Why Nigeria, others may wait till 2024 to access COVID-19 vaccine

• Africa records 74,500 new COVID-19 cases, 1,400 deaths in one week
• 1,516 cases, 13 deaths reported among healthcare workers

Despite assurances by the Minister of Health, Dr. Osagie Ehanire, that the country would receive some doses of the approved COVID-19 vaccines in January 2021, more reasons have emerged why Nigeria and other poor countries will have to wait months or even years to be able to access the vaccines.

Researchers at Duke University, North Carolina, United States, believe there would not be enough vaccines produced for the whole world until as late as 2024.

The people in 10 major economies – United Kingdom (U.K.), United States (U.S.), Canada, France, Germany, Japan, Qatar, South Korea, Sweden, and United Arab Emirates– will be able to access Pfizer’s COVID-19 vaccine by this week but Nigerians may not be able to get the vaccine due to a funding gap of $28.2 billion (N14.1 trillion).

The new report published by the Eurasia Group found that leaving low- and lower-middle-income countries (LLMICs) like Nigeria without access to vaccines amid the COVID-19 pandemic would cause significant economic damage that puts decades of economic progress at risk for both LLMICs and advanced economies.

The report warned that if the funding gap was not met, low- and low-middle income countries including Nigeria will have delayed access to these vital tools- tests, treatments and vaccines- in 2021, which will result in a protracted pandemic, with severe economic consequences, not just for these countries by also for the wider global economy.

The report was released as world leaders gather virtually at the Special Session of the General Assembly in response to the COVID-19 pandemic.

Also, Ehanire, had earlier in the week assured that the Federal Government had ordered initial 20 million doses of Pfizer’s COVID-19 vaccine through the COVAX/World Health Organisation (WHO) facility.

But critics worry about where the counterpart funding by the Federal Government would come from, considering the country’s present economic challenges.

COVAX is the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator. The ACT Accelerator is a groundbreaking global collaboration to accelerate development, production, and equitable access to COVID-19 tests, treatments, and vaccines. COVAX is co-led by Global Alliance for Vaccines (Gavi), the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO. Its aim is to accelerate the development and manufacture of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world.

Also, a new report published, Wednesday, by nbc.com claims that rich countries are hoarding COVID-19 vaccines while poor ones are missing out. It alleged that higher income countries like the U.S. and the United Kingdom U.K. are putting themselves at the front of the line — that is obviously what is happening.

In this critical game of medicine logistics — where supply is small but demand immediate and universal — campaigners and some officials accuse these wealthy nations of snapping up orders and hoarding more than they need.

The People’s Vaccine Alliance, a collaboration between several aid groups, including Oxfam and Amnesty International, has said that, unless drastic measures are taken, nearly 70 poor countries will be unable to vaccinate 90 percent of their populations next year.

One of these institutions is COVAX, led by the WHO, whose aim is to stop this exact thing from happening. It has raised $2 billion from dozens of countries and international organisations, and wants to provide one billion shots to poor countries next year. But the US and the UK have paid upfront for more than two billion doses of the vaccines for their citizens, whereas only 700 million doses of the vaccines are available for shipment now.

A vaccinologist and leader of Africa’s Vaccine Manufacturing Initiatives based in Maryland, United States, Dr. Simon Agwale, told The Guardian, Wednesday that the vaccine was tried in about 30,000 volunteers before its emergency use Authorization in the UK and USA. “Before a vaccine goes into human clinical trials, all safety issues are analysed in the laboratory and appropriate animal models. Apart from some minor side effects associated with all other vaccines (such as fatigue, muscle soreness and aches, joint pain and headache, redness or swelling at the injection site), the two COVID-19 vaccines were safe in the last phase of clinical trials.

“I don’t even think the mRNA would be used in Africa because it’s in short supply, and the initial doses have already been bought by wealthy countries. Secondly, it requires ultra-low temperatures for storage which makes it difficult for use in Africa. There are several other vaccines that will be available by the second or third quarter of next year that utilize known technologies that have been used in other vaccines, so I believe they’ll be the appropriate vaccines for use in Africa.”

