Vaccine nationalism poses a major threat to Africa as the West gobbles up supplies – we need to up our game

By David Monyae and Sizo Nkala counsel

The race to inoculate world populations against Covid-19 has begun in earnest and Africa is losing it. According to The New York Times, as of 4 February 2021 a total of 107.3 million vaccine doses had been administered to individuals across the world. North America leads with 6% of its population having been vaccinated, Europe is on 3.6%, Asia is on 0.9%, South America is on 0.7% and Africa lags far behind with fewer than 0.1% while Oceania has none.

In Africa, only four countries have begun administering vaccines to their populations. Morocco is ahead of the pack having administered 200,081 doses, Seychelles is a distant second on 30,861, Egypt has managed 1,315 while Algeria is fourth with a measly 30 vaccinations. South Africa will soon roll out its vaccination campaigns after receiving one million doses of the Oxford-AstraZeneca Covid-19 vaccines (ED: Doubt has now been cast on the efficacy of the Oxford-AstraZeneca vaccine to protect against what is commonly called the South Africa strain).

The latest numbers paint a gloomy picture for the continent, which has recorded just under 3.6 million cumulative cases, more than 407,000 active cases and 92,391 deaths. South Africa has been the hardest hit on the continent with more than 1.4 million confirmed cases to date and 44,946 deaths making up 48% of the continental total. Even more worrying is that the Covid-19 death rate has spiked from 2.1% in July 2020 to 2.5% at the moment, and in 21 African countries the rate is above the global average of 2.2%.

This is compounded by the emergence of a new coronavirus variant first identified in South Africa known as 501.V2 which reportedly spreads faster than the original virus and may undermine the efficacy of the current vaccines. The Africa Centres for Disease Control and Prevention (Africa CDC) has said that the continent needs to inoculate at least 60% of its population to achieve herd immunity. As such, Africa needs access to Covid-19 vaccines as soon as possible.

However, vaccine nationalism presents a formidable challenge as developed countries rush to hoard the available vaccines, leaving nothing for developing countries.

According to the Bloomberg vaccine tracker, rich countries have ordered vaccines from manufacturers multiple times their own population. Canada has ordered 123.8 million doses, which is more than 330% of its population. The United Kingdom ordered more than 201 million doses, which is about 302% of its population, and the United States has placed orders for 555 million, which is 169% of its population.

More than 4.5 billion vaccine doses have been reserved under bilateral pre-purchase contracts with various manufacturers – 46 African countries account for only just over 189 million (4%) of the doses under the pre-purchase contracts of which more than 128 million (67%) are due to Morocco and Egypt.

With vaccine prices ranging from $10 (R148) to $60 (R890.50) per dose, most African countries have been effectively priced out of the market. The Pfizer-BioNTech vaccine costs $19 per dose, Moderna and the AstraZeneca-Oxford vaccines cost $25-$37, Johnson & Johnson is priced at $10, Russia’s Sputnik V vaccine also costs $10 and China’s Sinovac is the most expensive at $60.

President Cyril Ramaphosa, who is also the African Union chairperson, decried the hoarding of the vaccines which is “being done to the exclusion of other countries in the world”. The African Vaccine Acquisition Task Team set up by Ramaphosa in August 2020 has reportedly secured an additional 270 million doses from Pfizer, AstraZeneca and Johnson & Johnson to be supplied later in 2021.

African countries are also relying on the 600 million doses to be distributed through the World Health Organisation’s Covax initiative, which will cover about 20% of the population.

The shameless and irrational hoarding of vaccines by Western nations has shown that when it comes to survival, the ever-busy Western supply chains will suddenly grow cold. Africa’s long-standing relationship with the West has historically necessitated a Western-inclined approach to African problems. This historical bias needs to be scrutinised. Over-dependence on the West can undermine the continent and its people’s survival when supplies of essential medical products like the vaccines become nationalised as they have been.

Just recently the European Union announced that it will institute export controls on vaccines made in European factories, further constricting already fragile supply chains. Even the notion of multilateralism, so fervently proselytised by the West, seems to be only viable in good times. In the rush to survive the pandemic, it is quickly cast out of the window.

The Covax initiative, which promises fair and equitable access to vaccines and which presents many poorer nations’ best chance to get the vaccines, has also been beaten to the market by the developed countries, some of which are even part of the initiative. According to the Economist Intelligence Unit, only three countries in Africa (Gabon, Libya and South Africa) have made financial contributions to the Covax facility. The rest of the countries joined the initiative under the Advance Market Commitment (Covax AMC) which relies wholly on donations through official development assistance. This reinforces Africa’s dubious distinction as an aid-dependent continent.

The emergence of China’s Sinovac and Sinopharm vaccines and Russia’s Sputnik V vaccine will diversify the supply chains to the advantage of Africa and other poor regions. Indeed Egypt, Morocco and Seychelles are inoculating their populations with China’s Sinopharm vaccine while Algeria is using Russia’s Sputnik V vaccine. The vaccines are less of a logistical nightmare as they can be stored in standard refrigerators whereas Pfizer, BioNTech and Moderna need to be stored at between -70°C and -20°C.

In a diplomatic offensive, China has already offered $2-billion to Africa and pledged to make the vaccine available to the continent. While this is a welcome offer, it is not sustainable as it makes Africa dependent on the goodwill of others for lifesaving medicine.

