Africa doesn’t deserve last place in the vaccine race

Where were you this July 4^th when America celebrated its 245^th birthday and its independence from the worst of the COVID-19 pandemic?

I was at Nationals Park in Washington, D.C., along with 34,000 largely un-masked spectators, thanks to America’s success in vaccinating our way out of the worst mass casualty event in U.S. history. This was an all-American accomplishment. Delivered by U.S. private sector innovation, powered by Trump’s Operation Warp Speed, and realized by Biden’s Build Back Better. However unintentional, it was an epic bipartisan success.

Nat’s fans (my family included) clad in red, white, and blue, were celebrating a return to normal. As for me, I was in culture shock — feeling disoriented and unsettled, having just returned from three weeks of travel in West and East Africa where many countries are in their third wave of COVID-19 fueled by the Delta variant.

Last week, Africa saw a 43 percent uptick in COVID-related deaths — with infections, hospitalizations, and patients in need of oxygen all on an accelerated rise. Lock downs and curfews are returning, and economic hardship is acute.

In America, healthcare providers are literally begging to put shots in arms. In Africa, the vaccine supply that had been available has run out, as the global plan to help the world’s poor, COVAX — the COVID-19 Vaccines Global Access Facility — has bogged down.

The Serum Institute of India, the primary vaccine supplier, canceled its supply commitments, having to re-direct vaccine at home — and despite high expectations, COVAX proved good at collecting financial pledges but not actual cash, putting African countries at the end of the line to purchase vaccines from for-profit drug manufacturers. As a result, only 1.2 percent of Africa’s population of 1.3 billion is fully vaccinated.

Americans have earned the right to celebrate the success of our mass vaccination campaign, which has enabled sports arenas across the country to operate at full-fan capacity. However, we have all learned the hard way that an infection anywhere can be a contagion everywhere, and this remains an undeniable, unassailable, indisputable truth, whether we chose to be vaccinated or not.

Africa did not deserve to be in last place in the race to fight the coronavirus pandemic. At first, many African nations did better than their western counterparts, taking aggressive steps in locking down their economies. Public health measures — including frequent hand washing, social distancing and mask wearing — were swiftly introduced, winning community-buy in.

The Africa Center for Disease Control, established in 2017 after the Ebola epidemic, launched a continent-wide platform for procuring laboratory and medical supplies and secured 270 million doses of vaccines with another 90 million on standby, made possible in part through the $2 billion facility approved by the African Export-Import Bank (Afreximbank).

However, regional solidarity can only go so far when there is “a deliberate global architecture of unfairness,” says Stive Masiyiwa, the African Union’s special envoy tasked with leading efforts to procure COVID-19 vaccines.

Masiyiwa argues that the continent has been crippled by the global COVID-19 supply chain crisis in which governments with deeper pockets hiked prices of vaccines, while national export controls on essential commodities and raw materials further blocked access. He notes that without its own vaccine production, Africa has been rendered a continent of beggar vaccine nations.

Masiyiwa’s apportionment of blame to external actors does not diminish the agency of Africans in their fight against the pandemic, nor does it appropriate the responsibility of African governments. Uneven governance and lack of transparency has also taken its toll across the continent. Until recently, Tanzanians lived under a president who denied the existence of the disease and the utility of scientific treatments. But these domestic circumstances do not account for the disparity of outcomes.

Larry Summers, former U.S. Treasury Secretary and one of the co-chairs of the of the G-20 panel put together to look at post-pandemic preparedness, recently said “this is a profound moment in international relations.” Agreed.

Like Summers, I believe that the United States must confront the vaccine imbalance as well as tackle the injustices in the global health infrastructure that got us here.  Both will be essential to a sustained economic recovery in Africa and to building international solidarity to combat other challenges, including the existential threat of climate change.  

In the short-term, it will be all about ramping up production, redeploying excess vaccines from wealthier nations, and ensuring that cash is available — in real-time — to help Africans purchase and administer the doses. This will be especially important with the African Union doses where Johnson&Johnson is positioned to deliver but full funding has not been secured.  It will also demand giving African nations the fiscal space to absorb the shock of the COVID-19 recession. 

The Biden administration has taken some important initial steps. This week it initiated delivery of 25 million doses to 49 African countries, with the first shipments to Burkina Faso, Djibouti and Ethiopia coming in days.

In addition, at the recent G-20, U.S. Secretary of Treasury Janet Yellen supported the IMF’s allocation of $650 billion Special Drawing Rights — a reserve asset created by the IMF and exchangeable for hard currency — with the presumption that G20 members will donate their share of the allocation to low-income countries.

In the longer term, it is going to take more.

It’s going to take an “all-in” mentality by the Biden administration — and “all-in” will mean heeding the advice of Larry Summers and his co-chairs to invest $15 billion a year in additional funds for a major overhaul of the world’s health governance infrastructure. It will need to entail debt forgiveness, not just debt suspension, and bringing on board the private sector creditors and credit agencies. Finally, it will demand holding China accountable — but that is a column for another day.

Addressing systemic societal inequities should not stop at the water’s edge. As Kenyan journalist Nanjala Nyabola writes, we cannot permit rich countries to use charity as a buffer for injustice.

NOTE: This post has been updated from the original to correct the amount of the IMF special drawing rights.

K. Riva Levinson is president and CEO of KRL International LLC, a D.C.-based consultancy that works in the world’s emerging markets, award-winning author of “Choosing the Hero: My Improbable Journey and the Rise of Africa’s First Woman President” (Kiwai Media, June 2016). You can follow her @rivalevinson