We can vaccinate 70% of the world against Covid by mid-2022. Here is how | Bipasha van der Zijde

As Western countries scramble with their booster deployment to cope with the Omicron wave, only 8.4% of people in low-income countries have received at least one dose of vaccination against Covid.

The gap in immunization rates between high-income and low-income countries is wider than ever. We cannot continue to close our eyes to this.

Vaccines distributed to African countries under the Covax program are often close to the expiration date and their delivery is ad hoc the best. In Nigeria, where only 2% of the population is fully vaccinated, they just had to destroy over a million vaccines that were close to expiring.

Nigeria is not the only country in difficulty. In Ghana, where 7.4% of the population is vaccinated, Fred Osei-Sarpong, representative of the World Health Organization said: “Receiving vaccines with a short shelf life puts undue strain on staff and makes difficult proper planning vaccine delivery.

These short shelf lives seriously hamper the delivery of vaccines to rural areas. We worked with Benjamin Ongeri, health supply chain specialist at Crown Agents in Kenya – where 7.2% of the population is fully vaccinated – on the delivery of drugs for neglected tropical diseases (NTDs). He says, “There are huge challenges in getting drugs to the last mile. We know this from years of working with NTDs. Reaching those most affected is very difficult because they are vulnerable, often marginalized and live in remote places with poor roads and infrastructure.

Covid vaccines at a landfill in Abuja, Nigeria, December 2021. More than a million doses of expired vaccines have been destroyed. Photograph: Xinhua / REX / Shutterstock

The same challenges have slowed uptake of Covid vaccines. And this is exacerbated by the fact that these vaccines require a cold chain (or ultra-cold) logistics infrastructure that is often non-existent in these areas.

It also doesn’t help that the vaccines primarily given in Africa are the ones the West has decided not to accept.

“In Ghana, at the initial stage of vaccine deployment, a strong demand was generated,” Osei-Sarpong said. Then there were no vaccines. The interruption of the deployment affected communications efforts and this gap created a space for disinformation and rumors.

According to WHO vaccinesstrategy, published in October, the goal is to have 70% coverage worldwide by June 2022. How to achieve this goal?

The liberalization of intellectual property rights, often cited as a possible solution, will it bridge the widening gap? Neither Osei-Sarpong nor Ongeri think this is the answer. For a country, starting to produce vaccines from scratch would be a huge challenge. According to Ongeri: “Countries like Kenya have started this journey by targeting the final filling of vaccine vials locally, which is still quite difficult given the need for state-of-the-art pharmaceutical manufacturing plants that will guarantee safe production without risk of contamination. . “

Much more will be needed in terms of technology transfer and strengthening of the expertise necessary to fully produce vaccines locally, these objectives cannot be achieved in the short or medium term.

The answer lies in global funding mechanisms like Covax – provided they can ensure pre-planned vaccine availability. A more equitable distribution of jabs on a structural basis with longer retention periods will allow realistic and efficient planning.

“With the provision of funds for operations and the availability of vaccines, Ghana will be able to strategize and achieve the coverage set by WHO,” Osei-Sarpong said.

In addition to common elements such as a lack of sufficient vaccines with an adequate shelf life, each country has its own set of circumstances that lead to low immunization rates. So, with the funding available, each country can tailor its efforts to tackle these circumstances and ensure that vaccines can reach the last mile.

In Kenya, Ongeri says they need the resources to undertake door-to-door vaccination campaigns as they do for childhood vaccination.

Where there is a well-functioning delivery system, countries have high vaccine delivery rates. Kenya, for example, has an estimate 80% coverage for childhood vaccines. In Ghana, it exceeds 90%. The WHO target may not be as out of reach as it seems.

It is not only in the interests of countries with vaccine shortages that urgent action must be taken. As the UN Secretary General António Guterres said: “None of us are safe until all of us are.”

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