A vaccination site in Kigali
Two years since the world fell in the grip of the SARS-CoV-2 pandemic, it is clear that the concept of humanity coming together against the virus, has not come as naturally, as might have been hoped.
Writing in the Manchester Guardian, late last year, former British Prime minister, and now World Health Organisation (WHO) ambassador for global health and financing, Gordon Brown, argued that the new Covid-19 variant, should come as no surprise, given the rich world’s failure to share the vaccines equitably.
Brown reiterated WHO warning that unless all are safe, globally, no one country, or part of the world will be safe. He deplored the rich world’s hoarding of vaccines, while poorer nations remained largely unvaccinated.
With around 2 billion vaccines manufacture every month, there is now manufacturing capacity to satisfy global demand. By the end of last year, at least 12 billion vaccines had already been manufactured, enough to vaccinate the entire world.
Most vaccines however, remained stored in richer nations, which acquired just under 90% of all vaccines manufactured. Much of what was left, after vaccinating their own populations, was kept in storage, with millions of doses having to be destroyed, after it had gone past its use by date.
According to COVAX (Covid-19 Vaccines Global Access) Western nations will destroy 100 million vaccines, as they go past their use by date. Put this against a vaccine rate in low income countries, of 3%-4%, and the picture is of a world barely vaccinated. The wider the virus spreads, the greater the likelihood of new mutations.
But there is some improvement. From a supply of 2-3 million vaccines a week, Africa for instance, can now expect 20 million a week, according to the WHO.
This however, is creating a problem of its own. Many countries complain that too often vaccines are arriving too close to their expiry date, leaving little time to administer them to people.
The result is that poorer nations are themselves now having to destroy vaccines. Nigeria, Africa’s most populous nation, has vaccinated only under 3% of its people, and yet, last December, they destroyed a million vaccines, while the Democratic Republic of Congo (DRC), equally under vaccinated, returned over a million vaccines, that were about to expire.
Nigeria and the DRC are not alone by any means. Nigeria has said it will no longer accept vaccines that are too close to their use by date, a stance supported by the Africa Centre for Disease Control (Africa CDC).
There has been a combined call, from Africa CDC, WHO, and African vaccine Acquisition Trust (AVAT), for better planned, more predictable donations. Their concerns are shared by GAVI, the vaccine alliance, that works to increase immunisation in poorer nations. Together, they suggest that recipient nations should be allowed four weeks to prepare for the arrival of vaccines, which should have a minimum of two months’ shelf life.
And the problem should not be too exaggerated, according to GAVI. Disposal of vaccines beyond their use by date, is not uncommon. Although there are efforts to decrease the rate, 5% is normally regarded as within acceptable limits. Low income nations have had to dispose only 0.2% of what they received. Much less than wealthier nations.
With Africa CDC preparing to help countries with the needed technical support to administer the vaccines more efficiently, including storage capacity, and better communication to lower vaccine hesitancy, even that rate should see a decrease.
Most of the wastage is in Africa, but the continent also has two of the best performers, in Rwanda and Ghana, to offer examples best practice.
Rwanda boasts one of the continent’s most efficient, if not the most efficient universal healthcare system. The organisation emphasises primary healthcare, provided by health centres in every locality, with community health workers ensuring accessibility to services, for every household.
The structure was adapted to meet the demands of fighting the pandemic, enabling vaccines to be administered to people, almost as soon as they are received.
Ghana’s vaccination drive puts it, with Rwanda, alongside countries in the world, with more than a realistic chance, of reaching a vaccination target of 70% of their population.
More than the wastage, therefore, the main problem remains what the WHO dubbed vaccine nationalism, almost as soon as the first vaccines left the production line.
The lesson of Omicron, is to emphasize the no one is safe, until all are safe, message.
In many ways, the world has been lucky with the variant. It may be highly contagious, but it has not been as severe as was feared. The next mutation of the varus could be more deadly, and scientists have made it clear, that the only effective way of combating these mutations, is to vaccinate as much of the world, as possible. For this to happen, wealthy nations must abandon “vaccine nationalism” for vaccine internationalism.
