, the preliminary plans for which will be announced next week, the Sputnik V, Sinovac and Sinopharm vaccines will likely all be accepted as part of the certificate system, along with the EMA-approved vaccines. 

This system is designed to ease certain restrictions for individuals who have been inoculated, specifically for travelling between particular countries or within regions, in an effort to revitalize air travel and ease the pressure on economies.

Including the Chinese and Russian vaccines is being seen as a pragmatic move insofar as some EU countries have also authorised the Sputnik V, Sinovac, or Sinopharm vaccines for use, or are preparing to do so. 

Image Credits: Novavax, RDIF.

The daily new COVID-19 cases in Kenya, reaching over 550 on 11 March.

Kenya has officially announced a third wave of the COVID-19 outbreak this week, while the World Health Organization’s (WHO) Africa region reported a “slight uptick in cases and an upward trend in 12 countries, including in Cote d’Ivoire, Ethiopia and Cameroon.”

Dr Matshidiso Moeti, WHO Regional Director for Africa, during the weekly press conference said there was an upward trend in some countries. 

On Friday, Kenyan President Uhuru Kenyatta tightened up the country’s COVID-19 measures, extending the 9pm curfew and decreeing that bars and restaurants close by 9pm.

Kenya recorded 713 new cases and 12 deaths on Wednesday, a record number since the start of this year. The positivity rate is up to 14% since November last year and the country’s total official death toll is 1,898. The Africa CDC reported a 13% average increase in deaths for Kenya for this week’s COVID-19 epidemiology update.  

Mutahi Kagwe, Kenya’s Cabinet Secretary for Health, said there had been an increase in the number of patients on ventilators and in need of oxygen and warned that the situation could worsen. 

“We are about to start another difficult period, but we can also overcome this period. It has taken a toll on us over the past year, and it is at this time that we can’t let our guard down,“ Kagwe stressed.

Meanwhile Raila Odinga, the leader of opposition in Kenya is being treated with COVID-19 in Nairobi Hospital, according to a statement from his doctor.  

Kenya’s health ministry established a National COVID-19 Vaccine Deployment Task Force this week to guide the rollout of COVID-19 vaccines, including regulation and safety monitoring, financing, procurement and logistics.

This week the Kenyan Conference of Catholic Bishops (KCCB) condemned the statement by the Kenyan Catholic Doctors’ Association that COVID-19 vaccines were “totally unnecessary.” The KCCB said in a statement on Tuesday that the association did not speak for the Catholic Church, and encouraged all Kenyans to accept the vaccine.

Africa Centres for Disease Control (CDC) director John Nkengasong told last week’s WHO Africa briefing that “we are beginning to see the beginning of a third wave in East Africa.”

The WHO warned that Africa is poised to surpass 4 million COVID-19 infections this week since the continent’s first confirmed case in February 2020, but described the arrival of vaccines in the continent over the past two weeks via COVAX as a “crucial boost.”

More than 14.6 million vaccine doses have been delivered to 22 African countries since 24 February through COVAX, a global vaccine effort co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance and the WHO.

“While deaths reported have dropped by more than 50% over the past 28 days compared with the previous 28 days, the case fatality ratio or the proportion of deaths among confirmed cases is at 3.6% for the past 28 days. This is higher than the global average,” warned the WHO Africa.

Image Credits: Twitter: @WHOKenya, Our World in Data.

Rumours about the whereabouts of Tanzanian president John Magufuli, are intensifying as the leader who questioned the existence of the SARS-CoV2 virus was reportedly in intensive care with COVID-19 – somewhere in Nairobi or possibly now even in India.

Magufuli has not been seen for almost two weeks, sparking widespread speculation about his health. His absence is unusual as he is known for making frequent public speeches and appearing on state television several times a week.

Tanzanian opposition leader, Tundu Lissu, who lost last year’s election to Magufuli, tweeted on Thursday that the president had been transferred from a hospital in Kenya to India – although he did did not provide evidence:  “His COVID denialism in tatters, his prayers-over-science folly has turned a deadly boomerang!” Said Lissu in a tweet. 

But Tanzania’s Prime Minister, Kassim Majaliwa, urged citizens to ignore “fraudsters”, claiming that  the president was strong and at work, as usual. Majaliwa also said he had talked to him on the phone and that he was grateful to the voters.

“The president is very busy. Where do they want him to go? Have you ever found him wandering around Kariakoo or Magomeni?” he asked while at a function in Tanzania’s Njombe region. The information was sent in tweets on social media in Swahili.

Rumours and Conspiracies

However, the government is under increasing pressure to reveal Magufuli’s whereabouts – as an online publication speculated that the rumours about him also were being fed by the Tanzania Intelligence and Security Service (TISS) as part of a power struggle withn in the ruling party.

Government sources in Tanzania told Health Policy Watch that they did not know the whereabouts of the President: “

We are just following what is happening on social media and other news outlets but we do not know what is happening to him,” one source said. 

Some source salso  are reporting ‘unusual activity’ at the Tanzania High Commission in Nairobi, Kenya. 

Opposition leader Lissu told the BBC that the 61-year-old president had suffered a cardiac arrest before being flown to a hospital in Nairobi for urgent treatment.  Lissu later said that the president was in a coma and had been transferred to a hospital in India. 

Scientist and Devout Catholic – But COVID-Skeptic

Magfuli, a scientist and a devout Catholic, has frequently played down the threat of COVID-19, saying that God would protect his nation from the disease.  In late-February, following a rebuke by the WHO and the death from COVID of his own vice-president, Magfuli finally signaled that he was willing to take the disease more seriously.   

At that point, the Tanzania Medical Association unleashed a new camapign on prevention of COVIVD-19.  But some worry that the shift may have been too little too late. 

For months, Tanzania has refrained from reporting to the WHO on new COVID cases – and doctors in the country privately admitted that they were under tremendous pressure to write anything but COVID on death certificates. 

Meanwhile, officials such as the chief government chemist, Fidelice Mafumiko, promoted the use of herbal medicine to cure COVID-19. Tanzania’s Health Ministry announced in a press conference last month that it had no plans to accept COVID-19 vaccines, insisting that the country is safe. 

Now social media is awash with news of the Tanzania president allegedly being admitted in a high care hospital because of the virus. 

Many people posting on social media with the hashtag #prayforMagufuli have also criticized irresponsible the way Tanzania handled the pandemic.  

“If it’s true Covid denier Magufuli is in Nairobi Hospital with related complications, the inequity of it would be endless. He gets to fly to a Nairobi hospital, while those who listened to him stay home inhaling eucalyptus steam & hanging on to prayers. Still, wish him recovery,” said Charles Onyango- Obbo, a Ugandan author, journalist and editor.