...Underscoring Need for Consistent Supply
and Additional Logistical Support
Individual COVID-19 preventive measures,
such as handwashing and wearing masks, mark the path forward in protecting
people while vaccine efforts scale up
However, as of November 2021, less than 7%
of the African continent has been vaccinated. This gap between acceptance and
coverage demonstrates a substantial unmet need and underscores the importance
of consistent and predictable vaccine supply as well as increased support for
vaccination programs in Africa. The latest PERC report considers why global
vaccination efforts have been plagued by inequity, as well as the logistical
challenges to vaccinating the African continent. The report further outlines
the continued importance of preventive measures—particularly individual
measures such as masking and social distancing—that minimize the social or
economic harm that can occur when mobility, economic and social gathering
restrictions are imposed.
“We must work urgently toward equitable
access to safe and effective vaccines on the African continent,” said Dr. John
Nkengasong, Director of the Africa Centres for Disease Control and Prevention.
“The PERC data show that demand for vaccines is substantially higher than
supply.”
At 78%, vaccine acceptance was higher than
in the previous PERC survey fielded earlier this year (67%), which may indicate
the success of risk communication campaigns. In five surveyed countries—Guinea,
Morocco, Mozambique, Tunisia and Zimbabwe—acceptance was 90% or higher. Vaccine
acceptance was high among both those who trusted their government’s pandemic
response and those who felt COVID-19 posed a personal risk to them or to their
country. Such high acceptance contradicts media reports suggesting that low
vaccination rates across Africa are due to hesitancy.
Among the 20% of respondents who expressed
vaccine hesitancy, the top reasons were: low risk perception (24%), not having
enough information about vaccines (22%) and lack of trust in government (17%).
The reasons for low risk perception are complex, but officials can take
concrete action to address them. Offering more and better information to people
about COVID-19 and vaccines through trusted sources, particularly health care
providers, coupled with consistent and reliable vaccine supply, can further
increase acceptance. Respondents’ top information sources included local health
centers, television and radio.
A number of bottlenecks have contributed to
the failure to achieve higher vaccination coverage. Unpredictable supply—in
terms of volume, timing and shelf life—threatens countries’ ability to meet
demand. When offered, vaccination is frequently inconvenient, requiring people
to travel far distances or visit vaccination sites at inopportune times.
“I am heartened by the efforts of the
African Vaccine Acquisition Trust (AVAT) and the COVAX facility to expand vaccine
access,” said Amanda McClelland, Senior Vice President of Prevent Epidemics at
Resolve to Save Lives, an initiative of Vital Strategies. “But there is still
work to do. Vaccine donations sent too close to expiry dates, for example,
leave countries unable to launch effective vaccination campaigns.”
COVID-19 preventive measures remain crucial
to mitigate the health impact of the virus. PERC researchers analyzed what
influences support for and adherence to such measures and found that individual
actions—handwashing, mask-wearing and social distancing—all garnered support
from at least 90% of survey respondents. Such high support suggests that these
key measures can continue to be effective strategies for reducing COVID-19
transmission.
Preventive measures restricting gathering
or movement received less support. Unemployment and food insecurity were
widespread among survey respondents and made adherence to restrictive community
measures a challenge. PERC researchers concluded that such measures should be targeted
to specific, high-risk populations as needed to minimize harm.
Income loss also may have had an adverse
impact on access to essential health services. Cost and affordability were
cited as the primary obstacles to receiving care. Declines in the number of
health visits have likely contributed to declines across key health indicators.
PERC researchers advocate for urgent investment to stabilize health systems and
regain progress lost during the pandemic.
“The PERC data enable policymakers to both save
lives and minimize impacts on livelihoods,” said Dr. Tom Frieden, President and
CEO of Resolve to Save Lives, an initiative of Vital Strategies. “The global
community has an opportunity to invest in health care workers and public health
infrastructure to support vaccine delivery and COVID-19 care and prevention in
the near term, and also repair and restore health service delivery disrupted by
COVID-19 for the long term.”
Based on their findings, PERC authors recommend:
- The global community should support AU Member States in supplying vaccines at a better coordinated and more systematic pace to allow broader, more effective and equitable distribution. Resources and expertise to support vaccine delivery must be part of the supply machinery to ensure coverage.
- COVID-19 preventive measures (described as public health and social measures, or PHSMs, in the report) are critical to mitigate COVID-19 transmission, particularly as new, possibly more transmissible, variants emerge in under-vaccinated populations. Promoting adherence must remain a top priority.
- Ministries of Health have competing priorities—both maintaining longer-term investments in endemic diseases, such as HIV and tuberculosis, and preparing for and responding to immediate epidemics, such as yellow fever, Ebola and measles. Investments in preparing health security systems can be utilized both for COVID-19-specific responses and long-term priorities.
- Strengthening health data systems to be better prepared for health threats is critical. It is important that investments prioritize epidemiological data, as well as contextual data and data on community perceptions and actions toward countermeasures for disease mitigation and prevention. Together with the data itself, timely collection, analysis and dissemination are integral to systems strengthening and emergency response.
- The global community and national governments should invest—to the fullest extent possible—in public health infrastructure and social protection programs that build and maintain resilience, in order to improve health and economic outcomes and reduce the opportunity costs of vaccination and PHSM adherence.
The PERC survey—the fourth in its “Using
Data to Find a Balance” series—was fielded in September, when many countries in
Africa were recovering from a third wave of COVID-19 driven by the Delta variant
and before the emergence of the Omicron variant. PERC polled approximately
23,000 people across 19 African Union Member States; compiled social, economic
and epidemiological data from a range of sources; and compared results from
previous surveys conducted in February 2021 and August 2020. A French version
of the report will be available in January 2022.
To read the full report, please visit:
https://preventepidemics.org/wp-content/uploads/2021/12/PERC-Finding-the-Balance-Part-IV.pdf