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COVID’s Aftershocks: 86% of COVID cases undetected

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, and read on for Uganda’s record-breaking school closure, a South African company working to replicate Moderna’s vaccine, and details of Pfizer’s leaked contracts.

Top news

See no evil: 6 in 7 COVID-19 cases in Africa go undetected, according to the WHO. That means the continent’s COVID-19 cases could be as high as 59 million, far above the 8 million reported cases. This news also complicates otherwise encouraging reports of decreasing case loads. Senegal, for example, reported zero new cases on 20 October, the first time since the pandemic began. To address the disparity, the WHO Regional Office for Africa announced a new initiative to increase COVID-19 screening in eight countries, aiming to reach over 7 million people with rapid diagnostic tests over the next 12 months.

School’s out… forever? Uganda’s schools have been fully closed for nearly two years, the longest in the world. Despite efforts to use television and radio to reach students, experts warn that Uganda’s 15 million students face a “shadow crisis” the longer schools are shuttered. This is especially true for children with disabilities. Universities are set to re-open in November, and primary and secondary schools in January 2022, provided that teachers, support staff, and students over 18 are fully vaccinated. Just 1% of Uganda is fully vaccinated, despite surging demand.

Kingmaker: A consumer watchdog group launched a report this week that accused Pfizer of “consistently place[ing] Pfizer’s interests before public health imperatives.” The report is based on a number of leaked, unredacted confidential contracts brokered with national governments. The leaks showed language to block donations of their doses (!!!) and Pfizer’s ability to change delivery schedules and demand public assets as collateral. The revelations expose the pharmaceutical industry’s capacity to play kingmaker with contracts that have life or death consequences.

Ctrl copy: While Moderna deflects increasing appeals to share its vaccine recipe, the WHO hired an African start-up to crack it themselves. The $100 million investment aims to make a COVID-19 vaccine as close as possible — if not better than — Moderna’s version. The company is aiming to make a clone that is stable at higher temperatures and thus better-suited to last-mile delivery in remote areas.

And another shot: A new vaccine that uses inactivated Sars-CoV-2 virus, as opposed to mRNA technology, could be even more effective than the Oxford/AstraZeneca vaccine. Manufactured by the French company Valneva, it is a whole-virus vaccine, which could enable it to protect against variants. The vaccine can be stored in a standard refrigerator, which would make it easier for low-income countries to use.

Approval denied: South Africa’s drugs regulator is not approving the emergency use application for the Sputnik V shot over concerns about potential risks for those with HIV. Some studies suggest that administering vaccines using the Adenovirus Type 5 vector (which Sputnik V does) can lead to increased susceptibility to HIV, a major concern given that South Africa has one of the world’s highest HIV burdens.

Economic self-harm: A coalition of more than 350 trade unions around the world are calling for politicians to waive the patents on COVID vaccines.”Failing to do so would compound supply chain crises and inflict ‘economic self-harm,’” they argue. They warn that the global transport system — already under duress — could collapse if more workers aren’t vaccinated. Currently only 31% of the world’s 1.4 million seafarers are vaccinated. 90% of all goods travel by sea. The cost of shipping containers have increased 10-fold, and experts warn that supply chain challenges could persist for two years.

Boosting an apartheid: Kenyan President Uhuru Kenyatta is the latest to accuse rich countries of “vaccine apartheid” for hoarding vaccines and administering booster shots while most poor countries have yet to vaccinate their most vulnerable. In the past week, the US — which further expanded booster eligibility — has given more than 2 million booster shots. In that same period, Zambia gave 47,000 first or second doses. The US has partially or fully vaccinated more than 65% of its population, compared to just 1.6% in Zambia. The EU announced it has exported over 1 billion vaccine doses, but most have gone to well-off countries.

Hoarder do over? Merck’s oral antiviral medication, molnupiravir, could be a significant development in the treatment of COVID-19, especially in poor countries with low vaccine access. The drug can be shipped and stored at room temperature, making it easier to transport to remote places. Some experts are voicing concerns that rich countries will buy up supply once the drug is approved, similar to what’s happened with COVID-19 vaccines. Merck insists that it will make the drug available to low-income countries; it may be part of a newly announced WHO deal to secure inexpensive antiviral drugs, and Merck is positioning generic manufacturers to sell it at a steep discount. The Gates Foundation said it will invest $120 million to increase access to the drug in lower-income countries.

Heir apparent: A descendent of the Delta COVID strain could be 15% more transmissible than the original.If true, that makes AY.4.2 the most infectious COVID strain to date. While it may be the latest, it likely won’t be the last. Scientists continue to warn that COVID has plenty of room to evolve. As one expert noted, “We’d have to be idiots to think the virus is done with us, and it will continue to evolve.”

Pay and price hikes: The economic recovery in rich countries is currently experiencing dramatically increased prices and wages. Supply chain bottlenecks and rising energy prices are major contributors to price inflation. The cause of increased wages have a less discernible cause. It could be related to fear of the virus in the workplace, worker demands for higher wages, or a reordering in the labor market as people switch professions.

Speculation crisis? African countries are hurtling toward a debt crisis, and it could be the source of the next global economic emergency. This comes at a time when the IMF is warning that markets are particularly vulnerable. That’s because trillions of dollars of emergency government financial support in rich countries has fueled an extended period of investor speculation. Combined with rising virus infections, global supply chain concerns, and continued uncertainty about the economic recovery in emerging markets, this added speculation could trigger market instability.

Trust factor: G20 ministers have thrown their weight behind a proposed IMF trust that would provide “affordable long-term financing” to low- and middle-income countries. The Resilience and Sustainability Trust could be a vehicle for rich countries to reallocate their portion of Special Drawing Rights (SDRs) to middle- and low-income countries that need this windfall to finance their recoveries. Cheers to that.

The numbers

  • 1.7 million: The number of COVID-19 tests that Botswana has conducted, placing it 92nd in the world, and well behind European countries of similar sizes.
  • 100%: The estimated percent increase in poaching in Uganda last year. Animal conservation efforts in Africa, primarily funded through ecotourism, took a major hit due to COVID-19 closures.

More reads

  • ONE’s Executive Director for Africa Edwin Ikhuoria argues that “there is one world and two pandemics” as he urges rich countries to support Africa’s economic recovery.
  • The Accountability Music Awards recognize African musicians and artists who are challenging corruption on the continent. Read about the awards and get ready to vote on October 30.
  • Multilateral failures to respond to the COVID pandemic mirror some challenges in combating climate change. A new report warns that Africa’s glaciers are on the verge of disappearing, driven by outsized impacts of climate change on the continent.
  • As much as half of all cash in circulation is being used by criminals, according to this fascinating piece by Oliver Bullough.

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