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The problem facing Africa is whether vaccine supplies will run out before new vaccine supplies come from America, Britain and France. Only less than 1% of African people have been fully vaccinated out of a population of 1.3 billion people. US president Biden said America will provide 500 million doses of Pfizer vaccine to poor nations before the G-7 meeting in Cornwall, UK. Britain added 100 million and France 30 million doses. With new more transmissable variants out there Africa is in considerable danger today. The Delta variant from India has been shown to be about 70% more contagious than the Alpha variant from Kent UK. It is already the dominant variant for new cases in the UK. The new variants are now spreading in Africa. Cities such as Johannesburg, South Africa, and Kampala, Uganda are seeing a surge in cases. Another problem in Africa is that governments are increasingly reluctant to impose strong lockdowns because of the economy. Already it is believed that Africa's middle class has been severely affected during the last 18 months. ...

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The lack of vaccine supplies in Africa and Latin America, parts of Asia, is a major problem in 2021. Of the 66 million doses of vaccine planned to be given to Africa under COVAX plan only 19 million have been delivered. In total about 49 million doses have been delivered. Vaccine shortages are a result of the huge wave of coronavirus in India in April, so that vaccine shipments from India have stalled. Of the countries in Africa a few have made some progress- Egypt, Ghana, Nigeria. Other problems in Africa are lack of trained people to give vaccination. Last week 2.3 billion dollars in additional funds were raised at a donor conference for COVAX, the initiative for poor countries vaccines. That is enough to buy 1.8 billion doses. US and UK have not exported vaccines. India has made a good start in shipping vaccines to many countries in Africa, Asia and Latin America as shown in the Ministry of External Affairs website of the Indian government. For India to do this once it meets its own needs and resume exports, vaccine patent protection needs to be lifted for sometime, which the US is now accepting. ...

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Stephanie Nolan's reports from Africa provide the few glimpses one can get today of the situation in Africa where variants are growing as a result of lack of vaccines (vaccine inequality) and the faltering vaccination drive, shortage of medicine and food supplies. Her report from South Africa showed how healthworkers and scientists in South Africa are working hard on the frontlines. This one from Zambia looks at the vaccination centers and vaccination workers as vaccination drives falter. The African continent with 1.4 billion people received 404 million doses. Today only 7% of the population is vaccinated in Zambia and the rest of Africa. People in Zambia do not have car transport so they have to walk 3-6 kilometres to get to a vaccination center, when they turn up at a center and it is out of vaccines they stop coming. Other problems are the social media accounts that show the vaccination drives as harmful to people, or CNN and other news that talk about blood clots that when carefully understood affect a tiny fraction of people. There are other issues also. Ida Musonda, a nurse in a clinic near Lusaka says after not many people turned up that she should go to markets and churches, but says there is no fuel for the vehicle to get clinic workers there. Bernadette Kawango is shown with her children. She works at an auto parts store and lives in a low income neighborhood in the edge of Lusaka. She ignores all the social media accounts that scare people from vaccines, yet she says she worries more about cholera, TB and malaria, and also HIV, AIDS. And she does not know anybody diagnosed with coronavirus.  The result is that there is vaccine shortage resulting in a kind of vaccine indifference (why walk miles to a center if it may not have vaccines), compounded by other problems such as the other diseases that also pose a threat in Africa, and the low incomes in a shrinking economy. And with about 8% vaccinated in Africa, the problem of variants can only be tackled by consistent and not erratic supply of vaccines. ...

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This report in The Times shows how Africa is tackling malaria by using modern methods such as drones. Drones are used in Ghana to send medicine to remote parts of the country. The rollout of the world's first malaria vaccine is taking place in Malawi, Ghana and Kenya. The Glaxo developed vaccine requires 4 doses over 18 months. Gavi is a partnership that brings UNICEF and WHO in partnership with private companies to  buy vaccines in bulk and distribute them where it is not affordable. Gavi supported 66 million vaccines in 2018 for children, yet about 20 million children in Nigeria, Congo and other parts of Africa lacked routine immunizations in 2018. UPS and health service workers are joining in the effort for administering this vaccine correctly.  Software that tracks the taking of the vaccines by children is essential for success and this is being implemented with Ghanian authorites. This report shows how it is done in Dateng, Ghana, a town of 800 people 3 hour drive from Accra.  ...

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Moderna has made the initial batches of doses of the vaccine for the variant of coronavirus including South African variant, and shipped these to the National Institutes of Health in the US. If the test results are positive the vaccine for variant could be given authorization by the third quarter of 2021. It is becoming crucial to stay ahead of variants developing from the coronavirus and pharmaceutical companies Pfizer, J&J, Astra Zeneca are working on the technology to tackle this.

