Covid-19: how to explain such a low vaccination rate in Africa?

Covid 19 how to explain such a low vaccination rate in

If the Covid-19 can now seem to belong to the past with the lifting of the majority of health restrictions, the epidemic remains present in France but also abroad, particularly in countries with low vaccination rates. On the African continent, cases are on the rise again in South Africa, which is experiencing a significant rebound in contamination. According to data from the National Institute of Communicable Diseases (NICD), 4,631 cases of contamination were recorded in the last 24 hours on Friday April 22. The day before, the institute had reported 4,406 new cases.

Friday’s figures are the highest recorded in nearly three months in the country and they mark a sharp rise from the 1,300 new cases on average recorded last week. This increase was described Friday as “worrying” by the Minister of Health Joe Phaahla.

The continent has very low vaccination coverage with a rate of 16%, according to last digits dated Friday, April 22. This is very far from the 80% of fully vaccinated people reached in several Western countries. However, more than two-thirds of Africans have been infected with Covid-19 since the start of the pandemic, i.e. 97 times more than the confirmed cases officially declared, according to a WHO study.

Expired doses too quickly

This low vaccination rate is due to various reasons. The first is the lack of vaccines. Despite an overproduction of doses, the world population is still very unevenly vaccinated, with doses going primarily to Western countries that have the means to buy them. On average, 42% of people in the 92 poor countries of the Gavi Global Alliance have received their primary Covid vaccination, compared to 58% worldwide.

  The rate of inhabitants vaccinated in Europe compared to Africa as of April 22, 2022

The rate of inhabitants vaccinated in Europe compared to Africa as of April 22, 2022

Screenshot Our World In Data

The Covax mechanism, a public-private partnership managed by the WHO, which aims to guarantee equal access to vaccines, has so far delivered 1.4 billion doses in all to 145 countries. This is less than expected: he initially expected 2 billion at the end of 2021. In addition, Covax claims to have access to enough doses to vaccinate around 45% of the population of the 92 countries benefiting from donations. But 25 of them do not have the infrastructure to conduct an effective vaccination campaign.

This is particularly the case in Africa. “There are problems of costs, infrastructure, transport and storage while vaccines are fragile products”, explains to L’Express Michèle Legeas, teacher at the school of advanced studies in public health (EHESP) , specialist in the analysis and management of health risk situations. “You need to have the logistics of the cold chain, the trucks to transport, the lists of vulnerable people, to organize a vaccination campaign …”, adds to L’Express Anne Sénéquier, doctor, researcher, co-director of health observatory at the Institute of International and Strategic Relations (IRIS) and author of The geopolitics, simply (Eyrolles).

A problem all the more important as certain doses arrived very late, sometimes a few weeks before being expired. Several countries such as Nigeria, South Sudan, Malawi or Kenya were then forced to destroy doses of AstraZeneca received from Covax. “It left us with very little time, just a few weeks, to use them, after deducting the time needed for transportation, clearing, distribution and delivery to users,” explains the BBC Osagie Ehanire, Minister of Health of Nigeria. “The validity period of the vaccine is quite short, and when we make donations to other countries, the expiry date has sometimes already passed”, confirms Anne Sénéquier.

According to the doctor and researcher, “bilateral donations have also focused on international relations rather than on preparing the health system so that it can carry out a real vaccination campaign. Aid is always subject to conditions of from the West,” she notes. This contributes to a lack of interest on the part of the population for this vaccine.

A distrust of the population

As Anne Sénéquier reminds us, “on all continents, there is distrust of vaccines. In Africa, it comes in particular from vaccine inequity, with Western countries having reserved the doses. Covax could not be completely effective for lack of vaccines”, according to the specialist. She recalls that at a time when in France and in Europe, the product of the laboratory AstraZeneca was becoming the unloved anti-Covid vaccines, it is precisely these doses that were sent to Africa. “When the European population favored the Pfizer, there was an echo in the French-speaking media in Africa and the message that ultimately gets through is that we are giving a vaccine that we no longer want, which has developed a anti-Western sentiment of the countries of the south mainly”, she adds.

In addition, there are many health problems that are not related to Covid-19. Malaria, polio, HIV, malnutrition are issues that affect the daily lives of Africans who, moreover, have not “experienced the epidemic explosion of Covid-19 that we have seen in Europe, notes Michèle Legeas. It is a disease that does not necessarily appear to be a priority for the population”. The young population with fewer comorbidities in Africa has indeed been affected less severely than Europe or other continents in terms of severe forms and deaths.

The number of Covid-19 deaths in Europe and Africa

The number of Covid-19 deaths in Europe and Africa

Screenshot Our World In Data

Covid-19 has become the priority of health authorities who have put a stop to other vaccine campaigns, which are nevertheless essential. “Funding has been redirected to the fight against Covid with the abandonment of vaccination against polio, illustrates Anne Sénéquier. There is a real impact from the fact that all the other health problems have been abandoned, the population wonders why we vaccinate against a disease from which we do not die when there is a real need for the rest”. Between the lack of confidence, the absence of available doses, “it’s a multitude of little things that went wrong that explain this low vaccination rate”, adds the doctor researcher.

Disparities between countries

It is always difficult to speak of Africa as a single block. Many disparities exist between the States regarding anti-Covid vaccination. “There are more or less low-income countries with more or less good health systems,” recalls Michèle Legeas. Maghreb countries such as Tunisia and Morocco show rates well above the average for the continent with respectively 53.24% and 62.59% of the population having followed the initial vaccination protocol against Covid-19.

South Africa is also more vaccinated, as the country was heavily affected by the epidemic with the Delta and Omicron variants. “When you have been personally impacted, you feel more concerned so the vaccination rate is higher”, analyzes Anne Sénéquier. She also points out that the country is also better endowed in the pharmaceutical industry compared to other sub-Saharan countries. Additionally, South Africa has launched labs to manufacture vaccines on the continent and sealed an agreement with German company BioNTech to manufacture its messenger RNA vaccine locally, such as Rwanda and Senegal, notes The world.

To view the map, Click here

In sub-Saharan Africa, countries “have very bankrupt health systems with drug stock-outs and not the human resources they need”, adds Anne Sénéquier. In addition, the multiple health restrictions applied in Europe have also played a role in the daily lives of these inhabitants: they are indeed economically very dependent on the diaspora who live abroad and who were stuck by the confinements. This economic impact has pushed health into the background of priorities. “Some populations are in a survival mode so a vaccination, which is not even available, is not the priority”, slice Anne Sénéquier.

However, the issue of vaccination in Africa is not only a problem for this continent. The active circulation of the virus in some African countries can lead to the development of new variants that jeopardize the efforts of all countries in the world to overcome the pandemic. To meet the challenge of vaccinating the population of African countries “we will have to do something other than simply deliver doses, warns Anne Sénéquier. “We will have to generate people’s interest in vaccination with local health, on a case-by-case basis. , but also available vaccines accompanied by a vaccination campaign via the Covax system supported by other southern countries and not by the West, she explains. Because telling them to vaccinate to avoid a new variant in order to protect the West, it will not work.


lep-life-health-03