Some unexpectedly good news came out of the long-beleaguered DRC on July 2nd, when the WHO declared an end to the Ebola outbreak that had started just 42 days before. The announcement prompted a global sigh of relief, as the outbreak was the country’s first since the catastrophic West African epidemic that raged in five countries between 2014 and 2016, killing more than 11,000 people.
But it would take a special kind of innocence to assume that the Ebola virus has finally been tamed. In fact, any public health expert worth their salt would agree that the international community is years away from having a functioning emergency response system to deal with intra or inter-continental pandemics. Not to mention that the quickly deteriorating political situation in the DRC raises serious doubts about whether the country will have the capacity to contain the next outbreak.
All things considered, the DRC’s win over Ebola looks more like the exception than the rule. Indeed, the DRC contained last month’s outbreak largely because the virus struck in the remote region of Likati, 1,300 kilometers away from Kinshasa, and infected only a small sample of people. As such, local and national health authorities were able to enact an efficient and coordinated response: the second victim was immediately suspected of Ebola and the local health center rushed a sample to the national lab in Kinshasa. The workers there had the right expertise and connections and ran preliminary testing while also alerting international colleagues.
After the first case was confirmed, the government notified the World Health Organization, which activated their emergency response mechanisms. The successful escalation was also boosted by a new weapon in the WHO’s arsenal: a $41 million contingency fund that the health body set up following the lethargic response to the previous epidemic in West Africa. This fund helped the WHO and other groups rapidly rent helicopters for flying staff, generators, and other supplies into the affected zone.
Lastly, all of this happened in a country that has been battling Ebola for over 40 years and has seen off eight separate outbreaks so far. Which is why the international community should not rest on its laurels, but should instead take urgent action to bolster the readiness of other African countries susceptible to fall pray to the virus. Indeed, Guinea, Liberia and Sierra Leone are still years away from building the capacity to fend off the virus, despite the fact that these three countries accounted for over 90% of Ebola cases during the 2014 outbreak.
Then, the WHO’s foot dragging and political dysfunction in all three countries – two of which, Liberia and Sierra Leone, were still recovering from civil wars – led to the direct death of thousands. If it had not been for charities like Doctors Without Borders (MSF) and private companies, which shouldered the bulk of the initial emergency response, the outcome would have been much worse. MSF led the frontline response and was the first to spot the initial cases in March 2014. Their volunteers were forced to handle the lion’s share of medical treatment, quarantine, and educational efforts as the WHO ignored their calls for help. Meanwhile, the Russian mining company Rusal built and equipped a microbiological research and medical treatment center for patients with infectious diseases in Guinea, as part of a public-private partnership to boost the fight against Ebola and to strengthen the local healthcare system. The project spearheaded by Rusal, among the biggest investors in the country, helped result in a new vaccine that is being delivered to Guinea and will undergo trials later this summer.
It just goes to show that while the private and non-governmental sector quickly mobilized resources, they are no panacea for the international coordination that global health bodies are supposed to offer.
Which brings us to a crucial point: stability is key in the proper management of epidemics. It would be a mistake to ignore the way political and economic agendas shape the way public health science is understood and implemented. If the international community really understood this feedback relation, it would take steps to stabilize the brewing civil war in the DRC.
Indeed, last December, with 16 years in power under his belt, President Joseph Kabila decided to settle in after finishing his constitutionally mandated last term, sparking deadly protests in the capital. Even after signing a subsequent agreement to step down and hold elections before the end of 2017, he has made no sign that he’s ready to do so. Instead, he’s been leading a smear campaign against the main opposition candidate for the presidency, Moise Katumbi, whom he regards as his biggest threat. The former governor of the Katanga province, Katumbi has garnered nationwide support in a country so large and divided that many have openly wondered if it’s even governable.
Unfortunately, Katumbi has been living in exile in Europe since May 2016 and faces the prospect of imprisonment if he returns home, where he has been convicted on a number of trumped-up charges. Meanwhile, as the deadline for the government to call elections approaches, violence between security forces and militia members has been rising. A surge in violence in Kasai province, which comes on top of grinding conflict in the volatile Kivu regions, has caused the deaths of at least 3,300 people and the displacement of more than 1.3 million.
