Africa's vaccine drive slowed by indemnity spat, Pfizer choice

A drive to get Africans vaccinated against the coronavirus is being hamstrung by governments’ reluctance to sign indemnity clauses, a preference for Pfizer Inc. vaccines over other more readily available shots and a lack of preparedness to distribute the inoculations.

Delays in vaccinating the continent’s more than 1.3 billion people will likely lead to additional resurgences of the virus, may result in mutations that will potentially be more transmissible and could lead to economic damage associated with strict lockdowns.

Less than 20 million people have been inoculated in Africa, with almost half of those living in Morocco, according to Bloomberg’s COVID-19 Vaccine Tracker.

So far, seven African countries have yet to start vaccinating their populations, said Phionah Atuhebwe, the New Vaccines Introduction Medical Officer for Africa for the World Health Organization.

Eritrea, Burundi and Tanzania have as yet declined to join Covax, the global initiative that most African countries are relying on to secure the shots, while Burkina Faso hasn’t signed the indemnity and liability agreements needed to allow shipments of the vaccines to the country, Atuhebwe said in an April 30 interview. Burkinabe officials say they’ve signed all agreements they were asked to.

Vaccine Preference

Madagascar has only recently expressed interest in securing vaccines and joined Covax and the Central African Republic has just put together a vaccine deployment plan, according to Atuhebwe.

Chad has meanwhile rejected shots developed by AstraZeneca Plc that Covax has to offer and said it will wait for Pfizer shots to become available, she said.

“Madagascar is a priority, Central African Republic is a priority” for inoculations, she said. “Burkina Faso said they are not ready now for deployment.”

Already the Democratic Republic of Congo has ceded 1.3 million of the 1.7 million vaccine doses it received because it said it didn’t have the capability to distribute them. Burkina Faso would have received a portion of 1 million AstraZeneca vaccines sold by South Africa to the African Union but wasn’t ready to receive them, she said.

“In terms of order of priority when it comes to next phase we will focus on getting vaccines to those countries that are due for a second doses,” Thabani Maphosa, managing director for country programs at Gavi, the vaccine alliance, said on a virtual briefing on Thursday. “Next in line are those who are ready to receive vaccines, but have not yet received any shots. Meanwhile, we’ll continue working with those countries that are not yet ready to receive doses.”

The delay in starting vaccinations in Chad is purely due to its vaccine preference, a government official said.

“We prefer Pfizer over the other vaccines, so we decided to wait,” Ouchemi Choua, the National Health Response Coordinator for Chad’s vaccination program, said from N’Djamena, the capital, adding that Pfizer doses are expected to start arriving in June. “The delay won’t have any major impact on the response, as long as distribution starts as scheduled.”

AstraZeneca’s shot appears to be less effective against a variant of the virus first identified in South Africa late last year, and concerns it may cause blood clots have seen delays in its rollout in Europe and elsewhere.

Signatures Needed

Still, Chad is yet to sign a number of agreements including some needed by Pfizer to allow it to receive vaccines, according to a person with knowledge of the situation, who asked not to be identified as they aren’t allowed to speak to the press. Burkina Faso is finalizing the documentation to receive its first doses, but as of April 28 had not signed indemnity agreements, the person said.

“Vaccines are a delicate matter,” Emmanuel Seni, public health director at Burkina Faso’s health ministry, said by phone. “We didn’t want to sign anything before we knew exactly what we were agreeing to.”