The world let out a collective sigh of relief on Monday the 9th of November, as Pfizer announced to the world the successful creation of a covid-19 vaccine developed in partnership with German biomedical company, BioNtech.
With the vaccine completing all relevant and necessary trials over 90% effectiveness, a wave of optimism has come over the world, which has been reflected in the market’s hope to return normal by the end of 2021.
The following week other leading vaccine candidates, Moderna, announced on the 16th of November that their vaccine was even more effective against the virus at a rate of 94.5%.
In the background of these developments has been the scramble by countries to secure access for their citizens. As soon as these companies announced their quest to find a safe and effective vaccine, deals were being done to provide access to viable manufacturers should their candidate pass clinical trials. In the western world, governments have successfully purchased at a huge cost, enough inoculations to vaccinate their populations entirely by the end of 2021.
Those lucky enough to live in countries with extensive, well-funded and will resourced public health systems will see normalcy return next year.
Others aren’t so lucky.
Nowhere is this truer than in West Africa, which has long been a difficult area to provide wide scale medical assistance in times of crisis. Home to an estimated 380 million people, living in some of the least developed social and economic circumstances, vaccine acquisition and distribution is challenging for a number of reasons.
Firstly, is the inability to purchase vaccines outright. With no ability to manufacture, the West African region will subsequently be some of the last countries to receive doses, and even then, the amount that they are able to acquire through 2021 may not be sufficient to stop the virus spreading to the most vulnerable. Developed countries are understandably focusing on domestic wide-scale inoculations to mitigate the economic impact of the virus, but their ability to negotiate and purchase ‘off-the-shelf’ puts them at the front of the que for the overwhelming majority of doses.
Such is the discrepancy in vaccine accessibility that according to Clare Wenham, assistant professor of global health policy at the London School of Economics and Political Science, “90% of the world’s pharmaceutical products serve 10% of the world’s population”.
Many smaller poorer nations all over the world are struggling to secure the doses needed which has eaten into the ability for the rest of the world to access the vaccines. This has seen the WHO and Gavi work to create COVAX, an amalgamation of 165 of both some of the world’s poorest and wealthiest countries. The aim is for 75 countries to finance the vaccines from their own public finance budgets while assisting up to 90 lower-income countries vaccinating up to 20% of each participant countries population.
Secondly and arguably more importantly, once a vaccine is secured, both the storage and distribution become a greater challenge. Sub-Saharan West Africa is one of the hottest, and must humid areas in the world, which further increases storage risks. For example, most countries in the region do not have adequate means to store the vaccines, especially the Pfizer vaccine, which needs to be stored at -70 C. The region faced similar infrastructure problems when distributing Ebola vaccines in Sierra Leone, with many remote health clinics using solar-powered refrigeration.
Likewise, getting the vaccines into these remote areas is extremely complicated. Roads and access to certain areas simply doesn’t exist, which again leaves some of the world’s most vulnerable people waiting. Similarly, countries would need to increase their domestic capacities in training people to administer vaccines once they have arrived. The highly contagious nature of the virus means that time cannot afford to be wasted in the vaccine to roll out, and as such, large numbers of professionals will be needed to safely administer the doses.
With the first vaccines expected to be delivered around the world by years end, it’s clear from these regional challenges, that for West Africa and world-wide vaccination remains some years off.
Only once we are all vaccinated can we breathe easy, and we are reminded by the WHO that, “With such a highly contagious virus, and in a globalised world, no country will be safe from the fallout of the pandemic until all countries are protected”.