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So far Covax Africa is proving to be a failure. Consider the numbers 1 billion people only 31 million vaccines given. Another wave of the virus is underway with 130% rise in cases in Uganda, increase taking place in DRC, Namibia. About 30% increase in cases for all of Africa this week. The new Delta variant that is twice as contagious as the original virus is widespread in the UK and is an unacceptable risk in Africa and in Europe and the US.


 By comparison India has 1.2 billion people and 230 million people vaccinated with at least one dose.

US has 330 million people and has adminstered 300 million doses. UK and Brazil have each adminstered over 70 million doses.

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The French British collaboration effort will bring a new vaccine to the global effort against coronavirus. This vaccine was expected in February 21. It will be ready by the third quarter of 2021 just as vaccine supplies are being ramped up. The Sanofi Pasteur unit and GSK Glaxo SmithKline are the two companies in this vaccine venture. This vaccine will address the problem of new mutations of the virus in the British and South African versions and can be stored at normal temperatures. 
 

The new vaccines will boost supplies just when the situation is bleak for vaccine supplies in Latin America and Africa, South East Asia, places left out in the vaccine race in advanced countries and in India. Britain has ordered 60 million doses. 

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In some countries such as Tanzania and Chad the vaccination drives have not even begun says this report in the DW.com. A new surge now underway in Africa as cases increase by 30% in June comes at abad time with African vaccination drives stalled. Only 31 million doses adminstered in Africa for a population of 1 billion people. Less than 1% of world vaccine supplies are going to poor countries in Africa and Latin America.

Vaccine companies chose to sell their vaccines to the highest bidders, putting Covax  behind. Aims of Covax are also coming down and watered down to vaccinating 20% or 30% of the population in poor countries, says this report in DW.com.

This means new variants could develop and move back to Asia and Europe, the US in 2022. It means the coronavirus could affect African economies in 2022 and beyond.

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Pfizer and Moderna's plans to make mRNA vaccines in Africa, Asia or Latin America may take much longer than 2022. The solution to producing an mRNA vaccine in Asia that could be mass manufactured and distributed throughout Africa, Asia and Latin America is now at hand. Gennova based in India, is partnering with Seattle startup HDT Bio to attack the problem of temperature and scalability in manufacturing for a mRNA vaccine that acts as a global solution using India's manufacturing capabilities. Dr Singh who founded Gennova, says- "We wanted to solve the problem of the scalability issue, and the temperature issue. If we can solve these problems, we are building a solution not just for India, but also a global solution." Gennova received seed funding from the Indian government. Other companies in Brazil and South Africa lack the manufacturing capabilities or financing needed that exist in India. The Indian government has achieved an initial goal of one billion vaccinated in just 6 months. The next step for India in its health infrastructure buildup is a mRNA vaccine that is an improvement over Pfizer and Moderna vaccines that can be stored easily, adapted for variants, and manufactured in large quantity as a global solution. ...

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India plans to vaccinate 300 million people in the first drive of the vaccination campaign. The two vaccines approved are the Covishield from Astra Zeneca partnership with Serum Institute of India, and the Bharat Biotech vaccine. India is the largest vaccine manufacturer in the world, and its vaccination production and campaign is being watched closely.  The largest maker of vaccines is Serum Institute of India based in Pune. Countries that are seeking India's help in vaccines are Brazil, South Africa, Morocco, Saudi Arabia, Bangladesh. Brazil has ordered 1.5 million vaccine doses. The Indian government has approved sending vaccines to other governments. Price of 100 million doses to be supplied by Serum Institute to the Indian government is 200 rupees a dose or about $2.73 a dose. Vaccine sold in private markets will be priced at 2000 rupees a dose. Serum Institute and Bharat Biotech have stockpiled 70 million doses. ...

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In a major move president Biden backs suspending IP protection for Covid vaccines, therapeutics and tests. In fall 2020 India and South Africa submitted a resolution to WTO to suspend IP protection for Covid vaccines, therapeutics and tests, From the Indian perspective this decision comes a bit late when India has already vaccinated over 1 billion people using the Astra Zeneca Oxford vaccine. The Oxford vaccine was made available to Indian manufacturing companies to make locally in a way the could be done at low cost to meet needs of over 1 billion people in India. From the perspective of pharmaceutical companies this is giving away technology even if this was a public health emergency, as shown in this editorial from WSJ.

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The problem of lack of vaccine supplies in African, Latin American and South East Asian countries needs immediate attention. With vaccine supplies going unused in America and Europe because of vaccine hesitancy, all of Africa and much of Latin America, parts of Asia lack vaccine supplies.

