Omicron, Africa and global health politics

GREEK ALPHABETS ARE NOT STRANGE to those familiar with sciences, especially those involving quantitative analyses and calculations. Their use as notations, symbols and formulae can be described as legendary and historic as they have been associated with breakthrough scientific solutions to many natural phenomena and mysteries.  Economists are also familiar with those alphabets in the course of their advanced and complex computations. The use of these alphabets seemed to have receded in the memories of most people until recently when molecular scientists found it convenient to name the various mutant strains of COVID-19 virus in the forms of Greek alphabets to distinguish them from one another. Beginning with Alpha, Beta, Gamma and Delta, the Greek alphabets crept back surreptitiously into public consciousness. This was just as the descriptive nomenclature of convenience for 2019 novel coronavirus (2019-nCov), considered as novel virus, was named by the Chinese researchers, only for the International Committee on Taxonomy of Viruses (ICTV) to modify the name of the virus to SARS-CoV-2 and the disease was referred to as COVID-19.

What was not immediately considered at the outset were the likely mutations as the big pharmaceutical multinationals rushed into massive vaccine production, based on the considered need to enable everyone to have access to the vaccines. If anything, those big pharma companies are not regretting on their bets as their products have gained supply side advantages, buoyed by national policies and states’ demands. In all of these, none of the vaccine manufacturers seems to have been made to assume responsibility for any untoward effects of COVID19 infections on users. Now that the virus is ahead of the vaccine manufacturers in its speed of mutations, some subtle suggestion was recently heard, implying that additional booster doses of the vaccine would have to be received by fully vaccinated people to secure them from succumbing to new virus strains. So, the earlier vaccine regimen of first dose and then a booster dose was no longer sufficient. There must be another dose after a booster dose, in this case to curb the effect of the new variants. Many more vaccine types will have to be produced for the emerging strains as long as new variants keep emerging.

The committee that named the various strains of COVID-19 viruses appeared systematic at the beginning, following the Greek alphabets in sequential orders, from α, β, γ, to δ (Δ), but tactically avoided the next alphabets in that order, preferring rather to jump. In so doing, they jumped many alphabets and landed on omicron (omikron), an alphabet that follows ν (nu) and ξ (xi), probably in trying to avoid the controversy of bringing the name of a country’s president into the virus nomenclature. But it still succeeded in stirring controversy anyway, as Southern Africa – the region from where the specific molecular markers were identified – was immediately treated as a pariah region, with the same treated extended to no fewer than eight African countries, including Nigeria. China would probably have felt justified for choosing to obfuscate facts and hoard vital information about the origin of COVID-19 virus at the very onset until it became a global crisis. While President Cyril Ramaphosa of South Africa openly lamented that his country and region got punished for openness required during a global emergency, voices from other countries, particularly Nigeria, regarded as “apartheid” the ban on flights from any African countries to Europe or North America on account of Omicron discovery.

To what extent this profiling would help Africa in overcoming the pandemic is a matter of conjecture. Poverty has increased, many jobs have been lost and many businesses have collapsed since COVID-19 first hit. Two years on, COVID-19 has shown no sign of abating, but rather expansion despite the draconian lockdowns, deaths, massive vaccination exercises and sustained campaigns to encourage more to get vaccinated. Hiding under stereotypes is an insufficient gambit among various strategies for distracting people’s attention away from the realities in Africa, which has fully vaccinated only 77 million people, just six per cent of its population. This is markedly different, comparing with the over 70 per cent of high-income countries. Nigeria’s COVID-19 vaccination rate is currently estimated at three per cent of the total population of about 200 million people, according to the World Health Organisation (WHO). It remains to be seen if the Western countries prevented African countries from testing for COVID-19, providing isolation rooms, sensitisation messages or the promotion of positive attitudes and public trust toward the vaccine. A Nigerian high ranking government official was recently quoted as saying that the low level of COVID-19 infections, hospitalisations and deaths could have been as a result of the good work the federal government in the present regime is doing. What could have been more delusive!!

