When Ghana received 50,000 doses of COVID-19 vaccine from India last month, it came to a frustrating blockade: it had not trained enough staff to distribute them.
According to the head of Ghana’s vaccination program, the country was still deploying features received in late February from the global COVAX vaccine sharing program and did not have the capacity to expand that operation.
Instead of going directly into the arms of health workers, the extra doses were put in a cold storage in the capital Accra, Kwame Amponsa-Achiano told Reuters, adding that his team had received a two days notice on shipment.
“We were in the middle of the first campaign,” Amponsa-Achiano said. “How do you plan 50,000 when you’re already running another campaign?”
The problems facing Ghana, one of the most economically developed nations in sub-Saharan Africa, illustrate how a continent with experience in fighting deadly infectious diseases has been found ill-prepared to inoculate people against it. pandemic.
Many African countries, which are already facing a shortage of affordable vaccines, are stunned by the unprecedented scale of the distribution challenge when doses arrive.
Authorities do not have enough equipment such as masks and cotton due to funding shortfalls that could add up to billions of dollars, according to more than a dozen health experts and some internal government documents seen by Reuters.
They also lack the staff and sufficient training to distribute vaccines at short notice.
Although Africa has so far been relatively free of COVID-19, some experts fear that stuttering launches could cause the outbreak in the region, which could lead to more deaths and economically damaging restrictions on a continent that is already the most vulnerable. poor in the world.
Benjamin Schreiber, COVAX coordinator at the UN agency UNICEF for Children, said logistical problems could increase in the coming weeks and months as countries try to vaccinate their general populations.
“As we begin to deploy larger quantities, we will begin to see more problems,” Schreiber said.
“Gaps in health systems will be gaps that make deployment difficult,” he added. “My concern is that we are missing whole communities.”
NEEDED: MILLIONS OF DOLLARS
Ghana, where the new coronavirus has infected more than 91,000 and killed more than 750, is considered one of the most prepared countries in Africa to conduct a mass vaccination campaign because of its political stability and economic development.
The government plans to initially inoculate 17.6 million people, about half its population, at a cost of $ 51.7 million, according to a national plan seen by Reuters.
It expects to cover $ 7.9 million of that money with a World Bank loan, but it is less than $ 43.8 million, which is described as a “funding gap” in the internal government document.
Vaccination chief Amponsa-Achiano said he was unaware that the situation had changed since the plan was formulated in February.
Ghana’s finance and health ministries did not respond to requests for comment.
Ghana was the first country in the world to receive a shipment of COVAX, on February 24, with the delivery of 600,000 doses of the AstraZeneca / Oxford University vaccine, manufactured in India.
It began its vaccination union on March 1 and had vaccinated 599,000 people on April 7.
While this vaccination rate is better than many of its African counterparts (Côte d’Ivoire vaccinated just over 53,000 people between March 1 and April 6), it lags far behind the fastest-growing countries in world level. Britain, for example, administered doses to about 2 million people in the first month of its unit.
NEEDED: FRIDGES, COTTON WOOL
Ghana’s national plan shows how even relatively prosperous African nations lack vital equipment.
Money is needed in general, including $ 1.5 million for 11 cold rooms and more than 650 refrigerators to keep vaccines between 2 and 8 degrees Celsius.
About $ 25 million is needed for supplies and waste management, including 33,600 boxes of facial masks, 240,000 bottles of hand sanitizer and about 55,000 rolls of cotton, according to the plan. About $ 21 million is needed to train more than 171,000 health workers and volunteers.
To add to Ghana’s challenge, its next COVAX shipments, scheduled for April and May, have been delayed until June, as India suspended major exports of vaccines manufactured there.
In its budget for 2021, outlined in mid-March, the Ghanaian government allocated 929,296,610 cedis ($ 160 million) for the acquisition and deployment of vaccines.
Amponsa-Achiano said, however, that it was not clear how much would be spent on distribution or when the funds would materialize.
It’s a common problem in Africa, UNICEF’s Schreiber said.
“The question is when will this funding touch? Will it be on time?”
EBOLA CONGO BUDS
Some African authorities are familiar with the deadly contagions. Since 2018, Congo has contained four Ebola outbreaks with a vaccine to be stored between -60 and -80 degrees Celsius.
But the scale of the vaccination unit against COVID-19 is new.
COVAX, the donor scheme led by the World Health Organization (WHO), has delivered more than 18 million doses to 41 African countries, according to Reuters data.
This is the first wave that is expected to deliver 600 million doses to Africa this year, enough to vaccinate 20% of its populations. Russia, China and India have also given some of their vaccines.
Funding is just a problem that delays vaccine deployment.
Another is the irregular maintenance of records in many public health systems, which experts say make it difficult to identify people who should be prioritized because of age or comorbidities.
Demand for shots is also weak in some countries due to mistrust of health authorities, lack of education about vaccines and concern about possible side effects.
Poor electricity and poor transportation connections in some places add to the challenge, while medical teams will have to negotiate safe passage through parts of the Democratic Republic of Congo, Mali, Somalia and other places where insurgencies are manifesting. .
VACCINE UNTIL THE END-2022?
John Nkengasong, who heads Africa’s Centers for Disease Control and Prevention, says it may take until the end of 2022 to vaccinate 60% of the continent’s 1.3 billion people.
Do the task facing Mali, an impoverished country fighting an Islamist insurgency. It needs $ 14.7 million to deploy vaccines, including gasoline, vaccine storage and training, according to an internal government vaccination plan seen by Reuters.
The government will need funding from WHO, UNICEF, the GAVI vaccine alliance and the World Bank, according to the plan. All of these organizations seek to provide funding to deficit-stricken African nations.
South Sudan, still raped after the civil war that ended in 2018, has seen COVID-19 infect at least 10,300 people and kill more than 100.
It began distributing 132,000 doses of COVAX vaccine on April 7th. However, authorities will not begin administering shots outside the capital Juba and its surrounding county until May, said Kawa Tong, a member of a COVID-19 steering committee advising the government.
“The key reason is the lack of funds for a deployment outside of Juba. The transportation of vaccines, the training of health workers, community outreach, all of this is tied to funding,” Tong told Reuters.
In addition to the difficulties, in May the rainy season will be well advanced, cutting off transport links to large parts of the country, he said. The vast majority of the population of 11 million people live outside of Juba County.
Atem Riek Anyom, director general of primary health care at South Sudan’s health ministry, said the government had applied for World Bank funding, adding that vaccines would soon be rolled out across the country.
“There is no challenge when it comes to vaccine deployment,” he added.
The World Bank, which has a $ 12 billion fund to help developing countries around the world buy and distribute vaccines, said it was reviewing applications from Mali and South Sudan.
The bank said it approved $ 2 billion in 17 countries, including seven in Africa: Ethiopia, Cape Verde, Ivory Coast, Eswatini, Tunisia, Rwanda and The Gambia.
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