Early predictions were wrong.
The continent of Africa has seen fewer deaths from COVID-19 in the last year than people initially projected, thanks to its early response to the pandemic.
The continent of 1.2 billion people has had roughly 4 million cases and 106,000 deaths, far below Europe, the Americas or Asia.
Dr. John Nkengasong, the director for the African Union's Africa Centres for Disease Control and Prevention, says one reason for the low number of deaths so far is Africa's young population — the median age there is about 20 years old, and the recovery rate is high.
But a year into the pandemic, African countries are met with newer, more complex challenges — like navigating inequities surrounding the vaccine, critical shortages in oxygen and staving off a variant that emerged in South Africa that has already managed to creep into dozens of other countries.
At the head of all this is Nkengasong, who coordinates COVID-19 response across the continent.
"Vaccines are just now beginning to arrive on the continent," he tells NPR. By one count, Africa has administered less than 2% of the more 300 million doses that have gone out already across the world.
Early on, Africa faced limited supplies as rich countries bought up available and future doses.
One program meant to close the gap in vaccine distribution is COVAX, an initiative in partnership with the World Health Organization to ensure equitable access to the vaccine, especially in low-income countries.
COVAX has a goal of delivering 2 billion doses to 190 countries within the next year. But Nkengasong says COVAX allotments alone will not be enough.
He places his hope in the African Vaccine Acquisition Task Team, a group set up by the African Union that has been working to secure millions more doses.
"The goal of that is to bridge the gap, to acquire vaccines through a continental approach. And we have actually secured about 270 million additional doses that will hopefully complement whatever amount of doses we are getting from the COVAX facilities," Nkengasong says. He's also working on bilateral efforts with the U.S., Britain and European countries.
As for actually getting those doses into people's arms, Nkengasong says the special cold chain storage requirements for the Pfizer and Moderna vaccines make rollout "problematic." Other vaccines, such as Johnson & Johnson, don't have the same requirements.
"We are hoping that the vaccine landscape will improve," he says.
"We need to be able to roll out vaccines through major cities and also expand into remote areas as quickly as possible. That requires extraordinary logistics and unprecedented efforts that we have never done on the continent. As a matter of fact the continent of Africa has never vaccinated more than 100 million people in one year, so this is going to be a historic effort."
Nkengasong also says it could take until the end of 2022 to reach their goal of vaccinating 60% of Africa's population, even with the right support and partnerships.
"At that point, I would feel comfortable to declare that the continent is back to normality," he tells NPR.
Farah Eltohamy is NPR's Digital News intern. Ayen Deng Bior and Christopher Intagliata produced and edited the audio interview.
ARI SHAPIRO, HOST:
Early predictions were wrong. Africa has seen fewer deaths from COVID-19 in the last year than people initially projected - just over 100,000 to date. I asked Dr. John Nkengasong why that might be. He directs the Africa Centres for Disease Control and Prevention, and he pointed to the continent's young population. The median age there is just about 20 years old.
JOHN NKENGASONG: Many people are being infected, but they are recovering from those infections. I think that is clearly one reason why we've not seen a lot of deaths.
SHAPIRO: When I asked what most concerns him right now, he said it's getting vaccines.
NKENGASONG: What concerns me the most is the inability to have handy access to a vaccine that we all know would be a game-changer in defining the course of the pandemic.
SHAPIRO: The continent is getting some help from the World Health Organization but not enough, he says.
NKENGASONG: As we speak, vaccines are just now beginning to arrive to the continent.
SHAPIRO: The WHO program called COVAX is delivering vaccine doses to less-wealthy developing countries, but it won't come close to the number of doses Dr. Nkengasong says Africa will need to vaccinate 60% of its 1.2 billion people. So the African Union is working to round up more doses, and then comes the challenge of distribution.
NKENGASONG: That requires extraordinary logistics and unprecedented efforts that we have never done on the continent. As a matter of fact, the continent of Africa has never vaccinated more than 1 million people in one year. So this is going to be a historic effort to be able to do a vaccination at the speed at which we expect it.
SHAPIRO: Plus the extremely cold storage chain that Pfizer and Moderna vaccines require could be a problem in parts of the continent with less infrastructure. While the U.S. looks at maybe getting back to normal by the summer or the fall, Dr. Nkengasong told me the African continent might not reach that point until the end of next year.
NKENGASONG: At that point, I would feel comfortable to declare that the continent is back to normal again.
SHAPIRO: Dr. John Nkengasong, director of the Africa Centres for Disease Control and Prevention, speaking from his office in Addis Ababa, Ethiopia.
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