Africa Left in the Dust: Inequity in Vaccine Distribution

The unequal distribution of COVID-19 vaccines is inhibiting progress in developing countries and preventing the world from a full recovery from the pandemic. At the start of the pandemic, wealthy countries spearheaded the distribution of COVID-19 tests and personal protective equipment, later prioritizing the administration of vaccines in several lower-income countries. However, much of the western world today is already offering boosters, while developing countries are struggling to ensure that their population has the ability to receive even a first dose. As the world slowly climbs down from its fourth wave of COVID-19, the U.S. and other developed countries cannot forget about the developing world, in particular sub-Saharan African countries whose healthcare systems are already struggling.

“Vaccine inequity is not just holding the poorest countries back – it is holding the world back,” said UNICEF Executive Director Henrietta Fore. “As leaders meet to set priorities for the next phase of the COVID-19 response, it is vital they remember that, in the COVID vaccine race, we either win together, or we lose together.”

On September 21, 2020, the UN General Assembly outlined several goals in their COVID-19 recovery plan, promising a new multilateral system that secures “peace, dignity, and equality on a healthy planet.” In their 75th declaration, they pledged to “leave no one behind.” However, their promises have not been executed, as only 10 percent of people in low-income countries have received at least one dose. As of January 24, 2022, the African continent has received approximately 540 million vaccine doses out of more than 9 billion produced in the world. Testing is another immense factor that severely limits poor countries from adequately handling outbreaks in vulnerable communities. According to the WHO, only one in seven COVID-19 infections were being detected on the African continent in September of 2021 due to limited testing. In reality, the UN’s multilateral system does not seem to be making ends meet for Africa. 

The distributed doses certainly do not reflect the promises made by richer nations. Though the efforts to establish a multilateral system have led to a growing number of nations pledging millions of vaccine doses to COVAX, a worldwide initiative aimed at equitable access to COVID-19 vaccines, there is still a significant vaccine gap. “Multilateralism… has not yet translated into substantial development in favour of Africa,” noted Mr. Moussa Faki Mahamat, the Chairperson of the African Union. In September, a total of about 1.3 billion doses from an advanced supply developed by wealthy nations were promised, but only 356 million doses were provided to developing countries. Since then, the pledge has risen to more than two billion, and by the end of 2021, COVAX was able to deliver a little more than 900 million vaccine doses. Africa has received only about 300 million of those doses. A major factor in this issue is the gap in vaccine manufacturing.  “It took a pandemic for the world to learn that African countries import 99 percent of their vaccines,” according to a Nature article since most out of ten of the continent’s vaccine manufacturers import their products.

At the 35th African Union (AU) assembly held on February 5, 2022, African leaders emphasized the necessity of a continental strategy toward solidarity, strengthening partnerships, and removing operational and logistical issues. The main focus of the strategy will be the acquisition of vaccines and their manufacture, said Mr. Faki, before highlighting the importance of partnerships with “concrete, transformative and integrating megaprojects.” African leaders emphasized this goal even further. However, Mauritius and Seychelles have been the only countries, so far, to have met the 70 percent mark. By December 2021, the UN did in fact increase Africa’s vaccine supply, but administering the doses and getting the entire population of the continent to at least 70 percent fully vaccinated—the goal established at Rome’s G20 Meeting—has become a difficult feat. Most African nations lack the means to distribute vaccine doses into the hands of their citizens. 

Along with already damaged and poor healthcare systems, they are at high risk of stronger COVID-19 outbreaks and hospitals unable to care for sick patients. Many sub-Saharan African countries lack the public health infrastructure and resources needed to combat the pandemic and protect their civilians. Funds and supplies given to these countries through the UN and COVAX have not been enough, in fact, the U.S. and other rich countries have been “making matters worse for developing countries through their own disastrous management of the disease.” 

Though much of the western world has maintained its strong economies and developed a significant supply of COVID-19 vaccines, many of them have not been able to manage outbreaks nor have they reached their 70 percent goal. In turn, this has prevented lower-income countries from successfully managing the virus as well. Many African nations are lacking in a number of nurses or other trained health professionals. According to the World Bank, “The average number of nurses in sub-Saharan Africa countries is one per thousand of the population, compared to… 15 per thousand in North America.” In addition to the lack of healthcare workers, according to the WHO, less than one in 10 healthcare workers in Africa are fully vaccinated.

Though the overall daily number of new cases in Africa has slowed to a downward trend, according to Africa CDC, it is important that wealthy countries use their influence and economic advantage to fulfill the promises they’ve made. President Felix Tshisekedi, the African Union Leader and president of the Democratic Republic of Congo, emphasized the necessity of the West to support African countries struggling with a vaccine shortage, arguing that the world would not be able to advance further if vaccine inequity continues. The support needed, however, should not involve more dependency.

International organizations should provide developing countries of Africa with enough funds to allow them to build up their healthcare systems and develop their own vaccines. COVAX has been crucial for Africa, but it is short of funds and has not been fully transparent in terms of vaccine doses and price details, according to Nature. In order to fill the gap, South Africa and other World Trade Organization member states are collaborating to obtain waived intellectual property rights for COVID-19 vaccines and treatments. This sharing of knowledge and manufacturing capacity has proved to be helpful in the case of South Africa, whose scientists have been successful in their efforts to produce the Moderna vaccine with mRNA vaccine technology. So far, the Africa CDC and the WHO are supporting this process, which is said to be key to allowing the African continent to become self-sufficient in combating COVID-19 along with other diseases. Clear, equitable vaccination is within reach, but more support is needed. “If the pandemic is to be overcome,” said Tshisekedi, “the continent must be supported by all means – the West would be wise to realize that nothing can be won as long as the developing world is left in the dust.” In order to overcome this pandemic, equity needs to be a priority.

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