Health
Russian COVID-19 Vaccines Disappear from Africa’s Radar
By Kestér Kenn Klomegâh
Until recently, Africa has not been high on Russia’s policy agenda. African leaders have to understand that Russia, for the past three decades, Africa was at the bottom of its policy agenda. After the end of the Soviet era, Russia has focused broadly on the United States and Europe, dreaming of becoming part of Europe, part of the configuration of the Global North. The low economic presence of Russia from 1991 until 2019 was a testament to the fact that Africa was at the bottom of its priority list. Of course, the October 2019 summit was symbolic, but after that, Russia has left most of the bilateral agreements undelivered across Africa.
With its “special military operation” on Ukraine that necessitated the imposition of stringent sanctions from the United States, European Union and their allies, the United Nations Security Council, mounting pressure on Russia since February 24 2022, pushes Russia to begin soliciting aggressively for support in Africa. Last July, in an article posted to its official website, Foreign Minister Sergey Lavrov wrote: “The development of a comprehensive partnership with African countries remains among top priorities of Russia’s foreign policy; Moscow is open to its further build-up multifaceted relations with Africa.”
In his Op-Ed article, Lavrov argues: “We have been rebuilding our positions for many years now. The Africans are reciprocating. They are interested in having us. It is good to see that our African friends have a similar understanding with Russia.” Lavrov, however, informed about broadening African issues “in the new version of Russia’s Foreign Policy Concept against the background of the waning of the Western direction” and this will objectively increase the share of the African direction in the work of the Foreign Ministry.
Lavrov consistently displays his passion for historical references. Soviet support for struggles for political independence and against colonialism should be laid to rest in the archives. The best way to fight neo-colonialism is to demonstrate by investing in those competitive sectors and depart away from hyperbolic rhetoric on an endless list of sectors. In practical terms, we rather face today’s development challenges and what is in store for the future generation. Africa today does not need anti-Western slogans; Africa simply needs external players who would passionately and genuinely invest in the critical economic sectors. The fundamental fact is that Africa is making efforts to transform its economy to create employment, modern agriculture, and industrialize the continent, especially with the introduction of the African Continental Free Trade Area (AfCFTA).
Despite criticisms, China has built an exemplary distinctive economic power in Africa. Besides China, Africa is largely benefiting from the European Union and Western aid flows and economic and trade ties. Compared, Russia plays very little role in Africa’s infrastructure, agriculture and industry and makes little effort to leverage the African Continental Free Trade Area (AfCFTA). Our monitoring shows that the Russian business community hardly pays attention to the significance of the African Continental Free Trade Area (AfCFTA), which provides a unique and valuable platform for businesses to access an integrated African market of over 1.3 billion people.
Lavrov’s efforts toward building non-Western ties in these crucial times are highly commendable, especially with Africa. But, the highly respected Minister easily and most times forgot the fact that during these two-three years of a global pandemic, the coronavirus that engulfed the planet, in every corner of the world, Africa was desperately looking for vaccines. Health authorities are still warning that Covid-19 has not been completely faced throughout the world.
Quartz, a reputable global media, reported early this year that “as of the end of 2022, about a quarter of the population of African countries has been fully vaccinated against Covid-19, according to the latest figures shared by Africa CDC. The coverage varies drastically depending on the country. In Liberia, for instance, nearly 80% of the population is fully vaccinated, while only 34% is in neighbouring Sierra Leone. Congo, Sudan, Senegal, and Madagascar all have vaccination rates below 10%.
In his briefing, Ouma said the target for Africa remains to vaccinate 70% of the population. That goal, however, was set by the World Health Organization (WHO) for the overall population. These numbers are about to change – and not because of an increase in vaccinations. Africa CDC acting director Ahmed Ogwell Ouma announced in a video briefing on December 22 that it will modify the way it reports vaccination rates. Rather than reporting coverage of the overall population, it will only report vaccinations of the eligible populations aged 12 or more.
