Beyond the great vaccine divide: how African leaders are tackling vaccine hesitancy to capitalise on new supplies

The IMF’s latest World Economic Outlook highlights how the “great vaccine divide” continues to impede Africa’s recovery. Undelivered donation pledges, the launch of boosters, India’s export ban and an overreliance on the global vaccination initiative COVAX culminated in half of the continent vaccinating less than 2% of their population. This is well below the World Health Organisation’s target of 10% vaccine coverage by October. But an improved supply outlook provides cause for cautious optimism. The question remains whether this can materialise into a more effective vaccination rollout across the continent.

The number of covid-19 vaccines that arrived in Africa nearly doubled from 103m to 200m doses between August and October, driven by supplies from the US, China, and the UK. India is expected to resume exporting vaccines at the end of October, while President Joe Biden and President Xi Jinping have announced donation pledges of 1 billion and 2 billion doses, respectively.

Although the supply challenges are not over, this represents progress. However, vaccine hesitancy remains a notable hurdle to the rollout. Anxieties and uncertainties about the safety of vaccines underlie scepticism across the continent, with as few as 50% of the population willing to take the jab in Cote d’Ivoire, Ghana, and Zambia. Misinformation, for which the WHO has coined the term “infodemic”, only adds to public concern. The Ghanaian Ministry of Health website states “there is no vaccine to protect against this family of viruses” to encourage people to continue with hand-washing and social distancing – a glaring example of poor communication. In Kenya, meanwhile, the government is tracking 90,000 people who have skipped their second jabs under the impression that mixing different doses can provide a greater level of immunity - a measure not currently approved by Kenyan health authorities and warned against by the WHO.

To overcome this hesitancy and ensure that vaccines not only enter Africa’s borders but also its citizens’ arms, several countries have implemented new strategies.

Kenya is focusing its efforts on tackling the issue of misinformation. The Media Council of Kenya, on October 4th, launched a new covid-19 information portal, aimed at providing media professionals and the public with a one-stop shop on factual and verifiable information. The same week, the Kenyan government launched a campaign specifically aimed at raising awareness among public service transport operators.

Other countries are already at different stages of considering quasi mandates. Having had a month to comply with a directive to get vaccinated, unvaccinated civil servants in Zimbabwe can no longer access their offices and must forego their salaries. From December 1st, Nigerian government employees will similarly be required to show proof of vaccination or a negative PCR test to access their offices. In Togo, too, parliament approved vaccination passports which need to be presented to enter public buildings, hospitals, banks, or universities, while Cote d'Ivoire is mulling the adoption of a French-style health pass. These measures appear to be as unpopular in countries where vaccines are scarce as they are where doses are plentiful, such as the US. For example, the Zimbabwe Congress of Trade Unions has taken the government to court, claiming that the mandate infringes on workers’ rights. Nonetheless, they tend to help overcome doubts and boost vaccine uptake.

Meanwhile, Zambia’s newly elected president Hakainde Hichilema relaunched the country’s vaccination programme on October 7th, announcing that bringing the virus under control was crucial to the economic recovery. Hichilema appointed a covid-19 advisor, urged leaders from all sectors to raise public awareness, and announced a more realistic vaccination target of 30% by December 2021, down from 70%. Although fully vaccinated Zambians have risen from 2.36% of the population to 2.63% since relaunching the programme, there remains a long way to go to achieve the new target.

So, improved supply does not guarantee a successful vaccination campaign given underlying vaccine hesitancy amid a proliferation of misinformation. But better information provision, quasi mandates and renewed vaccination programmes illustrate the determination of many African leaders to ensure the new vaccines are used more efficiently. The early signs are positive, but whether they continue to be effective remains to be seen.