Export restrictions in India could hamper Africa’s 2021 vaccination targets

India’s recent announcement that it is restricting the export of COVID-19 vaccines means that the African continent may not meet the “critical” target of vaccinating 30% of its population by the end of the year, said John Nkengasong, director of Africa Centers. for Disease Control and Prevention. India’s move is creating uncertainty about when African nations might receive dose shipments from the COVAX Facility, a global initiative aimed at equitable access to COVID-19 vaccines.

“We are very concerned,” Nkengasong said during a news conference on Thursday. “There is absolutely no way … we are going to meet our needs if India is late.”

African nations began receiving free doses of the vaccine developed by AstraZeneca and the University of Oxford from the COVAX facility in late February, with the expectation of receiving follow-up shipments in the following months.

In the World Health Organization Africa region, 28 countries have already received 16 million doses of COVAX, many of which were produced by the Serum Institute of India. The continent expected to receive about 75 million doses produced in India from COVAX in the first half of this year, vaccinating around 37.5 million people.

But due to the increasing number of COVID-19 cases in India, the government temporarily suspended the export of the vaccine to meet domestic demand. While the institute said it would continue to supply the COVAX facility, there is uncertainty about when dose shipments might arrive to other countries.

If these delays evolve into a total export ban, it would be “catastrophic” for the continent, Nkengasong said, adding that the Oxford-AstraZeneca vaccine doses are the “backbone” of vaccination programs in Africa.

While Africa’s CDC aims to ultimately vaccinate at least 60% of the continent’s population to achieve herd immunity, the initial goal is to vaccinate at least 30% of the population by the end of this year. About 400 million people must be vaccinated to reach that goal, Nkengasong said. The COVAX Fund aims to help participating countries reach 20% of their population by the end of the year, and the African Union is working to fill additional gaps with vaccines available for countries to purchase through payment plans. .

The delays are deeply troublesome, Nkengasong said. There is an urgent need to vaccinate populations quickly and on a large scale, not only to save lives, but also so that the coronavirus cannot mutate in a way that existing vaccines are ineffective.

Last week, scientists said a highly mutated form of the virus was found in three people traveling from Tanzania to Angola, but it is not yet clear how this new variant might interact with vaccines. Tanzania has not implemented public health measures or started implementing vaccines to try to stop the spread of the virus, which scientists say provides ample opportunities for the mutation.

Helping to “ease the situation” around these vaccine shipment delays, according to Nkengasong, is an agreement signed this week with Johnson & Johnson for up to 400 million doses of its vaccine, which will be available for countries to purchase. through the African Union. African Vaccine Acquisition Fund. The company’s vaccine only requires one dose, while the AstraZeneca and Oxford University vaccine requires two.

But Johnson & Johnson’s 220 million initial doses won’t be available until the third quarter of this year, with the rest expected next year. This leaves a gap of several months, which puts countries in a state of limbo with respect to the existing doses supplied by COVAX.

Earlier this week, Antoinette Ba-Nguz, UNICEF Regional Immunization Coordinator for Eastern and Southern Africa, said the situation in India has created a dilemma for these countries over whether to administer all the doses they already have, hoping more batches will arrive in time for people to receive their second injections.

Alternatively, each country could vaccinate a smaller group of people than originally planned to ensure sufficient supplies for the second doses. Ba-Nguz said that even when countries have access to the doses, they have been slow to deliver them to their populations, calling it “very worrying.”