Charm offensive with a vaccine that still needs testing

Charm offensive with a vaccine that still needs testing

With 200,000 doses of a vaccine, whose effectiveness against the Covid-19 South African variant has yet to be tested, Mozambique's Government clai

With 200,000 doses of a vaccine, whose effectiveness against the Covid-19 South African variant has yet to be tested, Mozambique’s Government claims gains in the fight against the coronavirus pandemic. An investigation by the Centre for Investigative Journalism (CJI) found that the country, in addition to the Chinese windfall, will only be able to benefit from more vaccines in late 2021. Meanwhile, another lobby, which the CJI has started tracking, intends to introduce in the country, until the end of June, the Oxford/AstraZeneca vaccine, which has proved ineffective against the 501Y.V2 variant. CJI learnt that this is the variant that mostly circulates in Mozambique.

While health workers are immunised, Mozambique must consider immunising more than 2,691,119 citizens aged over 50, who account for 76% of coronavirus deaths in the country. Prime Minister Carlos Agostinho de Rosário is optimistic about success in the immunisation of health personnel, but warns that “the vaccine must be seen as a complementary measure in preventing Covid-19”. Mozambique has a solid experience to deal with this process, not only because of its ability to rollout vaccines, but also because of its extensive experience with regard to immunisation against other diseases throughout the country.

CJI spoke to several health professionals and many are concerned about the vaccine’s effectiveness. At least four out of 10 say that matters were in their hands, they would not be vaccinated. Mostly, fear arises from the fact that, in their opinion, the absence of side effects is not guaranteed. Furthermore, the belief in the health sector is that it would be much more effective to use the vaccine tested in South Africa, for very natural reasons.

CJI knows that, first, from an epidemiological standpoint, the country needs to test the vaccine beforehand. It is premature to move towards a vaccination campaign without a greater certainty of its effectiveness. However, the executive in its powerful cosmetic action presents something that is not known whether it will work as a great solution for health professionals and the country.

The Government is unable to bear the costs for vaccines to be purchased and to reach all regions of the country, as is the case with vaccination campaigns where there is always a donor. In fact, the Extended Vaccination Program (PAV) has an advanced technological system for the control and distribution of vaccines, albeit on a small scale. However, the great challenges start with the availability of the vaccine, but also with the real existence of databases that allow to adequately schedule the stages of vaccination in a transparent manner. Thus, several players have legitimate doubts. Journalist Armando Nenane wrote on his Facebook page that the “vaccination plan was being disseminated through unofficial means and using unauthorized spokespersons who tend to pollute public opinion”.

A public health specialist pointed out that in his opinion the number of vaccines  “is low for the needs of the main urban centres”. “Despite the fact that the process has to match the needs and available resources, and taking into account the corresponding physical infrastructure, an immense effort will be necessary to meet the goal of inoculating 20% of the population, considering the premise of protection and respect for the needs health sector ”, he said. For their part, others doctors indicated as challenges the avoidance of the politicisation of the vaccine, the expansion of the installed capacity, the update of databases and not to neglect other vaccination plans or the provision of health services, as well as to monitor the possible emergence of vaccine sale cartels.

Logistics

In terms of logistics, a CISM (Manhiça Health Research Centre) researcher also saw many challenges and said that the main thing in this field is to operate under scarcity and uncertainty. “Today, no developing country knows when, nor clearly how many doses will arrive, and the demand exceeds the supply by several times. This condition requires a different planning that contemplates different scenarios to assess which is the best option in the midst of geographical conditions like ours plagued by natural disasters. It is not the same as vaccinating in Maputo, for example, as in Niassa, taking that Maputo and Matola account for a good percentage of the population.

Another key point is to minimize waste. “A conventional vaccination campaign works with a logic where the loss of doses, not a desirable scenario, prioritises the individual’s health. This logic is appropriate in a context of abundance. In a pandemic situation with insufficient doses, collective health should prevail over individual health and that changes the effort to be made, both in the macro and micro perspective ”, he stated.

In this regard, he suggested that the vaccination process be “productive, fast, efficient and accurate”. “We cannot move at a rate of 40 vaccinations a day, this is not suitable for an emergency situation, we must design processes for each centre to deliver thousands of doses per day. We should have few vaccination centres located in such a way as to avoid wastage of doses and ensure a better control and coordenation between supply and demand. We have to have the vaccine, but 200,000 doses is playing around.”

“At this stage, I do not believe that the Government will meet the goal of immunising 3,000,000 Mozambicans”, he warned. However, Mozambique has applied for access to the Covid-19 vaccine, through a global distribution scheme co-led by the World Health Organization, giving it the option to buy doses for at least 20% of its population , President Filipe Nyusi said. The problem for the experts is not availability, but distribution and timing.

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