Addis Ababa, Ethiopia: The Africa Centres for Disease Control and Prevention today released the results of a new 27-country analysis on the health and economic impact of COVID-19 vaccination. The retrospective study on the roll-out of COVID-19 vaccine programmes demonstrated that earlier start dates and rapid scale-up delivered greater health benefits – measured in terms of hospitalizations and deaths averted – and were more cost-effective when compared with programs that started later and scaled more slowly. Furthermore, the benefits of COVID-19 vaccines vary widely depending on the pace of roll-out, the population targeted, and the type of vaccines used in the campaigns. The analysis also drew on research from Kenya, Nigeria, Ethiopia and South Africa.
The analysis demonstrated that vaccine programs deliver the best value for money when focused on the most vulnerable, including the elderly, pregnant women, health workers and those with comorbidities. This is especially true in countries with a low overall risk of severe outcomes from COVID-19, such as nations with younger populations or that have already had significant exposure to the virus. In Kenya, researchers found that scaling up to 30% of the population, but focusing on the elderly, was far more effective than reaching 70% coverage of the general population. Nigerian researchers found the same result when modelling targeted scale-up to 25% of the population.
“The evidence is clear – countries should aim to vaccinate those most at risk, as quickly as possible, with the most cost-effective vaccines available to them,” said Dr. Ahmed Ogwell Ouma, Deputy Director of the Africa CDC. “This is how we can save the most lives and deliver the highest value for money.”
The research found that it is not only the overall vaccine coverage reached that determines the benefits of a vaccine program. Rather, starting early and moving quickly are critical levers to increase the impact of any COVID-19 vaccine program. In South Africa, a 40% vaccine coverage achieved through a fast roll-out was found to provide greater health benefits over a year than 67% coverage attained slowly. For countries where large numbers of the population remain unvaccinated, moving with urgency and scaling up quickly is critical. The study also found COVID-19 vaccine efforts become less cost-effective – or not cost-effective at all – as countries take longer to scale their programs.
“This new research gives us a clear direction of travel,” said Prof Edwine Barasa, Director at the Nairobi Programme of the KEMRI-Wellcome Trust Research Programme. “Many countries are struggling to scale – but if we can move faster and in a more targeted way, we can get the job done.”
There have been 11.5 million confirmed cases of COVID-19 in Africa, with more than a quarter-million lives lost. While scale-up of vaccine programs continues apace and more than 20% of Africans have now received one dose of a COVID-19 vaccine, this masks wide disparities across the continent. Several African countries have nearly vaccinated 70% of their populations with two doses; while others have not yet reached 1% of their populations with the first dose.
The study also explored how the choice of vaccines impacts the cost-effectiveness of vaccine programs across the continent. While the efficacy of COVID-19 vaccines does not vary significantly across products, mRNA vaccines tend to have significantly higher procurement and delivery costs. Choosing the least expensive vaccine options, especially in the case of budgetary limitations, is a pragmatic way to improve the cost-effectiveness of COVID-19 vaccine programs.
“There is no doubt that COVID vaccines remain cost-effective under a number of scenarios,” said Dr. Justice Nonvignon, Ag. Head of the Africa CDC Health Economics Programme. “But it is equally clear that as the pandemic evolves, we need to be thoughtful about how we spend our time and money. In certain contexts, African countries may deliver greater health benefits to their citizens by investing in other more cost-effective health programs.”
Cost-effectiveness studies weigh the benefits of a health program compared to its costs. This analysis included a detailed range of COVID-related costs. To measure the cost of COVID-19 vaccine programs, researchers studied the cost of the vaccines themselves as well as associated delivery costs for campaigns. To measure the costs of COVID-19, the study explored impacts on disability-adjusted life years (DALYs), a widely used measure for health benefits that includes years of life lost due to COVID-19 and years lived with disability for symptomatic cases, hospital stays in a general or critical bed, including long COVID.
The analysis was conducted by a broad coalition of local and international research groups. The Kenya Medical Research Institute – Wellcome Trust, University of Nigeria; Ethiopian Public Health Institute and the University of Warwick all contributed to the country-specific case studies; while the London School of Hygiene and Tropical Medicine prepared the regional analysis, with inputs from the Center for Global Development and the international Decision Support Initiative (iDSI). The Africa CDC oversaw the studies.