On what the Africa’s Vaccine Manufacturing Initiatives is doing to ensure local production of vaccines on the continent, Agwale, who is also the CEO of Innovative Biotech Limited, Keffi, Nasarawa State, said: “We are working hard to make sure that we have vaccine manufacturing capabilities throughout Africa. This will require human capacity development and funding. We also note that most of the efforts to discover and produce vaccines for the virus have been concentrated in Europe and America, China and Russia, and that virtually all the proposed doses of COVID-19 vaccines have already been bought by wealthy countries, leaving little hope for Africa and other developing countries to access these vaccines. There is a lot of interest now among policy makers; and the consensus is that vaccine manufacturing facilities are needed in Africa to enable us not only to address the current COVID-19 vaccine needs of our continent, but also to be ready to support future vaccine needs much quicker and offer pandemic readiness. This is based on the historical fact that less than one per cent of the vaccines currently in use in Africa are manufactured locally, and that developing and/or manufacturing a Covid-19 vaccine and other vaccines in Africa is of immense long-term strategic benefits to the continent.”

Meanwhile, according to the nbc.com report, it was undermined from the start, supporters say, after President Donald Trump declined to give the scheme any backing. Russia is the only other major economy to opt out.

COVAX says it is still $4.3 billion short of the cash it needs. And many experts are now skeptical it will ever provide the developing world with the necessary protection.

There are many who saw this coming. Back in April, keen observers predicted a sorry repeat of the 2009 swine flu pandemic, which saw rich countries push past poor ones to the front of the vaccine line. Today, vaccine nationalism is once again moving “at full speed,” United Nations Secretary-General Antonio Guterres warned at a news conference last week.

COVAX has signed advanced purchase orders for 700 million doses, but no deals to ship them to their destinations. According to research by Duke University, this modest stockpile remains dwarfed by the almost four billion doses secured by rich nations.

Data compiled by Airfinity, a science analytics company, shows that almost half of COVAX’s pre-orders are from AstraZeneca and Oxford University, whose vaccine is awaiting regulatory approval. Most of the rest are by Sanofi and GlaxoSmithKline, whose candidate has been delayed until late 2021 after trials showed a weak response in older people.

COVAX is in talks with Pfizer-BioNTech. But these shots are far more expensive and experts say they would be unsuitable for developing nations because they need to be kept at extremely low temperatures.

Even if the programme succeeds in its eventual aim of inoculating 20 percent of people in poor countries, it will fall way short of providing them with herd immunity. The researchers at Duke believe there won’t be enough vaccines produced for the whole world until as late as 2024.

Asked about these challenges, a spokesman for Gavi, the vaccine alliance, another organization coordinating COVAX, remained optimistic about its prospects.

“With strong commitment from vaccine manufacturers and the right level of backing from donor governments, we can ensure global access to doses in a timely fashion for all countries, not just those able to pay their own way,” a spokesman said via email.

But WHO Director General, Tedros Adhanom Ghebreyesus, struck a far less confident note on Monday. “High-income countries are now starting to roll out vaccines, while those in low-income countries can only watch and hope,” he told a meeting to discuss this issue, warning that COVAX was already “at risk of failing to fulfil its potential.”

Some experts say it is unsurprising the medical-industrial complex that underpins rich nations’ relationships with big pharmaceutical companies has outmatched these altruistic efforts.

The U.S. has a world-class medical regulator that works hand in glove with drug makers to approve vaccines efficiently. It is home to Pfizer and its manufacturing facilities, and it has the economic and infrastructural wherewithal to conduct mass rollouts.

According to director of studies at Doctors Without Borders, a humanitarian organization, Dr. Natalie Roberts, “COVAX does not have the power it needs, it does not have the money it needs and it’s too slow, because governments like the U.S. have already made their deals quickly.

“The vaccines just are not available because they have already been bought by others — it is too late.”
Meanwhile, the UK, last week Wednesday, became the first Western nation to authorise a COVID-19 vaccine, a landmark moment in the coronavirus pandemic that paves the way for the first doses to be rolled out across the country next week.

