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COVID’s Aftershocks: A COVID-fueled debt crisis


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Face saving or life-saving?: BioNTech announced the launch of not-for-profit (aka at-cost), movable vaccine factories to scale up mRNA vaccine production in Africa and other regions with low vaccine rates. The modules, enclosed in shipping containers and described as a “turnkey solution,” are capable of producing up to 50 million vaccines per year. The first units will be shipped to Rwanda and Senegal (and possibly South Africa), with a fill-and-finish role for Ghana. Ghana’s President Nana Akufo-Addo welcomed the news, thanking “BioNTech and the kENUP Foundation for their contribution” to helping Africa achieve “self-reliance.” That praise is… strange: just last week documents surfaced showing that kENUP, a consultancy hired by BioNTech, had been actively working to undermine a WHO-led effort to produce mRNA vaccines on the continent.

Patently concerning: Staying “on brand” with other pharmaceutical companies’ efforts to stymie Africa’s vaccine self-reliance, Moderna has filed numerous patents in South Africa that could undermine domestic vaccine production. Moderna promised not to enforce patents for its mRNA COVID vaccine during the pandemic (while unhelpfully not sharing its IP or technology). The recent filings raise concerns that Moderna may be preparing to enforce its patents after all. The resulting uncertainty could cast a chill on efforts to replicate and mass produce Moderna’s mRNA vaccine. Notably, Moderna’s filings come just weeks after South African scientists successfully reverse engineered the company’s COVID vaccine. Coincidence?

Pivotal moment: It looks like a TRIPS waiver for COVID vaccines will be the elephant in the room at this week’s AU-EU Summit. The EU remains steadfastly opposed to a waiver (though France is supportive). In ONE’s panel discussion hosted by Politico this week, an EU Commission representative faced tough questions over the EU’s opposition. Will the marked messages of partnership and interdependence before the summit lead both sides to realize they are stronger together? We’ll be watching.

Starvflation: Soaring food prices driven by rampant inflation is leading to food insecurity, emigration, and unrest in a number of African countries. The UN estimates that 120 million people across the continent face a food crisis. Prices have risen by one-third in Uganda, which has seen 100,000 people emigrate to the Middle East in the past year in search of better opportunities. In Malawi, rising costs have led to protests and more than 1,000 arrests. Inflation rates of 300% in Sudan have sparked anti-government blockades. Closed borders, COVID-19 protection measures, and increases in global food prices are leading causes of the food crisis.

A pandemic by any other name: Analysts are warning that Ghana, Kenya, Angola, Ethiopia, and Zambia will face debt risks over the next two years as the long-term impacts of COVID-19 begin to manifest. With China having pulled back its financial support to the continent, countries may need to look for other solutions. Ghana’s finance minister said Ghana will not ask for IMF assistance, perhaps out of concern over the fiscal austerity measures that commonly accompany such support. So while the WHO has declared the beginning of the end for the pandemic, this “end” means something different depending on your income level. Economic growth in advanced economies is now better than pre-pandemic levels, while sub-Saharan Africa has yet to rebound.

Longue durée: While some world leaders seem keen to move on from COVID-19, we’re still learning new things about its long-term impacts. Last year, scientists began raising awareness of COVID’s impacts on the brain. Last week, a large study revealed that COVID-19 survivors are experiencing higher rates of heart disease, even in those who didn’t require hospitalization. 20 different cardiovascular issues were identified in the “most impressive Long Covid paper we have seen to date.” This week, a separate study concluded that having COVID-19 significantly increased the risk of developing mental health issues. As many countries ease restrictions even as scientists warn that the next variant could be more deadly, the pandemic’s true toll is only beginning to come into focus.

Balance of power: The EU has announced a €150 billion ($170.2 billion) package to support investments in key sectors in Africa. The move is seen as an effort to compete with China, whose development banks provided 2.5 times more financial support ($23 billion) to Africa between 2007 and 2020 than all other countries combined. Meanwhile, the African Development Bank remains the continent’s largest multilateral investor, and the International Finance Corporation is increasing its investments to $10 billion a year.

Last mile challenge: Africa’s low vaccination rates reflect both supply — and increasingly — distribution challenges. Supply logistics in many African countries are well behind most of the world, and major differences in infrastructural capacity between countries influences their ability to get shots in arms. South Africa is a top performer in both vaccine administration and transportation logistics, due to its large economy, wide network of health services, sea ports, and connections to major transportation hubs. Meanwhile, Malawi’s poor infrastructure and large rural population have made getting doses into arms a challenge. The country has only administered 67% of the doses it’s received (and just 5% of the country is vaccinated). A US-Africa initiative to harness PEPFAR’s far-reaching networks may help address infrastructure challenges.

Human capital: A fifth wave could hamper recovery in Africa’s tourism sectors. Morocco saw three times fewer tourists in 2021 compared to 2019, and revenues dropped from $8.6 billion to $3.2 billion. In South Africa, a third of travel agents are still operating with reduced staffing, but 60% of those surveyed were optimistic about a return to normal business this year. In Kenya, tourism dropped by 70% – but indigenous people continued their effective stewardship of conservation projects without an influx of tourist-driven cash, a lesson in natural resource preservation.

Resistance movement: Africa accounts for over 90% of the 500,000 annual deaths from malaria, and now scientists warn that the virus is becoming drug-resistant. Some worry that COVID’s impact on resources is hampering efforts to monitor drug-resistant malaria. The available research suggests that antivirals were 10% less effective in Rwanda and 20% less effective in Uganda in eliminating malaria in 2019. While hope lies in new antivirals, they’re at least four years away. A newly developed malaria vaccine is also on the way, just in time for the establishment of the African Medicines Regulator, which received a €100 million injection ahead of the AU-EU Summit. And in other news for progress against pervasive diseases, a woman appears to have been the third person in history cured of HIV.

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