COVID shots are finally arriving, but Africa can't get them all into arms

* Vaccine deliveries to Africa finally accelerating

* Deliveries welcome, but not all countries are prepared

* Lack of funds, staff and community outreach hamper campaigns

* Continent already well behind in vaccination rates

* Omicron variant a warning of risks this poses

By Maggie Fick and Edward McAllister

SEKENANI, Kenya, Dec 6 (Reuters) - When a group arrived at the Sekenani health clinic in rural Kenya for their COVID-19 vaccines recently, staff told them there were no doses left and that they should come back soon.

For some, it meant a long wasted journey on foot and a day away from their cattle herds.

Yet Narok county, where the clinic is located, was not short of vaccines; nearly 14,000 doses were sitting in a fridge in the nearest town, 115 km away. A mix-up with county officials meant Sekenani did not get enough, two health workers said.

"We had to say sorry. It's not a good feeling, when somebody comes and they want the vaccine, and we don't have it," clinician Mike Nalakiti, 27, told Reuters.

The small failure in a village 270 km southwest of the capital Nairobi is an illustration of the challenges African nations now face as they battle COVID-19: even though vaccine supplies are finally ramping up, getting needles into arms is proving the hard part.

Successful vaccination campaigns in Africa are vital to ending the pandemic globally, health experts say. The continent's low inoculation rates encourage viral mutations like the new Omicron variant spreading across South Africa, which has prompted another spate of international travel bans.

Only 102 million people, or 7.5% of the continent's population, are fully vaccinated, according to the World Health Organization, which warned vaccine inequity will prolong the pandemic.

African governments have been crying out for higher vaccine deliveries this year, but production constraints and hoarding by richer countries severely limited supplies until recently.

Shortages of funds, medical staff and equipment, as well as vaccine hesitancy, were already hobbling inoculation campaigns in some parts of Africa. The anticipated surge, comprising millions of jabs in the coming weeks, could expose those weaknesses further, experts warn.

About 40% of vaccines that have arrived so far on the continent have not been used, according to data from the Tony Blair Institute for Global Change, a policy think-tank.

The rate of vaccine use will have to rise four-fold to keep up with expected supply in coming months, the institute says.

"We are all, like you, very concerned that countries are not picking up the vaccines. The uptake is not as we would have loved to see," head of the Africa Centres for Disease Control and Prevention John Nkengasong said.


Vaccination rates vary widely across Africa, a continent of well over a billion people, and some health systems in relatively small nations and in North Africa are having more success.

Cape Verde, an archipelago nation off West Africa with a population of about 600,000, has vaccinated nearly 65% of adults, rivalling some European countries.

In Democratic Republic of Congo, a restive country in Central Africa with a population of nearly 90 million, the number is 0.1%.

In some ways, Kenya is doing relatively well. East Africa's largest economy has received nearly 5 million doses in the past two weeks after months of slow supplies.

On Dec. 1, it vaccinated a record 110,000 people and aims to maintain that rate for the next 30 days, said Willis Akhwale, head of the government's COVID-19 vaccine task force. That would bring the total vaccinated to 10 million out of a population of 47 million, he said.

Yet in the rural Sekenani clinic at the edge of the famous Maasai Mara Game Reserve, where elephants and lions roam, challenges abound.

The clinic started offering COVID-19 vaccinations four weeks ago. It keeps running out of doses and has only one reliable fridge, which is also used for routine immunisations, said clinical officer Gerald Yiaile.

Staff need motorbikes to take vaccines to the community, semi-nomadic livestock herders from the Maasai ethnic group who struggle to afford transport for healthcare, he said.

He applied to local authorities for funds for mobile vaccination and has not heard back.

"We have been forced to ask the community to come to us instead of us going to them," Yiaile said.


African nations scrambled to ready their health systems earlier this year as global vaccine-sharing scheme COVAX began delivering doses in small quantities months after wealthy countries began inoculations.

Cash-strapped countries were short Link of cotton wool, fridges, face masks and trucks.

COVAX deliveries were then disrupted after COVAX's major supplier India halted Link vaccine exports. The pause gave countries time to improve vaccination rollout without being inundated. They did so to differing degrees.

