Africa full of money, overwhelmed by the challenge of the COVID vaccine

When Ghana received 50,000 doses of COVID-19 vaccine from India last month, it hit a frustrating hurdle: it did not prepare enough staff to distribute them.

The country was still conducting photos received at the end of February from the global COVAX vaccine sharing system and did not have the capacity to expand that operation, according to the head of the immunization program in Ghana.

Instead of going directly into the arms of health workers, the extra doses were put in cold stores in the capital Accra, Kwame Amponsa-Achiano told Reuters, adding that his team received a two-day notice of transportation.

“I was in the middle of the first campaign,” Amponsa-Achiano said. “How do you plan for 50,000 people when you’re already running another campaign?”

The problems facing Ghana, one of the most economically developed countries in sub-Saharan Africa, illustrate how a continent with experience in fighting deadly infectious diseases has found itself ill-prepared to inoculate people against this pandemic.

Many African countries, which are already facing a shortage of affordable vaccines, are amazed at the unprecedented scale of the distribution challenge when the doses arrive.

Authorities do not have enough equipment, such as masks and cotton wool, due to funding shortfalls that could total billions of dollars, according to more than a dozen health experts and internal government documents seen by Reuters.

They also lack the necessary staff and training to distribute vaccines in the short term.

While Africa has so far been relatively unscathed by COVID-19, some experts fear that stuttering launches could attract the outbreak to the region, leading to more deaths and economically harmful restrictions on a continent that he is already the poorest in the world.

Benjamin Schreiber, COVAX coordinator at the UN children’s agency UNICEF, said logistical problems could arise in the coming weeks and months as countries try to obtain vaccines for their general population.

“As we start launching larger quantities, we will start to see more problems,” Schreiber said.

“Gaps in health systems will be gaps that hinder implementation,” he added. “I worry that we miss whole communities.”

REQUIRED: MILLIONS OF DOLLARS

Ghana, where the new coronavirus has infected more than 91,000 and killed more than 750, is considered one of the best prepared countries in Africa to carry out mass vaccination due to its political stability and economic development.

The government aims to initially inoculate 17.6 million people – about half its population – at a cost of $ 51.7 million, according to a national plan seen by Reuters.

It hopes to cover $ 7.9 million of this money with a World Bank loan, but is short of $ 43.8 million, described as a “funding gap” in the domestic government document.

The head of immunization, Amponsa-Achiano, said he was not aware that the situation had changed since the plan was formulated in February.

Ghana’s ministries of finance and health did not respond to requests for comment.

Ghana was the first country in the world to receive a shipment from COVAX, delivering 600,000 doses of AstraZeneca / Oxford University vaccine, manufactured in India, on February 24th.

It started its vaccination activity on March 1 and vaccinated 599,000 people by April 7.

While this vaccination rate is better than many of its African counterparts – Ivory Coast vaccinated just over 53,000 people between March 1 and April 6 – it is far behind the fastest-growing countries in the world. The UK, for example, administered doses to about 2 million people in about the first month of walking.

REQUIRED: REFRIGERATORS, COTTON WOOL

Ghana’s national plan shows how even relatively prosperous African nations do not have vital equipment.

Money is needed, including $ 1.5 million for 11 cold rooms and over 650 refrigerators to keep vaccines between 2 and 8 degrees Celsius.

About $ 25 million is needed to manage supplies and waste, including 33,600 boxes of face masks, 240,000 bottles of hand sanitizer and nearly 55,000 rolls of cotton wool, the plan says. It takes about $ 21 million to train more than 171,000 health workers and volunteers.

To add to the challenge in Ghana, the next COVAX deliveries, expected in April and May, were postponed until June as India suspended major exports of vaccines manufactured there.

In its 2021 budget, presented in mid-March, the Ghanaian government allocated 929,296,610 cedis ($ 160 million) for the purchase and implementation of the vaccine.

Amponsa-Achiano said, however, that it is not clear how much will go for distribution or when the funds will materialize.

It is a common problem in Africa, said UNICEF’s Schreiber.

“The question is when will this funding reach? Will it be on time?”

EBOLA CONGO FOCUSES

Some African authorities are familiar with the deadly contagion. Since 2018, Congo has contained four outbreaks of Ebola with a vaccine that must be kept between -60 and -80 degrees Celsius.

But the magnitude of the COVID-19 vaccination impulse is new.

COVAX – a donor scheme run by the World Health Organization (WHO) – has delivered more than 18 million doses to 41 African countries, according to Reuters.

This is the first wave of an action expected to deliver 600 million doses to Africa this year, enough to vaccinate 20% of their populations. Russia, China and India have also donated some of their vaccines.

Funding is just a problem that delays the launch of the vaccine.

Another is the unjustified retention of records in many public health systems, which experts say makes it difficult to identify people who should be prioritized because of age or comorbidities.

Demand for shooting is also weak in some countries due to distrust of health authorities, lack of education about vaccines and concerns about potential side effects.

Improper electricity and poor transport links in some places add to the challenge, while medical teams will have to negotiate the safe passage of parts of the Democratic Republic of Congo, Mali, Somalia and other places where insurgencies break out.

VACCINATION UNTIL THE FINAL-2022?

John Nkengasong, who heads Africa’s Centers for Disease Control and Prevention, says it could take 60 percent of the continent’s 1.3 billion people to be vaccinated by the end of 2022.

Take on the task facing Mali, a poor country fighting an Islamist insurgency. It needs $ 14.7 million to implement vaccines, including gasoline, vaccine storage and training, according to an internal government vaccination plan seen by Reuters.

The government will need financial support from WHO, UNICEF, the GAVI vaccine alliance and the World Bank, the plan says. These organizations are all looking to provide funding to African nations in need.

South Sudan, still plagued by violence after a civil war in 2018, has seen COVID-19 infect at least 10,300 people and kill more than 100.

It began distributing 132,000 doses of COVAX vaccine on April 7. However, authorities will not start firing outside the capital Juba and the surrounding county until early May, said Kawa Tong, a member of a COVID-19 steering committee advising the government.

“The main reason is the lack of funds for the launch outside the city of Juba. Transportation of vaccines, training of health workers, informing the community – all these are related to funding,” Tong told Reuters.

In addition to the difficulties, by May, the rainy season will have started well, disrupting transport links to large parts of the country, she said. The vast majority of the population of 11 million lives outside Juba County.

Atem Riek Anyom, director general of primary care at South Sudan’s health ministry, said the government had applied for funding from the World Bank, adding that vaccines would soon be distributed across the country.

“There is no challenge in launching the vaccine,” he added.

The World Bank, which has a $ 12 billion fund to help developing countries around the world buy and distribute vaccines, said it is examining applications from Mali and South Sudan.

The bank said it has approved $ 2 billion to 17 countries, including seven in Africa: Ethiopia, Cape Verde, Ivory Coast, Eswatini, Tunisia, Rwanda and The Gambia.

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