America is abandoning Africa on vaccines
ERIC BAZAIL-EIMIL: As the United States reports that over 15 million doses have been thrown out since March of 2021, and as the conversation around boosters continues, the sobering reality that the West has largely squandered and wastefully distributed doses becomes all the more apparent when looking at the comparative state of vaccinations around the world. Courtesy of strict patent rules, favorable purchase agreements with manufacturers and a logistical and market advantage, Western nations have successfully vaccinated large swaths of their populations. Meanwhile, the Global South has lagged far behind in vaccine distribution.
Nowhere is the disparity more apparent than in the Democratic Republic of Congo. Just over 120,000 doses have been administered in Africa’s largest country, a country home to 105 million people; most of the Congo’s citizens who have received the vaccine are members of the country’s elite class concentrated in its capital. The DRC also struggled to distribute doses provided by COVAX, finding itself forced to donate 1.3 million doses of the Astra-Zeneca vaccine due to logistical challenges and intense vaccine hesitancy among its population.
The Democratic Republic of Congo’s struggle to vaccinate its population is not unique, even when factoring in its especially turbulent postcolonial history. Indeed, the DRC’s plight is emblematic of the widening deficit in vaccine access plaguing Africa today. Less than 3% of Africans are fully vaccinated, almost all more affluent residents of larger cities and/or small states on the continent. Only Morocco, Mauritius and the Seychelles have vaccinated more than 50% of their populations, and among continental Sub-Saharan African countries, only South Africa and Zimbabwe are approaching a 20% vaccination rate. Even compared to other areas of the Global South, African countries have been most impacted by what many on the continent decry as “vaccine apartheid.”
On paper, Africa has been largely spared the worst of the pandemic, with lower than expected case counts and deaths reported. Part of this is of course due to inadequate data collection, as predictable undercounts are exacerbated by weaknesses in healthcare and communication infrastructure. However, African nations also imposed strict entry and exit controls on international tourists in mid-March 2020. This quick policy response early on, coupled with the reduction of flights to the continent helped limit the ability of variants to penetrate the continent. Collaboration and coordination among African governments further ensured that the continent could act as one cohesive unit on lockdowns, reopenings, mask mandates and testing and treatment strategies.
Without vaccines, Africa’s fortune cannot last forever. The rise of the Delta Variant, and the anticipated continued emergence of new variants, reflects the continued strength and resilience of this virus. These new variants are already impacting the continent. Despite strict travel restrictions and continued pandemic measures, the Delta variant now accounts for almost three-fourths of cases in the DRC and 97% of cases in nearby Uganda. Already, a new variant of the virus, one which exhibited high degrees of mutation, was detected in South Africa. Even as cases begin to decline after a spike over the summer, the World Health Organization (WHO) has confirmed that the rate of deceleration, or the rate by which case counts decrease over a specific period of time, is far slower than during previous spikes.
Getting Africans vaccinated is of the utmost importance in mitigating the spread of COVID on the continent, and around the world. And still progress lags.
This past July, the Biden administration pledged to donate 25 million vaccine doses to 49 African countries as part of its efforts to mitigate global spread. On a continent of 1.2 billion people, however, a donation of that scale would be a drop in the bucket. African countries have been priced out of the global market for vaccines by Global North countries. Worst of all, due to patent restrictions on the formulation of COVID vaccines and a lack of technology sharing with the Global South, many African countries are left unable to manufacture their own doses. Meanwhile, COVAX, the WHO’s global vaccine distribution program, has been mired by supply issues itself.
As it stands, the United Nations projects that Africa will experience a 470 million dose deficit, preventing it from reaching a 40% vaccination target. This deficit should give us all concern. Ensuring that African nations can equitably access and distribute doses of available COVID-19 vaccines is not only an important strategic consideration in the global fight against COVID-19, but also a moral imperative for the United States and other Western nations to honor, especially as doses are wasted in affluent nations.