Due to delays in international vaccine deliveries, Africa lags behind the rest of the world in Covid vaccination rates and is the only continent where less than 50% of the population is fully vaccinated. Currently, just more than 800 million doses of vaccines have been administered in Africa, or 80% of the total received. About a third of the vaccinations have been made with Johnson & Johnson’s vaccine, followed by Pfizer (22%), AstraZeneca (17%), China’s Sinopharm (15%) and Sinovac (7%).
Several reports monitored by this author show that Russia has played a minimal role in the entire health sector in Africa. With the Covid-19 vaccination, Russia randomly sprinkled a few thousand as humanitarian assistance among its “Soviet friends”, including Egypt, Ethiopia, Guinea, Angola, Mozambique, Zimbabwe and South Africa. Nevertheless, the worse was Russia’s sudden failure to supply the 300 million vaccines through the African Union (AU), especially during the times of health crisis.
An authoritative policy report presented in November 2021 titled ‘Situation Analytical Report’ and prepared by 25 Russian policy experts headed by Sergei A. Karaganov noted explicitly the failure to supply Sputnik vaccines to the African Union. The report criticized Russia’s current policy and lukewarm approach towards Africa.
“In several ways, Russia’s possibilities are overestimated both publicly and in closed negotiations. The supply of Russian-made vaccines to Africa is an example. Having concluded contracts for the supply of Sputnik V to a number of African states, Russian suppliers failed to meet contractual obligations on time,” says the report in part.
The coronavirus outbreak a pandemic on March 11, 2020. Worth noting that Russia claims that it was the first to find a coronavirus cure. The World Health Organization (WHO), until today, has not certified Russia’s vaccines, though. On the other hand, all the vaccines that have been registered in Russia – Sputnik V, Sputnik Light, CoviVac and EpiVacCorona – are produced in large quantities by Russian pharmaceutical companies and are currently used for vaccination.
Director of the Gamaleya National Research Centre for Epidemiology and Microbiology Alexander Gintsburg has several times highlighted aspects of vaccine production and marketing. He noted to raise the attractiveness of the vaccines on foreign markets, including countries in the Middle East, Africa and Latin America.
The Russian Direct Investment Fund, tasked to engage in marketing the vaccines abroad, got messed up, especially in Africa. Of course, it took steps and speedily registered the vaccines in more than 20 African countries but terribly failed on delivery deadlines. Worse was the Russian Direct Investment Fund supplied, at exorbitant prices, through middlemen in the Arab Emirates to a number of African countries. Russia’s Foreign Ministry has, however, held a series of African Foreign Ministers during this Covid-19 period and desperate moment reiterated to assist with direct supplies to Africa. That is Russia, considered a reliable partner for Africa.
The above thoughts on the part of the Covid-19 business offered the reasons why Russia absolutely refused to join and be part of the Covax facility, which acts as a global collective bargaining initiative to secure vaccine doses for countries who signed up, including those are self-financing their purchases, as well as assistance from donors for poorer developing countries. The first vaccines purchased through Covax were indeed destined to reach Africa. That was, monitored by this author, some 88.7 million doses of the AstraZeneca and Pfizer vaccines distributed to 47 countries, including Africa, during the first half of 2021. This same year, during the virtual meeting of G7 leaders, the European Union announced it had donated a further 500 million euros to the COVAX program. The World Bank also committed $12 billion as concessional loans to assist African countries in accessing foreign vaccines.
That is not all from several reports monitored. In April 2022, writing under the headline: “How Russia’s Hollow Humanitarian Hurt Its Vaccine Diplomacy in Africa,” – the co-authors, Matthew T. Page and Paul Stronski, both noted in 2020 that Russia touted deliveries of medical and protective supplies to several African countries, while the Russian-developed Sputnik V vaccine offered hopes that African countries would soon be able to launch large-scale immunization drives. Russian efforts to promote Sputnik V in Africa have floundered for a variety of reasons, including regulatory worries, production and logistical shortfalls, bureaucratic inertia, and even sticker shock. There is, however, another key factor behind Moscow’s failed vaccine diplomacy: its traditionally diminutive post-Soviet development presence on the continent.
