Africa CDC’s John Nkengasong on a Vaccine Game Plan for the Continent and His Greatest Worry

 

This interview originally appeared at COVID HQ Africa and is re-posted here with permission.

 

John Nkengasong is the Director of the Africa Centers for Disease Control and Prevention as well as the WHO Special Envoy for Africa. In this Interview, Dr. Nkengasong discusses a range of issues, including his vision for vaccine distribution in Africa, and his greatest worry. 

Interviewer

Africa is in a second wave of the virus, what should we be doing?

Dr. John Nkengasong

Avoid gatherings, and continue face masking as much as possible. I think if we do all of those things, and increase our testing, then we at least have the public health measures in place. Second is to be aggressive with the vaccine. There is no way we are going to completely eliminate this without vaccination to achieve health immunity which targets 60% of the population. The third thing we need to do is to put in measures for care. That is essentially dramatically increasing oxygen. We need availability of oxygen because a lot of the mortality that we are seeing is because of the lack of very basic needs, like the lack of oxygen.

Interviewer

Why has the variant hit South Africa so hard and not the rest of us. Is it a matter of time?

Dr. John Nkengasong

I think the variant has hit South Africa hard because they are sequencing in a very systematic way. The hypothesis and assumption is that you already have this variant all over the continent. It is just that it is not being sequenced. Like now we know that we have the same variant in Botswana and Zambia, and I am sure, if it is sequenced, in Namibia, Zimbabwe, and Swaziland, too. You will see the variant across the continent. So it is just because South Africa has the tools and has a stronger sequencing system there. The same measures for the new variant apply: wear your mask, wash your hands, and sanitize. That will get rid of the variant.

Interviewer

What is your vision for the vaccination plan in Africa. How do you go about vaccinating 60% of a billion people?

Dr. John Nkengasong

I am happy you start with 60%. That is a target, and that is a target we believe will allow us to achieve community immunity or heard immunity. I think that is very important and the thing is that we truly don’t have a choice. We have to get ourselves into a mode where we use all means possible to get to that target in a very short period of time. So it is not a choice of whether we do it or not. We have to do it and do it at scale.

Now, what we need to do to get there is that we need to use a phased approach. If you look at the epidemiology of a pandemic a lot of infections are of course in a major city, that is where you start. You start with setting up vaccination centers which, of course, are tied to the health centre around them. Say, for example, in Nairobi i is very possible that you can put up 20 vaccination centers, which means 4 things you have to put in place:

• One, if you have a -70 refrigerator, back that up with a generator so that your vaccine does not suffer any shock when electricity goes off.
• Two, train your health care workers. I mean a lot of them so that doctors, nurses are all trained to deliver that shot.
• Three, create a register to track people, because remember all the vaccines that we have for now require that you vaccinate and then you come back after three to four weeks. So you really need a close follow up.
• Four, the community. Make sure that you intensify community vaccine literacy which means that the radio, the media, and social media are all engaged in explaining to the population why they must return to complete their second dose. Otherwise your loss that will follow out will be significant and your vaccine program will fail.

Do this for a few months, then other companies will come with their own vaccines that require normal cold chains like 2 to 4 degrees to 8 degrees and we can begin to use that to expand that into more and more areas of the country. Let’s not make this look like it is some rocket science, no. We have rolled out anti-retroviral therapy across Africa massively. We know how all these things work is just a question of devoting and applying ourselves to it.

Interviewer

What worries you the most?

Dr. John Nkengasong

What worries me most is that the continent doesn’t get its vaccination program in order in a timely fashion. That means we have to pursue an aggressive process not a passive process. If we are passive, our economies will continue to be shattered, the death toll would increase significantly and virus may become more widespread in Africa.

Next I would not be surprised that by the end of the year or in the middle of the year when Europe and the United States have finished their vaccination, they would issue a requirement that you will have to have a COVID-19 vaccine certificate to fly. That would become a tough thing for the continent of 1.3 billion people to move around.

Another thing is the lack of availability of oxygen on the continent. As you get more cases, more people are sick and they are going to the hospitals to seek care and overwhelming the hospitals. It would help if oxygen was available, and you can actually divert traffic from the hospitals to the local health centre. Availability of oxygen to manage mild to severe cases is very important as access to vaccines in a timely fashion is critical. I think those are the things that will begin to change as we manage the second wave of the pandemic.

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This article originally appeared at COVID HQ Africa and is re-posted here with permission. The views and opinions are solely those of the author(s) and do not purport to reflect the opinions or views of COVID-19 Africa Watch or any affiliated organization. The original article is available here.