The continent should harness and develop manufacturing and research and development capacities of its own so as to cut the dependency on foreign-controlled supply chains, especially for pharmaceutical products. Although there are fairly vibrant pharmaceutical industries in Egypt, Kenya, Morocco and South Africa, the continent depends on foreign suppliers for 80% of its pharmaceutical and medical supplies. Chronic shortage of human resources, lack of capital and modern technology, and the Balkanisation of African markets are some of the factors that have to be addressed urgently to stimulate the growth of the all-important pharmaceutical industry in Africa.

The implementation of the new African Continental and Free Trade Area – especially the elimination of tariffs and non-tariff and technical barriers to trade and the application of the rules of origin – may give a new lease of life for the pharmaceutical industry. The establishment of the Africa CDC in 2016 to boost the continent’s public health policies is also a step in the right direction.

While Africa welcomes the assistance in the construction of its CDC by its strategic partner, China, it nonetheless raises questions about the ability of its leaders to invest in health infrastructure. It certainly does not inspire confidence that the AU will be able to independently source the funds to support the activities and the work of the CDC.

Moreover, there is a need for a paradigm shift in the understanding of national security among African leaders. African countries spend between $8 and $129 on health per capita per annum, far below the $4,000 average spent in high-income countries.

While Africa carries 23% of the disease burden, it accounted for only 1% of global health spending in 2015. Major countries like Nigeria, Kenya and Ghana spent 0.5%, 2.1% and 1.1% of their budgets on healthcare respectively in 2017, which is way below the 15% threshold recommended at the 2001 Abuja Declaration.

Yet military spending has gone up 20% in the past 10 years. As such, there is a need to move away from a traditional understanding of national security as military spending, to embracing a holistic view of security as inclusive of poverty reduction and, much more importantly, public health preparedness. With a shift in budget priorities, Africa can build a robust public health system and wean itself off foreign supply chains whose sudden nationalisation has crippled the continent’s response to the Covid-19 pandemic, putting the very survival of its people in jeopardy.

Dr David Monyae is the Director for the Centre for Africa-China Studies at the University of Johannesburg and Dr Sizo Nkala is a postdoctoral fellow at the same centre.

Source: This article was first published in Daily Maverick

 

 

South Africa borrows from the IMF for the first time since apartheid

And may not be the last.

Johannesburg.

 

Although it is rarely shy about spending other people’s money, the African National Congress (ANC), South Africa’s ruling party, has long been wary of the IMF. After Nelson Mandela came to power in 1994 the fund practically begged to help his new government. Mandela eventually saw the potential benefits of a cheap loan. But the ANC rejected the offer.

 

Opposition to the IMF has remained a shibboleth of the party. Yet on July 27th South Africa said it had agreed to a $4.3bn IMF loan. The deal signed by South Africa, one of 78 countries to have received covid-related help, is not a standard IMF programme and thus does not have stringent conditions. But the need for it nevertheless reflects the extent of the country’s underlying economic problems.

 

For some of the ANC’s self-styled comrades the worry about the IMF has perhaps been that it would make it harder for them to loot state coffers. For others, including Thabo Mbeki, Mandela’s successor, an IMF loan would have meant an intolerable violation of sovereignty.

 

Despite his doubts about the IMF, Mr Mbeki pursued macroeconomic policies so orthodox that a rabbi might have blessed them. Under Trevor Manuel, finance minister from 1996 to 2009, and Tito Mboweni, governor of the reserve bank from 1999 to 2009, South Africa closed its budget deficit, and tamed inflation, which had averaged 14% in the 1980s. Though the ANC’s patronage machine kept whirring, GDP grew by more than 5% a year from 2005 to 2007.

 

Then came Jacob Zuma. Under his presidency corruption thrived and public spending ballooned. The negative effects of rigid labour markets and affirmative action intensified. Real GDP per person has shrunk every year since 2015. The ratio of public debt to GDP rose from 26% in 2008 to 56% in 2018. As early as 2015 writers such as R.W. Johnson warned that South Africa was heading for a bail-out.

 

This condition-light deal is not quite the Rubicon-crossing that some envisaged. But it is a toe in the water. In a letter to the fund, Mr Mboweni, who in 2018 returned to the government as finance minister, and Lesetja Kganyago, the reserve bank’s current governor, made several pledges, primarily relating to public finances.

 

They promised to cut the share of spending that goes on public-sector wages and to speed up structural reforms, for example to state-owned enterprises such as Eskom, the indebted electricity utility. They are open to a self-imposed “debt ceiling” (public borrowing is projected to hit 87% of GDP in 2024 before declining). But little of this is new. In June Mr Mboweni gave a statement to parliament with similar commitments.

 

South Africa’s problem is not a lack of ideas. It is politics. Although he has said he supports Mr Mboweni, President Cyril Ramaphosa has done little to show it. He has often made the job of his finance minister harder, for instance by promising that there would be no “mass retrenchment” of public employees, and by dithering over state enterprises. Corruption remains rife. Credit-rating agencies doubt that Mr Mboweni will meet his targets. Few believe that Mr Ramaphosa will face down trade unions or his party ahead of its National General Council and local elections in 2021.

 

So this may not be the last time South Africa turns to the fund. The next bail-out would come with tough conditions, which would infuriate the ANC. But the party ought to appreciate what Mr Mbeki and Mr Manuel understood: that the way to protect your economic sovereignty is to avoid the need for the IMF in the first place.

 

Source: The Economist

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