Compared to Australia, Canada, the European Union, Japan, the United Kingdom, the United States, and even many foundations, Russia has provided a tiny share of international development assistance to African countries since the end of the Cold War. Unlike India and Cuba, it has provided scanty medical assistance to – or investment in – African countries.
Suppose Russia wants to be influential on the continent. In that case, African political and economic leaders should demand more of Moscow, not simply settle for the symbolic diplomatic engagements or agreements at which the Russian leadership excels. Indeed, Africa has not ranked high on the Russian foreign policy agenda for much of the past three decades, getting barely a mention in the country’s key security documents except as either a partner in an emerging multipolar world or a source of instability.
Indeed the time has come for African leaders to rally together to ensure that no effort is spared in facilitating and supporting the building of large-scale vaccine manufacturing capacity on the continent. The African Vaccine Manufacturing Summit held in April 2021 was an encouraging start. Focus needs to be on developing real vaccine R&D capacity, which must necessarily lead to health products. This requires substantial investment and a long-term commitment. In a similar vein, under the aegis of the African Union, leaders have to begin looking for inside solutions rather than base hopes on these geopolitical games, great external powers seeking only support for their peculiar or parochial interests.
Understandably, while making efforts to maintain and expand its presence in Africa, Russia simply lacks the capability to deliver on its various promises in Africa. Surely, African countries have to begin to re-evaluate their relationship with Russia. African leaders should not expect anything tangible from meetings, conferences and summits. Since the first Russia-Africa summit held in 2019, very little has been achieved. Given the stringent sanctions imposed following Putin’s invasion of neighbouring Ukraine, it is even more improbable that Moscow would commit adequate financial resources to invest in economic sectors.
In stark contrast to key global players, for instance, the United States, China and the European Union and many others, Russia obviously has limitations. Notwithstanding that, for Russia to regain a part of its Soviet-era influence, it has to address its policy approach, this time trying to shift towards new paradigms – implementing some of the decade-old pledges and promises, and those bilateral agreements; secondly to promote development-oriented policies and how to make these strategic efforts more practical, more consistent, more effective and most admirably result-oriented with African countries.
By Kestér Kenn Klomegâh
Health authorities in the Democratic Republic of Congo (DRC) and the Africa Centres for Disease Control and Prevention (Africa CDC) have bitterly complained over their inability to track down new cases of Ebola, which has spread into the Republic of Uganda. An estimated 1,635 Ebola cases have been confirmed, and 127 people have died from the dangerous infectious disease in the DRC.
The Ebola outbreak is increasingly impacting social interaction and people-to-people movements, as scepticism toward the disease appears to accelerate among the population, and cross-border movements are being controlled daily. Alarm was sounded last week as the virus moved into new areas of the DRC. In some instances, patient routinely escapes, and limited contact tracing undermines containment efforts. Contact tracing coverage has plummeted to 56.5 per cent, a sharp decline from the 95 per cent target, Health Ministry officials said.
“We remain committed to supporting affected countries until transmission is stopped. We call on partners and donors to urgently mobilise resources to strengthen the response and save lives,” Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, said on Sunday.
Shortage of Medical Kits
The World Health Organisation (WHO) reported that the three major laboratories, in South and North Kivu, have run out of Ebola testing kits, as infections continue to rise daily. Teams are working through a large backlog of samples from suspected Ebola patients, many of which were collected several weeks ago, to confirm or rule out the presence of the deadly virus.
In a situation report released earlier this week, the global health agency said the labs in major cities including Bukavu and Goma were awaiting the arrival of reagents–substances ​ required to run the tests–to resume work on the backlog of samples.
“Running out of Ebola testing reagents during an active outbreak is a serious setback,” Dr Krutika Kuppalli, associate professor in the division of infectious diseases at the University of Texas Southwestern and former WHO officer, told The Telegraph.
“Diagnostics are the foundation of outbreak control; if cases cannot be rapidly confirmed, this may lead to delays in isolation, treatment, and contact tracing, which can allow transmission to continue unchecked,” said Dr Kuppalli.
