As concerns about a third wave of Covid-19 cases in South Africa and the rest of Africa rise, it is vital that limited resources, such as vaccines, are fairly allocated.
This was the consensus during an online event hosted by Stellenbosch University's Faculty of Medical and Health Sciences (FMHS) on 25 May to mark Africa Day 2021.
Important issues in vaccine equity on the continent was raised at the event, titled Deepening Networks and Collaboration for Vaccine Equity in Africa.
In her keynote address Professor Keymanthri Moodley, director of the Centre for Medical Ethics and Law, highlighted ethical issues related to the pandemic, including the “extremely concerning" lag in terms of vaccine distribution between the USA and Africa.
“Only 1.42% of our population have received one dose of a vaccine and 0.39% have received two doses… Compare this to the US where 40% of the population have already received two doses," she said.
“There is great inequity in terms of how vaccines are being distributed. If we look at important ethical considerations … it becomes problematic that some countries have ordered more doses per person than is required," Moodley said. “Even the Secretary General of the United Nations has commented on the 'incredible disconnect' between self-interest and common interest. At a broad ethical level this is something we really need to think about as we move forward."
Turning to the ethics of vaccine research, Moodley said there are important lessons in terms of researcher responsibility.
“Often as we collaborate on research, especially with high-income countries or the pharmaceutical industry, we as scientists may forget our advocacy role in ensuring access to interventions that prove to be efficacious within the context of research.
“In South Africa we know that despite participating in clinical trials, our cost per dose of vaccine for the initial tranche of AstraZeneca vaccine was double the cost that Europe paid for similar vaccines."
Moodley said it is also important to think carefully about adding to the literature from a global south perspective and ensuring contextual issues particular to Africa are taken into consideration.
Calling for solidarity and equity, Moodley quoted the world-renowned author and activist, Arundathi Roy saying that, after the pandemic, “nothing could be worse than a return to normality" in such an unequal world.
In his opening address, Professor Nico Gey van Pittius, FMHS Vice-Dean: Research and Internationalisation said that Africa Day should be a day of celebration, but also a call to action.
“Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next," he continued.
“This year we focus on the inequity that still exists in the world, and specifically that our continent still experiences. We consider the fact that while more than 1.3 billion vaccines have been administered worldwide, 83% of these have gone to only a handful of wealthy nations, with well over three-quarters of all doses having been administered in only 10 countries, none of them in Africa.
“This situation is not going to change soon and experts predict most of Africa won't see significant quantities of Covid-19 vaccines until early 2023 if vaccine procurement proceeds at current pace," he said.
Speakers in the panel discussion highlighted the ongoing efforts towards an equitable vaccine rollout by governments, institutions and communities.
Professor Pierre Viviers, Senior Director, Campus Health Services, said as some areas in South Africa enter the third wave of the pandemic, campus communities will be important cohorts when planning the rollout of vaccines.
Professor Hassan Mahomed, Public Health Specialist for the Western Cape Department of Health, cited challenges faced by the health department in dealing with Covid-19. These included vaccine supply; vaccine hesitancy; misinformation and inequities.
Other challenges have been the electronic systems used to manage the vaccine process that created barriers for people without access to technology, reports of adverse events of side effects of the vaccine, and ethical consent issues, in, for example, people with Alzheimer's disease who cannot consent on their own.
Professor Mark Tomlinson, Co-Director of the Institute for Life Course Health Research in the FMHS said that people have been exposed to numerous conspiracy theories about the vaccine and that there is a need to strengthen community networks to counter vaccine hesitancy. Campaigns to encourage people to have the vaccine must be context and community specific, he stressed.
Ms Mia Malan, Founding Editor-in-Chief of the Bhekisisa Centre for Health Journalism, an independent media organisation that focuses on health and social justice issues across the continent, spoke about the role of the news media in the vaccine rollout.
“If we're doing our job properly, we provide people with accurate information that's fair and balanced and helps them make decisions without us lobbying them one way or another. It's also our job to highlight inaccuracies and misinformation. In a pandemic where science moves so quickly, this is hard."
Malan described how a training programme run by Bhekisisa aimed at better equipping journalists to report on Covid-19 vaccines had received positive feedback from journalists who had to “become health reporters overnight".