African countries must step up efforts on Covid-19 vaccination, conference told

On Tuesday, the Africa Centres for Disease Control and Prevention (Africa CDC) and African Union hosted the inaugural Conference on Public Health in Africa, drawing together heads of state, international health experts and activists.

Speaking at the conference, Africa CDC Director Dr John Nkengasong was emphatic that as Covid-19 vaccines are now beginning to come into Africa, more countries need to increase efforts to vaccinate their population rather than just focusing on vaccine acquisition.

Nkengasong also stressed that testing must be done consistently and that public health measures like social distancing, wearing masks and sanitising have been proven to be effective against all variants.

Professor Penny Moore, Research Chair of Virus-Host Dynamics at the University of the Witwatersrand, gave a presentation showing how “vaccine distribution is highly unequal”.

Her presentation showed that sub-Saharan Africa is undervaccinated against Covid-19 and also bears the burden of HIV/Aids, with 7.5 million South Africans living with HIV/Aids, two million of whom are being virally suppressed, meaning they have compromised immune systems.

Moore said that the Omicron variant had shown itself to be the most divergent Cobid-19 variant to date and accounted for 10% of new infections globally, while also showing a substantial resistance to antibodies.

She said a real-time assessment of emerging variants is essential, especially in light of undervaccination and high levels of HIV prevalence in Africa.

Moore concluded her presentation by highlighting: “The global spread of Omicron, which is extremely antibody-resistant and appears to be highly transmissible, further highlights the role of genomic surveillance linked to immune profiling.”

Epidemiologist and infectious diseases specialist Professor Salim Abdool Karim told the conference that Omicron has been dominating South African cases. He said research in Tshwane showed that over the past three waves of Covid, about two out of three cases were severe. In the first three weeks of Omicron, however, only one in four cases across all age groups was severe.

Karim confirmed that diagnostics and treatment protocols were still doing well and that public health interventions all remained in place against Covid-19. However, he said, reinfections were increasing rapidly in SA’s fourth wave and were reported as being 2.4 times higher than expected.

He reiterated that vaccines remain effective for all past variants and against severe Covid-19 or hospitalisation, saying that viral loads go down faster in vaccinated people, showing the community benefit of getting vaccinated.

He said there was no need to panic and that closing borders has no benefit. Hospitals needed to be better prepared because of the new variant’s higher transmissibility even though the vaccinated are less likely to have severe Covid, he added. 

Professor Ibrahim Abubakar, University College London’s dean of population health sciences, said scientists know for certain that three different versions of coronaviruses have previously emerged with the potential for a pandemic and it is certain that others will emerge in the future, so the world needs to be ready.

Abubakar said that while research showed that infections were driven by seasonality, the main seasonal drivers were not the actual temperature changes but how populations responded to temperature changes.

Speaking about the importance of immunity, both natural and through vaccines, he said vaccination is key. However, there were low levels of vaccinations in the poorest parts of Africa. He stressed the importance of African countries being self-sustaining, with the ability to manufacture vaccines.

Regarding mitigations against the virus, Abubakar said public health measures are still important. He said one of the key things that had spared Africa devastation from Covid-19 was its young population.

Abubakar called for greater investment in health systems, investment in research and innovation, and discovery science so that Africa can design its own vaccines. He said there needed to be a greater focus on the industrial underpinnings of public health in Africa and for leaders to learn from scientists and health industries in China, India and Europe.

The Conference on Public Health in Africa runs until Thursday. DM/MC