In the Lagos, the state hosting the commercial nerve centre of Nigeria, official warnings have been published in the media about the “fourth wave” of COVID-19 infections. That sounds questionable, putative and non-factual in a state that the majority in the population falls within the lower class and people tend to operate in crowds for the most part: in the homes, markets, schools, buses, hospitals and social gatherings, yet without testing, much less vaccinations. Scientifically, it can be argued that the category of people getting infected with COVID-19 in Lagos is not within this crowd. When travel bans were imposed on Nigeria, it made more scientific sense to have recourse to issues that must have precipitated such a decision. Foremost, those advanced countries are fully aware of the low regulatory support by the national and sub-national governments in Nigeria and the multiplier effects, including apathy, indifference, hesitancy or compliance fatigue.  Any accusation of apartheid therefore begs the question of vaccine inequity in Nigeria as in the Sub-Saharan Africa. In particular, it sounds more like a diversionary tactic from the government of Nigeria.

How about the one million COVID vaccines that got expired in Nigeria last November? The expired doses, made by AstraZeneca (AZN.L) and delivered from Europe, according to Reuters, “were supplied via COVAX, the dose-sharing facility led by the GAVI vaccine alliance and the WHO which is increasingly reliant on donations.” The doses were said to have “arrived within four-to-six weeks of expiry and could not be used in time, despite efforts by health authorities.” Inadequate cold storage facilities and very low cold chain integrity have a significant role to play in the wastage and expiration of such vaccines. “Nigeria is doing everything it can. But it’s struggling with short shelf life vaccines,” noted Reuters, adding that, “now (supply is) unpredictable and they’re sending too much.” It quoted the WHO as saying that vaccines delivered with “very short” shelf lives were a problem. In Reuter’s opinion, “Nigeria’s vaccine loss appears to be one of the largest of its kind over such a short time period, even outstripping the total number of vaccines that some other countries in the region have received.” How does this situation help in the accusation of vaccine inequities? Vaccines, like other consumables, are bound to be wasted. Only that the quantum of wastes might vary from place to place, region to region and the time of the year might also vary widely as varying degrees of wastages have been reported in Germany, UK and France earlier in the year.

Nigeria typifies most other Sub-Saharan African countries. In most of them, the situation is even worse. They have to contend with shortages of qualified staff, inadequate appropriate equipment and scarcity of funds for vaccine purchase. Sudden supplies of as much as one million became a burden rather than a help, especially when the healthcare infrastructure and personnel are inadequate or substandard. AstraZeneca prides its vaccines as among the cheapest, at a bit lower than $10 per dose. Its wastage may well have cost Nigeria a fortune, the lowest prices notwithstanding. Add all costs – including transportation and storage – together, therefore at an estimated $10 per dose, Nigeria has wasted $10 million worth of vaccines, that is N4.8 billion, in a country that cries “apartheid,” discrimination and vaccine inequities. The possibilities of some privileged few in government setting up vaccine black market cannot be ruled out. It is even possible that the scheme towards black market led to the wastage of the one million AstraZeneca doses, particularly in the circumstances of inconsistent supply of electricity to reliably operate cold storage. Yet, some people found it convenient to blame other countries for shutting their airspace against Nigerian in-bound travellers, as if it has become an offence for other countries to promote their own people.

The poor state of infrastructure all over Africa serves as a major obstacle to effective reach, especially of people in difficult terrains. The cost of deploying modern means of delivering such products, using drones for instance, could be prohibitive in many countries. Insecurity, Islamic insurgencies, banditry and terrorism will prevent effective reach to many nations’ countryside, especially in Mali, Burkina Faso, Ethiopia, Sudan, South Sudan, Burundi, Central African Republic, DR Congo, Cameroon, Niger, Chad and Mozambique. Rather than blaming all on foreign powers, African countries need to look inwards and fix the essentials. A statement attributed to Dr. Osagie Ehanire, the current Health Minister of Nigeria, summarises it all. He reportedly said that “the foundation is not strong. And if you don’t have a strong foundation, there’s not much you can build on top.” In Africa, therefore, the place to start is the foundation. Once the foundation is strong, every other thing on it will be strong and dependable. Leadership is fundamental here. Africa’s leadership needs transformation for the good of all. Then may we be able to free ourselves from the perennial weaknesses and assert ourselves in the changing world where personal interests and national interests are paramount.