The World Health Organization (WHO) in Africa joined immunization experts in urging the international community and countries in Africa to take concrete actions to ensure equitable access to COVID-19 vaccines, as researchers around the world race to find effective protection against the virus.“It is clear that as the international community comes together to develop safe and effective vaccines and therapeutics for COVID-19, equity must be a central focus of these efforts,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Too often, African countries end up at the back of the queue for new technologies, including vaccines. These life-saving products must be available to everyone, not only those who can afford to pay.”

WHO and partners launched the Access to COVID-19 Tools (ACT) Accelerator to speed up the development, production and equitable access to COVID-19 diagnostics, therapeutics and vaccines. It brings together leaders of government, global health organizations civil society groups, businesses and philanthropies to form a plan for an equitable response to the COVID-19 pandemic. WHO is collaborating with Gavi, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) to ensure a fair allocation of vaccines to all countries, aiming to deliver 2 billion doses globally for high-risk populations, including 1 billion for low and middle-income countries.

The African Union has endorsed the need for Africa to develop a framework to actively engage in the development and access to COVID-19 vaccines. Countries can take steps now that will strengthen health systems, improve immunization delivery, and pave the way for the introduction of a COVID-19 vaccine. These include: mobilizing financial resources; strengthening local vaccine manufacturing, and regulatory, supply and distribution systems; building workforce skills and knowledge; enhancing outreach services; and listening to community concerns to counter misinformation.

Globally, there are nearly 150 COVID-19 vaccine candidates and currently 19 are in clinical trials. South Africa is the first country on the continent to start a clinical trial with the University of Witwatersrand in Johannesburg testing a vaccine developed by the Oxford Jenner Institute in the United Kingdom. The South African Ox1Cov-19 Vaccine VIDA-Trial is expected to involve 2000 volunteers aged 18–65 years and include some people living with HIV. The vaccine is already undergoing trials in the United Kingdom and Brazil with thousands of participants.

According to the African Academy of Sciences only 2% of clinical trials conducted worldwide occur in Africa. It is important to test the COVID-19 vaccine in countries where it is needed to ensure that it will be effective. With more than 215 000 cases, South Africa accounts for 43% of the continent’s total cases. Clinical trials must be performed according to international and national scientific and ethical standards, which include informed consent for any participant.

“I encourage more countries in the region to join these trials so that the contexts and immune response of populations in Africa are factored in to studies,” said Dr Moeti. “Africa has the scientific expertise to contribute widely to the search for an effective COVID-19 vaccine. Indeed, our researchers have helped develop vaccines which provide protection against communicable diseases such as meningitis, Ebola, yellow fever and a number of other common health threats in the region.”

Earlier, this month WHO Africa’s principle advisory group on immunization policies and programmes – the African Regional Immunization Technical Advisory Group (RITAG) – also noted the need to ensure equitable access to COVID-19 and other vaccines in the region.

“As the world focuses on finding a vaccine for COVID-19, we must ensure people do not forget that dozens of lifesaving vaccines already exist. These vaccines should reach children everywhere in Africa – no one can be left behind,” said Professor Helen Rees, Chair of the RITAG.

Initial analysis of the impact of the COVID-19 pandemic on immunization in the African Region suggests that millions of African children are likely to be negatively impacted, as routine immunization services and vaccination campaigns for polio, cholera, measles, yellow fever, meningitis and human papilloma virus have been disrupted.

Despite these challenges, RITAG members also noted significant milestones and markers of progress. For example, there have been tremendous gains in the fight against wild poliovirus, and the African Region is expected to be officially certified free of wild poliovirus in August 2020. The Democratic Republic of the Congo also announced the end of its 10th Ebola outbreak in eastern DRC, which was the worst in its history. An effective vaccine was a key tool in the response.

Dr Moeti spoke about COVID-19 vaccine development in Africa during a virtual press conference today organized by APO Group. She was joined by Professor Shabir Madhi, University of Witwatersrand, Principal Investigator of Oxford Covid-19 Vaccine Trial in South Africa; and Professor Pontiano Kaleebu, Director of the MCR/UVRI and LSHTM Ugandan Research Unit. The briefing was streamed on more than 300 African news sites as well as the WHO Regional Office for Africa’s Twitter and Facebook accounts.