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Four lessons from Covid to help African leaders prepare for next pandemic

Ifeanyi M. Nsofor
By Ifeanyi M. Nsofor

Dr Ifeanyi M. Nsofor is a Senior New Voices Fellow at the Aspen Institute and a Senior Atlantic Fellow for Health Equity at George Washington University. He is CEO of EpiAFRIC and Director Policy and Advocacy at Nigeria Health Watch. You can follow him on Twitter @ekemma.

Posted on Tuesday, 2 March 2021 13:41

Doctors tend to a patient suffering from COVID-19 and receiving oxygen, in a ward for coronavirus patients at the Martini hospital in Mogadishu, Somalia on Wednesday, Feb. 24, 2021. (AP Photo/Farah Abdi Warsameh)

Vaccine nationalism is a fancy way of describing the vaccine inequity being perpetrated by richer western nations that are buying up Covid-19 vaccines to the detriment of poorer nations.

For example, Canada had bought nearly four times the vaccine doses required to vaccinate its citizens. Meanwhile, an analysis by the Economist Intelligence Unit shows that it would take until early 2023 for most African countries to be fully vaccinated compared to late 2021 for most richer western nations.

Even with the vaccines from the COVAX facility that have started arriving on the continent, the facility is only able to vaccinate about 20% of the continent by late 2021, leaving a huge gap and Africa unable to achieve herd immunity. 

I have written and spoken on this vaccine inequity and why hoarding by richer western nations is not the way to end a global pandemic. Sadly, hoarding of Covid-19 vaccines is not the first time that richer western nations have been selfish with Covid-19 commodities. In 2020, they hoarded personal protective equipment, therapeutics and other commodities. This action left African countries scrambling to buy supplies.

Further problems

Beyond Covid-19, African countries are currently dealing with 104 infectious diseases outbreaks and 13 humanitarian emergencies, according to the World Health Organization weekly epidemiological bulletin.

Some of these infectious diseases include Ebola, Lassa Fever, Cholera, yellow fever, etc. I have also argued that this experience responding to infectious diseases in Africa is a major reason that African countries have responded better to Covid-19 despite the hoarding by richer nations. Indeed, experience is the best teacher when it comes to responding to pandemics.

Since 2018, I have been the Project Director of Nigeria Health Watch’s  #PreventEpidemicsNaija project. A core component of our advocacy messaging is to push the government of Nigeria to allocate more funds for epidemic preparedness by reminding them that epidemics/pandemics will always happen although no one knows when. It is imperative for African leaders to review the global response to Covid-19 and prepare better for the next pandemic.

Four lessons

These are four lessons to ensure Africa is more self-sufficient and does not fall victim to vaccine nationalism in the future.

First, the Ubuntu spirit of “all above self” helped Africa respond better to Covid-19. Africa acted fast, decisively and together. Several initiatives enabled this community effort – Africa Medical Supplies Platform (AMSP), Africa Vaccine Acquisition Task Team (AVATT) and Partnership to Accelerate COVID-19 Testing (PACT) set up by the African Union.

These platforms led to better coordination of testing, purchase of commodities and sourcing of vaccines. For instance, African countries can now pre-order vaccines and other supplies through the AMSP. Doing so has unleashed the strength of the 1.2 bn population and gives African countries better bargaining power with suppliers. These platforms must be strengthened and deployed to address other communicable and non-communicable diseases. Never should an African country buy health commodities alone. We are stronger together.

Second, local manufacture of vaccines in Africa should be a necessity. As a response to vaccine nationalism, the Africa Export-Import Bank (AFREXIM Bank) – an agency of the African Development Bank set up the vaccine financing framework. Through this initiative, AFREXIM will provide advance procurement commitment guarantees of up to $2bn to candidate vaccine manufacturers.

Furthermore, the AFREXIM Bank credit facility should also be extended to support the manufacture of vaccines against other infectious diseases killing Africans. For instance, Lassa fever is endemic across West Africa, infects up to 300,000 and kills about 5,000 yearly. The Coalition for Epidemic Preparedness Innovations (CEPI) is already funding clinical trials for a vaccine against Lassa fever. CEPI has launched Lassa vaccine Phase I trial in Ghana. When the efficacy and safety of the Lassa fever are ascertained, funds will be needed for the production of the vaccine.

Third, publicly-funded universal health care system is a way to prepare for pandemics. The World Health Organization defines universal health care as a spectrum of care – health promotion, prevention, treatment, rehabilitation and palliative. These are core components of epidemic preparedness/response and vaccination is a very important intervention to prevent infectious diseases. Health insurance is a way to achieve universal healthcare on the continent.

However, across Africa, an average of 33% of the health expenditure (high of 77% in Nigeria and 3% in Botswana) is out-of-pocket, according to the World Bank. This means that about 420 million Africans pay for healthcare at the point of need. This is inequitable, unsustainable and pushes people into poverty. The African Union must continue to push member states to increase the domestic financing of healthcare in order to meet its UHC 2030 targets. They must find ways of channelling the high out-of-pocket health expenditures towards health insurance to protect Africans from future pandemics.

Fourth, the private sector is a key player in epidemic preparedness and should be actively engaged. Their support in Nigeria’s Covid-19 response is exemplary and is worth emulating.

Through the Private Sector Coalition Against COVID-19 (CACOVID), the private sector has so far raised more than $75 million to support Nigeria’s response to the pandemic. The African Union must keep tapping into funds, innovation, logistics networks and expertise within the private sector. Through the Africa Vaccine Acquisition Task Team, the AU should engage with private sector investors who are interested in procuring vaccines to meet the short term demands and also produce for the long term for the continent.

Bottom line

African leaders must end the over-dependence on foreign aid and be self-sufficient in vaccinating Africans. In the face of vaccine nationalism by richer western nations, this is the right thing to do to prepare for the next pandemic. 

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