Financial challenges fuel delays in Africa's COVID-19 vaccine rollout
A blockage on supplies and financial challenges are delaying Africa’s rollout of COVID-19 vaccines and risk curtailing plans to significantly expand the continent’s rollout later this year.
Vaccine deliveries to Africa through the COVAX facility ground to a near halt in May as the Serum Institute of India diverted doses for domestic use. Between February and May the continent received just about a quarter – 18.2 million – of the 66 million expected doses through COVAX.
“As people living in richer countries hit the reset button this summer and their lives start to look normal, in Africa our lives will stay on hold. This is unjust,” said Dr Matshidiso Moeti, the World Health Organization (WHO) Regional Director for Africa. “We are optimistic that vaccine availability will improve significantly in the second half of the year. We can still catch up and make up for the lost ground, but time is running out.”
The COVAX Facility continues to explore options to mitigate the impact of this global supply shortage and is in active negotiations with other manufacturers of COVID-19 vaccines to diversify the portfolio while supporting the medium- to long-term scale up of manufacturing capacity.
“The supply gap can be closed if countries with surplus doses set aside a percentage of vaccines for COVAX,” said Dr Moeti. “I welcome the pledge by the United States this week to share 80 million doses with other countries, in addition to recent shipments of vaccines from France to Mauritania. Dose sharing is key to ending the supply crunch and the pandemic as a whole, as no one is safe until everyone is safe.”
While limited supplies of doses are hampering the large-scale rollout of vaccines, funding for operational costs is also a critical barrier. Eight countries have used up all their vaccines, but over 20 countries have administered less than 50% of their doses.
COVAX is providing its share of vaccines for free to lower-income countries, but there are other significant costs. It is estimated that 60% of every dollar spent on delivering vaccines is needed for operations. The World Bank calculates that on top of the money needed to buy enough vaccines to ensure adequate protection from COVID-19, another 3 billion is required to deliver the vaccines into the arms of people.
In some African countries, the lack of funds is already causing delays in addition to a shortage of vaccinators, sub-optimal training, weaker communications to boost the uptake of vaccines and an inability to capture crucial data or to print and distribute immunization cards.
Most African countries have financial plans in place to cover the first 3% of their populations, but early evidence shows that many financial plans are inadequate for the larger, more geographically spread next phases. The costing plans also miss crucial expenditures such as hiring vaccinators, administration, cold-chain storage, logistics and transport for vaccines to reach widely dispersed populations.
While domestic financing of these operational costs is encouraged, COVAX, Gavi, the Vaccine Alliance, the World Bank and other donors are ready to provide some funding. However, to unlock these funds, robust financial plans are necessary.
“It’s critical to use this time, while there are only limited doses, to cost and plan for a more effective rollout and ensure that all doses are used as effectively as possible and none go to waste,” said Dr Moeti. “WHO is on hand to support countries with their COVID-19 costing plans.”
Only a handful of African countries have made good use of the COVID-19 Vaccine Introduction and Deployment Costing Tool produced by the COVAX Facility, which aims to help countries determine their funding needs. The tool is the first step to a well-structured budget, offering a quick yet comprehensive estimation of incremental costs.
Together with the World Economic Forum, WHO held a virtual press conference today with Dr Moeti, Dena Ringold, Regional Director, Human Development, West and Central Africa Region, World Bank, and Razia Khan, Standard Chartered, Head of Research and Chief Economist, Africa & Middle East. They were joined by Dr Richard Mihigo, Coordinator, Immunization and Vaccines Development Programme, WHO Regional Office for Africa.