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Making the most of Africa’s pandemic dividend




THE Covid-19 crisis brought a significant increase in government and multilateral investments in public health in Africa. If leveraged appropriately, these funds could substantially boost the continent’s capacity to respond to future health emergencies, endemic diseases, and pandemics.

Vaccinating African populations against Covid-19 has proved a difficult feat. Whereas the continent once grappled with vaccine shortages, it is now facing a shortage of attention. The pandemic is widely perceived to be over, and some commentators now argue that African countries should lower their Covid-19 vaccination targets and direct their resources toward more urgent priorities, including other disease outbreaks (such as Marburg virus disease and Ebola) and routine immunisation. This would be a mistake.

While current Covid-19 vaccines have done less to reduce transmission than one would have hoped, they significantly reduce the severity of the illness, resulting in lower hospitalisation rates. This is particularly important in Africa, where those who are hospitalised with Covid-19 are significantly more likely to die than those hospitalised with the disease elsewhere. Yet only three African countries have reached the World Health Organisation’s vaccination target of 70% of the population, with the average across the continent standing at just 24%.

But mass vaccination is bigger than Covid-19. The pandemic brought a significant increase in government and multilateral investment in public health. The World Bank provided US$39 billion in new financing, the Mastercard Foundation another US$1.5 billion, and the European Union about US$113 million. These sums have been accompanied by global contributions through the Financial Intermediary Fund for Pandemic Prevention, Preparedness, and Response, which has allocated US$1.3 billion. African governments have also made large contributions.

If leveraged appropriately, these investments could substantially boost Africa’s capacity not only to end the Covid-19 crisis, but also to respond to future health emergencies, endemic diseases, and pandemics. But this “pandemic dividend” can be realised only if the continent remains committed to vaccination. If governments begin to roll back or redirect funding, the returns on pandemic investments could prove temporary.

One such return has been the rapid establishment and strengthening of systems for procuring, storing, and delivering vaccines. Africa has developed regional pooled procurement mechanisms for vaccines and other medical products, expanded and strengthened its cold-chain systems, and streamlined logistics.

A continued commitment to reaching vaccination targets for Covid-19 will help to accelerate and entrench this progress, translating into greater support for vaccination against influenza, human papillomavirus (HPV), and hepatitis B, for which there are currently limited programs. It will also enable the delivery of emerging vaccines against deadly endemic and emerging infectious diseases – such as malaria, tuberculosis, and Lassa fever – at scale. And it will help to safeguard the WHO’s Essential Programme on Immunisation initiatives for children, by enhancing routine vaccination systems and facilitating the adoption of integrated approaches.

But the Covid-19 pandemic may support future vaccination in an even more fundamental way. The crisis highlighted the need to foster vaccine demand in a way that is evidence-based, people-centred, guided by a tailored strategy, and integrated into a country’s long-term immunisation plans. The Africa Centres for Disease Control and Prevention’s Saving Lives and Livelihoods initiative, together with many African governments, have been investing in the development of such systems.

Continued efforts on mass Covid-19 vaccination will spur progress in refining these systems. It will also help to foster public trust in vaccines, thereby boosting demand for other vaccines in the future.

Pandemic investments have also catalysed progress in the adoption of health technologies, which have facilitated major improvements in data collection. Until recently, most African countries did not gather data on priority health groups or have systems in place to record data digitally. But many, such as the Gambia and Uganda, have now implemented vaccine-recording and health-registration systems. The accurate and real-time data these systems provide can inform vaccination strategies, improving countries’ ability to reach priority groups.

community-health platforms that were created to help deal with HIV/Aids Similarly, in Nigeria, a contact-tracing workforce established for polio was used to help manage the Ebola outbreak.

Covid-19 poses a serious enough threat to merit a continued commitment to vaccination. But the short-term benefits are just the beginning. Mass Covid-19 vaccination campaigns can also catalyze progress in a wide range of crucial areas, from vaccine procurement to health-care delivery, thereby boosting the continent’s ability to prevent and respond to future health emergencies. This is the pandemic dividend, and Africa must not squander it.

About the writers: Ebere Okereke, a senior technical adviser at the Tony Blair Institute for Global Change, is an honorary senior public health adviser at the Africa Centres for Disease Control and Prevention and an associate fellow at Chatham House.

Adam Bradshaw is senior Covid-19 policy adviser at the Tony Blair Institute for Global Change.–Project Syndicate.