The GAVI vaccine alliance, a co-leader of COVAX, initially did not prioritize investing in the ultra-cold chain equipment needed for mRNA shots like Pfizer's because it expected the bulk of doses to be the cheaper and easier-to-administer AstraZeneca shots produced in India, Reuters reported Link in September.

As vaccine deliveries to Africa soar, absorption of large volumes is expected to represent a major challenge for many poor countries, particularly because a substantial volume will be from Pfizer, GAVI said in internal documents prepared for its board meeting last week and seen by Reuters.

Even Kenya, which has the ultra-cold chain capacity to store 3 million Pfizer doses, is worried its cold chain will get constrained by the influx, threatening its routine immunization program, Akhwale said.

Cameroon in Central Africa had 244 vaccination centres at the start of its vaccine rollout in April, and now has 1,000, said Njoh Andreas Ateke, deputy head of the immunisation program.

But health workers and officials say that power outages and lack of staff have compromised vaccines.

The country has one refrigerated truck suitable to transport vaccines, said Leonard Kouadio, UNICEF'S health section head in Cameroon. It needs at least 2,500 more fridge temperature gauges and more trucks to increase distribution, he added.

Mali, one of Africa's largest and poorest countries, has two refrigerated trucks to carry vaccines long distances. Some health workers fled their posts in the north because of insecurity caused by an Islamist insurgency, said UNICEF health program manager in Mali, Abdoul Gadiry Fadiga.

The country expects to receive about 3.5 million doses between now and the end of March, more than double the number it has received since inoculations began, Fadiga said.

Mali has enough cold chain capacity to deal with the initial rush of doses until March, Fadiga added, but it still needs 288 fridges and freezers for its full rollout, only 10 freezers of which had arrived.

Funds have been slow to materialise. The World Bank has approved $9.8 billion for emergency health responses, including for vaccine deployment, in developing countries globally, but so far only $4.4 billion has been disbursed.

Mali and Cameroon await support.

A World Bank official said disbursements were happening "very fast".


Even when help arrives it can backfire. Donors have sometimes sent African nations vaccine batches nearing expiration, in some cases rendering them unusable.

Countries desperate for vaccines, including South Sudan and Congo, had to send some back because they could not distribute them in time. Namibia warned Link last month it may have to destroy thousands of out-of-date doses.

South Africa asked Link Johnson & Johnson and Pfizer to delay delivery of vaccines because it had too much stock.

A key difficulty in administering vaccines is community skepticism, sometimes driven by religious belief and mistrust of Western drug companies and their own governments. Insufficient education about COVID-19 vaccines enables rumours to spread.

That can be the result of local staff and budget shortages, health workers from across the continent told Reuters.

Ethiopia is worried that vaccines might expire before they are used due to low demand, and is trying to overcome vaccine hesitancy through outreach to communities via local religious and civil society groups, said Muluken Yohannes, a senior adviser to Ethiopia's health ministry.

"Currently, developed countries ... have satisfied their vaccine needs. As a result, they are pushing leftover vaccines ... to developing countries. However, the golden period to absorb these vaccines has already passed," he said.

Kenya has ramped up its vaccine rollout with social media and television and radio ads promoting vaccines. Posts on the health ministry Twitter feed urge pregnant and breastfeeding mothers to get vaccinated.

Not everyone gets the message. Nicky Theron, 20, who works at a clothing shop in the town of Talek, is five months pregnant and scared of the jab. She doesn't follow any government Twitter accounts.

"I have never heard of anybody who is pregnant receiving the vaccine," she said.

Some feel they could be persuaded if someone came to explain in person.

Julius Tuyioto, who herds livestock on arid plains in southern Kenya, hears the government warn of the dangers of COVID-19 on the radio. But the disease hasn't hit his community; he says it doesn't feel real.

"There is no civic education on why we should be vaccinated. No one is telling us," Tuyioto told Reuters outside his mud brick home in Narok County, to the chime of goat bells.