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Peter Hotex of Baylor Medicine in the US is a pioneer and leader in getting low cost traditional vaccines to billions in Africa, Asia and Latin America.  Here Peter Hotez of the Baylor College of Medicine Tropical School is interviewed in The Hindu. He talks about how the new mRNA vaccines are "shiny toys" pushed forward in the US in 2020 under innovation drives, and that the vaccines made by traditional methods are just as effective and provide lasting protection. Without vaccinating the entire world population including the billions of people living in Africa, Asia and Latin America, there will be no end in sight for the pandemic, he says, and the best way to do this is through vaccines made by traditional methods, methods used by Bharat Biotech for Covaxin and Biological E for its vaccine. He said mRNA is a brand new technology  and "it will take years to scale it up to make 9 billion doses" of vaccine for poor countries. Baylor has developed the vaccine technology using traditional methods such as yeast fermentation expression technology used for Recombiannt Hepatitis-B vaccine. Its been around for 40 years. Baylor will transfer the technology to Indonesia, India, Bangladesh, all over the world. He says in terms of virus neutralizing anti-body immune responses it is as effective as the mRNA vaccines. Hotez is critical of some pharma companies- "the rest of them want to bicker about patents. we're not going to go down that direction." Baylor is providing its technology for manufacture to companies to fill the need in poor countries, without patent protection or quibbling about legal things such as indemnities, says Hotez. Hotez also thing recombinant protein technologies vaccine with its traditional approach could also overcome vaccine hesitancy, a key factor for unvaccinated in Europe and US which have stuck to mRNA vaccines. The newer technology behind mRNA could make parents hesitate to vaccinate their children with these technologies, and also be a part of the mental attitude of unvaccinated adults having hesitancy.   ...

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There are 100 vaccines being developed all over the world, of these 30 are in India. One is a collaboration with Britain for the Oxford Astra Zeneca vaccine to be produced largely in India. The other is one by ICMR. Other vaccines are the Johnson and Johnson  one dose onl vaccine. These vaccines have the advantage of not requiring ultra low temperature storage. 

Even though the Pfizer BioNTech vaccine is off to a start in Britain this does not mean that the other vaccines are not going to be out soon as early as by the end of December. There is also no clarity on how long the protection lasts. More than the one billion doses of the Pfizer vaccine will be required making the other vaccines just as or even more important. Asia and Latin America, Africa are still not in the picture and will have to be for the protection to be effective.

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Worldwide coronavirus vaccine development and distribution is covered in the The guardian. There are surprising results in a 2019 Lancet study about how strongly people in each country think vaccines are safe. Only 17% of people in Japan and Lithuania think vaccines are safe. Most of Eastern Europe, some western European countries, Russia and China are shown as countries where about half of the people have doubts about the safety compared to 87% in Bangladesh and Uganda. In India and most of Africa people think vaccines are safe says this report showing the Lancet study results in a graphic.

Vaccines once developed will require cold storage for distribution and adminstering the vaccine. Some vaccines may require ultra cold storage of -60 degrees  or -80 degrees centigrade which may be hard to find in many countries. Most of the cold storage containers available have already been acquired by countries.

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The Oxford vaccine is shown to be effective for older adults over 70 years in age. One of the key features of the Oxford vaccine is that it is designed to be accessible in cost for not just high income countries but across all parts of the world including the countries in Asia, Africa and Latin America where some of the poorest people live. The cost will be a fraction of the cost of the Moderna and Pfizer vaccine. Results for regulatory approval are expected by Christmas. This vaccine is expected to cost about $4 a dose compared to $25 for the Pfizer or Moderna vaccines. Oxford also uses a technology for the vaccine that has already been proved effective with least side effects fr other virus such as Ebola virus. Oxford researchers took the existing vaccine technology and modified it to tackle coronavirus in a way that proves effective for this virus also. Countries such as South Korea say they will not rush into the first vaccine that is available and have not responded to requests for sale from Moderna or Pfizer. India's Serum Institute is the leading manufacturer of vaccines in the world. It is preparing for production of the Oxford vaccine. India's vaccine effort includes other vaccines developed by its research institutes. The focus of India is for a vaccine that is effective as well as meet cost so that it can be used to vaccinate over 1.3 billion people. Because India has strong already established manufacturing capabilities for vaccines and is collaborating with Oxford and Astra Zeneca for a low cost vaccine it is in a position to drive the campaign for an effective plus low cost 100% accessible vaccine for people around the world. Another aspect of the Astra Zeneca partnership with Oxford is that it has committed not to make a profit from the vaccine. This is important for Oxford researchers and its organizational goals. ...

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The problems of vaccine access in Africa affect us all - this is the simple truth. Here the NYT gives letters from people on the frontlines, healthcare workers in Africa who in one situation in the Sudan had over 4000 people arrive some by canoe through floods and had only 545 vaccines. Africa Centers for CDC show 79% of people in Africa will take the vaccination. Vaccine access for Africa is something that should be on the top of the list for Biden in the US, Johnson in UK, Modi in India, Scholz in Germany, and for all world leaders.

