By Axel Van Trotsenburg
World Bank’s Managing Director of Operations
As the health systems of countries across Africa are put under increasing pressure by new waves of COVID-19, there is an urgent need to step up vaccination efforts. Accelerating equitable access to vaccines is essential for economic recovery and saving lives in Africa.
Achieving the African Union’s targets of getting 40% of the population vaccinated by the end of this year and 60% by the middle of next year will be a great challenge because vaccination rates in Africa remain low.
While the World Bank is doing its part – already approving 30 operations for vaccine financing and deployment in Africa totaling $2.7 billion – with 11 more on the way – much more is needed.
And that is why we welcome the partnership with the African Union’s Africa Vaccine Acquisition Task Team (AVATT) – an initiative of the African Union Commission, the Africa Centers for Disease Control and Prevention (CDC), Afreximbank, the AU Special Envoys for COVID-19, and UNECA – to convene all relevant players in one virtual room to discuss the roadblocks to vaccine access.
Last week, AVATT, together with the World Bank, held its second coordination meeting with 35 Ministers of Finance and Health from across Africa to identify the myriad of challenges, both in acquisition and deployment of vaccines that countries on the continent are facing to get jabs in arms and agree upon practical solutions.
These meetings build an intensive effort with our partners to reach a vaccine financing arrangement, aimed at vaccinating over 400m people. In this context each regional and multilateral institution plays a critical role.
There are considerable benefits for countries in taking the regional route towards vaccine procurement — not only does this take everyone along, but it also achieves value for money and is more efficient than each country going alone and negotiating bilaterally with suppliers.
We are already seeing progress. This week, a South African pharmaceutical plant rolled out the first monthly COVID-19 vaccine shipments to the region supported by the World Bank’s partnership with AVATT.
We are also focusing on helping countries get ready to administer the shots and address some of the deployment bottlenecks they have experienced during the first phases of their vaccination programs. Key priorities we are seeing across countries are focused on areas such as: (i) logistics management for multiple types of vaccines, including data analysis, inventory tracking, and waste management; (ii) communication and information systems for registration and patient tracking and monitoring of adverse effects following immunization (AEFI); and (iii) support for enhancing service delivery models and train human resources to be more people-centered so that vaccines reach people equitably down to the last mile.
We know that vaccine hesitancy is real. Our projects include support for tailored engagement programs that address vaccine hesitancy, including innovative use of social media. In Cote d’Ivoire, for example, vaccinations were low when the roll out started in March, but ramped up from 2,000 to 20,000 people per day over a period of weeks in response to growing demand and public confidence. Similarly, Sierra Leone, Malawi, Rwanda, and Ghana have rapidly deployed the doses they received.
In addition to our ongoing coordination with AVATT, last week the World Bank announced a new agreement with COVAX that will help us accelerate COVID-19 vaccine supply globally through a new financing mechanism that builds on GAVI’s advanced market commitment or AMC cost-sharing arrangement.
This new agreement allows AMC countries to purchase doses beyond the fully donor subsidized doses they are already receiving. COVAX will now be able to make advance purchases from vaccine manufacturers based on aggregated demand across countries, using financing from the World Bank. Participating developing countries will have greater clarity and visibility of available vaccines, quantities, and future delivery schedules. This will enable countries to secure doses earlier and prepare and implement vaccination plans more effectively.
This development means that World Bank financing will support the purchase and deployment of doses secured by both AVATT and COVAX.
Along with coordination, transparency is going to be key to speeding up vaccination efforts. It is critical to improve clarity and transparency around the evolving vaccine market, expected production volumes, delivery schedules, and pre-purchase options. That’s why the Task Force on COVID-19 Vaccines, Therapeutics and Diagnostics for Developing Countries, established by the World Bank Group along with the International Monetary Fund, World Health Organization and the World Trade Organization, launched a new website that includes the first phase of a global database and country dashboards on vaccines, therapeutics, and diagnostics. By highlighting specific gaps, the database and country-by-country dashboards aim to focus international attention and mobilize action.
Achieving vaccine access across the world can only be done by working collectively and transparently. Only through strong collaboration with our partners and a shared sense of urgency can we be successful in achieving the vaccination goals for Africa.