Many African countries ‘can’t afford a national jab campaign’

In this file photo taken on Dec 8, 2021, a woman is vaccinated by a member of the Western Cape Metro EMS in an ambulance which has been converted to facilitate vaccinations at a COVID-19 vaccination event in Cape Town. RODGER BOSCH / AFP

WASHINGTON / MEXICO CITYADDIS ABABA / DAKAR / ACCRA – It's noisy inside the Mamprobi clinic in Accra as kids clamber over their mothers while they wait to get their measles vaccines. Outside, an area reserved for COVID-19 shots is empty. A health worker leans back in his chair and scrolls on a tablet.

Only 17 percent of Africa's 1.3 billion population is fully vaccinated against COVID-19 – versus above 70percent  in some countries – in part because richer nations hoarded supply last year, when global demand was greatest, to the chagrin of African nations desperate for international supplies

One woman, waiting to get her daughter inoculated, is fully aware of the dangers of measles: the high fever, the rash, the risk to eyesight. But COVID-19? She has never heard of a single case.

The perception that COVID-19 doesn't pose a significant threat is common in Ghana's capital and elsewhere in Africa, whose youthful populace has suffered a fraction of the casualties that have driven vaccine uptake in places like Europe and America, where the disease tore through elderly populations.

Only 17 percent of Africa's 1.3 billion population is fully vaccinated against COVID-19 – versus above 70percent  in some countries – in part because richer nations hoarded supply last year, when global demand was greatest, to the chagrin of African nations desperate for international supplies.

Now though, as doses finally arrive in force in the continent, inoculation rates are falling. The number of shots administered dropped 35 percent in March, World Health Organization data shows, erasing a 23 percent rise seen in February. People are less afraid now. Misinformation about vaccines has festered.

That worries public health specialists who say that leaving such a large population unvaccinated increases the risk of new variants emerging on the continent before spreading to regions such as Europe just as governments there abandon mask mandates and travel restrictions.

In a sign of possible perils to come, cases of two Omicron subvariants have shot up in recent weeks in South Africa, the continent's worst-hit nation, prompting officials there to warn of a fifth wave of infections.

To boost uptake, countries are focusing on mobile vaccination drives, in which teams visit communities and offer doses onsite.

However many African countries can't afford the vehicles, fuel, cool boxes and salaries needed for a national campaign, according to more than a dozen health officials, workers and experts across several countries. Meanwhile, donor funding has been slow to arrive, they said.

Now the continent has too many COVID-19 vaccine doses. Vaccination sites lie empty; millions of unused vials are piling up, and one of Africa's first COVID-19 vaccine producers is still waiting for an order. 

To boost uptake, countries including Ghana, Gambia, Sierra Leone and Kenya are focusing on mobile vaccination campaigns that visit communities. But finances are stretched.

Misinformation is tough to unglue on a continent where big pharmaceutical companies have in the past run dubious clinical trials resulting in deaths. Health workers say they need funds to counter false rumors.

Ghana, one of Africa's most developed economies and one applauded for its early inoculation surge, has a funding gap of $30 million to carry out another campaign, according to the World Bank. Irregular power supply jeopardizes the vaccine cold chain. Doses expire.

"We don't have any problem with the number of vaccines anymore. It's only a problem with uptake and the money to get those vaccines out to people," said Joseph Dwomor Ankrah, who manages the country's COVID-19 vaccine distribution.

Niger, where only 6 percent of the population is fully vaccinated, lacks enough cold storage for vaccines in its vast rural areas, or motorbikes to distribute them, according to the World Bank.

There have been some successes; Ethiopia has vaccinated 15 million people in a nationwide push since mid-February, for example.

Yet uptake is "abysmally low" in the tiny state of Gambia, said Mustapha Bittaye, director of health services.

The African Union wants Gambia to take delivery of more than 200,000 doses, but the country is still working through an old batch and doesn't need more, Bittaye said.

In Zambia, where coverage is 11percent, officials are planning outreach campaigns but worry they won't be able to cover the cost of feeding doctors working far from home or pay for their transport.

In Sierra Leone, where 14 percent of the population is fully vaccinated, radio stations sometimes refuse to broadcast the government's pro-vaccine messages because of unpaid invoices, said Solomon Jamiru, the country's COVID-19 spokesman

A World Bank fund for vaccine purchases and rollouts has sent $3.6 billion to sub-Saharan Africa. Of that, only $520 million has been spent. Amit Dar, the bank's human development director for Eastern and Southern Africa, said outdated health systems had struggled to absorb the funding.

Health experts say more funding was needed at the start of the pandemic for logistics and training.

"The fact that we didn't invest heavily a year or 18 months ago is a big part of what we are seeing now," said Emily Janoch, a senior director at aid group Care USA. "These are the consequences of earlier failures."

