GABORONE, Botswana — Health experts in Africa have praised the COVAX Facility as a solution for ensuring that the continent has prompt access to an affordable vaccine for COVID-19 — but concerns surrounding gaps in funding and the continent’s immunization needs have experts looking at alternative ways of securing vaccine doses.
While African countries should be able to access at least 220 million doses of vaccine through COVAX, Dr. John Nkengasong, director of the Africa Centres for Disease Control and Prevention, pointed out that this allocation is not nearly enough for a continent with a population of more than 1.3 billion.
“Africa is not doing enough on the COVID vaccine … we just wait for the world to do it and then hopefully we bump into it and hopefully things work.”— Joachim Osur, technical director of programs, Amref Health Africa
“As a continent, we have said that … to be safe we will need 60% of our population vaccinated as we believe that a level of vaccination from 40% to 60% will enable us to have herd immunity of the population,” Nkengasong said at a weekly press briefing.
The COVAX Advance Market Commitment — the financing instrument that supports the participation of low- and middle-income economies in the facility — also needs to raise $2 billion by the end of the year to reserve doses of vaccines for these countries. The AMC will need another $5 billion to purchase the vaccines in 2021. The latest figures show that it has secured an estimated $1.8 billion from donors, raising concerns about whether it will be able to raise the full amount needed by next year.
In order to counter the shortcomings of the facility, African experts say that countries need to be proactive in reaching out to vaccine manufacturers and start engaging in direct negotiations.
Through COVAX, Africa is supposed to gain the buying power to make such negotiations easier.
Dr. Richard Mihigo, program manager for immunization and vaccine development for WHO Africa, explained that the countries that have signed up to the COVAX Facility represent close to 65% of the global population. With these numbers and their buying power, he believes the facility will be able to ensure that the minimum supply of the vaccine is available to participating countries at a reasonable price.
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However, major economies such as Russia and the U.S. have refused to join the facility and have instead chosen to negotiate directly with drug manufacturers, and some high-income countries that have signed commitment agreements with COVAX have already secured vaccine doses through direct negotiations.
Oxfam estimates that wealthy nations that represent just 13% of the world’s population have already secured 51% of the promised doses of leading COVID-19 vaccine candidates and that nearly two-thirds, 61%, of the world’s population will not have a vaccine until at least 2022.
Africa CDC and the African Union Commission are also looking at making their own bilateral deals to cover the gap in the immunization target.
“We are also in discussion with private manufacturers … to say what if we came to the table with money, how would we get enough vaccines to cover the gap,” Nkangasong said.
Joachim Osur, technical director of programs at Amref Health Africa, believes that Africa has shown a lack of initiative in securing vaccines.
“Africa is not doing enough on the COVID vaccine … we just wait for the world to do it and then hopefully we bump into it and hopefully things work. I think that lack of proactivity and preparedness is our main problem,” he said.
For Osur, the solution lies in Africa being part of the vaccine development and manufacturing process.
“No one is going out proactively to look for the companies that are working on vaccines and offering to be part of the process. If you are part of the development process you become a priority when the vaccine is developed,” he said.
However, the South African chapter of the Vaccine Advocacy Resource Group, which advocates for equitable access to a COVID-19 vaccine, does not believe that participation will automatically translate to access.
“We are also under no illusion of the power, the influence, the agenda-setting, and the politics at play that ultimately will decide who lives and who dies. South Africa’s increased manufacturing capacity of COVID-19 vaccines will not automatically translate into increased access, neither will our ‘leadership’ role in the vaccine space,” it said in a statement.