Vaccines: a mirage for Africa. Under-resourced and with inadequate facilities

In the global race to secure the first doses of the COVID-19 vaccine, developing nations are at risk of being left behind. All of sub-Saharan Africa faces huge uncertainty, notwithstanding COVAX, the initiative co-led by the WHO to provide countries worldwide equitable access to the vaccine. The coalition is coordinated by Gavi (the Vaccine Alliance, an international organization to improve access to vaccines, funded by the United Nations and philanthropic groups), but countries with poor quality infrastructure and low numbers of storage and distribution facilities remain behind. Most importantly, funding to ensure free distribution is yet to come in. South Africa, one of the countries most severely impacted by COVID, is likely to receive the first doses (once the funds for free doses are available). Italian missionaries and NGO workers, who have been living for many years in Central Africa, Zambia and Mozambique, as well as in Lebanon, in the Middle Eastern context, gave us a first-hand account of the situation in under-resourced and heavily indebted Countries.

Central African Republic: "we are not equipped.” We contacted Davide Mariani, MD, member of Doctors with Africa CUAMM (NGO coordinated by the Xaverian missionaries and by Don Dante Carraro), working at the Children's Hospital in Bangui. "COVAX is a global network joined by 172 countries, created by the UN to ensure equitable access to vaccines," he said. "But there is considerable uncertainty as to whether and when they will be delivered to Africa at no cost. The goal is to vaccinate 60% of the entire African population and thus create herd immunity,

1.5 billion doses are needed, amounting to about $7 to $10 billion. But so far COVAX has raised $2 billion.

Vaccine distribution will likely start in Côte d'Ivoire, but many countries, including Central Africa, are not included. This vaccine must be kept at between -20 and -70°C, and many African countries cannot meet this requirement. Collection and distribution hubs must be set up throughout the territory. Central Africa is not equipped with any of this." It also requires especially trained health care staff, "which is completely lacking here," he pointed out. "I fear it will take a long time."

Zambia: "not even mentioned ...". The situation is not any better in Zambia: “Here vaccines against COVID-19 are not mentioned at all! Although the WHO would like to provide the vaccine at no cost - said Comboni missionary Father Antonio Guarino - no mention is made of it in the press. The government claims that sooner or later it will be able to obtain free doses, but we don't know when. National authorities have regarded COVID as just another disease right from the start. The coronavirus was never seen as an 'exception'. In fact it is perceived as a virus among many others.”

“Here and in Malawi competent authorities only make due inspections for travel purposes: in that case one must be tested and obtain a negative COVID-19 test result, but normally no mention is made of precautionary measures.”

Few masks in Zambia, hardly any controls, the missionary said. For our interlocutors, “the fact that, in spite of everything, Africa is not experiencing high rates of infection, is incomprehensible.”

Mozambique: the war takes precedence. The same picture emerges in Mozambique, where no prevention measures are in place except in churches, explained Combonian Sr. Rita Zaninelli. "The war in Cabo Delgado overshadowed the virus. I don't perceive it as a priority, but this doesn't mean that the virus is dead," the nun said. Moreover, the threat level “has also been reduced - concurred all the missionaries interviewed - and very few tests are being done.” 
The virus is not the biggest preoccupation:
“in the Central African Republic, concerns gradually waned after the first outbreak in March. We received a large amount of medical equipment in the first stages, but today no one is seen wearing a mask," said Sr. Elvira Tutolo, a missionary of the Sisters of Charity of St. Jeanne Antide Thouret. "Bangui continues to register a sharp increase in the number of funerals, and many people are dying for no apparent reason. The serious COVID alarm lasted no more than a month, then everything went back to normal, but the virus continues to circulate."

Lebanon, for free or for a fee? As Lebanon is struggling with major domestic security problems, “the Ministry of Health claims it has secured approximately 2 million vaccines due to arrive in March," said Salesian missionary Fr. Simon Zakerian from Beirut. "Health care workers, sick people and the elderly will be vaccinated first. But many people fear that once the vaccines arrive they will not be free of charge... In this country there is no guarantee that the vaccines will be free.”

(*) "Popoli e Missione" Editorial Staff
Ilaria De Bonis (*)