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In our “Africa Reacts” series, the CSIS Africa Program asks prominent African journalists, civil society activists, and thought leaders to share their analysis on developments in the United States. By flipping the script—featuring African analysts’ views on the United States rather than U.S. analysts’ opinions on Africa—we are seeking to turn a fresh page in U.S.-Africa relations.
In our 10th edition of Africa Reacts, we asked top African experts to provide their reactions to the United States’ distribution of Covid-19 vaccines, both domestically and internationally. The continent is watching as the United States—sitting on an abundant stockpile of Covid-19 vaccines—makes promises to equip partner nations with enough jabs to reach herd immunity. Many analysts commended the United States’ recent donation of 25 million doses to African countries through the COVAX mechanism, but noted the tremendous disparity in vaccine access between the United States and African countries. Others discussed the life-saving importance of waiving intellectual property rights to facilitate vaccine production in Africa, as well as the implementation of behavioral science techniques to boost vaccination rates. Finally, some experts noted the particularly pernicious danger of the Delta variant in Africa and called on the Biden administration to provide more support to the continent in what is still a global crisis.
The contributions in this commentary have been edited by the CSIS Africa Program for brevity and clarity.
As the United States sends vaccines to African countries and partners, it begs a bigger question about what really is the "goodwill" of the United States.
In the beginning, African countries had problems getting the vaccines. Despite a shared global pandemic that brought the whole world together fighting a common enemy, just until recently, African countries had to rely on donations to get access to vaccines for their rather vulnerable populations. But thankfully now, the Biden administration came out in support of waiving intellectual property rights over U.S.-produced vaccines, allowing African countries the opportunity to take charge of their destinies by developing the capacity to produce and distribute vaccines. But this whole dance begs a question about America: When is America's capitalism too much?
Even as the vaccines are coming to African countries, there are still several questions about the vaccines and what they really are. Right-wing and QAnon talking points about the vaccines have become a staple within African communities, with people questioning the pandemic and the real purpose of the vaccines. A lot of people believe the vaccines are a way for governments to track citizens or worse, a biblical precursor to the end of the world through the mark of the beast. Now, the narrative in conservative America is changing, but the damage in Africa might be permanent.
The United States has the infrastructure and resources to positively influence the glaring inequality that we have seen in the distribution of vaccines in the developing world. It is commendable that the Biden-Harris administration has just donated 25 million doses to African countries through the COVAX facility, in close coordination with the African Union (AU) and Africa Centers for Disease Control and Prevention (Africa CDC). The donation has led to Lesotho getting 302,400 vaccines just last week.
However, I think the United States abdicated its duty as the voice of reason. While it seems like Covid-19 has been decisively dealt with in the developed world, Africa is facing the devastating effects of lack of preparedness, which could easily have been fixed had the United States and other superpowers done the right thing of ensuring equitable distribution of vaccines. Lesotho, for instance, was one of the last countries to record Covid-19 cases in the world but until last Friday, it had received just 32,000 doses of vaccines. In the meantime, people are dying, and the small, fickle economy is dying too.
The Biden administration can correct this and force those in control to distribute vaccines equitably. The initial damage has already been done, but further damage won't be stopped without positive action.
U.S. progress on vaccines is commendable, but the recent slowdown also demonstrates the challenges in this process and suggests that the United States needs to find new ways to push those that are unvaccinated to get the injection. This is important for the United States but also for the world, as the longer we allow these variants to circulate, the greater likelihood another, more dangerous, one will emerge. This will be devastating for countries with weaker healthcare systems.
One lesson from the United States is that this isn't just about bringing in the health experts. A lot of the behavioral science expertise was ignored or brought in far too late when it came to vaccinations. This has been costly. In countries like Mali, we have been thinking about behavioral science and norm shifting as it relates to issues like conflict and corruption—and we must ensure this thinking informs the vaccine roll-out process too.
We commend and applaud the Biden administration signing up to the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) vaccine waiver as an important part of supporting less-developed countries to produce their own vaccines and be less reliant on global supply chains. We are looking forward to European countries following this good example. The inequality in the vaccine rollout is a serious issue—both within the United States and globally. It is unconscionable (as the head of the World Health Organization has pointed out) that some countries, such as Israel, are rolling out booster shots when many countries have yet to begin their vaccination campaigns. The United States has to prioritize COVAX and other means of getting vaccines to developing countries. This is not just a healthcare issue but an issue of political and economic stability that affects U.S. interests in myriad ways.
