African public health experts on Thursday hailed President Biden’s plan to expand global coronavirus vaccine donations, but warned that his ambitious goals would not be met without timelier deliveries and greater transparency about when and how many doses were coming.
Africa, the continent with the lowest Covid-19 vaccination rate, has suffered not only from a shortage of vaccine doses but also from delayed and inconsistent deliveries. Although supplies have been increasing — four million doses arrived over the past week from Covax, the global vaccine-sharing facility — African countries have still received only one-third of the doses they were promised for this year, experts said at a virtual briefing held by the World Health Organization.
“The first thing to say is, we appreciate all the donations that were pledged by the rich countries and those who have doses to offer,” said Githinji Gitahi, chief executive of Amref Health Africa, a charity. “But we call for a commitment to deliver on those, and deliver in a timely manner.”
Anger over the rich-poor divide in vaccine access was a consistent theme among the leaders of African countries speaking at the United Nations General Assembly on Thursday.
“Unfortunately, the global rollout of the vaccine has not been impervious to the scourge of inequality,” said President Hage G. Geingob of Namibia. He called the situation “vaccine apartheid.”
President João Lourenço of Angola said it was “shocking to see the disparity between some nations and others with respect to availability of vaccines.”
At a summit on Wednesday, Mr. Biden pledged to donate an additional 500 million doses of the Pfizer-BioNTech vaccine, nearly doubling the United States’ total committed donations to 1.1 billion doses, more than any other country. But only 300 million of the doses are expected to be shipped this year, leaving poorer nations with the prospect of a longer wait.
Mr. Biden embraced the target of vaccinating 70 percent of the world’s people by the end of 2022. But that would require raising the pace of vaccinations in Africa sevenfold, to about 150 million doses a month, said Benido Impouma, a program director with the World Health Organization’s Africa program.
“It is in every country’s interest that this happen quickly,” Dr. Impouma said of speeding up the continent’s vaccination campaign. “The longer the delay in rolling out the vaccine, the greater the risk of other challenges emerging,” he added, including the rise of more troubling coronavirus variants.
To date, he and others said, vaccine deliveries to Africa have been not only slow and scant, but also unpredictable. Many shipments have arrived with little notice, hampering health systems’ ability to administer them, and with doses soon to expire.
Understand Vaccine and Mask Mandates in the U.S.
- Vaccine rules. On Aug. 23, the Food and Drug Administration granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for an increase in mandates in both the public and private sectors. Private companies have been increasingly mandating vaccines for employees. Such mandates are legally allowed and have been upheld in court challenges.
- Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. Both California and New York City have introduced vaccine mandates for education staff. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
- New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations, although enforcement does not begin until Sept. 13. Teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose by Sept. 27, without the option of weekly testing. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.
Richard Mihigo, coordinator of the W.H.O. immunizations program in Africa, said that the agency had analyzed the vaccine shipments and found that the average shelf life of doses that reached Africa was two to three months. That wasn’t long enough for health systems to get the doses to people who needed them, many of whom lived far from health facilities, he said.
“Most of time the news about donations comes on short notice, within a couple of days,” Dr. Mihigo said. “Countries do not have time to prepare. To change this paradigm, we need a bit more predictability on doses, how many doses, when they are coming.”
The surfeit of soon-to-expire doses has also contributed to vaccine hesitancy in parts of Africa, said Jean-Jacques Muyembe, director general of the National Institute for Biomedical Research in the Democratic Republic of Congo.
“People consider that a short shelf life, such as three months, is a synonym for bad quality,” he said.
Rick Gladstone contributed reporting.