Getting vaccines from airports to arms

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In Ghana, COVID-19 vaccines are literally falling from the sky. As part of the West African country’s plan to ensure that vaccines reach people in remote villages, drones carry doses – up to 2,000 per flight – from a central warehouse to clinics in areas difficult to access by roads.

But while aerial deliveries offer an effective and creative solution to Ghana’s geographic obstacles, drones have not solved its biggest vaccine problem. Like many low-income countries, Ghana does not have enough vaccines to distribute, by drone or by any other means.

Without vaccine production capacity or direct purchase agreements with manufacturers, Ghana relied on donated vaccines from sources such as the World Health Organization’s COVAX facility, which delivered its first delivery of vaccines to the country in February. But after the rich nations blocked most of the initial supply, the doses have barely fallen. As of October, Ghana had administered only 2.7 million vaccines, with only about 800,000 of its 31 million people (less than 3%) having achieved full vaccination.

At its current rate, Ghana will not meet the 70% threshold that most public health experts deem necessary to reverse future waves of COVID-19 before 2025.

“Any bottleneck in the system affects the next steps in the distribution chain,” says Wenhui Mao, Ph.D., postdoctoral researcher at the Center for Policy Impact in Global Health (CPIGH) at the Duke Global Health Institute, who s ‘Strives to help low- and middle-income countries overcome obstacles in their immunization campaigns. “In the case of Ghana, they seem to have sufficient capacity to deliver the small amount of vaccine they have, but they are stuck on the first stage. “

Vaccine haves and have-nots

Speeding up the pace of vaccinations in places like Ghana may be the most urgent need in the ongoing fight against COVID-19. While nearly half of the world’s population has received at least one dose of the vaccine, rich countries have administered 32 times more doses than poorer ones. Only 3.5% of people in low-income countries had received their first jab at the end of October, leaving hundreds of millions of people vulnerable to the disease and creating the conditions for the emergence of new, more potent variants.

At the COVID-19 Global Summit ahead of the United Nations Assembly in September, world leaders set goals to close the gap by fully immunizing 40% of the globe by the end of 2021 and 70% by mid-2022. Increased vaccine production and commitments by rich countries to share vaccines are expected to improve the flow of doses to low- and middle-income countries.

But as vaccine production increases, supply issues can only give way to other logistical issues on the way to immunizing people on such a massive scale. When CPIGH researchers interviewed officials in 28 low- and middle-income countries in the first half of 2021, the majority – including almost all of those working in sub-Saharan Africa – expressed concern about the will of their countries to deliver vaccines to remote areas. populations. Most respondents from African countries reported large funding gaps beyond what they had already budgeted for. Ensuring cold storage, immunization tracking and surveillance, and the cost of COVID vaccination campaigns were not far behind on their list of concerns.

“Many of the challenges reflect problems with their health systems more generally,” said Ipchita Bharali, a political associate who led the survey. “Domestic funding is already very low in some of these countries, adding to the financial and logistical challenges related to vaccine procurement, storage and administration. Longer-term investments in financing capacity and health infrastructure are needed to strengthen health systems as a whole. “


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