Remarks by WHO Regional Director for Africa, Dr Matshidiso Moeti
I’d first of all like to acknowledge and greet you and greet Dr Cravioto who joined us from Latin America and greet all the Members of the Regional Immunization Technical Advisory Group (RITAG) and the partners and colleagues who have joined us on this line.
It is my great pleasure to welcome all of you to the RITAG meeting for 2021 and thank you for joining us for this important event and thank for you the time that you spent on reflecting on and advising us on some of the challenges that our Region is facing with regards to immunizing our populations, particularly our children and in this particular context of the COVID-19 which is a huge challenge.
As Helen has so eloquently said, I won’t talk about my state the fatigue. I think we are learning how to live with fatigue in extraordinary ways. Those of us who worked on HIV/AIDS, I think it’s the only period of my professional life that I can compare this to. It competes very well.
At the time of your meeting last November, when I had the opportunity to speak to you, there were positive phase three trial results for Pfizer’s COVID-19 vaccine which had just been announced. Now some months later, we have eight COVID-19 vaccines listed for emergency use by WHO, so that’s good news for all the efforts and the progress that has been made.
Globally around 3 billion have doses administered. This is a remarkable feat of the international scientific community, working with countries, working with partners, working with the private sector.
However, we have to acknowledge that African countries are now facing huge barriers in accessing the vaccines and that has been the case from the start due to many factors which I am sure you are going to discuss in some detail and you’ve already started to talk about this. It really boils down to limited supplies, inequitable distribution and massive failure of global solidarity, about which all of us have made so many speeches in the past.
So far only 46 million doses have been administered on the continent and Morocco accounts for around one-third of these doses. So, if you looked at continental numbers, you need to factor in the fact that Morocco has done better than any other country on the continent and to get a regional picture, we need to take out that data and see what’s been happening on the continent and in the Region.
So, you have multilateral solutions, I’m sure you are all aware of the COVAX Facility and I’d like to mention here the Africa Vaccine Acquisition Task Team (AVATT) established by the African Union to play their part on behalf of the governments, which I think was a real demonstration of leadership on the part of African governments.
These are very important elements and starting points to improving equity and facilitating coordinated distribution. So, it will be useful to hear your perspectives as to how we can keep strengthening these efforts. I’m certain you are aware of some of the media coverage and the comments about the COVAX Facility. Was it ambitious enough from the start? What was it intending to do? And is it part of the inequity or not? These are things that we can debate. Philosophically, the fact of the matter is that there have been huge challenges on this.
We just heard announced decisions by some countries especially the EU countries to proceed with COVID-19 vaccine passports focusing on vaccines that are approved by the European Medicines Agency and this is having repercussions in African countries, including vaccine-brand hesitancy you might say. We have seen this among our own who are very connected to European countries for one reason or another. Many staff have family members there and people are used to going to see these family members.
So, they are very reluctant to take a vaccine which is not approved so to speak by the European Medicines Agency and there is also confusion and misinformation. We are in communication with the EMA through our headquarters and from the Regional Office just in a way trying to clarify this situation and trying to advocate for WHO’s facility to be of use to Member States worldwide and also to advocate by the way for the International Health Regulations related issues of this action by the European countries.
So, your thoughts on this and your support to clarify the issues in ways that political leaders and communities can understand, will help to address some of the problems that we are facing. We’ve had WHO representatives summoned by governments who understandably were with the EU Member States Ambassadors celebrating the landing in their countries of the COVAX-supplied vaccines, only to understand that people vaccinated with these can’t get into their countries.
All of this is hugely related to several factors – the global supply distortions experienced during this pandemic have really brought home the many issues including the need for self-reliance and more equitable supply chains.
We all, probably, have heard the recent announcement that an mRNA vaccine technology transfer hub will be established in South Africa with the intention of also doing the same in Senegal and in Rwanda. This is an exciting example of political will quickly translating into action.
We have to begin something to solve the immediate and extremely urgent problem and we think it’s a very good start to moving in a certain direction. Scaling-up local production on the continent really will require the kind of strong partnerships across sectors, with the private sector, with pharmaceutical companies, with different governments and of course with local companies that are capable of producing. I look forward to your advice, as to ways to move this agenda forward as quickly as possible.
I’m certain in previous meetings we have discussed the issue of local production of vaccines being on the agenda of the African Union. Local medicine production for many years has been moving relatively slowly. We support the regulatory side which is very important in this effort. Your thoughts on this too will be very helpful.
Beyond the immediate and magnified attention on COVID-19 as Helen said, there are continuing major challenges in routine immunization that still require collective action, require innovations and strategizing. Our coverage of DTP3 remains stagnant, as it has for quite a few years. So, what is it that’s going to make the difference here? I’m certain we discussed this previously. What can we take on board of the current experience with COVID-19, with other diseases, other health initiatives, to incorporate into our strategies on immunization.
There is exciting news about the pilot implementation of the RTS,S vaccine against malaria that is showing huge promise in reducing illness and deaths caused by this disease. And here again, there needs to be discussions about local production. How can we make the link between that development and what’s happening around COVID-19 and understanding that our Region, and the continent is going to be the major beneficiary and user of malaria vaccines? We may as well be thinking ahead to local production on the continent.
Turning now to polio, several countries have started to use the novel oral polio vaccine (nOPV2) in response to outbreaks of circulating vaccine-derived poliovirus type 2 and so far more than 16 million doses have been administered. I have started working with our partners, Gates Foundation and UNICEF, convening meetings of Ministers of Health with their senior staff and our partners, in recent weeks to advocate for them to conduct high-quality synchronized campaigns in the fourth quarter of this year. We are hearing a very positive response from all the ministers that I’ve had discussions with, of course highlighting that we all need to work very hard on this. Some of the countries have problems with conflict, inaccessible populations, mobile populations and we have to see how to support all of this.
We are in the phase of transitioning as an African Region in terms of support for our polio work with significantly reduced funding following our success. We have to acknowledge the decision was reached by the Global Polio Eradication Initiative to focus on the remaining endemic countries of Afghanistan and Pakistan and Africa has been asked to focus on the outbreaks of vaccine-derived poliovirus and then transition essentially. So, we are advancing with arrangements for that, including integrating the teams working on polio surveillance and surveillance of other vaccine-preventable diseases. They’ve been together as we try to take the administrative and human resources steps related to this, which thus presents a challenge in terms of the motivation of our teams, without having to think about furthering their careers while working extremely hard on our vaccine programmes as we’ve outlined.
So, across a range of areas, progress is happening, but we need accelerated action to increase coverage, particularly to reach zero-dose children, to boost vaccine confidence and to invest in sustainable long-term approaches for vaccine production and access in our Region.
The global Immunization Agenda 2030 provides a framework to harness new solutions and to shape country-specific strategies towards meeting global and regional targets. And so, we need to look at that and see how it relates to the specificities of our Region and we will very much be looking forward to your advice.
So, over the next two days, I ask that RITAG members and participants create the space to put forward innovative approaches and to discuss interventions to get immunization back on track in African countries.
And I’d just like to end by assuring you that as WHO, we are committed to working with all our Member States and partners to ensure universal access to immunization, including COVID-19.
I thank you again for devoting your time, your expertise and your insights to supporting and advising us on our work.
I look forward to working with you to implement the outcomes of your discussions, as we really have an amazing tool in vaccines to protect people and we need to do our best to make sure it is delivered equitably, urgently and quickly to all the target groups that need vaccines.
Thank you very much.