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COVID’s Aftershocks: The complexity behind vaccine wastage in Africa

A roundup of the latest news, stats, and analysis of COVID-19’s impact in Africa. View our data tracker and sign up for our weekly newsletter. This week, we’re sharing the latest on Omicron’s antibody evasions, Kenya’s vaccine black market, and the complex factors behind vaccine wastage in Nigeria.

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Vaccine bandits: A black market for vaccines is undermining Kenya’s vaccination campaign, just weeks before a mandate goes into effect. Corrupt officials are diverting vaccines, falsifying records, and smuggling vials (to mostly remote areas) for $30 to $50 each. These vaccine bandits create significant health concerns: the doses are often transported without adequate refrigeration, they risk contamination, and they aren’t being administered by healthcare professionals with proper sanitation or precautions. The Kenyan government offers doses for free to its citizens, but the country’s shortage of vaccines, high demand, and other vaccination hurdles have enabled the illicit market to develop. Just 5.5% of Kenyans are fully vaccinated, and the existence of a thriving vaccine black market further undermines blanket claims about vaccine hesitancy in “Africa” (a continent of 54 countries).

Canary in the contagion: South Africa saw an unprecedented 1,715% increase in COVID-19 cases in two weeks. Children are the second-largest demographic hospitalized. Despite this phenomenon, authorities say there isn’t evidence to suggest younger patients are more vulnerable to Omicron or get more sick from it. Thus far, the rate of severe infections at hospital admission was halved compared to the third wave, and symptoms appear to be less severe overall. Experts are urging caution against overreacting to news (good or bad) of Omicron’s virulence until more research is done. The US and other countries are closely monitoring Omicron data from South Africa for clues on what’s in store for them. A dose of irony, given the crippling travel bans many of those same countries imposed on South Africa in the wake of Omicron’s discovery.

Science friction: An in-depth laboratory report released Tuesday suggests that Omicron is able to elude many of the antibodies from the Pfizer-BioNTech vaccine, though it provides some protection, especially from severe disease. On Wednesday, Pfizer and BioNTech announced that a three-dose course of their vaccine effectively neutralized Omicron in laboratory tests, but that only two doses resulted in significantly lower neutralizing antibody levels. Hours later, South Africa approved the Pfizer-BioNTech booster for those over 18. Omicron’s alarmingly high number of mutations has led virologists to call for better vaccines that are less susceptible to variants.

Vaccine uber: A mobile vaccine clinic in Malawi is expanding access to vaccines and helping overcome hesitancy by meeting people where they are, including at markets and shopping malls. This reduces barriers for those who can’t afford to travel to a clinic, and enables health workers to speak directly with people and dispel misinformation. Malawi is a critical country for targeted interventions, as just 3.16% of the population is fully vaccinated, and it’s one of the few African countries where vaccine acceptance has meaningfully declined over time (to 73.4%, around the same rate as in the US). Health officials in Mozambique are taking a similar mobile delivery approach to increase vaccination rates.

$ is for $upport: The US government is investing $400 million in Global VAX, a new program to bolster low- and middle-income countries’ vaccination campaigns, with an emphasis on sub-Saharan Africa. Global VAX is also aiming to help countries manufacture vaccines locally (notably, no mention of tech transfers). The EU just announced funding for UNICEF, also aimed at vaccination rollout programs. It seems they’re taking notes from the many African leaders who have called for increased rollout support. Hesitancy has received a lot of lip service recently, but many low-income countries simply aren’t equipped to distribute and administer doses they receive on short notice.

Vaccine refuse: Speaking of, the short shelf lives of donated vaccines, as well as limited healthcare infrastructure and investment, contributed to Nigeria’s recent wastage of 1 million doses. Some of those were reportedly delivered to the country with as little as four weeks left until expiry, less than half the amount of time the African Union has requested. Nigeria’s precarious security and health infrastructure mean that health workers in some parts of the country are traveling long distances, risking kidnapping by gang members, and going unpaid to deliver vaccines — incredible dedication. Vaccine wastage is not an African phenomenon: Last January, British officials forecasted 10% vaccine wastage. France reported wastage rates as high as 25% last April, and Germany and Switzerland have similarly struggled to deploy all their doses. The US threw away more than 15 million doses (👀) between March and September, in part due to … (drumroll) … vaccine hesitancy.

IP sharing is caring: The WHO is in talks with Chinese and Indian pharmaceutical companies to share vaccine patents and technologies with C-TAP (the COVID-19 technology access pool). Both countries are key players in the manufacturing game: China is currently the largest vaccine supplier to low- and middle-income countries, and India is one of the world’s largest manufacturers of vaccines. Bharat Biotech is currently negotiating its licensing agreement (the WHO recently approved its Covaxin vaccine for emergency use). Sinopharm and Sinovac have also expressed interest. Good news. But there is evidence that Sinopharm and Sinovac’s doses may not be very effective at preventing transmission, including for new variants like Omicron. Meanwhile, South Africa’s Biovac Institute will kick off its finish-and-fill Pfizer dose manufacturing in early 2022.

Economic contagion: Omicron could limit growth, further worsen inflation, and slow China’s economic engine, jeopardizing the global economic recovery. The aftershocks could be severe: food inflation in sub-Saharan Africa was already 11% before Omicron, nearly double pre-pandemic levels. Further economic disruptions could exacerbate global supply chain problems. On a more positive note, the implementation of the African Continental Free-Trade Area could help the continent counter the pandemic’s economic impacts. That is, “if stronger support measures targeting women, young traders and small businesses are implemented.” Advancing women’s equality could boost Africa’s GDP 10% by 2025. Such measures are urgently needed given that COVID-19 could set the continent’s women and girls back by a generation. Africa literally can’t afford to not cash in on its potential.

MTN’s strong signal: Africa’s largest mobile operator, MTN, will fire employees who refuse to get vaccinated by the beginning of next year. The move signals how the private sector can help fight vaccine hesitancy — assuming that there’s sufficient vaccine supply. Meanwhile, First Capital Bank, based in Malawi and Southern Africa, announced it would give annual bonuses to vaccinated employees.

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