The tragic history where access to HIV treatment in sub-Saharan Africa was delayed, and resulted in millions of deaths, is never far from mind when we discourse on the Aids epidemic in Botswana. Now several years later, the entire globe is fighting the Covid-19 pandemic which is flattening everything in its path, and Botswana has not been spared. Apart from Covid-19 laying bare some of the most glaring vulnerabilities of our society, Botswana is fighting tooth and nail to prevent the virus from spreading rapidly across the country. The only catch is that the measures to resolve the specific risks and impacts of covid-19 in Botswana are to a greater extent dependent on the COVAX facility, the initiative to deliver covid-19 vaccines to African countries as well as other poor countries.
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations, and the World Health Organisation. But approximately a year-and-a-half into the pandemic, it has not succeeded in achieving its intended target because of over-dependence on a few manufacturers and fund shortage.
So far the COVAX facility has lost out on over 140 million doses that were meant to come from India’s Serum Institute. As more and more African countries are starting to experience a third wave, and vaccines are increasingly scarce, 47 of Africa’s 54 countries—nearly 90%—are set to miss the September target of vaccinating 10% of their people unless Africa receives 225 million more doses. This new global target was announced recently at the World Health Assembly. Currently, some countries are not sure whether they will be able to give their citizens the second dose of the vaccine within the recommended 12-week interval.
The global vaccine distribution programme is in itself heavily flawed. It has seen just 16 percent of the world’s population locking up 60 percent of the global vaccine supply. Beset with delays and reservations over its ability to deliver on its targets, the COVAX initiative once touted as the “only truly global solution” to the raging Covid-19 pandemic has found itself significantly in short of funds and hindered by vaccine hoarding in high-income countries.
Whilst regional organs such as the African Union (AU) have reiterated the need for a fast and even-handed distribution of Covid-19 vaccines, there are still major hindrances as some countries are using their financial muscle to secure hundreds of millions of doses at the expense of poor nations.
A medical practitioner who spoke to this publication indicated that already there is increasing global divide which is widening between rich nations that are way ahead in vaccinating their populations against Covid-19 and poor countries that are experiencing a third wave and also running out of vaccines.
“There are three things we can learn from the recent massive surge in Covid-19 cases in India. Slow vaccine rollout, an ill prepared healthcare system and rapidly spreading variants are a cocktail for disaster for any country,” he says adding that the shocking Covid-19 surge in India, home to Covax’s main supplier, the Serum Institute of India, has extensively slowed deliveries since March to a trickle.
Administrator of the US Agency for International Development (USAID), Samantha Power, also shares the same sentiments stating that “COVAX has suffered a big blow given the scale of the pandemic in India”.
Now as India races to immunise its over a billion citizens, the Indian government has blocked exports from Serum Institute, which was meant to make the majority of COVAX’s AstraZeneca vaccines. Serum Institute of India expects to resume exports to COVAX at the end of the year and reports indicate that the Institute plans to launch another vaccine, Covavax, in the country by September. Covavax is a version of US firm Novavax’s Covid-vaccine candidate.
Although the WHO Director General Dr Tedros Adhanom Ghebreyesus says there is need to turn the tide quickly to ensure the resumption of vaccines from the Serum Institute of India (SII) to poorer countries, the situation on the ground seems to say otherwise.
Although some countries have fully vaccinated a large amount of their population, many others especially those which rely on the COVAX facility have only just begun, or in some cases are still waiting for their first doses to arrive.
While the phrase “No one is safe until everyone is safe” has become a motto for global health institutions such as WHO, and even if COVAX meets its objective to vaccinate 20% of the population in its 92 target countries, that would still be well short of the 70% level of immunity that experts say is needed to end the pandemic.
Inequality in vaccine coverage between low-income countries and high income countries is extreme. And as long as the slow roll out of vaccines continues, the more likely deadly mutations such as the Delta variant are likely to cause headaches for the world over.