When Ghana received 50,000 doses of COVID-19 vaccine from India last month, it hit a frustrating roadblock: it did not train enough staff to distribute it.
According to the head of Ghana’s vaccination program, the country still received shots received at the end of February from the global vaccination system scheme COVAX, and could not expand it.
Kwame Amponsa-Achiano told Reuters, rather than go straight into the arms of health workers, the cool dose was placed in the capital Accra, adding that his team had received two days’ notice.
“We were in the middle of the first campaign,” Amponsa-Achiano said. “How do you plan for 50,000 if you’re already doing another campaign?”
The problems facing Ghana, one of the more economically developed countries south of the Sahara, illustrate how a continent with experience in fighting deadly infectious diseases was unprepared to vaccinate people against this pandemic.
Many African countries, which are already facing a shortage of affordable vaccines, are amazed at the unprecedented scale of the distribution challenge when it comes to doses.
According to more than a dozen health experts and some internal government documents seen by Reuters, authorities do not have enough equipment such as masks and wadding because it has a shortage of funding that could run into billions of dollars.
They also do not have enough staff and training to distribute vaccines at short notice.
Although Africa has so far been relatively unharmed by COVID-19, some experts fear that faltering rollout could provoke the outbreak in the region, potentially leading to more deaths and economically damaging constraints in a continent that is already the poorest in the world.
Benjamin Schreiber, COVAX coordinator at the UN children’s agency UNICEF, said logistical problems could increase in the coming weeks and months as countries try to get vaccinations to their general population.
“As we start rolling out larger quantities, we’re going to start seeing more problems,” Schreiber said.
“The gaps in healthcare systems will be the gaps that hamper implementation,” he added. “My concern is that we are missing entire communities.”
REQUIRED: MILLION DOLLARS
Ghana, where the new coronavirus has infected more than 91,000 and killed more than 750 people, is considered one of the better prepared countries in Africa to carry out a mass vaccination operation because of its political stability and economic development.
The government initially plans to vaccinate 17.6 million people, about half of its population, at a cost of $ 51.7 million, according to a national plan seen by Reuters.
It hopes to cover $ 7.9 million of the money with a World Bank loan, but that is less than $ 43.8 million, which is described in the internal government document as a ‘financing gap’.
Amponsa-Achiano, head of immunization, said he was not aware that the situation had changed since the plan was formulated in February.
The Ghanaian Ministry of Finance and Health did not respond to requests for comment.
Ghana was the first country in the world to receive a consignment of COVAX, with the delivery of 600,000 doses of the AstraZeneca / Oxford University vaccine, manufactured in India, on 24 February.
It started vaccinating on March 1 and vaccinated 599,000 people by April 7.
Although the vaccination rate is better than many of its peers in Africa – the Ivory Coast vaccinated just over 53,000 people between March 1 and April 6 – it is far behind the fastest countries worldwide. Britain, for example, administered doses to about two million people in about the first month of its journey.
REQUIRED: REFRIGERATOR, COTTON WOOL
The Ghanaian national plan shows how even relatively prosperous African countries do not have essential equipment.
Money is needed across the board, including $ 1.5 million for 11 walk-in cold rooms and more than 650 refrigerators to keep vaccines between 2 and 8 degrees Celsius.
About $ 25 million is needed for inventory and waste management, including 33,600 boxes of face masks, 240,000 bottles of hand sanitizer and nearly 55,000 rolls of cotton wool, the plan said. About $ 21 million is needed to train more than 171,000 health workers and volunteers.
To contribute to the challenge of Ghana, the next COVAX deliveries expected in April and May were delayed until June because India suspended the large exports of vaccines produced there.
In its budget for 2021, set out in mid-March, the Ghanaian government allocated 929,296,610 seeds ($ 160 million) for the acquisition and deployment of vaccines.
Amponsa-Achiano said, however, that it was not clear how much was going to be distributed or when the funds would be realized.
This is a common problem in Africa, said Schreiber of UNICEF.
‘The question is at what point will this funding hit the ground running? Will it be time? ‘
CONGO EBOLA OUTBREAKS
Some African authorities know deadly infections. Since 2018, Congo has contained four Ebola outbreaks with a vaccine that should be stored between -60 and -80 degrees Celsius.
But the scope of the COVID-19 vaccination is new.
COVAX – the donor scheme co-led by the World Health Organization (WHO) – has delivered more than 18 million doses to 41 African countries, according to Reuters data.
It is the first wave in the fight that is expected to deliver 600 million doses to Africa this year, enough to vaccinate 20% of their population. Russia, China and India also donated some of their vaccines.
Funding is only one problem that slows down the explosion of vaccines.
Another wrongful record keeping in many public health systems, according to experts, is difficult to identify people who need to be prioritized due to age or co-morbidity.
The demand for shots is also weak in some countries due to mistrust in the health authorities, the lack of training on the vaccines and the concern about possible side effects.
Spotting electricity and poor transport 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 uprisings are raging.
NOTHING TO END-2022?
John Nkengasong, head of the African Center for Disease Control and Prevention, says it could take until the end of 2022 to vaccinate 60% of the 1.3 billion people on the continent.
Take on the task that Mali, an impoverished country facing an Islamic uprising, is facing. It needs $ 14.7 million to use vaccines, including for gasoline, vaccine storage and training, according to an internal government vaccination plan seen by Reuters.
The plan will require support from the WHO, UNICEF, the GAVI vaccine alliance and the World Bank. These organizations all want to provide funding to African countries that are in short supply.
South Sudan, which is still plagued by violence after a civil war 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 7, but authorities will only begin firing outside the capital, Juba, and the surrounding province in early May, Kawa Tong said. The government.
“The main reason is the lack of funds for a rollout outside of Juba. The transport of vaccines, training of health workers, community outreach – these are related to funding,” Tong told Reuters.
If it is even more difficult, the rainy season in May will be well underway and the transport connections to large parts of the country will be cut off, she said. The vast majority of the 11 million inhabitants live outside the province of Juba.
Atem Riek Anyom, director general of primary health care at South Sudan’s health ministry, said the government had requested funding from the World Bank, adding that vaccines would soon be deployed across the country.
“There is no challenge regarding the deployment of the vaccine,” 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 requests from Mali and South Sudan.
The bank said it had approved $ 2 billion for 17 countries, including seven in Africa: Ethiopia, Cape Verde, Ivory Coast, Eswatini, Tunisia, Rwanda and Gambia.
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