Source - Africa CDC
CAIRO: Egypt will spare no effort to help African states recover from the repercussions of the coronavirus pandemic, Foreign Minister Sameh Shoukry said at the seventh session of the Dakar International Forum on Peace and Security in Africa.
Egypt has started locally producing China’s Sinovac COVID-19 vaccine in preparation for exporting surpluses to African countries.
Shoukry said the pandemic has impeded efforts to achieve peace and stability on the continent and has exacerbated humanitarian crises.
It has become impossible to deal with the pandemic solely as a global health crisis, as it has affected all aspects of life, he added.
Shoukry highlighted issues that Africa should prioritize, including developing a common vision to address shortcomings in the continent’s medical infrastructure, such as dependence on foreign medicines and vaccines.
He also noted the importance of addressing the root causes of terrorism and armed conflicts in Africa by rebuilding societies that have suffered from the scourge of war and conflict.
He praised the selection of Senegal for the African Union presidency from February 2022 and expressed Cairo’s readiness to provide all forms of support to the country in light of Egypt’s experience as president of the bloc in 2019.
Shoukry handed a letter to Senegalese President Macky Sall from his Egyptian counterpart Abdel Fattah El-Sisi that discussed ways to strengthen bilateral ties, as well as issues of common concern.
Source - Arab News
Africa has stepped up its surveillance of emerging variants of the Covid-19 virus, and a detailed paper shows how the work of hundreds of scientists and public health officials from the continent is ensuring that Africa does not get left behind in the global response to the pandemic.
According to a paper published in the journal Science in September, when the Covid pandemic started, Africa was initially left behind due to its fragile health and scientific infrastructure, and diagnostics and reagents being hoarded by developed countries. As a result, Africa is the world's least vaccinated continent.
But a mammoth effort – involving 112 African and 25 international organisations, in close collaboration with the Africa Centres for Disease Control and Prevention (Africa CDC) and the World Health Organisation (WHO) – soon closed this gap. Together, they worked to create detailed analyses of the variants and lineages in Africa.
Genomic surveillance, which has been crucial to identify these variants and control outbreaks, took place in 33 African countries and two overseas territories. Without these networks in place, we would arguably be in a much worse situation.
Using advanced tech in Africa
Even when sampling was limited, the team of African scientists identified many of the variants of concern (VOCs) and variants of interest (VOIs) that are being transmitted across the world, such as the Beta variant which dominated South Africa’s second wave of infections.
“We are deeply committed to using the most advanced technologies in Africa to trace and combat the virus,” co-author of the paper, Professor Tulio de Oliveira, said in a news release by Stellenbosch University.
De Oliveira is a bioinformatician and director of the genomics surveillance lab KRISP (KwaZulu-Natal Research Innovation and Sequencing Platform).
He previously told Health24: “In South Africa, we were fortunate to identify [the Beta variant] quickly, otherwise we would have ended up with a more severe second wave because we wouldn't have been able to respond.”
Huge network in SA
Vaccines should be effective against new variant
Vaccines should be effective against the new C.1.2 COVID-19 variant. This is according to KRISP Director, Túlio de Oliveira. He says its mutational profile is similar to that of the Beta variant. Courtesy #DStv403
KRISP is the principal investigative institute for the network of genomic surveillance in SA, but it is part of a collaborative network comprising a handful of institutes, including the National Health Laboratory Service, the National Institute of Communicable Diseases, the University of Cape Town, Stellenbosch University and the University of the Free State.
“One of the things we showed, and one of the reasons South African science is being praised – not only nationally by our ministers and by the president, but internationally by scientists and funders – is because we have shown that by working together, we can do much more than by working independently,” said de Oliveira.
Collaboration a 'fulfilling' experience
De Oliveira dubbed the network of collaborations as a “very fulfilling” experience.
“Not only did we manage to share and analyse our African data together, the collaboration also involved complete sharing of knowledge, with all analysis scripts shared and hundreds of hours of capacity building in analysis and data generation so that genomics can be decentralised and performed in real time in Africa,” he said.
