N’DJAMENA,
Chad
At the small hospital where Dr. Oumaima Djarma works in Chad’s capital, there are no debates over which coronavirus vaccine is the best.
There are simply no vaccines at all.
Not even for the doctors and nurses like her,
who care for COVID-19 patients in Chad, one of the least-developed nations in
the world where about one third of the country is engulfed by the Sahara
desert.
“I find it unfair and unjust, and it is
something that saddens me,” the 33-year-old infectious diseases doctor says. “I
don’t even have that choice. The first vaccine that comes along that has
authorization, I will take it.”
While wealthier nations have stockpiled
vaccines for their citizens, many poorer countries are still scrambling to secure doses. A
few, like Chad, have yet to receive any.
The World Health Organization says nearly a
dozen countries — many of them in Africa — are still waiting to get vaccines.
Those last in line on the continent along with Chad are Burkina Faso, Burundi,
Eritrea and Tanzania.
“Delays and shortages of vaccine supplies are
driving African countries to slip further behind the rest of the world in the
COVID-19 vaccine rollout and the continent now accounts for only 1% of the
vaccines administered worldwide,” WHO warned Thursday.
And in places where there are no vaccines,
there’s also the chance that new and concerning variants could emerge, said
Gian Gandhi, UNICEF’s COVAX coordinator for Supply Division.
“So we should all be concerned about any lack
of coverage anywhere in the world,” Gandhi said, urging higher-income countries
to donate doses to the nations that are still waiting.
While the total of confirmed COVID-19 cases
among them is relatively low compared with the world’s hot spots, health
officials say that figure is likely a vast undercount: The countries in Africa
still waiting for vaccines are among those least equipped to track infections
because of their fragile health care systems.
Chad has confirmed only 170 deaths since the
pandemic began, but efforts to stop the virus entirely here have been elusive.
Although the capital’s international airport was closed briefly last year, its
first case came via someone who crossed one of Chad’s porous land borders
illegally.
Regular flights from Paris and elsewhere have
resumed, heightening the chance of increasing the 4,835 already confirmed
cases.
The Farcha provincial hospital in N’Djamena
is a gleaming new campus in an outlying neighborhood, where camels nibble from
acacia trees nearby. Doctors Without Borders has helped supply oxygen for
COVID-19 patients, and the hospital has 13 ventilators. The physicians also
have plenty of Chinese-made KN95 masks and hand sanitizer. Still, not a single
employee has been vaccinated and none has been told when that might be
possible.
That was easier to accept at the beginning of
the pandemic, Djarma said, because doctors all around the world lacked
vaccines. That has changed dramatically after the development of shots in the
West and by China and Russia that have gone to other poor African countries.
“When I hear, for example, in some countries
that they’ve finished with medical staff and the elderly and are now moving on
to other categories, honestly, it saddens me,” Djarma said. “I ask them if they
can provide us with these vaccines to at least protect the health workers.
“Everyone dies from this disease, rich or
poor,” she says. “Everyone must have the opportunity, the chance to be
vaccinated, especially those who are most exposed.”
COVAX, the U.N.-backed program to ship
COVID-19 vaccines worldwide, is aimed at helping low- and middle-income
countries get access. A few of the countries, though, including Chad, have
expressed concerns about receiving the AstraZeneca vaccine through COVAX for
fear it might not protect as well against a variant first seen in South Africa.
Chad is expected to get some Pfizer doses
next month if it can put in place the cold storage facilities needed to keep
that vaccine safe in a country where temperatures soar each day to 43.5 degrees
Celsius (110 degrees Fahrenheit).
Some of the last countries also took more
time to meet the requirements for receiving doses, including signing indemnity
waivers with manufacturers and having distribution plans in place.
Those delays, though, now mean an even longer
wait for places like Burkina Faso, since a key vaccine manufacturer in India
scaled back its global supply because of the catastrophic virus surge there.
“Now with global vaccine supply shortages,
stemming in particular from the surge of cases in India and subsequently the
Indian government’s sequestration of doses from manufacturers there, Burkina
Faso risks even longer delays in receiving the doses it was slated to get,”
said Donald Brooks, CEO of a U.S. aid group engaged in the COVID-19 response
there known as Initiative: Eau.
Front-line health workers in Burkina Faso say
they’re not sure why the government hasn’t secured vaccines.
“We would have liked to have had it like
other colleagues around the world,” says Chivanot Afavi, a supervising nurse
who worked on the front lines of the response until recently. “No one really
knows what this disease will do to us in the future.”
In Haiti, not a single vaccine has been
administered to the more than 11 million people who live in the most
impoverished country of the Western hemisphere.
Haiti was slated to receive 756,000 doses of
the AstraZeneca vaccine via COVAX, but government officials said they didn’t
have the infrastructure needed to conserve them and worried about having to
throw them away. Haitian officials also expressed concerns over potential side
effects and said they preferred a single-dose vaccine.
Several small island nations in the Pacific
also have yet to receive any vaccine, although the lack of outbreaks in some of
those places has meant there is less urgency with inoculation campaigns.
Vanuatu, with a population of 300,000, is waiting to receive its first doses of
the AstraZeneca vaccine later this month, but it has recorded only three cases
of coronavirus, all of them in quarantine.
At the Farcha hospital in Chad, nine health
care workers have gotten the virus, including Dr. Mahamat Yaya Kichine, a
cardiologist. The hospital now has set up pods of health care worker teams to
minimize the risk of exposure for the entire staff.
“It took almost 14 days for me to be cured,”
Kichine says. “There were a lot of caregivers that were infected, so I think
that if there is a possibility to make a vaccine available, it will really ease
us in our work.” - AP
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