Vaccination rates against COVID-19 remain disappointingly low in Africa, with only about 8% of the continent’s population fully vaccinated against the disease. And this average masks huge differences between countries. For example, Mauritius and Morocco have vaccinated 72% and 62% of their populations, respectively, but in countries such as the Democratic Republic of Congo and Burundi, vaccination rates are still well below 1%.
The number of COVID-19 infections is rising since the more contagious variant of Omicron emerged, but the continent’s death toll remains relatively low. However, given the known weaknesses of the African health sector, including the limited number of intensive care beds, there are concerns that if the Omicron variant continues to spread rapidly – or worse, a more transmissible and deadly variant emerges – Africa may would find themselves in the midst of an unprecedented public health crisis. So pre-vaccination appears to be the only option available to prevent a new disaster on the continent.
Unfortunately, according to the World Health Organization (WHO), Africa is not expected to meet the global target of 70% vaccination by mid-2022 to the end of 2024 due to several interrelated factors. In addition to the impact on the continent’s population, such a misstep could have large negative spillover effects on the rest of the world in terms of the emergence of new and potentially more harmful variants.
The main reason for the low vaccination rates in Africa is the low availability. In fact, high-income countries have been stockpiling vaccines, most recently a third “boost” dose, leaving low-income countries, including many in Africa, without access to adequate vaccines for even the most vulnerable populations and front-line health workers .
The limited shelf life of vaccines (3 to 6 months on average) also has an impact on vaccination rates in Africa, as it makes it difficult for vaccine-abundant countries to transfer excess doses to vaccine-poor countries before the vaccine expires.
But vaccine makers around the world are ramping up production, and demand for vaccines in high-income countries is slowly but steadily declining. According to the International Federation of Drug Manufacturers and Associations, at least 1.5 billion doses of the COVID-19 vaccine are currently being produced each month, with a total of 24 billion doses expected to be produced by June 2022. Vaccine supply could then exceed global demand. All this means that supply shortages in Africa are likely to end in the near future. This is undoubtedly good news for the mainland. But now, African countries need to focus on overcoming local bottlenecks, such as poor logistics, a lack of capacity to manage doses and vaccine hesitancy, which could hinder future vaccination efforts.
Failure to address these bottlenecks quickly and effectively could result in an increasing number of vaccine doses being returned to manufacturers or destroyed, especially given the short shelf life of most doses.
The continent has endemic logistical problems. For example, many major ports in Africa suffer from high levels of corruption, which has caused significant delays and increased import costs. These issues could also disrupt COVID-19 vaccination campaigns on the African continent. In addition, the cold chain infrastructure in Africa is seriously insufficient, which can easily lead to an average of 50% of the food in African countries being wasted. Given that COVID-19 vaccines require refrigeration — some at very low temperatures — this shortfall could also pose a threat to vaccination campaigns.
Even if these logistical issues are resolved, there is currently no way for most African countries to get all the doses they expect to receive into the arms of Africans before they expire. For one thing, there are hardly enough nurses or other trained health professionals to administer vaccines. According to the World Bank, the average number of nurses in sub-Saharan African countries is 1 in 1,000 of the population, compared with 10 in OECD or OECD member countries and 15 in North America. Also , and many of these countries also do not have enough syringes for widespread vaccination campaigns.
The low level of urbanization in many African countries is also an obstacle to the vaccine movement. Although the continent’s urbanization rate has increased rapidly over the past few decades, it remains relatively low, making it more difficult to vaccinate all citizens. According to the World Bank, six in 10 sub-Saharan Africans still live in rural areas. To reach parts of the population in remote areas, Côte d’Ivoire has deployed mobile clinics across the country, and Ghana uses drones to deliver doses to remote areas. Other African countries should also invest in such initiatives if they want to meet their vaccination targets in time.
In addition to these logistical issues, vaccine hesitancy is also an issue. Reports that the AstraZeneca vaccine can cause blood clots and several European countries’ decision not to vaccinate their citizens with the special vaccine have added to hesitation on the continent. Additionally, social media platforms, including Facebook, which has become synonymous with the internet in many African countries, have become a vehicle for spreading COVID-19 vaccine misinformation, causing many Africans to be hesitant to get vaccinated. Many African countries have failed to effectively respond to these misinformation campaigns by providing accurate vaccine information. Sadly, several respected public figures, including political leaders, have also directly contributed to the spread of misinformation and unfounded doubts about vaccine safety.
Domestic bottlenecks will be a major constraint on vaccination efforts as more doses reach the continent. With the support of development agencies, African leaders should develop clear vaccination plans and invest strategically in improving logistics and digital systems to better track doses. They should also expand and improve their cold chain infrastructure. They should invest in initiatives to ensure that doses reach parts of the population in remote areas. To address vaccine hesitancy, politicians, whether in power or not, should work with popular public figures such as football players, music stars and social media influencers to encourage Africans to get vaccinated. Economic incentives such as conditional cash transfers via cellphones can also help spur vaccinations and provide needed relief to families hard hit during the pandemic.
The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial position.