According to Dr John Nkengasong, director of the Africa CDC, strengthening genomic surveillance systems across the continent is critical for early detection and control of disease outbreaks.
“The [Africa CDC Institute Institute] is very proud of this collaborative work and will continue to coordinate collaboration among public health, academic and research institutions to strengthen pathogen genomics and bioinformatics capacity in Africa,” he said.
Gayle Smith, a former administrator with the US Agency for International Development, said in September 2020 that Africa was doing “a lot of things right the rest of the world isn’t”, AP reported.
Delta variant a 'wake-up call'
Currently, there are 40 000 African genomes available in GISAID, a global science initiative that provides genomic data of the Covid virus.
The highly transmissible Delta variant which is dominating infections in multiple countries, including South Africa, is a “wake-up call and underlines the importance of genomic information”, said Dr Matshidiso Moeti, WHO regional director for Africa. Moeti added that it underscores the importance of African scientists having the necessary resources to analyse the evolution of the virus.
“Without this analysis, variants can spread undetected on the continent and across the globe. This will prolong the acute phase of the Covid-19 pandemic, not just in Africa, but worldwide,” she said.
Stopping the evolution of the virus
Importantly, the authors point to the slow rollout of vaccines in most African countries, suggesting that it “creates an environment in which the virus can replicate and evolve".
This, in turn, can lead to additional VOCs with higher transmissibility than the Delta variant, and that escape vaccine-induced protection, for example, and further derail the global fight against Covid.
“If the virus keeps evolving on the African continent, this will become a global problem. It is our moral duty to try to protect Africa and the world,” said de Oliveira.
ASPEN Pharmacare is in talks to make Johnson & Johnson’s coronavirus shot under licence in South Africa, at what would be the continent’s first major independent distribution base for a global vaccine against COVID-19, the company has announced.
News of the talks coincided with the suspension of heavily criticised shipments to Europe from Africa of the same shot, which is already being made under contract and packaged by Aspen but distributed by J&J.
WHO Director-General Tedros Adhanom Ghebreyesus said last month he was “stunned” by that arrangement, since Europe has very high inoculation rates while less than 3% of Africa’s adults in Africa have been vaccinated.
Aspen CEO Stephen Saad told Reuters it was now seeking a far bigger deal with J&J that would allow it to make, market and sell the vaccine under licence for the whole of Africa, along the lines of the model used by India’s Serum Institute.
“At the moment we contract manufacture for J&J. So that’s what we do. We take it, they release it,” Saad said in an interview.
“…But a licence would be different. We would then sell to the end-customer. And then we have a brand. And then we also have control over where our product goes” and overpricing.
“…At the moment, J&J could take all the product we make because it’s their product, and sell it …wherever they choose to. We have no say in that.”
J&J did not immediately respond to an email from Reuters seeking comment.
In an online briefing, African Union (AU) coronavirus envoy Strive Masiyiwa said the arrangement whereby J&J was sending shots finished in Africa to Europe was halted following interventions by South African President Cyril Ramaphosa and European Commission President Ursula von der Leyen.
The fewer than 20 million doses shipped so far would be returned. “All the vaccines produced at Aspen will stay in Africa and will be distributed to Africa,” Masiyiwa said.
Africa aims to vaccinate 60% of its adult population by 2022.
But by August, just 10% of the doses that the COVAX vaccine-sharing programme, co-run by the World Health Organization, had forecast it would ship there by that time had been delivered, according to the AU.
Masiyiwa said the talks between J&J and Aspen also came as a result of the South African President requesting that the arrangement between them be changed.
Aspen is looking to expand its annual vaccine production capacity from around 300 million doses to about 450 million by February 2022.
Saad said it was too early to say whether some of that would be reserved for production under licence, though from October onwards, all of the J&J vaccine doses being packaged at its plant would go to African countries.
J&J has contracts to supply 31 million doses of vaccine to South Africa and at least 220 million to the rest of Africa.
The new arrangement would be “like (India’s) Serum where they get the licenses to manufacture. It’s not a foreign model,” Saad said of the licensing talks.