After all, Western nations, including the United States, have been the principal architects of Africa’s postcolonial woes. Indeed, the continent’s vulnerability to the COVID-19 pandemic is entirely connected to colonial patterns of development that valued resource extraction, and postcolonial patterns of economic and political engagement that cared little for stability and prosperity on the continent. Exploitative trade agreements, little infrastructure investment, and a blasé approach to cultivating governing institutions have all further contributed to the continent’s stark underdevelopment.
Moreover, structural adjustment plans championed by the International Monetary Fund and other Washington-based think tanks and aid groups forced African countries to adopt austerity measures, in turn leading to cuts in government healthcare spending. In the name of promoting “more responsible governance” on the continent, Western governments have in fact created new challenges for African states, ones which have become readily apparent during this pandemic. In light of their culpability in the current state of affairs, Western nations have an obligation to support African countries in their vaccination efforts.
Given the diversity of cultures, ecosystems, and economies on the continent, there cannot be a “one size fits all” solution imposed upon African nations. Indeed, African nations must be given the opportunity in any vaccine equity process to express their own needs and Western partners must honor those needs, rather than dictate or assume them.
This deference is especially important to honor when nations have unique security and logistical needs. For nations like the Democratic Republic of the Congo, providing doses would not be enough. After all, the DRC has just 1,400 square miles of paved roads in a land area the size of Western Europe. Moreover, instability in the DRC’s Eastern provinces complicates vaccine distribution, as aid workers and medical personnel could be put in harm’s way. In such circumstances, additional support, both from logistical and diplomatic angles, would be required to ensure doses can reach populations in remote and/or conflict-torn regions and that those administering and transporting doses can work safely. Other countries are experiencing personnel deficits on the continent, and still others are struggling to convince citizens to get vaccinated in the face of extensive disinformation and a history of the continent being medically exploited.
These considerations go to show that Western countries cannot wipe their hands clean solely by offering the vials. Working together with African countries to ensure shots get into arms is equally, if not more, important.
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In many respects, the current vaccine distribution failure in Africa calls to mind another pandemic: AIDS. From the mid-1990s through the late 2000s, AIDS ravaged Africa, especially Southern Africa, just as many countries began experiencing new democratic transitions and foreign aid dried up following the Cold War. At its peak in 2005, close to two million Africans a year were dying of AIDS. AIDS was consistently the highest cause of death on the continent, with many countries seeing one in four deaths a year coming from the diseases. Many African countries witnessed dramatic decreases in life expectancy (eSwatini seeing its life expectancy plummet by more than two decades), increases in child mortality rates and a rise in orphaned children.
Global collaboration with African states helped turn the tide significantly. Improved sex education, distribution of condoms and other STI-preventative tools helped reduce new infections. Meanwhile, expanded access to antiretroviral drugs and treatment has helped more people live with AIDS long-term. The data reflects the impact: life expectancy has nearly recovered to pre-AIDS levels, overall mortality rates have decreased as have transmission and new case rates, and the prevalence of comorbidities and AIDS complications has also decreased. Africa continues to be impacted by AIDS, and AIDS is far from defeated on the continent. However, Africa, with the help it has received from global partners, seems poised to win the fight.
Like with Africa’s current vaccine access crisis, global help on HIV/AIDS was slow to come, and hard fought. Stigma, bigotry and generalized disinterest in the continent’s affairs and uplift limited the immediate compassion of Western activists and policymakers. Today, we find ourselves worrying about “getting ourselves taken care of” before providing nations on the continent with the assistance they are in need of, and demanding. Without a doubt, millions died unnecessarily because of global inaction on AIDS in Africa.
America cannot repeat the mistakes the West made during the early hours of the AIDS crisis and abdicate its moral responsibility to aid African nations now in their hour of need. Vaccine distribution equity must be ensured not only to slow this pandemic, but also to ensure African countries are able to reintegrate fully in the global economy and prosper in the world COVID leaves behind. Such is the challenge before America’s leaders today, and history will certainly judge them if they choose not to join African nations as partners in their vaccination campaigns.
Eric Bazail-Eimil is a lead editor at On the Record. A junior in the School of Foreign Service majoring in Regional and Comparative Studies, Eric is originally from South Florida.