ANALYSIS: How Africa is leading from behind in global coronavirus vaccine race

As COVID-19 vaccines are currently being rolled out swiftly globally, it is becoming clearer that Africa will be the last region to get enough supplies of the much-needed jabs deemed the silver bullet for the highly contagious disease which is spreading rapidly across the continent.

The Nigerian government said it will receive at least 100,000 doses of the Pfizer and BioNTech approved COVID-19 vaccines by the end of January through the COVAX co-financing public-private facility.

But several global health experts and bodies told PREMIUM TIMES it is “almost impossible” for Nigeria to start receiving vaccines this January.

Evidence on the ground at the country’s National Strategic Cold Store suggests that the country does not have the capacity yet to effectively store the Pfizer vaccines, a check by this newspaper showed.

Nigeria does not have ultra-cold freezers much needed to store some of the foremost vaccines already in use such as the Pfizer-BioNTech and Moderna vaccines, according to Iyabo Daradara, Director, Logistics and Health Commodities at the National primary HealthCare Development Agency (NPHCDA).

“The National Strategic cold store has 11 walk-in cold rooms refrigerators which store at +2 to +8 and four walk-in freezer rooms which are used for vaccines that need freezing. she said, in an interview with PREMIUM TIMES. “We do not have ultra-cold freezers in the country.”

Most African countries, including Nigeria, are banking on benefitting from the COVID-19 Vaccines Global Assess Facility, or Covax, the World Health Organization-backed programme, which was set-up to divide a billion doses across 92 low- and middle-income countries.

The facility promised access to vaccines for up to 20 per cent of participating countries’ population with an initial supply beginning in the first quarter of the year to immunize 3 per cent of their population.

But whether the COVAX facility is able to deliver vaccines as promised or not, African countries must sort other alternatives to vaccinate at least 50 per cent of their population to reach herd immunity.

Other options for Africa

Africa seems not to be part of the supply priorities of the Pharmaceutical companies producing the foremost COVID-19 vaccines at the moment.

According to Quartz Africa, Pfizer-BioNTech offered to supply just 50 million COVID-19 vaccines to Africa starting from March to the end of this year while Moderna and AstraZeneca have not yet allocated supplies for Africa.

Many African countries experience spikes in infection rates are turning to Russia, India, and China despite scepticism about some of the vaccines.

Health experts said Russia and China rolled out their vaccines without phase 3 clinical trial results that confirm the vaccine effectiveness.

Sinovac, a Beijing-based biopharmaceutical company, is behind CoronaVac, an inactivated vaccine from China. It works by using killed viral particles to expose the body’s immune system to the virus without risking a serious disease response.

The Sinovac vaccines have been found to be 50.4 per cent effective in Brazilian clinical trials, according to the latest results released by researchers, the BBC reported.

Morocco has ordered 65 million doses of the Sinopharm vaccine, another vaccine from China, and AstraZeneca vaccine from Serum Institute India.

According to Quartz Africa, South Africa said it also made a deal with Serum Institute India and will be getting 1.5 million doses of AstraZeneca vaccine for its health workers this January. Guinea is testing the Russian vaccine, Sputnik V and has ordered 2 million doses.

Nigerian authorities said it is discussing with China on possible vaccine access.

Most of these vaccines from China, India and Russia are more convenient for Africa and developing countries in terms of purchase, storage and distribution costs.

The Oxford-AstraZeneca vaccine for instance had lower interim efficacy results, but offer the best possibility for distribution in Nigeria because the temperature required is not as low and manufacturers can produce it at a lower price.

While Africa grapples to find its footing in the vaccine race and the best available option in the market, PREMIUM TIMES looks at the efficacy of the foremost vaccines already widely in use, countries that have started using them: the progress, prospects and challenges.

Vaccine development

Vaccines typically take at least a decade to develop, test and manufacture, according to scientists. It took 18 years for scientists to successfully develop a vaccine against polio.

The College of Physicians of Philadelphia said it took two to four years just to identify a substance in the lab that could fight a disease. Both the chickenpox vaccine and FluMist, which protects against several strains of the influenza virus, took 28 years to develop.