The report by the Eurasia Group analyses ten major economies to assess the economic benefits to advanced economies of contributing to the work of ACT) Accelerator.

However, according to the report, the programme still has a significant funding gap of $28.2 billion (N14.1 trillion) – with $ 4.3 billion (N2.15 trillion) needed urgently to fast-track critical areas of work.

The report, which was commissioned by the Bill & Melinda Gates Foundation, found that the economic benefits of a global equitable vaccine solution alone for the 10 countries included in the analysis would be at least US$ 153 billion in 2020-21, rising to US$ 466 billion by 2025.
This is more than 12 times the US$ 38 billion estimated total cost of the ACT Accelerator. This figure was compiled using the expected negative effects of sustained coronavirus outbreaks in LLMICs, based on the downside and baseline scenarios of the International Monetary Fund (IMF’s) October 2020 World Economic Outlook forecasts.

According to the report, so far, the 10 countries featured in the report have contributed $2.4 billion to the work of the ACT Accelerator, with the United Kingdom committing just over US$ 1 billion, and Germany, Canada, Japan and France committing US$ 618 million, US$ 290 million, US$ 229 million and US$ 147 million respectively.

This new report emphasised the funding urgency and the return on investment for donor countries of the work of the ACT Accelerator, which published its Urgent Priorities and Financing Requirements on November 10.

Eurasia Group is the world’s leading global political risk research and consulting firm.

Meanwhile, latest figures from the COVID-19 Weekly Epidemiological Update, published yesterday, by the WHO, indicate that the number of new cases and deaths reported, in the last week, increased by 40 per cent (to 74,500 new cases) and 43 per cent (to 1,400 new deaths).

According to the WHO, several countries in the Region are reporting resurgence in both cases and deaths including Mali, Namibia, Nigeria, Senegal and South Africa.

It, however, noted that following a decline in July and August and a plateau in September and October, the number of new cases and deaths has consistently increased since the beginning of November.

South Africa has reported the highest number of cumulative cases and deaths in the Region, with more than 850,000 confirmed cases and over 23,000 deaths. In the last week, 42,500 new cases (700 new cases per one million population) and 1,000 new deaths (18 new deaths per one million population) were reported. Four provinces including Eastern Cape, Gauteng, KwaZulu-Natal and Western Cape were most heavily affected; collectively accounting for 84 per cent of all newly reported cases.

According to the WHO, the increase in affected provinces is expected to continue as the number of cases among those aged 15 to 19 years continues to increase. This increase could be partly attributed to end-of-school-year celebrations during which many adolescents gathered in large numbers.

In Uganda, the number of reported cases has continued to increase and in the last seven days, just under 5,000 cases were reported (100 new cases per one million population), a 118 per cent increase from the previous week. The districts of Kampala, Kasese, Luwero, Mbarara and Wakiso have consistently reported the highest number of cases for the past three weeks, with Kampala the most affected.

So far in the pandemic, a total of 1,516 cases, including 13 deaths, have been reported among health care workers, with the highest number reported in the week commencing November 23, during which over 150 cases in health care workers were reported.

On the global epidemiological situation, the WHO said in the past week the number of new COVID-19 cases and deaths continued to rise with 70 million cumulative cases and 1.6 million deaths globally since the start of the pandemic.

It noted that the Regions of the Americas and Europe continue to shoulder the burden of the pandemic, accounting for 85 per cent of new cases and 86 per cent of new deaths globally. However as new cases and new deaths continue to rise in the Americas, in cases stabilised in Europe for the third week in a row, while deaths continued to decrease.

According to the WHO, the African and the Western-Pacific Regions have both shown renewed rises in November and December. “This week the African Region reported a rise in new cases and new deaths of over 40 per cent compared with the previous week. In the South-East Asia Region, the number of new cases and deaths continued to decline following a peak in September. The Eastern Mediterranean Region also reported a decline in new cases and deaths from a peak in mid- November,” it noted.