Africa and COVID-19 Vaccines: The Politics Surrounding Equitable Access to Vaccines

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Street scene in The Gambia. Mask-wearing is not common, and social distancing is difficult. Photo by author

Global North countries, including France, Canada, the United Kingdom, and the United States, are hoarding COVID-19 vaccines, leaving countries of the Global South behind in equitable access to vaccines. As COVID-19 vaccines become available, many Global North countries have already purchased half of the available vaccines. Some of them have already purchased more doses than they need for their citizens. The European Union announced a deal with Pfizer and BioNTech for 300 million additional doses, giving the EU nearly half of the firms’ global output for 2021. Furthermore, Canada has struck deals that would enable it to immunize 505 percent of its population; the US has secured enough doses to vaccinate 200 percent of its population. This brute behavior leaves countries in the Global South far behind in the vaccine queue, or not in it at all. The delay in access to vaccines for citizens of Global South countries is ultimately more costly for all, as the pandemic will continue, further destroying lives worldwide. African countries are yet again behind in acquiring the needed vaccines, even though some of the clinical trials for these vaccines were carried out in Africa. This replicates the painful history of the 1990s, when many Africans participated in trials for the antiretroviral drugs to treat HIV, but Africans were among the last people to receive treatments. Many African countries rely on the COVID-19 Vaccines Global Access (COVAX) initiative to receive COVID-19 vaccines to vaccinate its population.

The COVAX Facility, a global initiative—led by the World Health Organization (WHO); Gavi, the Vaccine Alliance; and the Coalition for Epidemic Preparedness Innovations—to ensure equitable procurement and allocation of COVID-19 vaccines, promised to ensure 600 million doses for at least 20 percent of the African population, so that Africans can attain the vaccines at the same time as people in other regions. The facility has secured two billion doses of vaccine from five producers. However, nearly three months after the first vaccines have been administered in countries in the Global North, it is still not clear when many African nations will be able to start immunizing people. Reports say that an initial 30 million vaccine doses are expected to begin arriving in countries by March. However, as I write this article in my grandmother’s living room in Banjul, The Gambia, we just received news of only 36,000 doses of the Oxford-AstraZeneca vaccine for The Gambia’s two million citizens. There are some African countries. such as Senegal, Morocco, Seychelles, and Guinea. that have started vaccinations without the help of the COVAX facility. Most of these countries have acquired vaccines through bilateral trade agreements with China and Russia.

Amid surging demand for COVID-19 vaccines, the final shipments from the COVAX Facility, according to the WHO, will be based on production capacities of vaccine manufacturers and the readiness of countries, noting that recipient countries are required to submit finalized national deployment and vaccination plans to receive vaccines from COVAX. WHO reported that timelines and quantities could change, for example if vaccines fail to meet regulatory approval or due to challenges related to production, delivery, funding, etc. So far, about 320,000 doses of the Pfizer-BioNTech vaccine, which has already received WHO Emergency Use Listing, have been allocated to four African countries—Cape Verde, Rwanda, South Africa, and Tunisia—which have the capacity to store and distribute doses at minus 70 degrees Celsius. To complement COVAX efforts, the African Union has secured 670 million vaccine doses for the continent, which will be distributed in 2021 and 2022, as countries secure adequate financing. Still, this means that many Africans will have to wait at least another year before they can have access to the vaccines.

African countries are not only facing a challenge to get equitable access to vaccines. The Pfizer-BioNTech and Moderna vaccines require storage at minus 70 and minus 20 degrees Celsius respectively, which makes their distribution and storage a logistical problem for countries with tropical climates or for isolated regions. The Oxford-AstraZeneca vaccine, however, can be stored in normal refrigerated conditions for at least six months; its doses are also much cheaper: between $2 and $3 per injection, compared to at least $25 for the other two. However, South Africa halted the Oxford vaccine rollout, as it found that the vaccine offered “minimal protection” against mild and moderate cases.

Additionally, Global North countries have negotiated fair prices for vaccines. However, it is unclear if countries in the Global South will have the same power to get fair prices. Oxford -AstraZeneca is reportedly planning to charge $37 per dose for small orders. South Africa, for example, was asked to pay more than double the price that the European Union had negotiated for the Oxford vaccine. One could argue that maybe that is a fair price because the vaccine was developed in the UK, but didn’t the UK recently leave the EU? Ensuring equitable access to vaccines globally during a pandemic is not only a moral issue, but an economic imperative to protect the well-being of people everywhere. But when will Africa get the protection it needs? If all lives are equal, why isn’t access to vaccines?

Coastal scene in The Gambia. Photo by author

Finally, it should be noted that it seems as if some Africans are not eager to take the vaccines. In The Gambia, many people say that they will not take vaccines as they fear negative consequences. My aunt says she will not take the vaccines because she is already “sick enough” and does not want to mess with her body further. This is a common belief in The Gambia, as Africans do not trust vaccinations and medical trials because of the history surrounding unethical medical procedures being performed on Black bodies. Furthermore, with the exception of countries like South Africa, the virus has not (yet) spread dramatically. My cousin told me that he will not take any COVID-19 vaccines because he hasn’t seen or known anybody with coronavirus, and he is not alone. Many Gambians do not believe that the virus even exists, because of the low number of cases and the belief that the virus is a Western phenomenon. However, the virus does exist in The Gambia, as there are numerous cases and deaths reported daily by the Ministry of Health.

Fatou Jobe is a final-year master’s student in African Studies at UIUC, where she investigates the conflicts between local coastal communities and fishmeal factories in The Gambia. Her research aims to highlight the environmental, economic, and political impact of global aquaculture on local communities. She will join the Ph.D program in Sociology to further her study of fishmeal factories in West Africa.

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