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The coronavirus vaccine has been marketed in many countries, but can it benefit Africa in time?

The coronavirus vaccine has been marketed in many countries, but can it benefit Africa in time?

On June 3, epidemic prevention workers registered arrival passenger information at Serec Kama International Airport in Gaborone, the capital of Botswana. Xinhuanet Picture

Since the outbreak of COVID-19, the cumulative number of confirmed cases and deaths in Africa has exceeded 60,000. This health crisis has a sustained impact on Africa’s economic and social development and endangers Africa’s development gains for many years.

According to the African Economic Outlook 2020 report released by the African Development Bank, the gross domestic product (GDP) of African countries is expected to decline by 1.7% to 3.4% in 2020.

The epidemic also poses greater risks to the public debt of African countries. At the same time, due to the epidemic, the Continental Free Trade Agreement, which was originally scheduled to be officially implemented on July 1 this year, has been postponed to January 2021.

Due to the difficulty of social distancing and the urgent need to recover the economy, the prevention and control measures taken to contain the coronavirus epidemic are unsustainable in many countries and regions of Africa, and effective and affordable vaccines are one of the best opportunities for African countries to emerge from the epidemic in the future.

Recently, the United Kingdom, the United States, Canada and other countries have successively approved large-scale vaccination against the novel coronavirus.

Egypt also received the first Chinese-made coronavirus vaccine on December 10, becoming the first country in Africa to obtain a Chinese vaccine.

Despite the international community’s persistent call for equitable use of the coronavirus vaccine, this competition can be unequal, with some high-income countries already signing priority procurement agreements with pharmaceutical companies to secure future vaccine supplies. 90% of the population of dozens of poor countries may lose the opportunity to get the coronavirus vaccine next year because rich countries hoard far more vaccines than they need.

Ramaphosa, President of South Africa and Chairman-in-Office of the African Union, said that African people should get the vaccine in the first place, just like people in other regions.

In fact, the African Union prepared to formulate Africa’s plan to obtain a coronavirus vaccine as early as June to ensure that African countries do not lag behind. So can the coronavirus vaccine benefit Africa in time?

Join COVAX and look forward to equitable access to vaccines

The African Union, through the African Centers for Disease Control and Prevention (CDC Africa), promotes the development, manufacture, distribution and vaccination of the novel coronavirus vaccine on the continent.

The goal of the African COVID-19 Access Program is to select one or more safe and effective vaccines to reach the goal of covering at least 60% of the African population. Considering that most candidate vaccines require two doses, Africa will need about 1.5 billion doses of safe and effective vaccines. The AU also established the COVID-19 African Vaccine Acquisition Task Team in November.

For African countries, the best opportunity to get a vaccine for COVID-19 is to participate in the COVID-19 Vaccine Implementation Plan (COVAX) jointly sponsored by the World Health Organization (WHO), the Global Alliance for Vaccines and Immunization (GAVI) and the Alliance for Epidemic Prevention and Innovation (CEPI).

The goal of COVAX is to order multiple promising candidates and distribute successful candidate vaccines fairly to prevent individual countries from hoarding vaccines. COVAX aims to produce 2 billion doses of vaccine by the end of 2021 and allocate half of it to low-income countries, including some African countries.

All 54 countries in Africa have joined COVAX.

In addition to 8 countries that have agreed to obtain vaccines through self-financing, 46 low- and middle-income African countries are eligible for the support of the Advance Market Commitment (AMC) mechanism. Economies participating in this mechanism are not required to pay advances and enjoy subsidies from the plan.

Under the COVAX framework this time, government assistance funds (ODA) and charities from many countries have contributed to ensure the basic supply demand for vaccines in the “pre-market commitment economy”.

WHO recommends that after the successful development of the novel coronavirus vaccine, the first phase will distribute a certain dose of vaccine to the participating COVAX countries to reduce the overall risk; in the second stage, considering the threat of the epidemic, public health vulnerability and other factors in each country, priority should be given to medical personnel when the number of vaccines is limited.

the elderly over 65 years old, people with basic diseases, etc. are vaccinated.

The United Nations Children’s Fund (UNICEF) has undertaken the majority of vaccine supply work of the Global Alliance for Vaccines and Immunization.

After the availability of vaccines is launched, UNICEF will purchase at the most economical price, improve cold chain facilities, and deliver the vaccine to the most needed and difficult-to-reach places in Africa in the fastest and safest way through multi-stop charter and dedicated charters.