But the Pfizer-BioNTech and the Moderna COVID-19 vaccines were developed at breakneck speed in less than a year to become the fastest ever in human history.

According to researchers, the only difference between the COVID-19 vaccines and their predecessors is the use of the genetic material mRNA which is easy to make in a laboratory.

Before now, vaccines typically use a weakened version of the pathogen or a protein piece of it and because these are grown in eggs or cells, developing and manufacturing vaccines takes a long time. But by using just the genetic material that makes the Spike glycoprotein – the protein on the surface of the coronavirus that is essential for infecting human cells – the design and manufacture of the vaccine are simplified.

Manufacturing an mRNA vaccine rather than a protein vaccine can save months, if not years, health experts say.

The mRNA vaccines produced by Pfizer and Moderna are faster to develop as they do not require companies to produce protein or weakened pathogen for the vaccine.

Another factor that accelerated the vaccine development was the swift and efficient recruitment of patients for clinical trials as well as the urgent need for it due to the unprecedented spread of the COVID-19 infections.

COVID-19, the potentially dangerous pneumonia-like disease caused by the coronavirus and said to have emanated from a local Wuhan market to spread to over 200 countries, have infected more than 90 million people worldwide, claiming nearly 2 million lives, according to data from worldometer.info.

Vaccine Dilemma

The swift development of the coronavirus vaccines has raised a worrying level of vaccine hesitancy, especially in many African countries, a global survey by the Conversation showed in late last October.

While the fact that the vaccines already in use are not 100 per cent efficacious was a major reason for scepticism, many people that have received them thus far appear to have a slim option: they are faced with the dilemma of getting an unknown substance in their arms and living with the constant fear of contracting a killer virus.

According to the latest World Economic Forum-Ipsos survey on vaccine confidence, a strong intent to be vaccinated has risen in the US and the UK, following the release of the vaccine in the two countries amid swelling approval scepticism.

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The New York Times on December 8, 2020, reported how Britain’s National Health Service began delivering shots of the Pfizer-BioNTech vaccine, opening a public health campaign with little precedent in modern medicine and making Britons the first people in the world to receive an authorized, fully tested COVID-19 vaccine.

The UK and the U.S commenced vaccination almost the same day with the Pfizer vaccines and both countries have also approved a second vaccine made by Moderna.

But according to Business Today, the fact sheets for vaccine recipients in the US and UK for Moderna and Pfizer-BioNTech vaccines say the vaccines are yet to be fully approved.

Moderna’s fact sheet for recipients say its vaccine is unapproved and ‘may prevent COVID-19’. The UK government says it has only given approval for ‘temporary supply’ and not a marketing authorisation for Pfizer vaccine, the report said.

Vaccine race

Since Margaret Keenan, a 90-year-old grandmother became the first person in the world to receive the Pfizer-BioNTech COVID-19 vaccine in early December in the U.K., more than 40 countries have started administering coronavirus jabs among their populations.

While U.K. was the first to start, Israel is leading the world in terms of vaccination rate, with nearly 20 people in every hundred having received a dose, according to data compiled by Our World In Data, a research website affiliated with Oxford University.

This has been attributed to the country’s digitized healthcare system and the government’s early success in purchasing enough doses of the Pfizer and Moderna vaccines to cover the whole population.

The United Arab Emirates is currently occupying the second position after achieving thus far the achieved vaccination rate of 8.98 per 100 people. The UAE approved the Pfizer-BioNTech and Chinese-made Sinopharm vaccines for mass use and administered vaccines on December 14.

Bahrain followed at third position with 4.25 per 100 people.

The United Kingdom had administered 1.91 jabs per 100 people by January 8 to come fourth, while the United States had administered 1.79 doses by January 7 to come fifth.

Belgium received the first COVID-19 vaccines developed by BioNTech/Pfizer on December 28, 2020. The country plans to vaccinate 70 per cent of its population by the end of 2021. Meanwhile, the country is still one of the lowest at 0.01 per 100 people.