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CWA # 696, 13 March 2022

NIAS Africa Monitor
Africa’s slow COVID vaccination continues. Four reasons why

  Nireekshan Bollimpalli 

Africa's vaccination programme remains slow; it is unlikely to meet its target of vaccinating 70 per cent of the population by June 2022.

The COVID-19 pose immense challenges to Africa. Since its outbreak in February 2020, Africa has witnessed four waves of COVID-19 driven by the emergence of new highly transmissible variants, though not necessarily fatal, than those in the preceding waves. The individual governments' response and capacity to deal with the virus effectively has improved. Intensive Care units have increased across the continent from eight per one million people in 2020 to nearly 20 today. The oxygen-producing capacities have improved, too, thanks to the concerted efforts of the national governments. 

Despite the above progress, Africa's vaccination remains low, resulting in disastrous consequences if not addressed adequately. Africa's fragile and already strained healthcare systems are not ready to face the challenge that resulted in the loss of human lives and economic fallouts, which reversed years of progress that the continent has made in the recent past.

Until March 2022, Africa has received around 1.2 billion doses of vaccines. More than half of them (about 65 per cent) have been facilitated by COVAX, 29 per cent through bilateral deals and goodwill and the rest six per cent through the African union's vaccine acquisitions trust. However, the rate at which people are vaccinated against COVID-19 is disappointingly low in the continent, with only around 12 per cent of the total population fully vaccinated. The average percentage of fully vaccinated people also varies between the countries. It is estimated that eighteen countries have vaccinated less than 10 per cent of their population, and three of them only less than one per cent. Such stark differences in vaccination rates can be observed in the case of Seychelles and Mauritius, who have inoculated 81 and 75 per cent of their populations, respectively (owing to lesser population), while countries like the Democratic Republic of Congo and Burundi have their vaccination rates well below 1 per cent. The differences can also be observed among countries with the same levels of population. For example, while South Africa has fully vaccinated 29per cent of its population (with around 4per cent already receiving the booster dose), Tanzania managed to inoculate only 4per cent of its population. If these present trends of low vaccinations and regional disparities continue, it is improbable to meet the set target of vaccinating 70 per cent of the population by the middle of this year. This could also mean an impending risk from the upcoming variants, which could only be averted if there is a six-fold increase in the vaccination rates across the continent, according to the latest estimation by the World Health Organization. Although the target seems ambitious, it is impractical due to various factors that hinder and continue to affect the vaccination efforts in the continent. 

Four factors hindering Africa's vaccination
Africa's vaccination efforts are hindered by several factors that stand as a roadblock to the continent's fight against the virus. First, the widening supply gaps from various sources to Africa. They have fallen short of their targets, leaving the governments with no choice but to delay their vaccination campaigns. Export restrictions and hoarding by the developed countries are fueling these supply gaps. It is imperative that the partners in the developed world adequately address this issue and ensure timely and reliable delivery of vaccines as Africa is highly dependent on the vaccines coming from across the borders owing to their lack of vaccine manufacturing capabilities. 

Second, Africa's ability to manufacture vaccines. Although efforts are being made by the African Union to scale up the local manufacturing capabilities, this largely depends on how quickly Europe is ready to make investments and support technology transfers to the continent. The recently concluded EU-AU summit had not been a major breakthrough in this context. The European Union's refusal to waive the patent restrictions not only constricts the transfer of relevant technologies to Africa but, in the long run, emerges as a roadblock to the EU-AU relationship. None of the vaccine manufacturing companies approved in the EU agreed to work with the African partners in the manufacturing process. This needs to change for good. A genuine cooperation and partnership relationship must be struck to expand the vaccination coverage and build a healthier world. 

Third, logistical and operational issues contribute to the efforts. A lack of a proper cold chain infrastructure, problems in the logistical departments and corruption cause significant delays in adding costs to imports. Low urbanization levels are adding to the already existing problems. Although the rate of urbanization increased in the past decade or so, large segments of the population still reside in remote areas, making it difficult to administer the doses. Lack of a national government plan, inadequate trained medical staff and digital barriers among the people are the other problems that dampen the pace of vaccination in the continent. 

Fourth, mistrust and vaccine hesitancy is also driving down the demand for vaccines making it difficult to help people realize the public health importance of immunization. 

To conclude, there is still a long way to bring the pandemic to manageable levels in Africa. The lack of urgency and commitment from the developed world to tackle the virus problem in the continent is partly the reason behind the half-hearted efforts from the African countries. Therefore it is imperative now more than ever for a concerted and unified effort from all the relevant parties. Given the continuous emergence of new variants, it is only safe to dedicate the available resources towards containing the virus efficiently. Vaccinations must be ramped up equitably to meet the set targets. 

Achieving 70 per cent immunization by June 2022 is doubtful, considering the low levels of planning and administration. The governments must formulate strategies based on practical realities rather than ambitions. The focus must be on eliminating the domestic bottlenecks that impede the vaccination efforts by devising clear vaccination plans, improving logistics, conducting mass vaccination campaigns, and adequately managing the doses received. All these initiatives could undoubtedly improve vaccine coverage in the continent in the months to come.


About the author
Nireekshan Bollimpalli is a Postgraduate Scholar at Christ (Deemed to be University).

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