China joined COVAX in October and said that after the vaccine was developed and put into use, it was willing to take the lead in benefiting developing countries, especially African countries, as a global public good.

“COVAX is a groundbreaking global initiative that will ensure that African countries will not be ranked at the bottom of the team to get a vaccine for COVID-19,” said Mattshidiso Moeti, WHO Regional Director for Africa.

Ayekaba, deputy minister of health and social welfare of Equatorial Guinea, said: “We are concerned that some high-income countries have taken action to protect their interests. Through this initiative (the COVAX mechanism), we are able to get a vaccine that is successful in trials in a timely manner at a lower cost.”

On June 3, passengers wore masks and got off the plane at Serec Kama International Airport in Gaborone, the capital of Botswana. Xinhuanet Picture

Four major channels to raise funds for vaccines

WHO recommends that the initial vaccination rate of vaccines should be 3%, and then expanded to 20%. Once a COVID-19 vaccine is approved, the WHO says Africa will receive at least 220 million initial doses.

According to WHO regulations, the cost of each dose of COVID-19 vaccine, including transportation and other costs, is $10.55 Based on two doses of vaccine per capita, except for eight countries that have ordered vaccines in advance, other African countries need about $5 billion to complete vaccination coverage of 20% of their population.

But John Kengerson, director of the African Centers for Disease Control and Prevention, believes that this distribution is far from enough for Africa, which has 1.3 billion people. “We need to be vaccinated 60 percent of the population to be safe,” Kengersson said.

The African Centers for Disease Control and Prevention predicts that it will cost at least $9.1 billion to vaccinate 60% of the African population.

At present, the source of funding is the four channels of COVAX Facility, the World Bank, African countries’ self-financing and the African Export-Import Bank.

As of November, the AMC mechanism has raised only $2.1 billion, with a relatively large funding gap. In addition to the 8 self-financing countries, 46 African countries can receive support from the AMC mechanism, but they also need to share a part of the vaccine procurement and transportation costs, that is, $1.6 to $2 per vaccine.

Malpas, president of the World Bank, said recently that since March, the Bank has provided about $18.2 billion in loans, and the Bank will provide up to $50 billion in concessional funds in Africa over the next three years.

The Bank will also establish a fund for Africa to reward companies that develop or produce universal vaccines in Africa. The African Centers for Disease Control and Prevention also said that the Bank has written to African countries that it will provide $4 billion to $5 billion, not only for vaccine procurement, but also for cold chain equipment, logistics and transportation, community participation and other aspects.

In addition, on October 13, the Bank announced $12 billion in funding to developing countries to finance the purchase and distribution of coronavirus vaccines, testing and treatment of COVID-19.

CDC Africa is also exploring collaboration with the African Export-Import Bank (AFRE) to help member countries raise funds for pre-purchase of vaccines. The Export-Import Bank of Africa has launched the African COVID-19 Vaccine Financing Initiative, providing up to $5 billion to cover the funding gap.

Benedict Oramah, president of the African Export-Import Bank, said on December 14 that the most effective way to purchase vaccines is to centralize procurement in African countries, which helps to reach agreements with vaccine manufacturers and make it easier to finance cost-effective vaccines.

While China-Africa vaccine cooperation is in progress

In addition to the COVAX mechanism, China-Africa cooperation in the field of vaccines also plays an important role.

Egypt, Morocco and other countries negotiate with China on the issue of a coronavirus vaccine and seek local production of vaccines.

On the evening of December 10, China’s COVID-19 vaccine arrived in Egypt. Official website of Chinese Embassy in Egypt Photo

Egyptian media reports were quoted, Egyptian Health Minister Khalai Zayed said on December 11 that Egypt is negotiating with relevant Chinese companies to mass-produce China’s coronavirus vaccine locally.

The Egyptian Ministry of Health plans to establish a vaccine production line at the headquarters of Egypt’s Biological Products and Vaccine Holding Company, which is now ready, trained employees and has been legally licensed, while Egypt has established a refrigerated warehouse that can hold up to 110 million doses of vaccines.

On December 10, the Egyptian Ministry of Health received the first batch of coronavirus vaccines produced by China National Pharmaceutical Group at Cairo Airport.

