Institutional racism, greed, and a broken global health system are all working against African nations to ensure that people are dying from COVID in silence, according to a scathing assessment from the co-chair of the African Union's African Vaccine Delivery Alliance, Dr. Ayoade Alakija.
More than two years into the COVID-19 pandemic, wealthy nations like the U.S. are preparing for yet another vaccination campaign.
The Biden administration is examining plans to open up a fourth booster shot to all adults. And the FDA has asked vaccine manufacturers to prepare another set of boosters in the fall for the omicron subvariants that now dominate new cases in the U.S.
On the African continent, however, only one in every five people has received the initial two shots.
In an interview with All Things Considered, Alakija said it was time to rebuild the global health architecture and address the systemic inequality.
This interview has been lightly edited for length and clarity.
Interview highlights
On what the pandemic looks like on the African continent right now
I've been working over the last couple of years at the forefront, not just for access to vaccines, but for access to all countermeasures, which includes diagnostics and now treatments as they become available.
That has been a deeply depressing role to be in over the last couple of years, as we have seen that the high-income countries of the world have clearly prioritized themselves but forgotten that this pandemic is affecting all of us.
So from where one sits and where one looks at it, we as a global community have failed. We failed to stop a virus that continues to march on. And even today, as we speak, we will see new subvariants that are causing increasing infection, increasing hospitalizations and increasing deaths in countries in parts of the world where it shouldn't be happening because of this lack of equity, this lack of access to the countermeasures for all of the world.
On how inequity translates to human experiences
People absolutely are dying silently. The very measure of the impact of this pandemic around the world has been: How far are health systems being affected? Have hospitals been overwhelmed?
We saw in the early days those awful images from New York hospitals, and from hospitals in Brazil. And that was the measure of the impact. But what do you do in countries where you do not have health systems to be overwhelmed? So we have said in parts of Africa that, "Oh, well, they hadn't had COVID" and "COVID has not affected them," but that is not true.
It is just we haven't had the cameras in hospital wards, because those wards do not exist. So people have died silently, people have died at home and they haven't even been able to be celebrated or memorialized.
So many of these deaths have gone unrecorded. And therefore, there has been a silent pandemic, a silent toll on parts of this world where the inequity in measuring the impact of the pandemic itself is pushing the inequity of access to the countermeasures and to the tools needed to prevent further infection.
On whether she thinks the next generation of omicron-adapted vaccines will reach Africa in time
Absolutely not. I mean, this has been the core of my voice over the last two years.
Now, the vaccine doses are beginning to roll out to the African continent, but far too little, far too late in many ways. We were left at the back of the queue. One is seeing that whilst the world and many leaders are pushing to get vaccines and tests and treatments to Africa and other other low and middle-income countries of the world, the rest of the world has moved on.
The rest of the world is providing not just fourth boosters ... they're looking at the next generation of vaccines because clearly we need better vaccines against this virus that continues to march on. This virus that continues to best us. It is pushing against us. And we as a global community need to push back. But the only way to push back is by pushing back with equity, with health, justice, and ensuring that some people are not being left behind.
On what she thinks the fundamental problem is with the global approach
I mean, there's an institutional racism and an institutional otherism that's going on in this world at the moment. There are those saying that, "Well, you know, perhaps we don't need to vaccinate 70% or as many Africans as we had thought because so many of them have caught COVID already anyway; surely there's a wall of natural immunity brewing."
But the same people are not saying that there is a wall of natural immunity brewing in America where there's been widespread infection, or in Europe or in the U.K. So that begins to imply this otherism, this sense of, "Are they physiologically different to us?" Which is a dangerous place to go. It's either that or the question being posed is, "Are Africans not being as badly affected because we are not measuring their deaths in the same way?" Or, "Are Africans and other people dispensable?" I mean, these are really troubling sort of themes that are beginning to emerge.
There, of course, has been greed. There, of course, has been the sense of, "We must take care of our own first." And that is human nature. And any global leader, any president, any prime minister has a responsibility primarily to their own. But this virus is not a person. It is a virus that is airborne. And therefore, unless all of the world is safe and protected from it, we will continue to see these waves now. Today it BA.5. We don't know what it will be tomorrow.
So it is self-defeating, because to take care of one's own self should be to take care of the rest of the world and to help the rest of the world take care of themselves. Not charity, but global solidarity and partnership, I think, is what the world is calling for, which is lacking.
On whether she has hope that the gap in access to vaccines, tests, and treatments can be closed
One must always have hope. Do I have hope that the equity gap can be closed? I think the equity gap is due to so much more that is fundamental within our systems. I think the equity gap is due to the fact that the global health and global development infrastructure is flawed and fundamentally broken.
So what we must do is we must reshape. We must re-imagine. We must rebuild the global health and global development architecture of this world to make it more inclusive, to make it such that the voices from the South can be heard and can be understood, not in a tokenistic manner, not in a paternalistic manner, but in a fully participatory manner, where we build it again together for the good of the whole world, not just for some of the world. So that all may have a chance at life, and quality of life, and the true definition of health.
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