Mexico

COVID-19 cases in Mexico have been on the decline for four months, Undersecretary of Prevention and Health Promotion Hugo Lopez-Gatell said Tuesday.

While there have been some "slight variations" in case numbers over the past three weeks, there is an overall downward trend in infections, he told reporters at a press conference.

Health officials have also registered "less than one death per day on average in recent weeks," he added.

Meanwhile, the national vaccination campaign against COVID-19 has vaccinated almost 87.3 million residents out of a total population of 126 million, according to statistics.

Mexico has accumulated 5,751,579 confirmed COVID-19 cases and 324,611 related deaths since the onset of the pandemic in the country, according to the latest official data.

In this file photo taken on April 14, 2021, shoppers wearing protective masks carry bags in the Broadway Plaza Shopping Center in Walnut Creek, California, US. (PHOTO / BLOOMBERG)

US

Rising COVID-19 cases are driving up the use of therapeutics, with Pfizer Inc's oral antiviral treatment Paxlovid seeing a 315 percent jump over the past four weeks, US health officials said on Tuesday.

The US Centers for Disease Control and Prevention on Tuesday estimated that about half of infections last week were from the BA.2.12.1 sublineage of the Omicron variant, which has been on the rise since mid-April and is already the dominant strain along much of the East Coast

The increase in US cases and hospitalizations is starting to affect recommendations on behavior, with New York City, the nation's most populous city, advising stricter mask usage but stopping short of new mandates. Apple has scrapped return to office plans. 

"Increasingly, we'll see this virus hit people who are substantially older, frail, have underlying illnesses, or are distinctly immunocompromised," said Dr. William Schaffner, infectious disease expert at Vanderbilt University Medical Center in Nashville.

"But we now have better treatments and many of those people will leave the hospital vertically rather than horizontally."

The United States is averaging nearly 97,000 new cases a day, up from about 73,000 a week ago, according to a Reuters tally. Cases have been gradually rising since hitting a recent low of 30,000 new infections a day in late March.

The US Centers for Disease Control and Prevention on Tuesday estimated that about half of infections last week were from the BA.2.12.1 sublineage of the Omicron variant, which has been on the rise since mid-April and is already the dominant strain along much of the East Coast.

"The other thing that's going on is that we're providing the opportunity for spread; we've taken off our masks, we're going back to group activities both in business and for recreation," said Schaffner.

"Going forward, we will have to figure out when is the impact of this virus sufficient such that we might have to start putting our masks back on and doing more social distancing. That sort of discussion is going on in New York right about now," he added.

New York City raised its COVID-19 alert level to high on Tuesday with its health department strongly advising wearing masks in all public indoor settings for everyone and in crowded outdoor settings for those older than 65 or at high risk.

Based on population, the US Northeast has seen the greatest rise in new cases in the last seven days, led by Connecticut, Rhode Island and Massachusetts.

There are currently nearly 20,000 people hospitalized across the country, up from 16,500 last week, according to a Reuters tally. Hospitalizations have also been steadily rising from a recent low of 12,000 in mid-April.

Based on population, the states with the most hospitalizations are Maine, New York and Delaware.

Deaths, a lagging indicator, have held fairly steady at a daily average between of 300 to 500. COVID-19 has killed more than a million US residents since the start of the pandemic.

Nearly 115,000 courses of Paxlovid were dispensed during the first week of May, the Department of Health and Human Services said on Tuesday.

A total of 668,954 courses were administered out of the available supply of 3.3 million, HHS data show.

Paxlovid is approved to keep high-risk individuals with COVID-19 from becoming seriously ill. It is meant to taken for five days beginning shortly after symptom onset.

Providers gave out 230,257 courses of molnupiravir, Merck & Co's rival oral antiviral developed along with Ridgeback Biotherapeutics. About 3.2 million molnupiravir courses are available, HHS data show.

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The White House said last month it was aiming to address unexpectedly light demand by expanding access to treatments like Paxlovid by doubling the number of locations at which they are available.

"In recent weeks we've gone from 20,000 sites with Paxlovid to approximately 35,000 and we'll keep working to increase availability," the senior health official said, adding that 88 percent of the population lived within 8 km of a site.

Health officials face a challenge in convincing the public that repeat vaccinations are beneficial, said Schaffner.

"We'll have to keep vaccinating because it would appear that to one degree or another over a period of months protection against serious disease begins to wane," he said.

The US Food and Drug Administration on Tuesday authorized the use of a booster shot of Pfizer and BioNTech's vaccine for children aged 5 to 11, making everyone 5 or older eligible for a third shot. 

The government has shipped around 360 million coronavirus tests to homes nationwide, the official said, and has opened a third round of ordering on its COVIDtest.gov website on Monday to allow additional requests.