Previously, the State Pharmaceutical Group conducted a three-phase clinical trial of the vaccine in Egypt, and Zayed was also vaccinated against the vaccine, and affirmed the safety and efficacy of the vaccine.

On October 15, diplomatic envoys of African countries and agencies in China visited the China Biological Museum. Xinhuanet Picture

Morocco has recently begun to deploy vaccination work and plans to mass-produce Chinese coronavirus vaccines locally in the future. Kenya also hopes to cooperate with Chinese pharmaceutical companies to carry out coronavirus vaccine trials and ensure the supply of coronavirus vaccines in the future.

By establishing partnerships and cooperating with global stakeholders such as China, African countries can improve their domestic vaccine production capacity and thus better control the local supply of vaccines over time. “Africa has scientific expertise that can make a wide range of contributions to finding an effective vaccine for the coronavirus,” Moeti said.

Researchers in Africa have helped develop vaccines that target, for example, meningitis, Ebola, yellow fever, and many other common health threats in the region.”

According to the African Times, Aspen, a South African pharmaceutical group, recently announced that it has reached an agreement with partners to produce and distribute the coronavirus vaccine Ad26COV2-S locally in South Africa.

At the same time, the African Centers for Disease Control and Prevention is also supporting countries to strengthen their local production capacity of vaccines, such as launching the African Pathogen Genome Project (Africa PGI).

This is the refrigeration equipment used to store coronavirus vaccines in the factory of Pfizer Pharmaceuticals in Michigan. This vaccine needs to be kept at minus 70 degrees Celsius. Xinhuanet Picture

Vaccination faces multiple challenges

At present, the research and development of the novel coronavirus vaccine in many countries have achieved preliminary results, and large-scale vaccination work has gradually begun. The United Kingdom, Canada, Saudi Arabia, Bahrain, the United States and other countries have approved the use of the coronavirus vaccine jointly developed by Pfizer and BioNTech.

According to the Associated Press, citing John Kengerson of the African Center for Disease Control and Prevention, Africa may start vaccination against the novel coronavirus by the second quarter of 2021.

Ensuring equitable vaccination is the key issue at present, especially in African countries.

At present, vaccination in some African countries still faces many challenges, including the insufficient number of local clinical trials, insufficient cold chain supply chain infrastructure, and the need to eliminate vaccination misunderstandings.

Richard Hutchett, CEO of the Coalition for Epidemic Prevention Innovation (CEPI), said: “It is crucial for African countries to participate in vaccine trials.

Testing vaccines on the continent ensures the production of sufficient data on the safety and efficacy of the most promising candidate vaccines for African populations so that once the vaccine is approved, it can be safely replicated in Africa.”

In July, the African Union established the COVID-19 Vaccine Clinical Trials Alliance, which aims to integrate global vaccine developers, funders and institutions that promote clinical trials in Africa to carry out post-trial trials of more than 10 vaccines in Africa as soon as possible.

However, there are currently limited vaccine clinical trials in Africa. According to the African Academy of Sciences, only 2% of the world’s clinical trials are conducted in Africa.

Several countries in Africa are currently preparing clinical trials of COVID-19 treatments and vaccines with multiple international partners. The novel coronavirus vaccine developed by Oxford University and AstraZeneca in the United Kingdom and the novel coronavirus vaccine developed by Novavax in the United States have been undergoing three phases of clinical trials in South Africa.

Uganda is working with Imperial College of Technology to launch clinical trials of the coronavirus vaccine in December. Cameroon, Zambia, Zimbabwe and other countries are applying for pilot approval.

Africa’s weak infrastructure, especially the unstable power supply, and vaccines are perishable in high temperatures, affecting their effects.

Africa needs to build and support cold chain systems, including storage, transportation and other facilities, with accessible, sustainable and safe power supply. And some of the coronavirus vaccines developed by China can be stored and transported at 2 to 8 degrees Celsius, and can take advantage of the existing cold chain equipment in Africa, which is a huge advantage.

In addition, even if a coronavirus vaccine is available in Africa, other barriers to access exist, especially for people in remote areas. Bill Gates has said that the last obstacle to promoting the coronavirus vaccine will be to persuade people to get vaccinated.

This requires encouraging the broad participation of religious leaders and communities, advocating the need and benefits of vaccination, and eliminating people’s distrust.

Ultimately, vaccines themselves cannot save lives, and vaccinations can save lives.

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