Africa's Vaccine Drive Is Threatened by India's Supply Halt

NAIROBI, Kenya – The rapidly escalating coronavirus crisis in India is not only forcing hospitals to ration oxygen, it is sending families to find open beds for infected relatives. It is also wreaking havoc on vaccination efforts around the world.

Nowhere is this more evident than in Africa.

Most nations relied on vaccines made in the Serum Institute factory in India. However, the Indian government’s decision to restrict can exports as it deals with its own outbreak means that Africa’s already slow vaccination campaign could soon come to a standstill.

Before India stopped exporting, more than 70 nations received vaccines made by it with a total of more than 60 million doses. Many went to low and middle income countries as part of the Covax program, the global initiative to ensure equitable access to vaccines.

To date, Covax has dispensed 43.4 million doses in 119 countries, but that’s only about 2 percent of the two billion doses expected to be dispensed this year, according to Andrea Taylor, associate director at Duke Global Health Innovation Center.

“Export controls from India are the main limitation on Covax’s current offering,” she wrote in an email.

Even before India stopped shipping, Africa saw the slowest vaccine introduction of any continent. As of April 21, African nations, with a total population of 1.3 billion, had received more than 36 million doses of vaccine, but administered only about 15 million, according to the African Centers for Disease Control and Prevention.

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    • On April 23, an advisory panel to the Centers for Disease Control and Prevention voted to lift a hiatus on Johnson & Johnson Covid vaccine and put a label on an extremely rare but potentially dangerous bleeding disorder.
    • Federal health officials are expected to officially recommend states lift the hiatus.
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Only six million doses were administered in all of sub-Saharan Africa – fewer than many individual US states. The prospect of a reduction in supply complicates the already enormous logistical challenge for many African nations.

Many African governments prioritized giving initial doses to more of their populations in the expectation that more doses would arrive soon. Now they are struggling with what to do when there aren’t enough vaccines to get the full two-dose regimen that provides maximum prevention.

Countries like Rwanda and Ghana, which were among the first to receive doses of Covax, are about to run out of initial supplies. In Botswana, vaccinations were temporarily suspended in some areas this month after the allotted doses ended. And Kenya, which is nearing its initial 1 million dose, said this week it would try to acquire vaccines from Johnson & Johnson and Pfizer to continue its vaccination campaign. On Saturday, due to delays, the country extended the time between first and second dose administration from eight to 12 weeks.

Overall, the 10 African countries that have had the most vaccinations have gone through more than two-thirds of their deliveries, said Dr. Matshidiso Moeti, World Health Organization Regional Director for Africa.

The African Union Vaccination Group has secured funding to purchase up to 400 million Johnson & Johnson vaccines for member states – but those doses will not arrive until the fall.

“More than a billion Africans are on the verge of this historic march to end this pandemic,” said Dr. Moeti.

A spokesman for Gavi, who runs the Covax program, said in an email that it is in close contact with the Indian government to resume vaccine shipments, but “regarding the timing of the next shipments, we cannot confirm this phase. “

Even if the United States is betting on tens of millions of doses of the AstraZeneca vaccine – the most affordable vaccine that is widely available – African nations are turning to Russia and China for doses in those countries, despite concerns about the lack of clinical data their effectiveness and safety.

Amid the delays, some African countries are facing new and potentially more deadly waves of the pandemic. The African Centers for Disease Control and Prevention reported 2,155 deaths from the virus last week, up from 1,866 the week before.

In Nairobi, the capital of Kenya and home to one of the better health systems on the continent, officials have warned of a lack of intensive care beds and oxygen supplies. Last month, the Kenyan government ordered a new lockdown, which has fueled anger over the economic impact of the restrictions.