CAPE TOWN, South Africa – As a dangerous variant of the coronavirus first discovered in South Africa and killing thousands across the country, Jan Matsena has appeared every day to hit the shelves. selling at a supermarket in Cape Town, for fear of getting it too.
A neighbor died in December, then a co-worker this month. Now Matsena is waiting for a vaccination so he can return home to his hometown and hold his little girl again. But in South Africa, the hardest country to date with the difference, inoculations have not yet begun.
“Waiting for this vaccine has been a long, long time now,” said Matsena, a first-time father who has been living away from his family for fear of being exposed. “People are dying. People are losing jobs. It’s a trauma. ”
While more than 90 million people worldwide received the vaccine, only 25 in all sub-Saharan Africa, an area of about 1 billion people, received doses outside of drug tests , according to the World Health Organization.
But as new changes such as the one found in South Africa migrate to more countries – including the United States – it is becoming increasingly clear that the catastrophe for poor countries could be a tragedy for every country. The more the virus spreads and the longer it takes to vaccinate people, the greater the chance of continuing to circulate in ways that endanger the whole world.
Recent studies suggest that at least four vaccines that are effective in preventing infection with the original virus have not performed as well against the variant found in South Africa. This variation is also more contagious – as is another one, found in Britain – and now accounts for 90% of all cases in South Africa, according to data released by research together. It has appeared in dozens of other countries.
Ingestion stimulates the immune system to make antibodies to the virus, but as mutations change their shape, the virus can become more resistant to these antibodies. In the worst case, stopping the spread of the virus worldwide would allow more mutations that could make existing vaccines so effective, leaving numbers even in jeopardy.
“This notion of being safe is not just an adage that everyone is safe; it’s real, ”said Andrea Taylor, deputy director at Duke’s Center for Global Health Innovation.
Even in the most optimistic scenarios, Taylor said, at normal production speeds, there will not be enough vaccines for real global coverage until 2023. Conventional plans across Africa are expected to have only 20% to 35% vaccination of this population a year if all goes well.
And while some rich countries have received enough vaccines to cover their numbers several times, South Africa has received just 22.5 million doses for its 60 million people, and many countries are more late.
That difference is at the heart of what Tedros Adhanom Ghebreyesus, head of the World Health Organization, said could soon be a “catastrophic moral failure” as rich countries tear apart vaccine stock while leaving poor and middle-income countries struggling to find supplies. .
The first million doses of South Africa, made by AstraZeneca, are expected to arrive on Monday, and officials say it will take as long as two weeks to begin delivering the sights. The AstraZeneca vaccine, developed by Oxford University, is currently the most affordable option in the world, developed by low- and middle-income countries as its target. The company has not released any information on its effectiveness against the variant but is expected to do so soon.
A further 9 million doses have been ordered from Johnson & Johnson, which has yet to have a regulatory license. On Friday, the company announced that the effectiveness of its vaccine has dropped from 72% in tests conducted in the United States to 57% in those conducted in South Africa.
There are some encouraging signs. A growing body of preliminary evidence – gathered largely from the rapid lightning transmission in Israel – shows that vaccines perform well not only in tests, but in real world, reducing new diseases.
But it remains to be seen how well they help to incorporate the variables that are already in circulation. Scientists hope that, if necessary, vaccines can be modified and elevations improved to deal with new changes, but that will take time. And for a world struggling to correct itself, time is of the essence.
Dr Tulio de Oliveira, a professor and geneticist at the Nelson Mandela School of Medicine in Durban, who helped discover the variant first discovered in South Africa, said for it to appear as an awakened call.
“One of the things that should make this difference visible to the whole world is the need to control transmission – not just in their own country but in the whole world,” he said. e.
And while countries are in a hurry to seal their borders, the variables are already spreading in dozens of countries – just as the virus wiped out national borders last winter. Brazil, for example, seems to have aroused at least two kinds of anxiety, which had slipped its borders before many countries began to cut air travel from there.
The responsibility for giving vaccines to low- and middle-income countries relies heavily on a non-profit organization, Covax, created by a consortium of international organizations.
While more than 190 countries have pledged to receive vaccines through Covax, many are also striking contracts directly with drug companies or belonging to multinational organizations that do so. That threatens to raise prices and delay the delivery of doses through Covax.
Covax has announced that it has received 2.1 billion doses for 2021, but it is unclear how many of those will be delivered in 2021.
It is hoped that the next month or two will see the spread of poverty to poor countries.
“Covax is essential but not enough,” Taylor said. “It simply came to our notice then. We need it, and we need it to succeed. But even if they succeed, he will not find countries close to a herd’s immunity. ”
Orin Levine, director of global delivery programs at the Bill and Melinda Gates Foundation, said, “the stark reality is that by the end of this year, 75% of the population may be in income-generating countries. high incidence of immunization, ”compared to 25% in low-income countries.
For African countries, the slow pace of their release feels intimidatingly familiar.
When another scourge – HIV / AIDS – killed millions of people every year, Africa had the highest number of diseases and deaths. However, it took at least six years before the life-saving treatment available in rich countries was given to Africans.
AIDS has killed 12 million people in Africa in a decade, even as mortality in the U.S. fell sharply, according to studies by the African Centers for Disease Control and Prevention. Controversies over international property rights have delayed the production of more antiretroviral drugs or generic products.
India and South Africa have now teamed up to lobby the World Trade Organization to force drug companies to share their intellectual property on coronavirus vaccines as they did last with HIV / AIDS treatment.
“What we need right now is the special co-operation of all governments and pharmaceutical companies that claim to be in a pandemic, we are on the road to disaster,” said Fatima Hassan. , a South African human rights lawyer who fought for HIV AIDS drugs and has now turned to COVID-19 vaccines. “We need to share the technology and spend billions to save trillions.”
Solomon Zewdu, deputy director of health at Africa at the Gates Foundation, said maps and records showing global vaccination levels – with Africa almost completely gone – provoke public anger and cause some leaders to look for vaccine sources in addition to Covax.
The African Union announced the purchase of 300 million vaccines this month, for distribution through the regional agency’s African Medical Provision Platform, according to Nicaise Ndembi, senior scientific adviser for the African Centers for Control and Disease Prevention.
In countries like Mozambique, Zimbabwe and Zambia, where the variant found in South Africa is thought to be driving an increase in disease, authorities have no clear answers about when vaccines will arrive.
South Africa, meanwhile, has been relatively skeptical of a dispersed response, taking steps that have caused controversy within the country. President Cyril Ramaphosa has reinstated a 9 pm-to-5 am curfew, restricted attendance at funerals and religious gatherings, banned the sale of alcohol and made masks mandatory in all public places. Failure to wear a mask can result in a fine or six months in prison.
When vaccinations are expected to start, around mid-February, health workers will be first line, followed by those most at risk of serious illness.
For Matsena, a supermarket employee, who is 31 and healthy, it could be a long wait.
“It would have been better if it had arrived earlier because now people are scared of this pandemic,” he said. “It’s worse, worse.”