Last month, the government sent vaccines by motorbike to the nearest primary school, five kilometres away, he said. But he did not hear about it until the third and final day, when it was too late for him to go.
Reporting by Maggie Fick and Edward McAllister; Additional reporting by Francesco Guarascio in Brussels, Josiane Kouagheu in Douala, Cameroon and Giulia Paravicini in Addis Ababa; Editing by Mike Collett-White and Alexandra Zavis

دستبرداری: XM Group کے ادارے ہماری آن لائن تجارت کی سہولت تک صرف عملدرآمد کی خدمت اور رسائی مہیا کرتے ہیں، کسی شخص کو ویب سائٹ پر یا اس کے ذریعے دستیاب کانٹینٹ کو دیکھنے اور/یا استعمال کرنے کی اجازت دیتا ہے، اس پر تبدیل یا توسیع کا ارادہ نہیں ہے ، اور نہ ہی یہ تبدیل ہوتا ہے یا اس پر وسعت کریں۔ اس طرح کی رسائی اور استعمال ہمیشہ مشروط ہوتا ہے: (i) شرائط و ضوابط؛ (ii) خطرہ انتباہات؛ اور (iii) مکمل دستبرداری۔ لہذا اس طرح کے مواد کو عام معلومات سے زیادہ کے طور پر فراہم کیا جاتا ہے۔ خاص طور پر، براہ کرم آگاہ رہیں کہ ہماری آن لائن تجارت کی سہولت کے مندرجات نہ تو کوئی درخواست ہے، اور نہ ہی فنانشل مارکیٹ میں کوئی لین دین داخل کرنے کی پیش کش ہے۔ کسی بھی فنانشل مارکیٹ میں تجارت میں آپ کے سرمائے کے لئے ایک خاص سطح کا خطرہ ہوتا ہے۔

ہماری آن لائن تجارتی سہولت پر شائع ہونے والے تمام مٹیریل کا مقصد صرف تعلیمی/معلوماتی مقاصد کے لئے ہے، اور اس میں شامل نہیں ہے — اور نہ ہی اسے فنانشل، سرمایہ کاری ٹیکس یا تجارتی مشورے اور سفارشات؛ یا ہماری تجارتی قیمتوں کا ریکارڈ؛ یا کسی بھی فنانشل انسٹرومنٹ میں لین دین کی پیشکش؛ یا اسکے لئے مانگ؛ یا غیر متنازعہ مالی تشہیرات پر مشتمل سمجھا جانا چاہئے۔

کوئی تھرڈ پارٹی کانٹینٹ، نیز XM کے ذریعہ تیار کردہ کانٹینٹ، جیسے: راۓ، خبریں، تحقیق، تجزیہ، قیمتیں اور دیگر معلومات یا اس ویب سائٹ پر مشتمل تھرڈ پارٹی کے سائٹس کے لنکس کو "جیسے ہے" کی بنیاد پر فراہم کیا جاتا ہے، عام مارکیٹ کی تفسیر کے طور پر، اور سرمایہ کاری کے مشورے کو تشکیل نہ دیں۔ اس حد تک کہ کسی بھی کانٹینٹ کو سرمایہ کاری کی تحقیقات کے طور پر سمجھا جاتا ہے، آپ کو نوٹ کرنا اور قبول کرنا ہوگا کہ یہ کانٹینٹ سرمایہ کاری کی تحقیق کی آزادی کو فروغ دینے کے لئے ڈیزائن کردہ قانونی تقاضوں کے مطابق نہیں ہے اور تیار نہیں کیا گیا ہے، اسی طرح، اس پر غور کیا جائے گا بطور متعلقہ قوانین اور ضوابط کے تحت مارکیٹنگ مواصلات۔ براہ کرم یقینی بنائیں کہ آپ غیر آزاد سرمایہ کاری سے متعلق ہماری اطلاع کو پڑھ اور سمجھ چکے ہیں۔ مذکورہ بالا معلومات کے بارے میں تحقیق اور رسک وارننگ ، جس تک رسائی یہاں حاصل کی جا سکتی ہے۔

ہم کوکیز کا استعمال آپکو ہماری ویب سائٹ پر بہتریں تجربہ دینے کیلیے کرتے ہیں۔ مزید پڑھیے یا اپنی کوکی سیٹنگ تبدیل کیجیے۔

خطرے کی انتباہ: آپکا سرمایہ خطرے پر ہے۔ ہو سکتا ہے کہ لیورج پروڈکٹ سب کیلیے موزوں نہ ہوں۔ براہ کرم ہمارے مکمل رسک ڈسکلوژر کو پڑھیے۔