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COVID’s Aftershocks: Clinical trials in Africa, COP26, and Ethiopia


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Dose deployment: Johnson & Johnson will make its vaccines available for NGOs to deploy in conflict settings, waiving liability restrictions that have previously prevented nongovernmental actors from administering them. The US government will also donate an additional 1.5 million J&J doses to people in conflict settings. Significant hurdles remain in actually deploying vaccines in conflict zones, including security risks for humanitarian workers and establishing networks to share inoculation site information.

Ignoble Prize: Diplomats are desperately trying to avert an all-out civil war in Ethiopia. At least 16 UN workers and their families have been detained in the country, days after Nobel Prize-winning Prime Minister Abiy Ahmed encouraged citizens to take up arms and “bury the terrorist TPLF.” Arbitrary detentions of ethnic Tigrayans have spiked since Abiy declared a state of emergency; authorities can hold anyone suspected of supporting “terrorist groups” without a warrant. Ethiopia has the highest COVID caseload in Eastern Africa, and just 1.17% of the population is fully vaccinated.

Arms race: Meanwhile, the Chinese Defense Ministry donated 300,000 COVID-19 vaccines to the Ethiopian government’s troops. It’s one of more than 30 deliveries to 24 state militaries, most of which are in countries with strategic importance for President Xi Jinping’s Belt and Road infrastructure initiative. No other country has donated vaccines directly to other militaries on this scale. The donations coincide with other military aid, including medical training, scholarships, personal protective equipment, and ventilators.

Rich countries first: The UN climate agency published the first draft of the COP26 deal, which will be finalized on Friday. The agreement calls for countries to phase out coal and fossil fuel subsidies and nods to developing countries’ needs for increased financial resources to combat climate change. But it doesn’t include “clear and unambiguous commitments” that will hold leaders’ feet to the fire on 2030 emission reduction targets. Sub-Saharan Africa contributes just 3% of global greenhouse gas emissions, so when it comes to fossil fuel cuts, it’s the first time we’ll endorse rich countries going first.

Esprit de corps: US Secretary of State Antony Blinken announced a new Global COVID Corps, in which private companies will take up the mantle (pro bono) to ease some tarmac-to-arms vaccination hurdles in developing countries. This includes sharing expertise on supply chain management and optimizing vaccine sites. Moderna has faced a brutal learning curve in global logistics that could be particularly insightful if they participate.

Trials on trial: Just 150 of the 2,000 clinical trials for COVID treatments are in Africa, which significantly limits the continent’s access to approved medicines. Perversely, Africa’s low vaccination rate (6.3%) demands “effective therapeutics for COVID-19 as an option more than any other continent.” Strict regulatory regimes, logistical issues, and a dearth of both adequate technical supplies and willing participants make it more complicated to run clinical trials in low-income countries.

Prescription for disaster: Traditional Chinese Medicine (TCM) is having a renaissance in Africa amid the pandemic, which could be a “prescription for disaster” for endangered species like leopards, pangolins, and rhinoceroses. Many remedies used in TCM are plant-based, but demand for products like rhinoceros horns has long made the commodity more valuable than gold or heroin by weight, despite having no proven medicinal value for humans. South Africa, Cameroon, Tanzania, and Togo signed agreements with China to promote TCM, and South Africa and Namibia have recognized it in their public health systems.

Recovery dividends: Kenya’s largest bank launched a $4.48 billion loan program to help 5 million small and medium-sized businesses recover from the pandemic. Experts argue that loans geared toward tech investments for Kenya’s farmers, informal businesses, and gig workers will have the biggest recovery dividends. Nearly 1 in 30 Kenyans lost their livelihoods in the first few months of the pandemic.

Testing, 1-2-3: Africa CDC is launching a “vast campaign of extensive testing” that will deploy 200,000 COVID tests across the continent in the next six months. They aim to close the knowledge gap on infection hotspots during a relative lull in infections, as many countries recover from a third wave and brace for their fourth. Fewer than 1 COVID test is administered per 1,000 people daily in most of Africa. Digital self-reporting tools, like those used successfully in Ghana, can help fill in the blanks where tests aren’t available.

Bracing for the wave: South Africa officials are clamoring to increase their vaccination rate ahead of an anticipated fourth wave next month. Twenty-one percent of the country is fully vaccinated and 65% of adults 60+ have received at least one dose, which should ease pressures on the healthcare system. The fourth wave should be less fatal than the third, and even a 50% reduction would result in 55,000 official deaths. Seven African countries, including Kenya, Somalia, and Mauritius, are already in the throes of a fourth wave.

Blood money: The tobacco industry contributed $300,000 to Zambia’s COVID relief efforts in exchange for tax benefits, according to a new report. Experts argue that this is “blood money”: Taxation of tobacco products is typically a steady source of revenue, and it is the most effective way to reduce use. Prior to the pandemic, tobacco use accounted for 20% of male deaths worldwide and was gaining ground in sub-Saharan Africa. Mid-pandemic, the industry also sabotaged control legislation in Tanzania, and forged new trade agreements in Ethiopia.

The numbers

  • Around 200,000 people in West and Central Africa became newly infected with HIV last year, as health systems were brought to their knees by the pandemic.
  • Just 6.8% of studies on the knock-on health impacts of the pandemic covered low-income countries, despite evidence that they had the most significant service delivery disruptions.
  • 4% of low-income countries are on track to vaccinate 40% of their populations by the end of the year. Leading international health bodies created a comprehensive tracker to measure such global disparities.

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