When a few weeks ago United States President Joe Biden announced that he would support the possibility of temporarily suspending intellectual property rights on vaccines developed against Covid-19. The majority of African nations, as well as NGOs and international organisations such as the African Union (AU), welcomed and appreciated the initiative. Such a decision would, of course, allow any interested pharmaceutical companies to independently produce vaccines in developing countries as well.

With the ongoing global pandemic, there has been much reflection on the protection of health as a global public good — one that should take precedence even over the protection of intellectual property and private interests in cases of extreme emergency when the lives of millions of people are at stake. Pharmaceutical lobbies and economic-political interests, however, continue to push in the opposite direction.

Only 1 per cent of vaccines in Africa

On access to vaccination, as feared, many nations have been left behind, and African ones bring up the rear of the global rankings — despite the many promises and initiatives that emerged following the announcement of the vaccine's discovery. According to WHO data, only 1 per cent of vaccine doses administered worldwide have been administered on the continent, a further decline from a few weeks ago when the figure was approaching 2 per cent. According to estimates, at this rate Africa will not reach its vaccination targets to achieve immunity before 2023; indeed, while the rest of the world has administered 150 doses per thousand inhabitants, Africa is still at 8 doses per thousand inhabitants.

A continent less affected

It is true that the continent has not experienced the health crisis in the same way as other regions of the world. According to available data, the continent has recorded just over 4.6 million infections and just over 125,000 deaths. There are many variables and possible interpretations for the different course of the pandemic and its effects. Discussion has centred on a different resilience to the disease owing to a particularly young demographic pyramid and a different immune resistance to the virus, but also on doubts about the reliability of the data collected, given that detection systems are poorly efficient in some countries.

Only research will help shed light on this; however, even though cases are falling again after a brief peak recorded around January, and even though Africa is the only continent to have developed a unified strategy in the fight against the pandemic, "we must not let our guard down if we want to avoid the drama unfolding in India", as recently stated by WHO Director-General Tedros Adhanom Ghebreyesus, who warned of the danger posed by the slow vaccination rate in regions where healthcare systems are vulnerable.

Vaccines at variable speed

Much of the continent depends on international aid for access to vaccines. The main instrument has been the Covax programme, supported by the WHO and other international bodies and foundations. A project that aims to supply vaccines to the poorest countries, it would like to secure 600 million doses for Africa — enough to vaccinate at least 20 per cent of the population. In some countries, there are also donations — not entirely disinterested — from other economic powers such as Russia, India, China and the United Arab Emirates.

The first vaccine deliveries through Covax began in late February and the majority of African countries have signed up to the programme. To date, around 37 million vials have arrived on the continent, and six nations have yet to receive any: Tanzania, Burundi, Burkina Faso, the Central African Republic, Chad and Eritrea. Madagascar, which had decided not to make use of them, recently reversed course following a new wave of infections.

Large disparities have been recorded in the administration of doses. Eight countries have already exhausted the vaccine stocks they received from the programme, while nine have administered fewer than a quarter of the doses obtained and as many as 15 countries have administered fewer than half, according to the WHO.

The distribution challenge

These results show that African governments must not only tackle the challenge of procuring doses but also that of administering them, owing to a shortage of specialised healthcare personnel and of the healthcare infrastructure needed for distribution and storage (such as refrigeration systems for maintaining the cold chain), as well as mistrust among the population towards the disease and the vaccine. Indeed, in recent weeks the news that some countries have been forced to discard doses that were no longer usable — as in Malawi, South Sudan, and over 1,300,000 in the Democratic Republic of Congo — caused considerable uproar.

As many countries have attested — Senegal among them — governments are recording low uptake of vaccination campaigns because, in general, public opinion does not feel the urgency to rush and get vaccinated against a disease that is not seen as a threat, but as a "virus of Westerners". Here too, through fake news of every kind, a sense of mistrust has spread towards the vaccine — and in particular towards the one produced by AstraZeneca, which is widely used by Covax. The fear that this trend will spread is so strong that the WHO has launched the Viral Facts Africa campaign for the verification of health-related information.

Beyond these obstacles, a suspension of patents would undoubtedly help African countries to carry out more considered campaigns, including through awareness-raising. At present, only five African countries — Senegal, Morocco, Tunisia, Egypt and South Africa — would be capable of producing vaccines, but production could increase, as recently announced by the WHO with reference to interested countries such as Rwanda.