Several weeks ago, the US and EU imposed sanctions on eight government officials and a militia leader implicated in abuses. But they will need to go further, expanding sanctions and working with the DRC’s neighbors to press Kabila to hold credible elections. This wouldn’t just be in the interests of the Congolese people, but is a precondition of laying the foundations of a functioning global health system. The next outbreak is therefore not a question of “if” but “when” – and containing it will depend on preserving political stability in the country. Otherwise, the humanitarian disaster of 2014 will simply repeat itself.
African Union’s Inaction on Ethiopia Deplorable – Open Letter
A group of African intellectuals says in an open letter that it is appalled and dismayed by the steadily deteriorating situation in Ethiopia. The letter, signed by 58 people, says the African Union’s lack of effective engagement in the crisis is deplorable. The letter calls on regional bloc IGAD and the AU to “proactively take up their mandates with respect to providing mediation for the protagonists to this conflict”.
The letter also asks for “all possible political support” for the AU’s Special Envoy for the Horn of Africa, Olusegun Obasanjo, whose appointment was announced on August 26, 2021. A United Nations Security Council meeting on the same day welcomed the former Nigerian president’s appointment.
Earlier in August 2021, UN chief Antonio Guterres appealed for a ceasefire, unrestricted aid access and an Ethiopian-led political dialogue. He told the council these steps were essential to preserve Ethiopia’s unity and the stability of the region and to ease the humanitarian crisis. He said that he had been in close contact with Ethiopian Prime Minister Abiy Ahmed and had received a letter from the leader of the Tigray region in response to his appeal. “The UN is ready to work together with the African Union and other key partners to support such a dialogue,” he said.
August 26, 2021 was only the second time during the conflict that the council held a public meeting to discuss the situation. Britain, Estonia, France, Ireland, Norway and the United States requested the session.
Fighting between the national government and the Tigray People’s Liberation Front broke out in November 2020, leaving millions facing emergency or crisis levels of food insecurity, according to the United Nations. Both sides have been accused of atrocities.
Africa: The G20 Must Recommit to Covax
It is one year since the international community gave its backing to the COVID-19 Vaccine Global Access (COVAX) facility to lead a worldwide effort to end the acute phase of the pandemic. The initiative aimed to ensure that every country, and not just those with sufficient money or resources, could access life-saving vaccines once they became available. As G20 health ministers prepare to meet in Rome on September 5-6, they are in a position to ensure that COVAX fulfills its mission.
A year ago, no one knew when or even if it might be possible to develop a safe and effective vaccine against COVID-19, let alone the 20 that are available today. But since making its first international deliveries in February, COVAX a partnership established by the Coalition for Epidemic Preparedness Innovations, the World Health Organization, UNICEF, and Gavi, the Vaccine Alliance has delivered more than 235 million vaccine doses to 139 countries, and expects to deliver another billion doses in the fourth quarter. Only China, India, and the United States have delivered more. This start to the largest and most complex vaccine rollout in history has given hope to millions of people and laid solid foundations for how we respond to future pandemics.
Yet, so much more could, and should, have been achieved by now. It is unacceptable that only 1.8% of people in low-income countries have received their first dose of a COVID-19 vaccine, compared to 82% in high- and upper-middle-income countries. This shocking inequality is as economically senseless as it is destructive to human life, with the latest estimate of the cost of the slow rollout amounting to $2.3 trillion.
The world was woefully unprepared for a pandemic, and this is reflected in the challenges COVAX has faced. By the time initial funding arrived, wealthy countries had already locked up early vaccine supplies. Export bans affecting key suppliers, and difficulties experienced by many manufacturers in scaling up production to the required level, also undermined COVAX’s ability to access doses early.
Given increasing global vaccine inequity and the rise of new, more contagious coronavirus variants, we must put these challenges behind us. Thanks to the support of almost all G20 governments, alongside that of foundations and private businesses, COVAX has now raised nearly $10 billion and secured more than 600 million donated doses. All the preparations are in place for the most comprehensive vaccination effort that the world has seen.
Based on the committed orders COVAX has placed with vaccine manufacturers and the additional donations, hundreds of millions of new doses should now be available each month. We need to make sure they reach poorer countries and get into people’s arms. To avoid further delays, and for the facility to succeed, we need support from G20 leaders in four key areas.
First, we need doses, and we need them now. The premise of COVAX was always that the facility should be able to negotiate and buy its own doses. With our early vaccine access compromised, donations have played a vital role in maintaining our ability to keep doses flowing to those most in need. Of the 600 million doses pledged to COVAX to date, 100 million have now been delivered. We need more, and soon, with longer shelf lives and greater certainty so that recipient countries have time to plan their rollout. This can be achieved without jeopardizing high-income countries’ national vaccination efforts.
