It’s a game changer, a fundamentally new rule of the game – that’s how the South African pharmaceutical company Aspen was happy when it agreed a license with the pharmaceutical giant Johnson & Johnson last December: The South Africans should soon fill its corona vaccine for all of Africa and under the allowed to sell Aspenovax under their own name. A big step for global vaccination justice, health experts also found.
Just a few months later, Aspen has now surprised with a warning: They fear that production of the vaccine in South Africa will have to end. There is simply no demand for it.
Not a single order has been received for weeks, said John Nkengasong, head of the Africa Centers for Disease Control and Prevention at the African Union. “The risk is very, very high that the company will actually stop producing Johnson & Johnson vaccines,” said the virologist. “We cannot and must not allow that to happen.”
On the one hand, the low demand can be explained by the fact that richer countries are now donating more vaccines. Above all, however, the vaccination campaigns in African countries have almost come to a standstill. In the Democratic Republic of Congo, for example, just 0.1 percent of the approximately 80 million inhabitants are vaccinated. In South Sudan it is less than five percent, in Tanzania six percent. While around two-thirds of industrialized nations have reached the global vaccination target of currently 70 percent of the population less than 19 percent vaccinated on the African continent overall.
The rate of vaccination would have to increase ninefold
There is little hope of a quick fix. “The pace of immunization across the continent would need to increase nine-fold if we are to meet our goal of vaccinating 70 percent of the population by June 2022,” he said Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.
Even in South Africa, the vaccination rate is stagnating at around 36 percent. “That has been almost unchanged for a few months,” says Wolfgang Preiser, Professor of Virology at the University of Stellenbosch. As in other parts of Africa, there was initially a huge demand for vaccines, but very few doses. At that time, the manufacturer Aspen in South Africa mainly filled cans for Europe and the USA, not for their own country. When it became known last August that Aspen was exporting ten million cans while there was a shortage in Cape Town and Johannesburg, there was great outrage.
“Now there is enough, but the momentum has been lost. I fear that we are at the limit, that is, we have already reached everyone who wants to be vaccinated,” says Preiser. In June, millions of cans of Biontech expire in South Africa, and unused cans are also piling up in other African countries. Almost 40 percent of the vaccine doses shipped to the continent so far have not been used.
The long lamented lack of vaccinations worldwide has given way to a tragic vaccination fatigue in Africa. Why is that?
Fewer corona deaths than in Great Britain? Unlikely
In addition to the missed point in time, experts blame the course of the pandemic: Many Africans no longer see a great need for vaccination because there are hardly any deaths or serious illnesses in their environment. When the pandemic began, the worst was predicted for the continent – but a little over two years later, Africa has the world’s lowest death rates. The WHO reports only 170,000 deaths for the 1.2 billion people in Africa, fewer than Great Britain.
In the past few months, experts have tried to come up with many explanations for the comparatively gentle course of the pandemic. For example, there was speculation about an influence of the climate or about the amount of time people spend in the fresh air. Previous illnesses could also play a role, it said. “I don’t believe in African uniqueness,” says Preiser. “The average age in Africa is 19 years. The proportion of older people and therefore those who are much more at risk in the population is lower. If you factor that out, I don’t believe there are any fundamental differences.”
In addition, the low number of deaths can also be explained by the fact that many African countries lack reliable data. Even in South Africa, where it can be assumed that every death is at least registered, information on the cause of death is not always available. The government now assumes that the officially reported 100,000 dead will be around 300,000 more.
It could look similar in other African countries. According to a previously unpublished study by the South African epidemiologist Salim S. Abdool Karim, there are also signs of high excess mortality in Zambia. “The officially reported Covid-19 deaths in Zambia are only 4,000. But the country has had more than 80,000 deaths in the first two years of the pandemic,” says the professor at Columbia University in New York. “The ratio of excess deaths to population in Zambia is similar to that in South Africa.” PCR tests on the dead in the morgue in the capital Lusaka showed that the official number of Covid-positive patients is far too low.
Only after three Covid contacts – whether illness or vaccination – is the protection very good
The number of infected people also shows how imprecise the data is. According to the African Union, there are only 11.5 million – less than half as many as in Germany. In contrast, the WHO estimates that around two-thirds of Africans have already had an infection – and are therefore better protected against recurrence of the disease. So do we still have to be vaccinated? Definitely yes, says Stellenbosch virologist Preiser. Only after three contacts with Covid, whether through vaccination or illness, is the protection against fatal or serious courses very good.
For this reason, the vaccination targets for Africa should not be completely abandoned, but revised: Above all, older Africans and those at risk of previous illnesses must be reached. There is no longer a shortage of vaccines, but infrastructure, education and uniform communication from the government are also decisive for the vaccination rate. Many Africans perceive diseases such as malaria or tuberculosis as more threatening and many distrust the often corrupt elites.
The corona pandemic is only over when it is over all over the world. Experts from all over the world have said this again and again over the past two years. They warn that a large number of unvaccinated people could also lead to new virus mutants. Western donors have therefore again made five billion doses available for vaccinations in Africa.