• Study shows factors influencing COVID-19 impact on African countries

Director-General of the World Health Organisation (WHO), Dr. Tedros Adhanom Ghebreyesus, and a group of global health leaders, yesterday, pledged to vaccinate 70 per cent of the population of all countries by mid-2022.

They said more than 5.7 billion doses have been administered globally but only two per cent of those have been administered in Africa, even as they issued an urgent call for vaccine equity worldwide and in Africa in particular.

The leaders, at a press conference, stressed that the worst pandemic in the last hundred years will not end, unless and until there is genuine global cooperation on vaccine supply and access.

Ghebreyesus was joined by Chief Executive Officer (CEO) Global Vaccine Alliance (Gavi), Dr. Seth Berkley; African Union (AU) Special Envoy for COVID-19, Strive Masiyima; Africa Centre for Disease Control (CDC) Director, Dr. John Nkengasong; President and Chairman of the Board of Directors, Afreximbank, Prof. Benedict Oramah; United Nations (UN) Under-Secretary-General and Executive Secretary of the Economic Commission For Africa, Dr. Vera Songwe; and WHO Regional Director for Africa, Dr. Matshidiso Moeti.

WHO targets the vaccination of at least 10 per cent of the population of every country by September, at least 40 per cent by the end of the year, and 70 per cent globally by the middle of next year.

Almost 90 per cent of high-income countries have reached the 10 per cent target, and more than 70 per cent have reached the 40 per cent target. Not a single low-income country has reached either target.

Globally, 5.5 billion vaccine doses have been administered, but 80 per cent have been administered in high- and upper-middle income countries.
High-income countries have administered almost 100 doses for every 100 people. Meanwhile, low-income countries have only been able to administer 1.5 doses for every 100 people, due to lack of supply.

THIS came as a new research suggests that countries in Africa, perceived as least vulnerable to an epidemic, were the worst affected by COVID-19.

According to the study, nations with more urban populations and strong international travel links were worst affected.
The study, published in the journal, Nature Medicine, showed mortality rates and levels of restrictions – such as lockdowns and travel bans – were lowest in countries previously thought to be at greatest risk from COVID-19.

A team of researchers from the NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) from the University of Edinburgh worked with WHO African Region to identify factors affecting mortality rates during Africa’s first two COVID-19 waves and the timing of the first reported cases.

TIBA Director, Prof. Mark Woolhouse, who co-led the project, said: “Our study shows very clearly that multiple factors influence the extent to which African countries are affected by COVID-19. These findings challenge our understanding of vulnerability to pandemics.
“Our results show that we should not equate high levels of preparedness and resilience with low vulnerability. That seemingly well-prepared, resilient countries have fared worst during the pandemic is not only true in Africa; the result is consistent with a global trend that more developed countries have often been particularly hard hit by COVID-19.”

According to the study, among 44 countries of the WHO African Region with available data, South Africa had the highest mortality rate during the first wave between May and August 2020, at 33.3 deaths recorded per 100,000 people. Cape Verde and Eswatini had the next highest rates at 17.5 and 8.6 deaths per 100,000. At 0.26 deaths recorded per 100,000, the lowest mortality rate was in Uganda.

South Africa also recorded the highest mortality rate during the second wave between December 2020 and February 2021, at 55.4 deaths per 100,000. Eswatini and Botswana recorded rates of 39.8 and 17.7 deaths per 100,000. The lowest rate was in Mauritius, which recorded no deaths during the second wave.
The team found that as well as those with large urban populations and strong international travel links, countries with high rates of Human Immuno-deficiency Virus (HIV) were also more likely to have higher mortality rates. This may be because people with HIV often have other health conditions that put them at greater risk from COVID-19.

The weak link between mortality rate and the timing or severity of government-imposed restrictions on day-to-day activities shows the impact of the wide range of application and enforcement of these restrictions across the region, making a consistent impact pattern difficult to discern. Restrictions during peaks of infection are well documented to have interrupted transmission in the region.
The findings show that the earliest recorded cases of COVID-19 were in countries where most people live in urban areas, with strong international travel links and greater testing capacity. Algeria was the first of 47 African countries to report a case, on February 25, 2020. Most countries had recorded cases by late March 2020, with Lesotho the last to report one, on May 14, 2020.

Researchers document higher deaths during the second wave, as compared to the first. The peak of infections during the second wave was also higher, with 675 deaths across the continent on January 18, 2021 compared with 323 during the first wave peak on August 5, 2020. Potential under-reporting was accounted for in the analysis.