We also need G20 leaders to support our call for transparency. COVAX has legally binding agreements with manufacturers for more than four billion doses, but has all too often faced delays in accessing them. Without greater clarity regarding firms’ order books, it is impossible to know whether these holdups are due to production challenges or preferential treatment for bilateral arrangements. Insisting that manufacturers are transparent about their order timelines can ensure a level playing field where no one particularly those living in developing countries gets bumped to the back of the vaccine queue because of another bilateral deal.
In addition to ensuring that manufacturers keep their commitment to COVAX, governments should make global vaccine access their highest priority. Countries with pending orders for doses that they currently do not need should allow COVAX to take their place in the queue so that we can get doses to needy countries now.
Finally, lower-income countries require continued financial and technical support for their COVID-19 vaccine rollouts. Strengthening national health systems will help these countries to ensure delivery of doses and mitigate the pandemic’s secondary effects, and will leave in place infrastructure critical to future global health security.
By recommitting to COVAX, G20 leaders will recommit to a multilateral solution that builds on the astounding scientific progress of the past year. Based on COVAX’s latest forthcoming supply forecast, when topped up with doses through bilateral deals, equitable COVID-19 vaccine access can protect up to 60% of the adult population in 91 lower-income countries. This would represent a huge step toward the WHO target of 70%, which is needed to suppress the coronavirus everywhere, and COVAX represents the best opportunity to achieve it.
Failure would mean more lives lost, broken health-care systems, even deadlier and more transmissible variants, and a pandemic with no end in sight. The G20 must not allow that to be an option.
More African Countries Register Russia’s Sputnik Vaccine
Africa Centres for Disease Control and Prevention (Africa CDC) is a specialized technical institution of the African Union (AU) that strengthens the capacity and capability of Africa’s public health institutions as well as partnerships to detect and respond quickly and effectively to disease threats and outbreaks, based on data-driven interventions and programmes.
During the outbreak of the coronavirus, the African Vaccine Acquisition Task Team (AVATT), was established by African Union, as a component in support of the Africa Vaccine Strategy and was endorsed by the AU Bureau of Heads of State and Government on 20th of August 2020.
Dr John Nkengasong, Director of the Africa Centers for Disease Control and Prevention (Africa CDC), has emphasized: “Africa has to team up with development partners to achieve its 60% continent-wide vaccination in the next two years. I think that is why we should as a collective of the continent, and of course, in partnership with the developed world make sure that Africa has a timely access to vaccines to meet our vaccination targets.”
An official media release in February 2021, the Africa Vaccine Acquisition Task Team from the African Union (AU) informed that Russia would supply and deliver 300 million Sputnik V vaccines to Africa. That step was intended to support African countries to attain their targeted immunization of 60% of the population by the year-end. That vaccine story disappeared, but instead what become so common is the speedy registration of Sputnik V on bilateral basis in various African countries.
According to the latest, Nigeria has become the 68th country in the world to approve the Russian vaccine. The use of the Sputnik V coronavirus vaccine has been approved in Nigeria, the Russian Direct Investment Fund (RDIF) said in an official statement.
“The Russian Direct Investment Fund (RDIF, Russia’s sovereign wealth fund) announces the approval of the Russian Sputnik V vaccine against coronavirus by the National Agency for Food and Drug Administration and Control of Nigeria (NAFDAC). Nigeria has become the 68th country in the world to approve the Russian vaccine. Total population of all countries, where Sputnik V is approved for use, now exceeds 3.7 billion people, which is nearly half of the global population,” the statement said.
“Nigeria is the most populous nation in Africa, and the approval of Sputnik V will provide for using one of the safest and most effective vaccines in the world. Sputnik V is based on a proven human adenoviral vectors platform and is successfully used in over 50 countries. Approval in Nigeria will make an important contribution to the country’s fight against the pandemic,” CEO of the Russian Direct Investment Fund (RDIF) Kirill Dmitriev said.
Besides Nigeria, other African countries have registered Russia’s Sputnik V vaccine. Reportedly, the vaccine has been registered in Algeria, Angola, Djibouti, Egypt, Gabon, Ghana, Guinea, Kenya, Morocco, Namibia, Tunisia, the Republic of Congo (DRC) and Zimbabwe.
