As a highly infectious new strain of COVID-19 spreads through Southern Africa, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is calling for COVID-19 vaccines to be distributed equitably, prioritizing frontline health workers and people at highest risk of severe illness and death from COVID-19. Health workers in Mozambique, Eswatini, and Malawi are currently struggling to treat escalating numbers of patients with little prospect of receiving a vaccine to protect themselves or others from the virus.
“We are appalled by the inequitable distribution of COVID-19 vaccines across the world,” said Christine Jamet, MSF director of operations. “While many wealthy countries started vaccinating their health workers and other groups nearly two months ago, countries such as Eswatini, Malawi, and Mozambique—which are struggling to respond to this pandemic—have not received a single dose of vaccine to protect the most at-risk people, including frontline health staff.”
In Eswatini, a country of 1.1 million people, 200 new cases are being reported each day and deaths are approximately four times higher than during the first wave. Health workers are saying that patients are becoming more severely sick this time around. With health facilities overwhelmed, MSF teams have set up tented wards at Nhlangano health center in Nhlangano and brought in extra doctors and nurses to care for critically ill COVID-19 patients.
In Mozambique, case numbers are currently almost seven times higher than at the peak of the first wave. “Health workers are getting sick and those still at work are exhausted,” said Natalia Tamayo Antabak, MSF head of mission, whose teams are helping implement infection and prevention control measures at government COVID-19 treatment centers in Maputo to minimize infections among health staff working there.
In Malawi, new cases increased exponentially in January, doubling every four to five days. Queen Elizabeth Central Hospital, the main facility offering COVID-19 care in Blantyre, is close to full capacity for patients in need of oxygen. MSF has sent in extra staff and is ready to open an additional 40-bed ward for COVID-19 patients.
“The priority right now is protecting frontline health workers,” said Marion Pechayre, MSF head of mission. “If Malawi had 40,000 doses of vaccine, we could at least start by vaccinating health staff in the country’s main hotspots. Without this, the situation will soon be untenable.” Since the start of this second wave in mid-December, 1,298 frontline health workers in Malawi have tested positive for COVID-19 and nine have died.
“People in the poorest countries seem to be at the back of the line to access these crucial vaccines,” Jamet said. “There is an urgent need for vaccination in countries in Southern Africa struggling to respond to the aggressive spread of this new virus strain, which is overwhelming their health systems.”
While Mozambique, Eswatini and Malawi go without vaccines, wealthier nations that could afford to strike bilateral deals with pharmaceutical corporations are hoarding vaccines with the intention to vaccinate beyond the priority groups.
“It would be indefensible if some countries started to vaccinate their lower-risk citizens while many countries in Africa are still waiting to vaccinate their very first frontline health workers,” Jamet said. “This totally goes against the World Health Organization’s equitable allocation framework. Not only will it prolong the pandemic, but it will put even more lives at risk. We urge governments who have secured more doses than they need for vaccinating their high-risk groups to urgently share their doses, so that other countries can start vaccinating. This is a global pandemic that requires a global spirit of solidarity if we truly hope to bring it under control.”
From early on in the pandemic, MSF has been pushing to ensure that any COVID-19 vaccines that hit the market are distributed to people all over the world at an affordable, at-cost price. This could be done through the COVAX Facility, a global initiative under Gavi, the Vaccine Alliance, to ensure equitable access to vaccines for all countries.