Vaccination campaigns against Covid-19 are struggling to get off the ground in Africa because the different countries face a variety of obstacles: the fight against the variant, the skepticism of the population, the popularity of traditional medicine or the difficulty of conservation. certain vaccines.
Vaccination against Covid-19 is slowly starting in Africa.
The continent, affected by a second wave of contaminations more aggressive than the first, struggles to perceive the reality of the epidemic and remains suspicious of the remedies offered by the West.
Experts estimate that Africa will need 1.5 billion doses to vaccinate 60% of its population and achieve collective immunity.
Many rely in particular on the COVAX system set up by the World Health Organization (WHO) and the International Alliance for Vaccines.
This initiative is supposed to make it possible to immunize 20% of the most vulnerable people in the world.
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Traditional medicine often favored
The contracts to receive the vaccines are passed but the doses are slow to arrive on the continent.
Because the richest countries have monopolized the first production of vaccines, sometimes ordering enough to vaccinate more than three times their population.
And in Africa, the situation is very different depending on the country.
, vaccination began slowly on Tuesday thanks to 200,000 doses of the Chinese Sinopharm vaccine.
Senegal has been facing an increase in Covid-19 cases since the end of November: the virus has killed more than 800 people.
Vaccination is not unanimous in the country.
Many Senegalese continue to deny the existence of the coronavirus and do not protect themselves.
The Senegalese also turn more easily to traditional medicine, in particular based on medicinal plants.
At the traditional hospital of Keur Massar, located in the suburbs of Dakar, traditional healers, and not doctors, have put in place a preventive protocol against Covid-19 by mixing medicinal plants.
"These are bamboo leaves that are used in a herbal tea against lung diseases," describes Moussa Diallo in one of the hospital laboratories where we have only treated with medicinal plants for 40 years.
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"We have antiseptic lotion to really disinfect the hands or even an ointment to put into the nostrils to avoid breathing certain particles. It works miracles, it gives results! There are patients with really a clear improvement in their symptoms, "he continues.
A total of seven natural products, all harvested from the hospital garden, are used to prevent coronavirus and strengthen patients' immune systems.
The products can also be in the form of mouthwashes or powders.
Patients who arrive too late at the hospital
"We should not bring herbal products into disrepute because that is how antibiotics and many other drugs were discovered which are then produced industrially. But this is knowledge that has been acquired. in the long term. However, in the case of the Covid, it is a disease which appeared very recently for which there is no decline ", first poses Elisabeth Carniel, director of the Pasteur Institute in Cameroon and invited to the microphone from Europe 1.
"The tendency is to say that everything is good against the Covid, everyone goes for their own medicine, without any proven evidence. We are facing tons of drugs that are on offer. Which are good? Some are active to stimulate the natural immunity that can help fight the coronavirus, but there is nothing tangible! The problem is we are seeing deaths from people who arrive at the hospital too late, and where it is no longer possible to save them because they have treated themselves with traditional medicines, "warns Elisabeth Carniel.
The benefit of the vaccine is difficult to explain
At the traditional hospital of Keur Massar, the vaccine against Covid is not, however, the subject of any taboo.
For Djibril Ba, its director, getting vaccinated is in no way contrary to the care practiced in this hospital: "the vaccine is trying to stimulate the person's immunity against a specific disease. This is what we do. We do too! We prefer to stimulate organizations so as not to develop the Covid. My opinion is that personally everyone should be vaccinated or else no one is vaccinated. Because it is useless for a group to be vaccinated and the other no! ", he develops at the microphone of Europe 1.
In Senegal, the debate rages between pro and anti-vaccines.
In the east of the country, while yellow fever has resurfaced, people refuse to be vaccinated for fear that the doses used are actually those against the coronavirus.
And explaining the interest of the vaccine to the population is not always easy according to Elisabeth Carniel.
"The Covid has not hit Africa with the same force as Europe or America, so the risk perception is much lower. The death rate is still relatively low, but we are not at without waking up. Many forms are asymptomatic so that the risk is much less well perceived, to the point that some even say that there is not. This makes vaccination even more difficult because the population does not 'don't see the point,' she explains.
This mistrust prompted the authorities to call on religious leaders, in particular the marabouts of the Muslim brotherhoods, very influential figures, to the rescue to raise awareness among the population in each neighborhood and each village.
In South Africa, vaccines ordered then deemed ineffective
, the authorities are faced with different challenges.
The country has just over a million cases of Covid-19 and nearly 50,000 deaths, and the beginnings of vaccination are chaotic.