The Race for Vaccines
Vaccine candidates are racing to fill the gap. The Coalition for Epidemic Preparedness Innovations (CEPI)—a multinational nonprofit organisation that finances vaccine development for emerging infectious diseases—has so far prioritised several vaccine candidates for development.
Two are Ervebo-like prototypes aimed at recognising Bundibugyo’s specific blend of glycoproteins, a platform that showed experimental potential years ago. In 2013, an early version of the vaccine protected 100 per cent of monkeys infected with Bundibugyo. However, because most Ebola outbreaks didn’t involve this species, the vaccine didn’t get the investment needed to become licensed. That’s an outcome CEPI aims to remedy with its latest investment.
The International AIDS Vaccine Initiative and Public Health Vaccines are developing the vaccines, which, like Ervebo, also rely on the vesicular stomatitis virus. WHO called this technology the most promising of the candidates.
VSV-based vaccines are front-runners because the weakened version of the virus used to produce them is so good at replicating itself inside humans—including the small chunk of whatever germ it’s been hybridised with—without causing harm. As a result, a single dose typically leads to a strong immune response.
Another candidate, called ChAdOx1, operates using a similar concept: A virus shows the immune system part of a pathogen to generate a protective response. However, it uses an adenovirus that causes colds in chimpanzees—and is also harmless to humans—that University of Oxford scientists modified to keep it from replicating.
There’s also a vaccine candidate based on Moderna’s mRNA science, which was also used to produce the company’s COVID-19 vaccines. This vaccine employs tiny fat bubbles to deliver genetic instructions to cells on how to produce a small part of the Bundibugyo virus. The immune system generates a protective response, and the mRNA degrades quickly without causing lasting changes to cells’ genetic codes.
US-Backed Kenya’s Quarantine Centre
Health Cabinet Secretary Aden Duale has consistently defended the establishment of US-backed health centres in Kenya. The US says it will quarantine citizens exposed to the virus but not showing symptoms in a facility it is building in Kenya, and will not bring them home if they develop symptoms, instead sending them to a third country.
The CDC imposed temporary travel bans last month on people who have been in the DRC, Uganda, or South Sudan, including green card holders, who are typically exempt from such bans. It is also screening Americans travelling from those countries at three US airports. The strategy marks a sharp break from past practice as President Donald Trump’s administration seeks to keep all cases out of US territory.
There are 13 US treatment centres in a government-funded hospital network for severe infectious diseases ready to handle Ebola patients. Public health experts have, however, called on the government to bring any sick Americans home for treatment, and local protests at the Kenya site have led to at least two deaths. A Kenyan court has ordered a halt to the construction.
WHO Appeals for International Community Support
In a rapid and comprehensive response to WHO’s appeal to marshal resources for support of Ebola prevention, the United States has provided an additional $38 million. The additional funds brought the total amount committed by the U.S. to more than $200 million in direct funding, the State Department said in an official statement.
CDC model scenarios show that without strong public health interventions, the outbreak of the Bundibugyo strain of Ebola in the DRC could become as large as, or even larger than, the 2014-2016 West Africa outbreak, the agency said.
In modelled scenarios where the isolation of patients is limited, the outbreak could become one of the largest ever documented, said Jason Asher, director of the CDC’s Centre for Forecasting and Outbreak Analytics.
From Addis Ababa, the Africa Centres for Disease Control and Prevention (Africa CDC) also said it had received a €11.5 million renewed commitment from the European Union Commission (EU) to support a stronger preparedness and coordinated response to the Ebola outbreak. Dr Jean Kaseya, Director General, Africa CDC, described the partnership with the European Union as respectful and without any conditionality, a type of partnership the continent needs.
The package is aimed at reinforcing the EU Commission’s support through the Africa CDC emergency response to the Ebola crisis, within the long-standing and comprehensive AU-EU health partnership. This demonstrates the central role of Africa CDC in coordinating the continental response to health emergencies, as well as the EU’s action as the world’s largest humanitarian contributor.
