Uganda, millions of anti-Covid vaccines to be destroyed

Uganda is preparing to dispose of 5.6 million doses of expired anti-Covid vaccines worth 28.1 billion Ugandan shillings, or USD 7.3 million. The government had bought them with a loan from the World Bank. Auditor General John Muwanga, during a hearing in parliament on 10 January, announced that they would be withdrawn from the health facilities and destroyed. The same fate will befall those that expire in the coming months. The government has calculated that by the end of the year, losses due to expired vaccines will exceed USD 78 million. 'Demand for the anti-Covid vaccines is now at zero,' the head of the National Pharmaceutical Supply Agency, Moses Kamabare, told national broadcaster UBC. 'If there are no people who need them and no health facilities that require them, we expect that many more vaccines will expire before they can be used. Between the doses purchased and those received as gifts, almost 49 million doses had arrived in Uganda by the end of 2022. Just over half of them have been used.

East Africa, in addition to Uganda, Kenya, Rwanda and Tanzania, have millions of doses in storage that will have to be destroyed. To the cost of wasted vaccines, Dennis Miskellah, deputy secretary of the Kenya Doctors and Dentists Union, rightly points out, must be added the damage of the expense of disposing of such huge quantities of drugs. But the problem of expired vaccines affects practically the entire African continent. At the beginning of 2023, South Africa, for example, declared that it still had almost 30 million doses left. At the end of June, the Ministry of Health announced that almost 7.5 million Pfizer doses had expired. Johnson & Johnson's remaining 23 million doses will expire between 2024 and 2025.

In fact, the problem of expired vaccines has been a consideration in Africa since the beginning. The World Health Organisation (WHO) had stated it would be the continent most affected by the pandemic. According to the World Bank, Covid would decimate Africans and two decades of economic growth would be wiped out. UN Secretary General Antonio Guterres had declared that a 'global pact of solidarity with Africa' was 'imperative'. 'There will be millions of deaths,' he had said, 'at least USD 3 trillion will be needed'. The UN Economic Commission for Africa had urged African governments to demand the cancellation of the foreign debts they had contracted and had said that the continent needed $100 billion immediately to deal with the emergency and another $100 billion to invest in incentives, without which 1.2 billion Africans (practically all) would be infected and no less than 3.3 million would die in the first year of the pandemic alone.

Faced with such a scenario, as soon as the vaccines became available, hundreds of millions of doses arrived on the African continent, largely through international cooperation and in particular through Covax, a programme set up at the initiative of the WHO through which rich countries donated vaccines, either directly or by providing financial contributions to buy them, to low- and lower-middle income countries. The African continent needed, according to the WHO, 1.4 to 1.6 billion double-dose vaccines. In March 2021, Ghana and Côte d'Ivoire were the first African countries to start vaccinating their populations, and the WHO had announced that 1.27 billion doses, half of which were supplied by Covax, would soon arrive on the continent.

But, after the distribution of the first 30 million vaccines, what anyone familiar with the continent could have foreseen occurred, and that is how difficult it is in almost all countries to carry out vaccination campaigns without a massive contribution of foreign personnel: first of all, due to the extreme shortage of personnel and health facilities, the inadequacy of infrastructures, especially in rural areas, and, in many cases, the insecurity and impassability of entire regions due to ongoing conflicts. The Democratic Republic of Congo, for example, which has 0.07 doctors per thousand inhabitants and the entire east in the hands of dozens of armed groups, had received 1.7 million doses of vaccine from Covax by the beginning of March 2021. It had started the vaccination programme on 19 April. On 24 April, it had vaccinated only 1,265 people. Given the situation, on 27 April it had announced the transfer of 75 per cent of the vaccines, 1.3 million doses, to other African states, in the hope that they would be more efficient and able to use all the doses before the deadline. Nonetheless, one by one, the African countries found themselves in more or less the same situation: an abundance of vaccines and the prospect, indeed the certainty, of not being able to use them all in time. Thus, shortly afterwards, expired doses began to be destroyed.

In addition to the factors listed above, which made the vaccination campaigns too slow, in most countries there was often, it must be said, a lack of motivation on the part of populations that, threatened and truly decimated by other diseases - malaria, AIDS, tuberculosis, meningitis, Ebola... -, were not so afraid of Covid that they flocked to the centres where the vaccinations were being carried out. They were proved right. Since the beginning of the pandemic to date, official Covid cases worldwide are 701.6 million and 6.9 million deaths. In Africa, there are 12.8 million cases and 258,877 deaths.