 

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Jenny Strasbourg of the WSJ provides this much needed report from London about the courageous decision by AstraZeneca and Oxford University to give vaccines away at no profit to the whole world, to billions of people in Africa, Asia, and Latin America. Without this brave decision by a British company and a British University the world would be a lot poorer, more variants could have happened, making us realize the great contribution Britain has made and how indispensable it is to the planet. Add to this the effort of Indian companies including Serum Institute that provided the manufacturing facilities and capabilities for making most of the British vaccine. AstraZeneca delivered 2.3 billion doses of the vaccine globally as of mid-December, according to the company. The International Monetary Fund estimates that low and middle income countries received 3.25 billion vaccines as of Dec. 11, About half of this or 1.6 billion doses were Astra Zeneca shots. This is a bigger share than any other vaccine by far and a life saver to the world. AstraZeneca stepped up early in a true to the best ideals in Britain to meet the needs of the world-  aiming to deliver 3 billion doses in 2022 and sell them at no profit as long as the pandemic continues. As the shot does not need cold storage it is ideal for India and other Asia, Africa and Latin America. "We are all very proud throughout the company of the impact we have had," says AstrZeneca CEO Pascal Soriot. By far the biggest manufacturing was done at Serum Institute of India which supplied 1.3 billion doses of the AstraZeneca vaccine to 70 countries. Mr. Modi pushed forward the export of vaccine made in India to the world from the beginning in the same spirit of cooperation and the best ideals that Britain was living upto. Serum Institute can produce as much as 250 million doses of vaccine a month making it possible for India to tackle the vaccination population of 1.3 billion people.   None of this could have happened without Oxford University and AstraZeneca and Indian companies with Mr. Modi's active support living up to the best ideals of Britain and India for the world. "When you add up the benefits to humanity, I think you'll find the vaccine holds up pretty well in terms of the ill health it has prevented, and the deaths it has prevented," says John Bell, a senior Oxford academic who in 2020 guided the University through its vaccine-partnership talks with Astra Zeneca. Because in the real world AstraZeneca shot has held up so well it is also a choice for booster shots. ...

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How do you setup a vaccine business. Consider Mr. Adar Poonavalla in the city of Pune in India. His company Serum Institute of India, remains family owned. Founded in 1966 by Cyrus Poonavalla, it produces billions of doses of vaccines for measles, polio and other diseases. It is expected to be one of the key sources of vaccines because of its expertise and the stocks of vials and other supplies that it has in stock for the next 2 years of vaccine production. It is working on a separate facility for coronavirus production that could turn out 800 million doses of vaccine at a price of about $13 a dose over 2 years. Serum Institute is working with 3 companies that are doing the research on the vaccine for coronavirus in the U.S. and Europe, and will play a key role in the manufacturing of vaccines. To respond to the question how do you setup a company to produce vaccines for the people of the world. This is what Mr. Poonavalla says- he will only work with ethical long term funds and sovereign funds because he does not want to be in the situation where he has to charge high prices to give them returns. Unlike most countries in the world, India is unique in making certain that most of the basic pharmaceutical drugs are available to over a billion people at a low cost. Serum's goal is low cost quality vaccine production so that over a billion people in Asia can be "protected from the birth onwards." As the U.S. and Europe and large parts of Asia, Africa and Latin America, face the second vaccine phase of the coronavirus response following difficulties in PPE, Ventilators, and Masks in the first phase, they can have confidence because of companies such as Serum and the research centers in U.S. and Europe like the one at Oxford University. ...

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The Hindu data team looks at the Indian vaccination drive with graphs by state and progress by dates. During the first 10 days of June the vaccination drive has been stepped up. It is now over 3 million a day and at this rate should reach 400 million vaccinated by the end of July, 100 million below target. For the remainder of the year vaccine supplies have to be pushed up so that 8 million doses can be given each day. This would get India to where everyone in the country of 1.2 billion has been vaccinated by Dec 31, 2021. This would make it possible for India to then use its technology and large manufacturing capacity to help other nations in Asia, Africa and Latin America in 2022. This is the first time in history that India has taken on a challenge of this size and complexity. The vaccine strategy has changed to where the federal government is taking over the overall responsibility of coordinating the production of vaccines in the country and providing access to vaccines from other countries. Federal government is also taking on overall responsibility for distribution of vaccines and setting up the logistical effort. Vaccine supply is being opened up by opening India to multiple vaccines including Pfizer, Moderna, and other vaccines. Production of Covaxin is being stepped up. This strategy is designed to get India to somewhere closer to the 8 million doses a day needed and to ensure distribution and logistical efforts are in place. More resources are put into the effort. The speed of economic recovery also depends on the vaccination drive. Lessons were learned during the second wave in May 2021 and the government is better prepared for the hard work ahead. ...