This includes €6.5 million to strengthen the Africa Pathogen Genomics Initiative, to help equip frontline teams, train healthcare workers and improve surveillance through diagnostics and an in-kind contribution of €5 million worth of testing equipment, including rapid diagnostic devices and lab test kits, to be deployed quickly where they are needed most. The EU’s partnership with Africa CDC spanning technical expertise, capacity-building, and policy dialogue continues to play a key role in building resilient health systems.
Ebola epidemic at G7 summit
Amid the horror of the Ebola epidemic, world leaders gathered at the G7 summit in France were urged to find the “political will” to push through the final part of the Pandemic Agreement on Monday. In a joint letter, Brazil’s President Luiz Lula da Silva and WHO chief Dr Tedros Adhanom Ghebreyesus urged leaders gathered on the shores of Lake Geneva to get the “benefits sharing” annex of the deal signed with a “sense of urgency.”
The Pandemic Agreement, which seeks to ensure the world is better prepared for the next global outbreak, was agreed last year but a vital element of it was deferred because of arguments over its wording. It is unclear, and perhaps unlikely, that a truly global agreement on benefits sharing can be reached.
Nevertheless, an agreement between the remaining 192 member states of the WHO is possible and would represent a major step forward. “Every month this annex stays unfinished is a month the world is less ready than it could be, and people are less safe than they deserve to be,” say Mr Lula da Silva and Dr Tedros. “Finalising this Agreement, through a shared commitment to one another, is our collective promise to protect humanity.”
The epidemic, caused by the rare Bundibugyo strain of the virus, for which there is no approved vaccine or specific treatment, was declared on May 15. It has since spread across Ituri, North Kivu and South Kivu, regions marked by insecurity, displacement and cross-border movement.
The Democratic Republic of the Congo (DRC), also known as the DR Congo, is situated in the central African region. With a population of around 124 million people, it shares borders with the Republic of Congo and Angola to the south, the Atlantic Ocean, and the Central African Republic and South Sudan to the north, and also with Uganda, Rwanda, Burundi, and Tanzania (across Lake Tanganyika) to the east, and Zambia and Angola to the south.
By Adedapo Adesanya
The National Health Insurance Authority (NHIA) says the number of Nigerians enrolled in health insurance has risen to more than 22 million.
The Director-General of NHIA, Mr Kelechi Ohiri, said this resulted from the implementation of the mandatory health insurance, which has gained momentum nationwide.
He said this on Wednesday at the Annual General Meeting of the Nigerian Association of Insurance and Pension Editors (NAIPE) in Lagos.
Mr Ohiri said enrolment had increased to 22.03 million, representing a 35 per cent year-on-year growth, attributing this to stronger collaboration with state social health insurance agencies, ministries, departments and agencies, organised labour, employers, the private sector, and the gradual implementation of the mandatory health insurance provisions of the NHIA Act.
He said that the country had moved beyond policy formulation to delivering measurable improvements in healthcare access, service quality and consumer protection in line with the federal government’s health sector reform agenda.
According to him, Nigeria already has the necessary policies and legislation to achieve Universal Health Coverage, positing that the key challenge was effective implementation.
“The decisive variable is now implementation- consistent, rigorous and accountable execution that converts political commitment into healthcare access for real Nigerians,” he said.
Mr Ohiri said that the transition from the former National Health Insurance Scheme to the NHIA had strengthened regulation, consumer protection, accountability and strategic purchasing, while providing the legal and operational framework for achieving Universal Health Coverage.
He added that improving the experience of enrollees remained central to the Authority’s reform agenda.
According to him, NHIA has strengthened its complaints management system, introduced faster resolution timelines, and intensified compliance monitoring of Health Maintenance Organisations (HMOs) and healthcare providers.
He further added that NHIA had sanctioned facilities that failed to meet the required standards, adding that his organisation had resolved 3,878 complaints, representing an 87 per cent resolution rate, while 95 per cent of the cases were concluded within prescribed timelines.
Mr Ohiri noted that more than N14.2 million had been refunded to enrollees, while non-compliant healthcare facilities had been sanctioned.