First criticized for its inaction and slowness in launching the campaign, the South African government then bought 1.5 million doses of the vaccine.
They were bought at a high price - more than four euros per dose, or three times the price paid by the European Union - from an Indian laboratory.
One million of these doses were delivered on February 1, and received with great fanfare at Johannesburg airport.
But less than a week later, when the vaccination campaign was due to begin, authorities were forced to announce its suspension because the results of a clinical trial on the AstraZeneca vaccine were disclosed and it proved to be ineffective against mild and moderate symptoms of Covid-19 cases linked to the new variant identified in South Africa.
This variant, which now represents 90% of infections in the country, has turned everything upside down.
Since then, the South African government has been trying to find an outlet for this bulky stock of one million AstraZeneca doses which expire in April, and wants to start its campaign with the new vaccine from the Johnson & Johnson laboratory.
South Africa is also the first country in the world to use this vaccine.
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Too few doses for caregivers
The American laboratory has transferred 500,000 doses belonging to a research stock to South Africa, and the first shipment - 80,000 doses - arrived last week.
They are currently used to give priority to vaccinating health workers.
80,000 additional doses must arrive by Sunday, but this is still very far from the account since the country has a little more than a million health workers.
The country's goal is still to immunize two-thirds of the total population of 59 million by the end of 2021.
The Johnson & Johnson vaccine is administered as a single dose.
The laboratory carried out a large-scale trial in South Africa in which a third of the participants were over 65 years old, thus people at risk.
This trial showed that the vaccine was 85% effective in preventing severe forms of Covid-19.
However, this is the most important here: curb deaths and the number of hospitalizations.
South African government forced to change strategy
The country is suffering a violent second wave of infections.
Hospitals are saturated, the South African population is traumatized and fears a third wave soon.
So if part of the population remains suspicious of vaccines, many want access to them, which has forced the authorities to review their strategy.
The South African government initially pleaded for a common strategy to order vaccines and called "vaccine nationalism" the countries' direct negotiations with laboratories.
But he had to change course and South Africa finally ordered nine million new Johnson & Johnson doses, but also 20 million doses of the Pfizer vaccine.
Negotiations with other laboratories, notably Chinese and Russian, are also underway.
The country's strategy is to diversify its portfolio of vaccines, depending on availability and effectiveness against the variants present in the territory.
"Some vaccines are almost automatically eliminated"
But according to Elisabeth Carniel, director of the Institut Pasteur in Cameroon, African countries must also take into account other parameters: "the choice of vaccine against Covid is difficult because we can not take into account only the efficiency part and safety, even if these are two essential elements. In Africa, there are all the practical considerations such as the temperature of conservation. Moderna and BioNTech / Pfizer vaccines must be stored at very low temperature and this is almost prohibitive for many of country".
Vaccines that require two injections are also sometimes complicated to use in some areas.
"A vaccine that can be administered in one dose like Johnson & Johnson is much more interesting in Africa, than two doses two months apart where it becomes very complicated. This is another consideration to be taken into account. ", continues Elisabeth Carniel, before adding:" certain vaccines are almost automatically eliminated in many African countries ".
Kenya, future logistics base for the African vaccination campaign?
could play a central role in logistics of vaccination in Africa for an unexpected reason: pink industry.
Because Kenya is the kingdom of cut flowers, roses in particular.
Between eight and 13 cargo ships depart from Nairobi airport every day, particularly towards Europe.
The idea would be that, soon, they return to Kenya loaded with vaccines.
These cargo ships would indeed be suitable for transporting vaccine doses, since the Sinopharm, AstraZeneca and Johnson & Johnson vaccines require storage between 2 and 8 degrees, exactly like flowers.
Nairobi therefore proposes to become a hub on the continent to collect the vaccines where they are manufactured and deliver them to Africa.
The Kenyan capital is already an important air hub on the continent.
It connects most African capitals and Kenya Airways defends this position with the WHO.
The Kenyan company is at its worst financially, due to a lack of passengers since the start of the pandemic.
Its managers are therefore betting everything on cargo to save the company.
They even decided to transform planes that usually carry passengers into refrigerated cargo to expand their fleet and participate in the WHO goal of vaccinating 20% of the African population by the end of the year.
So all you need is vaccines to get started.
Because the country is still waiting for the four million doses whose delivery was announced for the end of February, without a more precise date.
In total, Kenya has ordered 24 million doses through the Covax device and has set itself the goal of vaccinating a third of its population by 2022, or around 16 million people.