As countries around the world that are already vaccinating their citizens against Covid-19 debate doses and time frames to protect efficacy, African countries are still struggling to come up with strategies, or not considering any at all.

Some governments in East Africa are at pains to assure their citizens that the vaccines will arrive soon, and others, like Tanzania, have said they have no interest in inoculating their population. Since declaring that the country had no more Covid-19 cases last June, this past week a Tanzanian government spokesperson said they see no reason for pursuing options to acquire Covid-19 vaccines at present.

“Tanzania has no Covid-19 and we have already forgotten about it, so what does the vaccine have to do with us?” Hassan Abbasi, the government spokesperson told The EastAfrican.

He made the remarks even as Gavi, the vaccine alliance, which plans to dispatch doses to countries through the World Health Organisation-backed Covid-19 Vaccines Global Assess Facility (Covax), said that only willing countries will be considered for the programme. Gavi confirmed that Tanzania is eligible for a subsidised global scheme to supply vaccines doses to protect vulnerable groups in the first half of 2021 should the country take up the offer.

Gavi is however short of $5 billion to cover vulnerable residents in target nations by the end of 2021, the organisation said. “Covax now has agreements in place to access nearly two billion doses of several promising vaccine candidates, and has laid the groundwork for further doses to be secured through contributions from donors,” a Gavi spokesperson told The EastAfrican in an e-mail message.

“Tanzania is one of the 92 low- and middle-income economies that will receive support for the procurement and delivery of fully subsidised donor-funded vaccine doses,” the Gavi spokesperson said.

Tanzania’s Health ministry this week issued a new Covid-19 directive for travellers, signed by recently appointed minister Dr Dorothy Gwajima, to address “daily increases in reported cases worldwide; the emergence of a new strain of the virus in some countries; a rise in rates payable for sample testing services due to an increase in the number of travellers and testing centres; and adoption of new testing technologies”.

The ministry declared a flat testing fee of $100 per person, with a 24-hour to 48-hour waiting period for results.

Willing countries

She said that only willing countries will be considered for the programme.

“The vaccine deals announced on December 18 mean Covax can plan for the first deliveries of vaccines in the first quarter of 2021, with the first tranche of doses — enough to protect health and social care workers — delivered in the first half of 2021 to all participating economies who have requested doses in this timeframe.

“Assessments for the first deliveries will be made based on a number of factors including country readiness, national regulatory conditions and the suitability of vaccine technologies in specific country contexts,” she said.

Many of Africa’s countries are largely dependent on the Serum Institute from India, whose chief executive Adar Poonawalla has said its first priority will be to supply the AstraZeneca vaccine to Indians, before distributing it to other countries under the Covax programme.

On Thursday, South Africa announced that it will import 1.5 million doses of the AstraZeneca vaccine to inoculate the country’s health workers. According to Health minister Zwelini Mkhize, the first one million doses will be delivered later this month from the Serum Institute of India, followed by an additional 500,000 doses in February. Last month, Morocco announced it had ordered 65 million doses of Covid-19 vaccines from China’s Sinopharm and Britain’s AstraZeneca.

On Wednesday, Kenya’s Health minister said the country is expected to start receiving 24 million doses of the AstraZeneca vaccine in February.

The EastAfrican has learnt that the government is yet to put together a solid vaccination roadmap, despite talk of an existing water-tight dossier. An 11-member vaccine advisory task force at Kenya’s Ministry of Health, headed by Dr Willis Akhwale, a senior presidential advisor on malaria, is yet to make any official recommendations.

“We are working closely with relevant health departments, and we are embarking on vaccine landscape discussions in our next meeting this week,” Dr Akhwale said.

The country’s vaccine plan is however not clear. For instance, Kenya’s health director-general Patrick Amoth says the government intends use a hybrid system of vaccination and has prioritised vaccinating about 438,000 Kenyan medics. Yet, according to the Kenya health sector strategic plan, as at November 2018, Kenya had 78,711, health workers, with 68,085 in the public sector and 10,626 in the private sector.

Going by the Ministry of Health’s vaccine priority figure of 438,000 health workers, the statistics indicate that the designated immunisation number is almost six times higher than that on the ground.

The dates of the vaccine’s arrival into the country have also been shifting depending on who you ask.

Uganda’s plan

In Uganda, the Health ministry’s Permanent Secretary Dr Diana Atwine said the country was eyeing the AstraZeneca vaccine and had applied for consideration to Gavi.

“Based on the evidence available and the recommendations of the scientific advisory committee of the Ministry of Health, Uganda will access the vaccine from AstraZeneca,” Dr Atwine said.

As countries in sub-Saharan Africa begin to announce progress in obtaining the vaccines, it may not be until April that the first doses arrive. At a press briefing, director of Africa CDC Dr John Nkengasong said that starting April, “we will begin to see an active vaccination program in the continent”.

Public health officials say that disparities are emerging as wealthier countries reserve most of the world’s doses, while poorer countries have secured scarce amounts.

Last week, South Africa’s President and chair of the AU Cyril Ramaphosa, in an interview with Bloomberg, said Africa has few options to procure Covid-19 vaccines. He said Pfizer-BioNTech has offered to supply Africa with 50 million vaccines for health workers between March and the end of the year. Moderna has no supplies for Africa, and AstraZeneca has reportedly directed the AU to negotiate with the Serum Institute of India, the world’s largest vaccine manufacturer, which is making the vaccine on behalf of AstraZeneca.

In its latest weekly media briefing, the World Health Organisation (WHO) said the Gavi Covax Advance Market Commitment (AMC) facility will begin receiving its first vaccine shipments between February and March.

“Covax and the Serum Institute of India have a contract to supply AstraZeneca and Novavax. We are still looking to get the vaccines between February and March and don’t anticipate any delay,” said Dr Soumya Swaminathan, a chief scientist at the WHO.

Some countries have begun contemplating introducing a vaccination passport.

“We do not recommend any vaccination proof before travel,” Dr Alejandro Cravioto, chairman of WHO’s Strategic Advisory Group of Experts on Immunisation, told an online news briefing on Monday.