The rapid spread of the Omicron variant has reminded us that the pandemic will not be over until all countries have vaccinated their people. The EU should focus its attention on vaccinating Africa, writes Professor Alberto Mantovani.
Professor Alberto Mantovani is based at the Humanitas Research Hospital in Milan.
The emergence of the Omicron variant has reminded all of us that the pandemic is nowhere near over.
South African hospitals are overwhelmed. The surge is putting an unprecedented strain on their healthcare system, and many African countries have been penalised as the EU and other countries moved to block flights and impose mandatory hotel quarantines on any arrivals.
Why has the spread in Africa been so rapid?
One reason is probably that the virus is more transmissible than other variants. But another is most likely that many people remain unvaccinated.
According to the World Health Organization, only five of Africa’s 54 countries have successfully vaccinated more than 40% of their people. For comparison, in the EU, 70% of adults are fully vaccinated.
The reasons for this are manifold. African countries have bought vaccines but are experiencing massive delays in getting them. In some cases, there’s a lack of access to equipment like syringes for administering the vaccines. In others, vaccines that have been delivered have expired, as has happened in other continents, including Europe.
Even though COVAX, the global platform set up to ensure equitable access to vaccines, has accelerated its shipments to Africa, it still appears that Africa will face a 275 million shortfall of COVID-19 vaccines against its year-end target of 40% vaccination across the continent.
Vaccine hesitancy also plays its part, hindering vaccination roll-out even where vaccines are available. Many African countries have a history of vaccine hesitancy, including the boycott of polio vaccines in Nigeria in 2003. High levels of mistrust in government means that many citizens are unlikely to trust in the vaccine in many countries.
Religious beliefs and misinformation also play a role – in the Democratic Republic of Congo and Cote D’Ivoire, many people do not believe that COVID-19 exists and therefore do not want to be vaccinated, while close to 90% of respondents to a survey in Niger and Liberia said that prayer was more effective than the vaccine.
Many African citizens simply don’t see COVID-19 as a threat. The population structure across the continent is young, so death rates are unlikely to be as high compared to the general population as they were in Europe and North America.
Yet, the health consequences for the African population are immense. The medical system in many African countries is now heaving under patients’ weight. As the hospitals focus on the coronavirus, screening programmes are once again neglected, routine checks have been postponed, and soon we will see the results of that.
While doctors provide emergency care, vaccination efforts should be ramped up.
One way to boost vaccination could be through sharing regional experiences. In Europe, we fought COVID-19 mostly on a regional level. We locked down region by region, county by county, province by province. We managed the situation within those regional boundaries. The ECDC’s map coded us red, orange or yellow not in accordance with our country borders but at regional level.
The Lombardy region has started to explore the possibility of bilateral initiatives with Sierra Leone. Lombardy was one of the worst-hit regions in Europe by COVID-19, the epicentre at the beginning of the European outbreak. In Lombardy, we had to react fast and under impossible circumstances. We can share the lessons learnt with our African colleagues and figure out together better ways to increase vaccine take-up, both in Africa and in Italy.
The European Union could encourage fostering bilateral initiatives between regional entities, developing a blueprint for collaboration that could be rolled out across the EU and Africa.
In terms of capacity building, BioNTech has just announced that they will launch a new manufacturing plant for its mRNA vaccines in Africa. Supported by the EU, this initiative will ensure that any BioNTech malaria and tuberculosis candidates will be manufactured in Africa and also boosts African capacity for developing COVID-19 vaccines. This should improve ease of delivery to African countries and will also build national capabilities in vaccine manufacturing more generally, which will be useful if there is a future pandemic.
The European Union should continue investing in improving training of medical doctors, nurses and technicians.
One example could be building the capacities of African doctors. Humanitas University is engaged with the Bambino Gesù Pediatric Hospital in Rome in training MD students in the Central African Republic’s capital, Bangui. The experience of “CUAMM Medici con l’Africa” with young physicians-in-training strongly suggests that spending time in Africa can represent a unique, enriching experience.
The time has come to translate our political promises into action. The European Union must support vaccination campaigns and capacity-building initiatives on our sister continent so that we can end the pandemic once and for all. Enough lives have been lost – enough families have been broken. We hold in our hands the key to success – the COVID-19 vaccines. We must make no more excuses.