NAIROBI, Kenya – The nurse was in bed this month, coughing, panting and feverish.
It was three months after rich countries vaccinated health workers, but Kenyans like nurse Stella Githaiga were left behind: she was pulled over in the country’s largest public hospital in February during an outreach to remote communities, she believes. to get rid of her even while Kenya is struggling with a brutal third surge of infections.
Me. Githaiga and her colleagues are the victims of one of the most ominous inequalities in a pandemic that has exposed so much: across the global south, health workers are getting sick and killed by a virus from which doctors and nurses in many rich countries are now largely protected.
This is just the most visible cost of a rich-poor rift deepening in the second year of the pandemic. Of the vaccination given worldwide, about three-quarters went to only ten countries. At least thirty countries have not yet injected one person.
Scientists have long warned that such unfair treatment could haunt not only poorer countries but also richer ones if the continued spread of the virus makes it possible to change the way vaccines are undermined. But the less human cost will almost certainly be borne by less wealthy countries.
Unvaccinated doctors and nurses have died this year in countries including Kenya, Mozambique, Nigeria and Zimbabwe, which are weakening health systems that can no longer afford workers and threatening to reduce the level of care in countries overwhelmed by variants.
The toll in Africa can be particularly deep. The continent has 17 percent of the world’s people, but so far it has administered about 2 percent of the vaccine doses worldwide.
“I do not think we have the ability to treat our own as a country and even as Africa,” said Hazel Miseda Mumbo, vice-chancellor of Great Lakes University in Kisumu, Kenya, who studied the country’s health system. ‘While these countries in the West are still looking for vaccines, Africa will have to wait. This can be a sad situation. ‘
In a worrying sign of how uneven the distribution is, even Kenya, one of the richest countries on the continent, is doing badly.
The first million doses of Covid-19 vaccine arrived on March 2 just before midnight. The delighted health minister, Mutahi Kagwe, said the country was ‘fighting this virus with rubber bullets’, but has now finally got the metaphorical equivalent of ‘machine’. rifles, bazookas and tanks. ”
But the arsenal was not all that it seemed. The doses were a month late, and a quarter of the promise. India has recently started a relatively small but welcome addition of 100,000 doses. Kenya has no idea when exactly the next group of vaccines will arrive.
Even under the best of circumstances, the country expects to vaccinate only 30 percent of its population by the middle of 2023, or about 16 million out of nearly 50 million. If anyone gets the chance, it’s someone’s suspicion.
The initial doses are passed on to health workers and other essential workers.
For the health workers who have been trying to get a tenfold increase in daily cases since the end of January, the initial shots only came after the illness. Me. Githaiga watched from her sickbed as the news media showed how health officials and fellow nurses and doctors received their shots.
“In the last year, there has been so much shock and anxiety about this virus,” she said. Githaiga said, who was recently released after a week in hospital. “So ironic that I was sick on the day the vaccine rolled out. I left out of account. ”
For wealthy countries, Kenya’s timeline for vaccination is unthinkable. Waiting months seem tough enough, especially with dangerous variants surrounding the world. President Biden has promised to have vaccinations for all adults in the United States by May. Israel vaccinated 60 percent of its people, and Britain vaccinated 41 percent.
Like many developing countries, Kenya relies on the global vaccine procurement and distribution mechanism known as Covax. The program was based on the idea that many countries, including richer countries, would use it to acquire shots as a way to spread their commitment across vaccine manufacturers. Instead, dozens of rich countries bought doses directly from pharmaceutical companies, which thwarted international efforts and delayed transportation to the developing world.
According to analysts, poorer countries are in a stronger position than they would have been without the effort. Covax aims to cover at least 20 percent of the people in participating countries by the end of the year.
In Kenya, strict restrictions – lockouts, curfews, flight suspensions and school interruptions that eventually forced children to repeat the school year – prevented the virus from overwhelming the country last year, as well as its relatively young population.
But controls such as locks, available to rich and poor countries, are no longer the best defense against the coronavirus. The most valuable currency now is vaccines, which open a gaping gap between those who can afford it and those who cannot.
The pandemic has worsened in Africa since a variant first seen in South Africa, which has been shown to re-infect humans, is starting to drive up cases in the southern parts of the continent.
“It was believed that Africa had escaped this pandemic,” said Tulio de Oliveira, a geneticist at the Nelson Mandela School of Medicine in South Africa. “Unfortunately it did not.”
With cases soaring in Kenya, delayed vaccines will cost more lives. The number of reported Covid-19 cases – more than 120,000 infections resulting in about 2,000 deaths – is thought to be an understatement.
The country expected more doses of Covax. But his health officials also hoped the country’s close security and trade relations with the European Union and Britain would help him secure vaccines. Kenya also ignored the concerns of other countries about the use of ‘trial cones’, and took part in the vaccination trials, which raised expectations for earlier shipments.
“The clinical trials led to vaccines,” said Dr. David Ngira, a postdoctoral researcher in global health law at Cardiff University, said. “And on this premise, Kenyan participants, as well as the surrounding communities and the country in general, had to take precedence in access to vaccines.”
But that did not happen. Even low expectations in Kenya have been scaled back: A promised 4.1 million doses of Covax by May have been reduced to 3.6 million doses. The country has ordered a total of 24 million doses.
Health officials say they are grateful, but even Covax shots come with a hook. Vaccinations covering the first 20 percent of the population in Kenya were free, but only on the basis that the government paid enough doses to cover another ten percent of its population.
For Kenya, the bill is expected to amount to about $ 130 million.
A task force for the vaccination of the African Union is trying to alleviate the burden by helping countries by mid-2022 to get enough doses to vaccinate 60 percent of the population.
The delay in vaccines is expected to wreak havoc on the country beyond the short-term countries. In the worst-case scenario proposed by one group of researchers, with poorer countries largely excluded from vaccines this year, the world economy could suffer losses of more than $ 9 billion, almost half of which in rich countries such as Britain, Canada and the United States. State sou val.
In Africa, the cost of the slow implementation of people and health systems is rising.
At the end of January, a heart specialist in Zimbabwe – a mentor for younger doctors and a pillar of the country’s health system – was killed by Covid-19. In the same month, a senior doctor in northern Nigeria died of the virus, confined to an isolation center.
Kenya’s health care system was already in turmoil last year through the mistreatment of doctors and nurses. Many health workers, who in some cases were unpaid for months and often received inadequate protective equipment, walked away from work and forced some hospitals to go months without nurses. One had to close his Covid-19 isolation unit and send patients home. In December, a 28-year-old doctor died of Covid-19 after working months without pay.
“It’s a moral emergency to protect health workers worldwide,” said Gavin Yamey, co-director of policy at the Duke Global Health Institute. “Illness and death of health workers in systems that are already weak can exacerbate the problems even further.”
For Nyachira Muthiga, a doctor at the public hospital who worked on a Covid-19 ward in Nairobi last year, the arrival of Kenya’s first vaccines brought a sense of relief. But the devastating experiences of the past year have made her wary.
Before she contracted the disease herself, she lost many patients. Substandard protective equipment left her vulnerable, she said. And reports of corruption defrauding hospitals of much-needed money broke something, she said.
Although she received the vaccine last week, she is concerned that the same endemic problems in the health care system – combined with the vaccination of rich countries through the vaccination – could have been far beyond the reach of ordinary Kenyans for much longer.
“I am still hopeful,” she said, “that the health of our citizens will be a high priority at some point.”
Abdi Latif Dahir reported from Nairobi and Benjamin Mueller from London.