More than 50 countries have missed the World Health Organization’s (WHO) target for 10% of their populations to be fully vaccinated against Covid-19 by the end of September.
The majority are in Africa, where the WHO’s overall figure for fully vaccinated people is currently 4.4 percent.
In the UK, nearly 66 percent of the total population has been fully vaccinated, 62 percent in the EU, and 55 percent in the US.
Which countries have not reached 10% target?
Many, but not all, are low-income countries struggling with vaccine supply and health-care infrastructure issues.
Yemen, Syria, Iraq, Afghanistan, and Myanmar are among those affected by conflict or civil unrest, while others, such as Haiti, have been hit by natural disasters, making the task of distributing vaccines extremely difficult.
However, wealthy Taiwan, whose vaccine programme has been plagued by delivery delays and other issues, is still only at 10%.
Vietnam, which had some of the lowest numbers of coronavirus cases in the world until recently, has also fallen short of the 10% target.
Only 15 of Africa’s 54 countries have reached the 10% target. Half of the continent’s countries have vaccinated less than 2% of their population.
Some larger countries with large populations fell far short of this goal. Egypt has only about 5% of its population fully vaccinated, while Ethiopia and Nigeria each have less than 3%.
Burundi and Eritrea are the only two African countries that have yet to implement vaccination programmes.
“Many of [the more highly vaccinated] countries are upper-middle or high-income countries that have obtained vaccines directly from manufacturers,” says WHO Africa regional director Matshidiso Moeti.
Why has Africa fallen behind?
African states relied on a combination of bilateral deals, donations and the Covax vaccine-sharing scheme to get their programmes started.
Countries struggled to get supplies through Covax earlier this year, but the situation improved in July and August.
At the G7 summit in the United Kingdom in June, wealthy countries announced donations to Covax – or directly to African nations.
There were further promises made at the UN General Assembly this month, when the US said it would donate another 500 million doses of Pfizer vaccine on top of what it’s already pledged.
Recent research on vaccine supplies in the G7 and the EU calculated that of more than one billion doses those nations had pledged to donate, less than 15% had so far been delivered.
“We need pledges of doses from wealthier countries to materialise now,” said Richard Mihigo, regional director of the WHO for Africa, on September 30.
The WHO previously estimated that the continent would require approximately 270 million vaccine doses to reach the target of 10% fully vaccinated by the end of September.
By the end of the month, it had received 200 million doses, leaving it 70 million doses – or nearly 25% – short of the target.
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What has caused vaccine shortages?
The most serious issue confronting the Covax scheme, on which many African countries relied, was its reliance on vaccines manufactured by the Serum Institute of India, the world’s largest vaccine manufacturer.
In April, India halted vaccine exports in response to its own urgent needs, and other manufacturers encountered difficulties ramping up production.
Wealthier countries had signed contracts with manufacturers for potential vaccines as early as July 2020, even though they were still in development and trials.
Manufacturers prioritised them, making it difficult for the Covax scheme, the African Union, and individual countries to obtain doses.
Earlier this month, a Covax statement on supply forecasts for the remainder of this year and early 2022 stated that the company was lowering its estimate of the number of doses it expects to receive.
It cited export bans, but also issues with ramping up production quickly enough and regulatory approval delays for some vaccines.
India has announced that it will resume some exports in October, with a focus on Asian countries and the Covax scheme (though it is unclear how much).
“When countries share doses, we have to ask them to share them with a longer shelf life,” says Ayoade Alakija of the African Union Vaccine Delivery Alliance.
The former UK prime minister, Gordon Brown, has called for urgent action to ensure that millions of unused vaccines stockpiled in wealthy nations don’t go to waste.
How much vaccine is needed in Africa?
The WHO hopes to have 40% of the world’s population fully vaccinated by the end of 2021.
However, Covax has already reduced the number of doses it hopes to deliver to Africa by then, from 620 million to around 470 million.
That will be enough to fully vaccinate only 17 percent of Africa’s population, with an additional 500 million doses required for African nations to meet the 40 percent target by the end of December.
“At this rate, the continent may only reach the 40% target by the end of March 2022,” says Ms Moeti.
Some countries are also concerned about vaccine hesitancy.
It’s hard to quantify the impact it may have, but a South African study showed that while there was an overall drop in hesitancy in the population as a whole, it had risen among 18 to 25-year-olds.