Lagos — Now that COVID-19 vaccines are available, the richest countries in the world have effectively bought them up. African leaders have let them.
As an African, I am disappointed at these leaders who have become so dependent on rich western nations to fund every aspect of healthcare delivery on the continent that they are willing to sit by and wait for the vaccines that can save African lives. Africans, it is time to take our destinies in our own hands and demand that our leaders do the right things to ensure everyone on the continent gets vaccinated against COVID-19, without waiting for handouts from richer nations.
Recently, Madhu Pai, Research Chair of Epidemiology and Global Health at McGill University, Canada, interviewed Ben Phillips, international anti-inequality activist, on the imperatives of using people power to fight inequalities. His words apply in this context. A statement which resonates the most with me was Philips' quote of Frederick Douglass, "Power concedes nothing without a demand. It never did and it never will."
Ordinary people can demand extraordinary changes. It reminds me of an Igbo word, Igwebuike, which means, "There is strength in the community".
Throughout history, people power has been the recipe for change. Transformation always takes the commitment of a community of like-minded people. Margaret Meade captured this group action succinctly, "Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has."
Indeed, we have the power to guide what happens next. In the spirit of Igwebuike, these are four ways that people power can lead to COVID-19 vaccine equity in Africa.
First, Africans must build coalitions and push for good governance, especially the fight against corruption. Africa loses an estimated $50 billion yearly due to illicit financial flows - a whopping U.S.$800 billion from 1970 to 2008. Plugging the loopholes through which these funds are lost could buy all the COVID-19 vaccines needed to vaccinate every African.
We could even spare some for underserved areas in richer nations. Coalitions such as "Follow the Money" are building communities against corruption. Every young African should be part of such efforts to build people power.
Second, all Africans must realize that without health, we have nothing. Therefore, we must show more interest in what happens in the health sector. A place to begin is to demand publicly-funded health insurance across the continent. Building large pools of the insured in each country can provide funds to pay for COVID-19 vaccines. Already, Africans spend so much on out-of-pocket expenditures for healthcare. These range from a low of 3.32 percent in Botswana to a high of 76.6 percent in Nigeria, according to the World Bank. These high out-of-pocket expenditures could be channeled to health insurance.
Third, Africans must be involved in actively electing their leaders, because everything rises and falls on leadership - good leadership. The current apathy towards participating in elections, demonstrated by a youthful continent, will not build the people power required to reverse inequities.
For instance, in South Africa's last election in 2019, only 30% of the population voted - 17.6 million out of a population of 58.78 million. In Nigeria's 2019 election, voter turnout was 35% - in a country of about 200 million people. This has to change. A fundamental way of building people power is ensuring everyone votes and that their votes count.
Lastly, African leaders must collectively continue to push for vaccine production on the continent. They should demonstrate the Ubuntu spirit of collective action because it is unsustainable to depend on vaccines manufactured outside the continent for 1.2 billion Africans.
Based on estimates by the Africa Centres for Disease Control (Africa CDC) – an agency of the African Union – Africa needs 1.5 billion doses of the vaccine to vaccinate at least 60 percent of its citizens to achieve herd immunity. This will cost between $7 billion and $10 billion to implement.
To fund vaccine production on the continent, AfreximBank is providing a vaccine-financing framework for Africa. Through this initiative, countries will issue "note payable", a written promise to repay, to AfreximBank, which will then arrange about $4 billion in revolving credit to back orders from African suppliers that have been certified by the Africa CDC. The Africa Medical Supplies Platform, set up by the African Union to counter the initial hoarding of COVID-19 supplies by western nations, should coordinate logistics and distribution of locally-produced vaccines to member States.
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To be sure, rich countries still have moral obligations to ensure a level-playing field for every country to acquire COVID-19 vaccines for her citizens. Some richer nations are already ensuring this by contributing to the COVAX facility, backed by the World Health Organization, which will ensure at least 20 percent of Africans are vaccinated by the end of 2021.
As commendable as this trickle-down support is, it would not enable Africa to achieve the immunity required to protect the continent. At least 60 percent should be vaccinated to reach herd immunity. At this rate of dependence, it would take three years to achieve.
A major lesson from fighting this pandemic is that leadership is crucial, and that leadership must be local first. Reversing vaccine inequity in Africa will truly begin to happen when Africans deploy the power of the community.
Dr. Ifeanyi M. Nsofor has been a Senior New Voices Fellow at the Aspen Institute , a Senior Atlantic Fellow for Health Equity at George Washington University and a 2006 Ford Foundation International Fellow . He is the Director of Policy and Advocacy at Nigeria Health Watch,