He said NHIA had also introduced service standards, including a one-hour treatment commencement target for enrollees requiring urgent care, to improve access to timely and quality healthcare services.
The NHIA boss further disclosed that capitation payments to healthcare providers had been increased by 93 per cent.
He said fee-for-service reimbursements rose by 378 per cent to enable providers to invest more in personnel, equipment and infrastructure.
According to him, 7,592 healthcare facilities have been assessed under the SafeCare quality framework as part of efforts to institutionalise continuous quality improvement across the country.
Mr Ohiri also highlighted interventions targeted at vulnerable groups, including support for more than 48,500 pregnant women, expanded maternal and newborn healthcare services, the Vulnerable Group Fund, and improved access to healthcare for pensioners and retirees.
He said Universal Health Coverage could only be achieved if every Nigerian, regardless of income or location, had access to quality healthcare services.
By Modupe Gbadeyanka
The new one-hour authorisation response time ultimatum policy introduced by the National Health Insurance Authority (NHIA) has received the full backing of SUNU Health Nigeria Limited.
This policy was introduced by the agency to ensure enrollees get prompt approval codes to access care.
Healthcare service providers have been urged to report any Health Maintenance Organisation (HMO) that violates this initiative through an email, with the HMO in copy and a timestamp attached as evidence of the request. They may proceed to offer services to enrollees thereafter.
Speaking at the company’s second-quarter Providers’ Forum for the Lagos-Ogun region in Lagos recently, the chief executive of SUNU Health, Dr Moyosore Olomola, expressed optimism that this policy would improve healthcare delivery in the country, especially for enrollees, who crave quality service.
At the event themed Improving Quality and Access to Care Through Stronger Provider Network, and held at the Nigerian Institute of Medical Research (NIMR) in Yaba, Lagos, Mr Olomola reaffirmed the HMO’s commitment to operating within legal and operational frameworks to guarantee adequate care for enrollees.
“Access to care and quality of care remain key priorities in our healthcare systems. We know quite well that deliberate collaboration, strategic partnerships, and a shared commitment to excellence are required to achieve these priorities.
“A strong provider network is doubtless the backbone of any effective healthcare system. It ensures that our mutual enrollees receive the right care, at the right time, in the right place, and at the right price,” Mr Olomola, represented at the programme by the organisation’s Chief Operating Officer (COO), Dr Faith Nwachi, stated.
He further assured that SUNU Health would strictly adhere to the one-hour authorisation limit, stressing that this aligns seamlessly with one of the organisation’s core values—promptness and its corporate slogan, Humanity is the centre of our initiatives.
In a bid to further improve access and quality of care, SUNU Health also demonstrated its new operational software and Mobile app, aptly named SUNU Legacy.
Also speaking at the event, the NHIA Lagos State Coordinator (Ikeja), Dr Bethuel-Kasimu Abraham, noted that the forum’s expected outcome is to significantly reduce delays in accessing medical care.
Other key expectations include ensuring continuity of care, improving patient outcomes, and strengthening accountability among HMOs.
Addressing specific pain points faced by enrollees, the NHIA Ogun State Coordinator, Mr Dare Adefeso, acknowledged that the agency had received complaints regarding out-of-stock drugs and the discrimination of enrollees by certain providers.
He affirmed that the NHIA is actively addressing these issues, stressing that moving forward, every facility must ensure enrollees are properly catered to regardless of their status, provided they have an active health insurance plan.
Corroborating the long-standing legacy of SUNU Health, the Ogun State Director of the National Orientation Agency (NOA), Mrs Aishat Tiamiyu, shared that her agency is responsible for public information dissemination and has been enrolled with SUNU Health for over 25 years.
Commending the HMO’s stellar service over two decades, she called for the immediate enrollment of new NOA staff into the scheme.
The Providers’ Forum remains one of the strategic channels employed by SUNU Health to consistently engage healthcare providers, understand their operational challenges, introduce new software updates, and solidify partnerships aimed at fostering premium healthcare delivery across Nigeria.
