Epidemiologist Salim Abdool Karim is co-chair of the South African Ministerial Advisory Committee on Covid-19, he is the government’s top adviser on the pandemic and has become the country’s face of Covid-19 science. He also sits on the Africa Task Force for Novel Coronavirus, overseeing the continent’s response to the global crisis. Karim, who directs the Durban-based Centre for the Aids Programme of Research in South Africa and is a professor at Columbia University’s Mailman School of Public Health, has long advocated for science and speaking truth to power. For three decades, along with his wife and scientific collaborator, Quarraisha Abdool Karim, he has been at the forefront of the fight against South Africa’s substantial HIV and tuberculosis epidemics and in the early 2000s was one of the scientists who spoke out against the government’s Aids denialism. Karim and Fauci, the US’s leading infectious disease expert, were recently jointly awarded the 2020 John Maddox prize for “standing up for science during the coronavirus pandemic”. The prize is given by the UK charity Sense About Science and the journal Nature.
It is worth citing his views on the COVID-19 pandemic.
Q. Africa as a whole has seen comparatively lower Covid-19 death rates than Europe or the US. Why?
A. The number of cases and the number of deaths are underreported throughout most of Africa. But I am confident – based on the fact we don’t find as many admissions for acute respiratory distress – that we’ve still had a much less severe impact from our first wave than most of the rest of the world. Probably we rank second to south-east Asia, where the impact has been even less. We don’t fully understand the reasons. Our youthful population plays a role, and early lockdowns contributed quite a bit. The hypothesis that there is some pre-existing immunity [from other circulating coronaviruses] – my view is the evidence is flimsy. They are present across the whole world. I don’t think there is something special we have in Africa that protects us.
Q. South Africa is slated to get some vaccine doses through Covax, the global procurement initiative to distribute Covid-19 vaccines fairly around the world, in the second quarter of 2021. I imagine that can’t come soon enough…
A. We have chosen to go the route of Covax and through it we will get doses for the first 10% of our population. That will cover our healthcare workers and the elderly. Separately, we have an open line of communication with several drug companies making vaccines, and we’ll take things forward with them when their results become available and when we have assessed whether they meet our criteria. Unlike some other countries – the US, UK, Canada – we haven’t made advanced commitments. We don’t have money to buy 10m doses and then not use it if it’s inappropriate.
Q. Are you worried that low- and middle-income countries won’t get enough vaccines?
A. Vaccine nationalism is a concern. There are countries – like the US – that believe they will be safe while the rest of the world is not. It’s a fundamental fallacy. None of us are safe if one of us is not. We have mutual interdependence. We need the whole world to be part of Covax: all the drug companies should have committed all their vaccine doses to Covax, which could then equitably provide the vaccine so all healthcare workers can get vaccinated. It will be terrible if the US is vaccinating low-risk young people while we in Africa cannot vaccinate healthcare workers.