The scale of the COVID-19 pandemic has been unprecedented and whilst some may feel that things are slowly getting back to normal, many countries are still in lockdown or yet to address the challenge of getting their population vaccinated. According to the WHO, there have so far been 4.6 million deaths and over 224 million cases globally. The death toll continues to rise but official figures may not even fully reflect the true number in many countries.
WHO’s global targets are to support every country to vaccinate at least 10% of its population by the end of September, 40% by the end of 2021 and 70% by the middle of next year. However, current WHO data shows nearly 80 per cent of countries in Africa – 42 out of 54 – won’t reach the September target. Currently only 3% of the continent’s population is fully vaccinated, compared to 52% in the United States and 57% in the European Union.
Within a generation, Africa has made tremendous gains in increasing access to routine immunisation and driving down the number of children losing their life to disease, in fact, several diseases are on the brink of eradication. But there are still great strides to be made and right now Africa is heavily reliant on COVID-19 vaccine donations from overseas. Most of these are donated via COVAX which is co-led by CEPI, Gavi and WHO, alongside key delivery partner UNICEF (in the Americas, the PAHO Revolving Fund is the recognized procurement agent for COVAX). The COVAX facility brings together governments, global health organisations, manufacturers, scientists, the private sector and civil and philanthropic bodies, with the aim of providing innovative and equitable access to COVID-19 diagnostics, treatments and vaccines around the globe.
So far, Africa has received only 103m doses for a population of 1.4bn and, while that shortfall is worrying enough on its own, even some of those donations have been wasted. In the early days of donations, many of the doses had previously been stockpiled by other countries so that by the time they reached African countries they were often close to their expiry date, leaving little time to mobilise a vaccination campaign.
Challenges facing vaccination programmes in Africa are further compounded by bad roads, the sheer remoteness of some communities, areas of conflict and a shortage of health workers. The process of vaccination is actually incredibly energy-dependent as most vaccinations (including all of the coronavirus vaccines) are acutely temperature sensitive and require specialist refrigeration in transit and in storage. A survey carried out by WHO found that almost a third of African countries still have gaps in cold chain capacity in more than half their districts.
Dulas has been working in Africa for decades, supplying solar powered refrigerators to remote locations that have weak or non existent grid connection. We work with local partners to install their equipment and train health centre workers to ensure users have the skills and knowledge required to maintain their cold chain. Ruth Chapman, Managing Director says: “Vaccine supply remains a key issue in Africa, and building an effective cold chain infrastructure is integral to resolving it. As the World Health Organisation says, it’s not vaccines that will stop the pandemic, it’s vaccination. We need to ensure everyone has access to vaccination, not just those in urban areas. Ensuring an effective cold chain is in place for every community, however remote, is the only way to do this.”
Just as the development of the COVID-19 vaccine required an unprecedented, co-ordinated global effort, in Africa a successful vaccine deployment will require tremendous investment and forward planning by multiple parties. According to the WHO Africa Vaccine Readiness tracker, just 51% of 46 countries assessed are equipped overall to deliver vaccines to their populations. If action is taken now to set up the necessary cold chain infrastructure to support COVID vaccinations to the last mile, the benefits would last way beyond the pandemic.