The request marks a shift in the challenges Africa faces — from not having enough doses to not being able to quickly get those doses into arms.
“It’s not to say that donations are not important,” he said. “It’s just to say let’s not just do it at once.”
Nkengasong said the available dose supply is no longer the main barrier to immunizing the continent. As the supply of doses has become more predictable, African leaders have been able to better plan distributions and make sense of how many they need for a certain period of time.
“It’s like buying a whole basket of foods and just to put it on your kitchen counter,” he said. “If you cannot use any, it will rot. But if you do that in smaller pieces, then you still get to the end goal with the same amount of food on your kitchen table — but at least you don’t have any waste.”
The Global Alliance for Vaccines and Immunizations has begun working to tailor Covid-19 vaccine dose supplies to countries’ needs — trying to offer choices in which vaccines are sent and when they’re administered.
“At the time of a pandemic, we don’t want waste. There’s always waste in vaccines campaigns, but we want to minimize that as much as possible,” Seth Berkley, the CEO of Gavi, said in a recent interview with POLITICO. “Early on, people wanted whatever they could get. But now we’re moving to a much more sophisticated place.”
Gavi has acknowledged the give-and-take between donors and recipients of Covid-19 vaccines, noting the shifting supply and demand.
“COVAX has supplied over half a billion donated doses to low income countries, and not a single dose has been shipped without first being accepted by the recipient country,” a Gavi spokesperson said in response to the Africa CDC’s plan. “Dose-sharing will remain an important aspect of the global vaccination effort as we strive to close the vaccine equity gap. It is important, in this respect, that we ensure supply remains aligned with demand and that shipments to countries continue to match country needs and national vaccination strategies.”
Even though there is a risk of new Covid-19 variants and changing demands in the coming months, Nkengasong said he was confident in the decision to delay future shipments.
The logistics of getting doses into arms — and vaccine hesitancy in many communities — are now the main challenges the Africa CDC faces. Though the testing supply has often been unreliable, Africa has reported nearly 250,000 deaths from Covid-19 and over 11 million cases, according to the Africa CDC — a testament to the need through the continent.
“The greatest barrier you have now is: how do you provide enough logistics to vaccinate at scale?” Nkengasong said.
The warehouses to hold vaccines when they arrive, cold storage capacity throughout vaccination sites and availability of needles, syringes and disinfecting swabs are all logistical challenges that must be solved, he said.
“There are scenarios where a government will deliver vaccines to a remote area, but when you go there, you realize that you just lack a needle to get the vaccines into arms,” he said.
This comes as the Biden administration is also looking to focus on last-mile vaccination strategies, POLITICO reported last week. As the supply of doses picks up around the world, leaders are focusing on how to get shots from the tarmac to the unvaccinated.
Reluctance to take the vaccine is another key issue for Africa at this point in the pandemic, Nkengasong said. Younger populations in particular are not seeing the virus as a threat and are not motivated to get immunized.
Though Nkengasong said the supply of doses is not a major challenge, he still said Africa’s ability to manufacture doses is important — not just to fight Covid but also future diseases.
He expects to ask for donations to resume in the second half of this year.
Erin Banco contributed to this report.