Last month, in my role as leader of the Africa Centers for Disease Control and Prevention, I asked that donations of Covid-19 vaccines to Africa be momentarily delayed until the third and fourth quarter of the year. At the moment, Africa’s most pressing need is administering the vaccines we have to willing people. Every country is unique in what it needs to fight Covid-19, but logistical challenges and issues of vaccine hesitancy — similar to those seen in other places around the world — have momentarily outstripped shortages for the continent. We do not want vaccines to go to waste. Now that supply is not the primary challenge, we need to focus on better delivery.
Africa has a robust plan to tackle Covid-19; long-awaited donations of vaccines are critical to that goal. Just because right now the greatest challenge is vaccine demand and delivery, as opposed to supply, does not mean there are not important ways for the global community to assist our efforts to protect Africans. But we need the world to better understand Africa’s health needs.
Many countries in the developed world are rapidly lifting restrictions like mask mandates and vaccine passports. There seems to be optimism that for many countries, 2022 will be the year that the emergency phase of the pandemic will end. But leaders must remain cautious and humble. There’s still much work to be done before this optimism is shared by everyone. The push toward normalcy should be accompanied by concerted efforts to achieve universally high rates of vaccination.
Only about 15 percent of the population in Africa has been fully vaccinated. Because of this, the trajectory of the pandemic on the continent remains unpredictable and uncertain. With low vaccination rates, we run the risk of being hit by new variants that may severely impact the effectiveness of vaccines globally and limit people’s lives once again.
African countries have been remarkably resilient in fighting the pandemic so far, and we are working on a strategy to end the Covid emergency in 2022 as well. On Feb. 5, President Cyril Ramaphosa of South Africa, the leader of the African Union’s Covid-19 response, presented a comprehensive report at the A.U. Summit of heads of state and governments.
As part of this plan, which was unanimously endorsed, governments must commit to achieving more than 70 percent vaccination rates for their countries by the end of 2022. Only about 14 of the 55 A.U. member states have so far vaccinated more than 40 percent of their eligible populations.
For vaccination campaigns to be successful, vaccine donation must be closely coordinated with either the COVAX and African Vaccine Acquisition Task Team initiatives, to ensure that countries in Africa are not overwhelmed. Too many doses without the infrastructure or coordination to distribute them could lead to vaccines expiring. Because it is very likely that repeated vaccination and boosting will be required, African countries need to be able to accelerate and strengthen their own vaccine manufacturing capacity, and need partnerships with vaccine makers.
Africa C.D.C. recently announced the launch of the Partnership for Africa Vaccine Manufacturing, which provides a framework for how Africa can manufacture 60 percent of its vaccines locally by 2040. There is also an urgent need to reshape the vaccine purchasing market to ensure that vaccines produced in Africa will be purchased and distributed across the continent and can be exported elsewhere, too.
As more vaccines continue to arrive, country leaders in Africa must now turn to vaccine delivery — getting shots into arms. This will require countries to decentralize vaccination centers, whether by employing mobile vaccination units for mass vaccination efforts, engaging faith-based organizations to encourage congregations and communities to get vaccinated, allowing vaccination centers to operate during weekends so people busy during the week can get vaccinated, or encouraging young people to get vaccinated — some estimates suggest about 60 percent of the continent’s population is under 25. In some African countries, such as Uganda, mass vaccination campaigns at places like bars have been shown to be effective in improving vaccine uptake.
Countries should also leverage existing global health infrastructure that has been used effectively to respond to H.I.V./AIDS, including ways of managing drug supply chains and virus surveillance. There also must be a specific focus on making sure people with H.I.V./AIDS can get vaccinated, as people who are immunocompromised may have a harder time fighting off the virus, which can increase the risk of new variants.
Another goal is to scale up the availability of rapid, at-home antigen tests so that at least 200 million people will have access to these tests by the end of this year. Africa also needs equitable access to drugs that treat Covid-19, so that people who test positive can quickly take drugs early on, when they are most effective. African countries can model this after successful strategies to test for and quickly treat H.I.V. To manage treatment of Covid, we need partnerships with the pharmaceutical companies that make these drugs to ensure that the medications are made and sold inexpensively in African countries.
Surveillance and monitoring of variants remains crucial, as is promoting measures like mask-wearing when cases are high. The continent must continue to strengthen its routine surveillance systems to rapidly follow and respond to the evolution of the coronavirus and its impact on communities. This is how scientists in South Africa and Botswana were able to rapidly warn the world about Omicron. It’s also becoming increasingly important to do population antibody testing and surveillance to understand what proportion of people have some immunity from vaccination and prior infections and what the impact of new variants might be because of that.
Finally, in many households in Africa, the pandemic has created a perfect storm for mental health, stress, economic uncertainty and social isolation. These conditions have given rise to domestic abuse of family members or partners as well as rising alcohol and substance use. Addressing the consequences of lockdowns, through efforts like establishing local counseling services, is urgent for Africa.
The global community must act collectively and decisively to control the Covid-19 pandemic in Africa. Otherwise, the rising sense of optimism that people around the world feel as they return to normal may be compromised by the emergence of new variants in other parts of the world with limited vaccination. This pandemic has shown that we are more connected and vulnerable than many of us believed, and that the risk of allowing health inequities to persist is too great. We must come out of this pandemic together, for the interest of our common humanity.
John Nkengasong is the director of the Africa Centers for Disease Control and Prevention, an institution of the African Union.
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