/ 9 December 2021

Africa’s problem is vaccine access, not hesitancy

A View Of Vials Containing Pfizer Biontech Covid 19 Vaccine
Has Africa taken its foot off the pedal in the race to secure enough Covid-19 vaccines for all?

As news of the new Omicron variant broke last week, there were waves of initial fear — and then anger.

Western travel bans were widely criticised as a knee-jerk reaction, punishing the skills and transparency of South African scientists who identified the variant. With cases predating these now being reported on other continents, the bans seem at worst racist, or at the very least too late to be useful.

The travel bans will devastate already fragile economies and tourism across Southern Africa. Lockdowns are a last-ditch policy, even in rich countries with functioning social security nets. But they are particularly horrific in much of Africa. There is deep fear of their possible return.

It’s still too early to understand the transmissibility and severity of Omicron, or the protections our current vaccines provide against it. It isn’t too early to look at how its arrival heightens existing problems of vaccine inequality and hesitancy.

Some Western commentary has been extremely misleading. The idea that Africa is hesitant, fuelling the rise of this variant, erases the reality of enormous inequality and delays in vaccine access. Africa urgently needs increased and predictable supply, to get our populations protected. The West has stood in the way of this happening.

Many external commentators focused on South Africa, but that’s an outlier in many ways. Africa is not a country. The large, online, white population — which makes South Africa feel accessible to international journalists — also harbours unique distrust of any black government.

Focusing on African hesitancy through this avenue is ironic. Research by the University of Johannesburg and the Human Sciences Research Council shows that vaccine hesitancy in South Africa is highest among white South African males and, as such, is not African, but an extension of the West’s infodemic.

The volume and familiar talking points of South Africa’s anti-vaxxers mask how niched their views on personal “rights” and government conspiracies are. News of Omicron amplified standard anti-vaxxer talking points online. Despite this, South African provinces saw record numbers getting vaccinated. 

As ever, the reality is more complex and revealing. Black South Africans remain more willing to get vaccinated than their white counterparts. At the same time, however, a higher proportion of white South Africans have actually received the vaccine than their black counterparts.

Class — and to an extent race — help explain some of the mismatch between vaccine intention and action. People with access to better health systems are far less concerned about side-effects than those without, who may be wary of even going to hospitals. It’s also easier to get vaccinated if you have a car.

Covid-19 creates unusual challenges. Inequality and access are critical.

In many African countries, we have some existing systems for vaccinations, but these require massive expansion and support for mass adult campaigns — even once a steady supply of vaccines is available.

In Kenya, where I work, we needed high-profile local language vaccination campaigns. Instead, politicians facing elections kept holding large public rallies. (This is not uniquely African — Brazil, India and the US made the same mistakes.)

Timing also matters. When the pandemic began and anxiety was highest, vaccines didn’t exist. Once they slowly became available, there was less sense of urgency. Cases here remained thankfully but puzzlingly low. We saw other highly vaccinated countries reopen their economies, European football stadiums filled with crowds, with little news of cases locally. People relaxed.

Despite anger at the travel bans, and vaccine inequality, we must not be distracted at home.

There is deep inequality within our countries. Relative elites in capitals quickly got themselves vaccinated, but stopped pushing for everyone. Masking and ventilation remain casual, despite planned holiday festivities. Simply receiving vaccines with fanfare, at national airports, is not enough.

That is the real lesson of Omicron: We are not safe, until all of us are safe.  

This article first appeared in The Continent, the pan-African weekly newspaper designed to be read and shared on WhatsApp. Download your free copy here