Covid in Africa

Pat Sidley, IBA Southern Africa CorrespondentTuesday 22 June 2021

When it comes to supplying Covid vaccines, the G7 wealthy nations are long on talk and short on action, leaving populations from poor countries across Africa highly vulnerable.

Warm words and a billion doses of the Covid-19 vaccine. This is what poorer countries, including those from Africa, received at the recent meeting of G7 countries in Cornwall, England. It was neither what they’d wanted nor what they’d asked for.

The figures paint a stark picture of the reality of Covid-19 in Africa, as well as underscoring the urgency of addressing the needs.

The 12 million people who have been fully vaccinated on the continent amount to fewer than one per cent of Africa’s population.

On 17 June, the World Health Organization (WHO) released its latest figures for the continent noting it was in the middle of a third wave. Covid-19 cases grew by 20 per cent week on week. The positive cases grew to over 116,000 in the week ending 13 June. In the previous week there were 91,000 new cases. There are more than five million cases in Africa.

It should be noted that few countries in Africa have good mechanisms in place for accurate counting and these figures are likely to be significantly lower than reality.

While the WHO says the vaccine rollout is picking up speed, the 12 million people who have been fully vaccinated on the continent amount to fewer than one per cent of Africa’s population.

Exacerbating the problem is the fact that, according to the WHO, as many as 23 African countries have used less than half the doses they have received. There could be several reasons for this. One is poor health systems in many countries, another is vaccine hesitancy. It has resulted in thousands of vials of vaccine being destroyed in Malawi. In South Africa, the first batch of the AstraZeneca vaccine was returned and sent to the African Union. While some scientists suggested it should be used anyway, it was decided that the expiry date was too soon and that there was no proof the vaccine was effective against the variant found in South Africa.

Nearly 85 per cent of all vaccine doses globally have been administered in high-and-upper-middle income countries – an average of 68 doses per 100 people. This, notes the WHO, compares with fewer than two doses per 100 people in Africa.

Some countries, like Uganda, have run out of vaccines and Kenya is almost out – and shortages available from global stocks make it unlikely either country will be able to stock up in the immediate future.

Against this backdrop, South Africa’s president Cyril Ramaphosa joined the G7 countries in Cornwall. He was representing the interests of the continent at large.

The wish list he brought with him included urging the countries to support the call for a limited waiver of intellectual property rules under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) at the World Trade Organization (WTO). Just weeks before, he secured agreement from US President Joe Biden and French President Emmanuel Macron, both of whom said they would support the waiver at the WTO. But, it was not taken up by other countries.

Fewer than two per cent of the world’s vaccines have been administered in Africa, according to the WHO. Those who do not want the intellectual property rights of the TRIPS Agreement tampered with point to the fact that it will take three to four years to set up factories and get raw materials to begin manufacturing. South Africa is one of less than a handful of countries that could manufacture vaccines. Other measures asked for, and referred to, in various statements of the G7 leaders included the transfer of technology and general know-how to set up future facilities, not only for vaccines but for treatments for the disease once it has been contracted. Most of this is imported.

While Ramaphosa put a brave face on his accomplishments (or lack thereof) in Cornwall, the consensus was that the outcome was economically, morally and diplomatically bad. That said, none of Africa’s serious Covid-19 problems are simple to solve – even with more vaccines. Andy Gray, a Senior Lecturer in pharmacology at the University of KwaZulu-Natal, raises some of the areas of concern and points to questions that need to be asked.

South Africa is the only country collecting adequate data to measure the spread of Covid-19 and deal with it. In the absence of data across the rest of Africa, Gray questions the widely held view that the continent is seeing fewer cases of Covid-19 than other parts of the world.

Gray questions how accessible Covid-19 testing is to most people in Africa. Very little testing is carried out and where there is some testing, like in Zimbabwe, it is not free.

He asks too about the distribution of vaccines by COVAX, the funding mechanism set up under the WHO to distribute vaccines to low- and middle-income countries. This distribution has stalled, owing in part to the catastrophic pandemic in India, where a large proportion of the Oxford AstraZeneca vaccine is made. COVAX was almost entirely dependent on India for its supplies.

He also asks about the countries that received vaccines and did not use them. The answers to that question raise other issues. For instance, to what extent is there vaccine hesitancy, or is there a lack of competently qualified people to administer vaccines? Gray says there is a history of poor health systems in many African countries.

But, Africa faces many other problems. A recently published article in the Lancet, shows that those with severe Covid-19 are more likely to die in Africa than in other countries, as they don’t receive adequate care. This study also considered the effect of the disease on patients with other conditions including HIV/AIDS, which remains widespread in Africa. The chance of dying from Covid-19 for somebody with HIV/AIDS almost doubles.

If the situation in Africa sounds bleak, that’s because it is. The Economist has pointed out that inoculating roughly 70 per cent of the planet’s population by April 2022 could cost about $50bn. Aside from the many lives saved, the cumulative economic benefit within just three years, due to increased global output, would be $9tn. The cost amounts to just 0.13 per cent of GDP for the G7 – a fifth of the amount its members have pledged to spend each year helping other countries. Meanwhile, Uganda is reported to have run out of oxygen and essential medication. Oxygen is generally in short supply in Africa.

Furthermore, three other countries have suffered the effects of leaders who have had ‘unconventional’ views on Covid-19. Burundi and Tanzania had presidents who did not believe Covid-19 was a threat to their people. Both presidents, who were deeply religious and relied on God to see them through the issues, have died recently but nobody has yet quantified the damage done – figures weren’t kept. The president of Madagascar has come up with an as yet untested concoction made from local herbs, which is being sold in several countries.

For many in South Africa this is all too familiar as, during his tenure as president, Thabo Mbeki doubted the existence of AIDS. He would not allow the importation of antiretroviral medicine for public use and hundreds of thousands of people, many infants, died unnecessarily.

The situation in Africa as compared to other parts of the world has, in the meantime, spawned new phrases such as ‘vaccine apartheid’, referring to the system of enforced segregation that was policy in South Africa until 1994 and which, in the new use of the term, refers to those countries with vaccines as opposed to those without. This goes hand in glove with ‘vaccine nationalism’, with countries hoarding vaccines for their own populations, and ‘vaccine inequity’, referring to the haves and have nots. Such clever use of language is all too easy, as we’ve seen on the part of the G7, where rhetoric abounds while meaningful action appears all too elusive.

Download the IBA Global Insight app

Access expert analysis on international rule of law, business and human rights