The recent call by Africa CDC director Dr. John Nkengasong, for donations of COVID-19 vaccines with a longer shelf-life of three to six months has perhaps lifted the lid on the other side of COVID-19 vaccine inequity in Africa. With about 2.8 million doses of vaccine reportedly expired, roughly 0.5 percent of the 572 million doses delivered to date on the continent, experts argue that this is no longer donation but a clear case of “dumping”.
At a time when the world is grappling with a new sub-variant (BA.2) of the Omicron variant of Covid-19 that can escape RT-PCR tests and has so far spread to 43 countries globally, it is important to consider the efficacy of the value chain for the vaccine uptake.
In January this year, Uganda announced its plans to destroy over 400,000 doses of expired Covid-19 vaccines despite less than half of the targeted 22 million of her people being vaccinated. Nigeria also reportedly destroyed 1 million doses of expired vaccines in December last year. This situation is further compounded by a United Nations Children’s Fund statement indicating that developing countries turned down more than 100 million doses of COVID-19 vaccines that were about to expire by the end of last year and in addition, around 15 million doses of vaccines donated by the European Union were also turned down by poor countries in October and November 2021.
The problem appears to emanate from rushed political decisions by rich countries to donate previously hoarded vaccines to developing countries when they are about to go bad. The donation rush is done without considering the distribution and cold chain challenges many African countries are facing, which make it impossible to get the vaccine in the arms of her people in time. This is a disturbing pattern that reinforces the gross injustice that continues to plague the COVID-19 vaccine roll-out globally.
According to several media reports, the cost of vaccines also continues to push many developing countries to the end of the COVID-19 vaccination queue with most low-income nations not even lining up. This is even as the so-called ‘level-playing field’ of the market fails to deliver for African countries with less vaccinated poor nations unable to afford fiscal efforts to provide relief or stimulate recovery.
An announcement by the United Kingdom on December 2 ordering an additional 114 million COVID vaccine doses – despite around 85% of its adult population being fully vaccinated – prompted caution by the World Health Organization (WHO) Director-General (DG) Dr Tedros Adhanom Ghebreyesus. Dr. Tedros in January warned that the world would be morally failing the lives and livelihoods of the world’s poorest countries considering that just 6 % of Africa’s 1.2 billion people had received two doses of the shot.
With the emergence of the need for booster shots as new variants and sub-variants of Coronavirus continue to show up because of mutations, the richer nations continue to have no regard for science and without any iota of doubt they have settled for profit over science and safeguarding all human life. Why vaccines often do not arrive in Africa in good time and only end up in the continent when their expiry date is almost due beats logic.
Rich nations buy up more vaccines for third shots, vaccination even as inequities are becoming starker. This means that buying up hundreds of millions of doses is in reality penalizing poorer countries that are already doubly deprived as by the end of the year they collectively likely had about 1.2 billion extra doses according to The Telegraph.
Rich countries protecting their own citizens will not prevent new mutants from emerging. In fact, furtherance of any model that promotes vaccine inequity will not only worsen the existing crisis but also stand on the way to ending this pandemic and recovering from COVID-19 sooner. Economically, epidemiologically and morally, it is in all countries’ best interest to use the latest available data to make lifesaving vaccines available to all and within periods commensurate wind individual country roll-out programmes to avoid battling with expiry dates which lead to wastage of vaccines. There is no viable alternative to this approach, and if wealthy countries continue to hoard vaccines or send nearly expired doses to Africa, the cycle of deadly waves and variants will continue for a long time.
By Dr Nduduzo Dube, Director of Quality Management and Clinical Operations – AIDS Healthcare Foundation Africa Bureau.
