East Africa got onto the global Covid-19 vaccination highway, with the arrival this week, of the first doses of the Oxford-AstraZeneca vaccine. Deliveries were made to Kenya, Uganda and Rwanda, setting the stage for extended vaccinations in the coming days.
The doses cover less than 10 percent of the target populations in these countries but they have been shipped under the moral assumption that vaccines are a global public good to which everyone rich or poor deserves access.
The other assumption is that limited as it is, the supply will be adequate to protect key population groups such as essential frontline groups such as health workers, without whose availability the pandemic would rapidly cascade into a wider social and economic crisis.
Ideally, there should be little worry over determining who gets the jab first. Being the last frontier of vaccination against common killer diseases, Africa, more than any region of the world, has better institutional memory of how to roll out a successful vaccination drive. The only difference in this case is that supplies are not universal, the available vaccines have tall logistical demands and target larger numbers than say, a polio vaccine aimed at under-fives.
In the context of the panic surrounding Covid-19, the key question is whether the recipient countries will be able to get their priorities right. The World Health Organisation has provided a logical framework for eligibility. With perhaps one exception however, and in light of the limited supplies, one cannot help but doubt about how this initial vaccination will unfold in the real world.
Logistical hurdles that could lead to spoilage of the delicate formulations, theft, queue jumping and hoarding are all possible especially given how Covid-19 testing has been handled. Because it was not systematic but mostly random, Covid-19 testing data is of limited value in guiding where the vaccine should go at this stage.
In the context of limited resources and overstretched vaccine supplies, more deliberate, community-wide testing should be undertaken to generate the data that can guide pin-point interventions in the coming phases.
In line with WHO recommendations, all countries have lined up health workers, teachers, members of the armed forces and the elderly as priority groups. Protecting these groups is important because without them, essential public services would collapse.
Yet in retrospect, nobody appears to have remembered that long-distance truck drivers, a key element of transmission in the initial stages of the pandemic, are actually frontline workers who deserve to be ahead in the queue. Nor have groups that work under minimal to no social distancing scenarios, such as market workers been considered under the first phase.
In East Africa, Tanzania, Burundi, South Sudan, Somalia and the Democratic Republic of Congo are yet to get the doses. This factor needs to be considered when community-wide vaccination is rolled out.
With people crisscrossing largely informal borders, herd immunity will not be achieved without a campaign that covers entire regional groupings.
Finally, having a vaccine is one thing, its acceptance by the public is another. With all the falsehoods circulating about the jab and a general mistrust of government in Africa, the importance of public information campaigns cannot be overstated.