The low susceptibility of the South African virus variant to vaccines creates problems in southern Africa. Photo: Global Panorama, flickr


Mutated coronavirus creates challenges for vaccine coordination in southern Africa

Escalating spread of a mutated, more contagious variant of the coronavirus increases the need for rapid and effective vaccine distribution in southern Africa. This at the same time as uncertainty about the effectiveness of Astra Zeneca's vaccine against the mutated virus version is testing healthcare and coordination projects.

After a turbulent start to the year, the vaccine coordination initiative Covax announced the long-awaited news that the delivery of vaccines to low- and middle-income countries around the world has begun. Already in the initial stage, the distribution project was faced with setbacks. Several obstacles, such as insufficient funding, a creeping market supply and the hoarding of vaccines in high-income countries, have hampered the coordination project. In southern Africa, a new virus mutation, first discovered in South Africa, creates further trials. 

 - Our staff is witnessing the serious effects of the second wave in southern Africa, where healthcare systems and their staff are struggling to cope with the influx of patients. In South Africa, there are not enough healthcare staff in many of the worst affected areas and the hospitals there have previously struggled to be able to provide care, says Philip Aruna, responsible for MSF's efforts in southern Africa i their report.

Study results point to reduced efficiency

Preliminary results from a smaller, South African study shows that the Astra Zeneca vaccine has only limited efficacy against mild to moderate symptoms of the mutated virus. In a press release before the WHO that the organization's expert group SAGE recommends continued use of the vaccine, even in countries with widespread spread of the mutated virus. SAGE draws attention to the fact that the study shows that there is an urgent need for a coordinated effort to monitor and evaluate the impact of new virus variants on the effectiveness of vaccines. As the study was conducted on a small scale with only younger participants with a mean age of 31 years, illuminates WHO the need for further studies to determine the level of efficacy for more severe symptoms. A study published in March in the New England Journal of Medicine also points to reduced efficacy of the vaccine. The Swedish-British vaccine manufacturer Astra Zeneca states that their vaccine is believed to protect against serious symptoms despite the reduced effectiveness. The company believes that the vaccine can therefore still have a central role in relieving healthcare in areas with widespread spread of the mutation. Astra Zeneca is now working with Oxford University to adapt the vaccine to be more effective against the South African virus variant, reports CNN.

The vaccine is a key component of mass vaccination programs worldwide and is particularly relevant for low- and middle-income countries, as it is cheaper and easier to transport than several of the competing vaccines. Of the 337 million doses that Covax aims to distribute, up to 336 million doses consist of Astra Zeneca's vaccine. Problems with the vaccine can help widen the gap between the world's richest and poorest countries, writes CNN.

Southern Africa is hard hit

The mutation has now become the dominant virus variant in southern Africa. Since the start of the pandemic, South Africa, which has been hit hardest on the African continent, has reported up to 1.5 million cases of the coronavirus. About 90 percent of those infected are believed to carry the virus mutation. MSF reports that the situation in Mozambique, Swaziland and Malawi is also extremely acute. Healthcare is heavily burdened and the need for vaccines is critical.

- I had high hopes that the vaccine would change the situation we are in as a country. Many lose their jobs. I'm a medical student and we're really vulnerable to Covid-19. It was a disappointment to me when I heard that the effect of the vaccine was lower, tells an anonymous South African paramedic to the BBC.

South Africa and Swaziland stop the vaccine

South Africa has now sold its Astra Zeneca doses to 14 other countries in the African Union, reports Aftonbladet. Health Minister Zweli Mkhize expresses disappointment that the vaccine has not proved more effective, but confirms that the country has secured nine million doses of the Johnson & Johnson vaccine, which is believed to be more effective against the mutation. CNN writes that even Swaziland, which had expectations of being able to vaccinate 20 percent of the population via Covax, has announced that Astra Zeneca's vaccine will not be used. The country is waiting to administer the doses that have been received.

- A truly fair distribution of vaccines is not just about countries getting vaccines, but it must be the right vaccine that is adapted to the context and the virus variants that are most common in the country. Countries must also get vaccines on time, and at an affordable price. If the leaders of rich countries and the pharmaceutical companies do not prioritize this immediately, new pandemics of vaccine-resistant forms of the coronavirus risk emerging. And such pandemics are not counteracted by travel restrictions but by solidarity, says Tom Ellman, who is in charge of MSF's medical team in South Africa in the organization's report.

Healthcare in South Africa is heavily burdened and is struggling to limit the spread of infection. Pictured is Steve Biko Hospital in Pretoria. Photo: International Monetary Fund, flickr

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