Vaccine Deserts Still Exist            05/09 08:59

   

   N'DJAMENA, Chad (AP) -- At the small hospital where Dr. Oumaima Djarma works 
in Chad's capital, there are no debates over which coronavirus vaccine is the 
best.

   There are simply no vaccines at all.

   Not even for the doctors and nurses like her, who care for COVID-19 patients 
in Chad, one of the least-developed nations in the world where about one third 
of the country is engulfed by the Sahara desert.

   "I find it unfair and unjust, and it is something that saddens me," the 
33-year-old infectious diseases doctor says. "I don't even have that choice. 
The first vaccine that comes along that has authorization, I will take it."

   While wealthier nations have stockpiled vaccines for their citizens, many 
poorer countries are still scrambling to secure doses. A few, like Chad, have 
yet to receive any.

   The World Health Organization says nearly a dozen countries -- many of them 
in Africa -- are still waiting to get vaccines. Those last in line on the 
continent along with Chad are Burkina Faso, Burundi, Eritrea and Tanzania.

   "Delays and shortages of vaccine supplies are driving African countries to 
slip further behind the rest of the world in the COVID-19 vaccine rollout and 
the continent now accounts for only 1% of the vaccines administered worldwide," 
WHO warned Thursday.

   And in places where there are no vaccines, there's also the chance that new 
and concerning variants could emerge, said Gian Gandhi, UNICEF's COVAX 
coordinator for Supply Division.

   "So we should all be concerned about any lack of coverage anywhere in the 
world," Gandhi said, urging higher-income countries to donate doses to the 
nations that are still waiting.

   While the total of confirmed COVID-19 cases among them is relatively low 
compared with the world's hot spots, health officials say that figure is likely 
a vast undercount: The countries in Africa still waiting for vaccines are among 
those least equipped to track infections because of their fragile health care 
systems.

   Chad has confirmed only 170 deaths since the pandemic began, but efforts to 
stop the virus entirely here have been elusive. Although the capital's 
international airport was closed briefly last year, its first case came via 
someone who crossed one of Chad's porous land borders illegally.

   Regular flights from Paris and elsewhere have resumed, heightening the 
chance of increasing the 4,835 already confirmed cases.

   The Farcha provincial hospital in N'Djamena is a gleaming new campus in an 
outlying neighborhood, where camels nibble from acacia trees nearby. Doctors 
Without Borders has helped supply oxygen for COVID-19 patients, and the 
hospital has 13 ventilators. The physicians also have plenty of Chinese-made 
KN95 masks and hand sanitizer. Still, not a single employee has been vaccinated 
and none has been told when that might be possible.

   That was easier to accept at the beginning of the pandemic, Djarma said, 
because doctors all around the world lacked vaccines. That has changed 
dramatically after the development of shots in the West and by China and Russia 
that have gone to other poor African countries.

   "When I hear, for example, in some countries that they've finished with 
medical staff and the elderly and are now moving on to other categories, 
honestly, it saddens me," Djarma said. "I ask them if they can provide us with 
these vaccines to at least protect the health workers.

   "Everyone dies from this disease, rich or poor," she says. "Everyone must 
have the opportunity, the chance to be vaccinated, especially those who are 
most exposed."

   COVAX, the U.N.-backed program to ship COVID-19 vaccines worldwide, is aimed 
at helping low- and middle-income countries get access. A few of the countries, 
though, including Chad, have expressed concerns about receiving the AstraZeneca 
vaccine through COVAX for fear it might not protect as well against a variant 
first seen in South Africa.

   Chad is expected to get some Pfizer doses next month if it can put in place 
the cold storage facilities needed to keep that vaccine safe in a country where 
temperatures soar each day to 43.5 degrees Celsius (110 degrees Fahrenheit).

   Some of the last countries also took more time to meet the requirements for 
receiving doses, including signing indemnity waivers with manufacturers and 
having distribution plans in place.

   Those delays, though, now mean an even longer wait for places like Burkina 
Faso, since a key vaccine manufacturer in India scaled back its global supply 
because of the catastrophic virus surge there.

   "Now with global vaccine supply shortages, stemming in particular from the 
surge of cases in India and subsequently the Indian government's sequestration 
of doses from manufacturers there, Burkina Faso risks even longer delays in 
receiving the doses it was slated to get," said Donald Brooks, CEO of a U.S. 
aid group engaged in the COVID-19 response there known as Initiative: Eau.

   Front-line health workers in Burkina Faso say they're not sure why the 
government hasn't secured vaccines.

   "We would have liked to have had it like other colleagues around the world," 
says Chivanot Afavi, a supervising nurse who worked on the front lines of the 
response until recently. "No one really knows what this disease will do to us 
in the future."

   In Haiti, not a single vaccine has been administered to the more than 11 
million people who live in the most impoverished country of the Western 
hemisphere.

   Haiti was slated to receive 756,000 doses of the AstraZeneca vaccine via 
COVAX, but government officials said they didn't have the infrastructure needed 
to conserve them and worried about having to throw them away. Haitian officials 
also expressed concerns over potential side effects and said they preferred a 
single-dose vaccine.

   Several small island nations in the Pacific also have yet to receive any 
vaccine, although the lack of outbreaks in some of those places has meant there 
is less urgency with inoculation campaigns. Vanuatu, with a population of 
300,000, is waiting to receive its first doses of the AstraZeneca vaccine later 
this month, but it has recorded only three cases of coronavirus, all of them in 
quarantine.

   At the Farcha hospital in Chad, nine health care workers have gotten the 
virus, including Dr. Mahamat Yaya Kichine, a cardiologist. The hospital now has 
set up pods of health care worker teams to minimize the risk of exposure for 
the entire staff.

   "It took almost 14 days for me to be cured," Kichine says. "There were a lot 
of caregivers that were infected, so I think that if there is a possibility to 
make a vaccine available, it will really ease us in our work."