Tanzania has rejected vaccinations altogether, raising fears that the east African country could act as a reservoir for the disease and threaten progress elsewhere. President John Magufuli said last week that Tanzania had “lived for over one year without the virus because our God is able and Satan will always fail” and insisted the pandemic can be fought with herbal remedies.
There is growing evidence that the 3.6m cases and 93,000 deaths from Covid-19 in Africa counted by the CDC may be a significant underestimate, deepening concerns that tens of thousands could die in the coming months if enough vaccines are not made available. Health systems across the continent have been overwhelmed since December as the second wave pushed daily recorded infections above 30,000. Oxygen has been in short supply, workers exhausted, and crematoria unable to meet demand. There have been acute shortages of beds in even relatively wealthy countries and high-profile casualties. The case fatality rate in Africa was now 2.6%, above the global average of 2.2%
African Union announced it had secured 670m doses for its 54 member countries, only 50m are likely to be available before June and the winter in the southern parts of the continent. It is estimated Africa will need 1.5bn vaccine doses to immunise 60% of its 1.3bn inhabitants, costing between $7bn and $10bn.
Even before the second wave, Covid killed more than 300 health workers in South Africa’s stretched public health care system. In Sudan, 41 doctors died from Covid-19 between March and January, medical associations said. The country has less than six doctors for every 10,000 people, half the minimum level recommended by the WHO. High numbers of casualties among health workers have also been reported in Zimbabwe, Mozambique and Kenya, where 30 doctors had died by November. Enema Amodu, the chairman of the Nigeria Medical Association, said at least 20 doctors died there in a single week in December after getting coronavirus. In Malawi, new cases increased exponentially in January, doubling every four to five days, and nine frontline health workers have died after testing positive for Covid-19.
Only a few countries in Africa will start immunising even frontline health workers until much later this year, prompting accusations that large orders by wealthy nations are costing the lives of medical staff in poorer parts of the world. Only six countries in Africa have now received relatively small quantities of vaccine,
“We haven’t started because we didn’t have the vaccines … some countries placed very important premarket commitments that made it difficult for vaccines to be available in Africa,” said Dr John Nkengasong, director of African Centers for Disease Control and Prevention (CDC),
“It would be indefensible if some countries started to vaccinate their lower-risk citizens while many countries in Africa are still waiting to vaccinate their very first frontline health workers,” said Christine Jamet, director of operations for the medical organisation Médecins Sans Frontières. “This is a global pandemic that requires a global spirit of solidarity if we truly hope to bring it under control.”
Dr Matshidiso Moeti, the World Health Organization regional director for Africa, said that the continent was “at a crossroads”.
Nigeria was spared the worst in its first Covid-19 wave that began in February last year. But more than half of Nigeria’s 131,242 confirmed cases have been logged in the past three months. Fatalities now total 1,586.
In South Africa, the country with the most reliable statistics, excess mortality figures suggest the true death toll from the disease may be as much as three times the official total of 44,000. The most recent statistics show more than 50,000 excess deaths in the four weeks from 27 December.
“The priority now is protecting frontline health workers,” said Marion Péchayre, MSF’s head of mission in Lilongwe. “If Malawi had 40,000 doses of vaccine, we could at least start by vaccinating health staff in the country’s main hotspots. Without this, the situation will soon be untenable.”