Russia’s drive to share Sputnik V vaccine, of course, offers a chance to raise its image and strengthen alliances in Africa. Ministry of Foreign Affairs of the Russian Federation has made efforts promoting the vaccine using all its channels. But supply and delivery have largely lagged behind, the pledges have simply not been fulfilled. Russian authorities have oftentimes said that they would step up efforts for fruitful cooperation in combating coronavirus in Africa.
Promising more than can be delivered appears to be a universal problem with coronavirus vaccines, and it is a real risk for Russia as well, said Theresa Fallon, Director of the Brussels-based Centre for Russia Europe Asia Studies. “They have won the gold medal for creating this very effective vaccine,” she said. “But the problem is how are they going to implement production and delivery?”
Russian Direct Investment Fund (RDIF), with profit motivation, has attempted supplying the Russian vaccines through, Sheikh Ahmed Dalmook Al Maktoum, from the Monarch family and a third party in Dubai, United Arab Emirates, to a number of African countries. For instance, the Republic of Ghana reportedly signed US$64.6 million contract for Sputnik V vaccine from Russia through Sheikh Ahmed Dalmook Al Maktoum. It was double the price from the producer as reported in the media.
On the other hand, Russian President Vladimir Putin has noted, in a speech early September, that advanced countries that produce vaccines against the coronavirus do little to protect humanity from the pandemic.
“The benefits of vaccination are enjoyed mostly by advanced economies. The bulk of the vaccines is made there, and it is used to protect their own population. But very little is being done to protect humanity in the broad sense,” Putin said at the plenary session of the Eastern Economic Forum in Vladivostok, the Far East of Russia. “This is very bad for the producers, because all this boomerangs around the globe. For instance, in Africa the level of protection with vaccines is minimal, but contacts with the African countries continue. There is no getting away from this. This infection will return again and again.”
According to an official release obtained late February, the Sputnik V vaccine the following advantages:
• Efficacy of Sputnik V is 91.6% as confirmed by the data published in the Lancet, one of the world’s oldest and most respected medical journals; It is one of only three vaccines in the world with efficacy of over 90%; Sputnik V provides full protection against severe cases of COVID-19.
• The Sputnik V vaccine is based on a proven and well-studied platform of human adenoviral vectors, which cause the common cold and have been around for thousands of years.
• Sputnik V uses two different vectors for the two shots in a course of vaccination, providing immunity with a longer duration than vaccines using the same delivery mechanism for both shots.
• The safety, efficacy and lack of negative long-term effects of adenoviral vaccines have been proven by more than 250 clinical studies over two decades.
• The developers of the Sputnik V vaccine are working collaboratively with AstraZeneca on a joint clinical trial to improve the efficacy of AstraZeneca vaccine.
• There are no strong allergies caused by Sputnik V.
• The price of Sputnik V is less than $10 per shot, making it affordable around the world.
In February, peer-reviewed medical journal The Lancet published an analysis from Phase III clinical trial of the Russian vaccine, showing its 91.6-percent efficacy against symptomatic COVID-19. The Sputnik V vaccine was developed by the Gamaleya Research Institute of Epidemiology and Microbiology.
Sputnik V was registered in Russia on August 11, 2020 as the world’s first officially registered coronavirus vaccine. Russian vaccines have advantages as no deaths have been reported after vaccination with the Sputnik V, Alexander Gintsburg, Director of the Gamaleya Center, the vaccine developer, said and was reported by TASS News Agency. “As of today, no deaths after vaccination with Sputnik V have been registered,” he said.
Russian Direct Investment Fund (RDIF) is Russia’s sovereign wealth fund established in 2011 to make equity co-investments, primarily in Russia, alongside reputable international financial and strategic investors. RDIF acts as a catalyst for direct investment in the Russian economy. RDIF’s management is based in Moscow.
In Africa, during first of September, the coronavirus-related death toll has topped 196,190, while more than 6.9 million recoveries have been reported. South Africa accounts for a majority of coronavirus cases and deaths across Africa – 2,777,659 and 82,261 respectively. The death toll in Tunisia climbed to 23,451, and 664,034 cases have been confirmed. Egypt recorded 16,736 deaths and 288,441 coronavirus cases.
In Sub-Saharan Africa, Ethiopia is ranked second to South Africa (308,134 cases and 4,675 deaths) and is followed by Kenya (235,863 cases and 4,726 deaths) and Nigeria (191,805 and 2,455). The total number of COVID-19 cases has reached almost 8 million in Africa, according to the World Health Organization’s (WHO) Regional Office for Africa.
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