“Even as Covid-19 cases are rising, only about 3 percent of all global Covid-19 vaccine doses to date have been given in Africa,” says Mercy Corps' regional director for Africa, Sean Granville-Ross. Granville-Ross, in trying to raise awareness of the dire impact of vaccine inequity on the developing world, underscores how this situation is catastrophic, or what he calls “a nightmare scenario.” His take speaks to the reality of inequity that has seen countries like the United States stocking up on vaccines in numbers that far exceed their national needs, while offering drops in the ocean of supply to countries in Africa, Asia, and Latin America and the Caribbean that are desperately lagging behind. While the United States has been lauded for donating 25 million doses to Africa through COVAX and saving up to 14 million jabs for “hotspots” that include Africa, the significance of this gesture is more symbolic than it is pragmatic.
As of July 28, as many African countries are suffering from a third wave of infections driven by the Delta variant, the continent has a vaccination rate of 4.6 percent. By contrast, the United States has given 57 percent of its 333 million people at least one dose, with 49 percent of the population already fully vaccinated.
On its own, South Africa, which has been hardest hit on the continent by unrelenting waves of infection, requires at least 80 million doses to ensure that 67 percent of its population is fully vaccinated. South Africa, together with India and other states, is pushing for patent waivers that would allow it and other countries to produce vaccines themselves. While some deals have been struck for companies in South Africa to finish the production of the Johnson & Johnson and Pfizer-BioNTech Covid-19 vaccine s for distribution across the continent, a waiver would expand production and ensure quicker distribution. The United States has (finally) lent its voice to this cause, but beyond rhetoric lies action. This will be the truest test of the United States’ commitment to vaccine equity and rid it of accusations of half-hearted engagement and hypocrisy. The global vaccination ball, so to speak, is in the United States’ court now.
The pandemic has revealed the vast inequality in the world we live in. In the beginning, the rhetoric from global leaders was, “We are in this together and no one is safe until we are all safe.” But the actions by developed countries have fallen shamefully short of their warm words. While the United States and the United Kingdom are ordering booster doses, tens of millions of healthcare workers in developing countries have not received even a single dose, and hundreds are dying each day working on the frontlines.
It is good that the United States is donating 25 million doses to Africa and that Pfizer and Johnson & Johnson are processing vaccines in South Africa. These jabs will be lifesaving. Governments in Africa have a huge task ahead to acquire the vaccines, deliver them to every corner of the continent, and run public awareness campaigns so that almost all of us get vaccinated. We need allies to help us bridge the gap as we cannot afford to buy and deliver vaccines across the whole continent.
We are on the precipice of a generational disaster, and the lack of leadership in addressing the issue is really a symptom of how much the concept of principled leadership has fallen away at the international stage. As I write this, only 1 percent of African adults have been fully vaccinated against the coronavirus, while rich countries like Canada and the United States have hoarded supplies of available vaccines for up to 10 times their current population. At the beginning of the pandemic, there was a lot of talk of Covid-19 being a global equalizer. Instead, it is turning out to be the opposite as rich countries make it apparent that there is simply no concern for anyone else. It is unjust for India (and increasingly China) to carry the burden of providing vaccines for the world when the burden could have been more equitably distributed. It is also unjust that millions of doses of the AstraZeneca vaccine that we depend upon are languishing in storage in the United States while a third wave of infections tears through poor countries in Africa and Asia. By March 2021, China and India had exported just under 50 percent of the vaccines that they had produced. The United States had exported zero. Germany and the European Union continue to block an intellectual property waiver that would make it possible for poor countries to make their own vaccines. The United Kingdom has purchased enough vaccines for 225 percent of its population. History will not judge the West kindly for how these countries have behaved during the course of this pandemic.
What we have is an indication that there is no place for justice, fairness, and other moral values in the international system. The indication is that there is no interest in poor countries becoming free or stable. No one is asking for charity. The bottom line is there are currently enough vaccines in existence to protect all of the world's frontline healthcare workers. We are asking for justice—a fighting chance—but the fact that the United States and other countries are hoarding vaccines and then promising meager charity after domestic needs have been met is indicative of a style of international politics that is predicated on dependence rather than the pursuit of equality. Honestly, it just feels like rich countries need for us to fail or to suffer in order for their existence to be validated. And it is dehumanizing and really cruel.
It is a relief to see the United States, though belatedly, begin to demonstrate strong leadership in fulfilling its international legal obligation of cooperation to ensure equitable global vaccine access. It is morally wrong that European and North American countries have the capacity to inoculate 70 percent of their adult populations by the end of this month (July) while African countries struggle to vaccinate barely 1 percent of their population. Sharing from the United States’ vast store of vaccine doses would be crucial for saving lives as Africa grapples with the surging third wave of Covid-19 infection cases, driven by variants. But tackling the global inequities that present the greatest obstacle to achieving herd immunity across the board requires the United States to do more to deploy its influence to convince other high-income countries to agree to the TRIPS waiver without further delay. The waiver will help overcome the severe shortage of Covid-19 vaccines and other medical products that continue to impair the enjoyment of the fundamental human rights to life, health, and a decent standard of living for people in lower-income countries.
Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).
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