The country that decided not to apply COVID-19 vaccines and the risk it poses to the rest of the world

Tanzania has taken a very specific approach to controlling SARS-CoV-2. Last year, Just months after the start of the pandemic, President John Magufuli declared Tanzania free from COVID-19 after three days of national prayers.

Since, refused to impose a lockdown, reopened schools, allowed major sporting events, continued religious gatherings, stopped testing and suspended public communications campaigns on the virus. The country has also stopped reporting cases and deaths.

The argument was that people should stop living in fear and trust God and African traditional remedies to avoid contagion. Tanzania is perhaps the only country in the world to have adopted this approach, which goes against everything that has been recommended by scientists, other national health agencies and the World Health Organization ( WHO).

Therefore, it is not surprising that Authorities have said they have no plans to vaccinate the population, or at least not at the moment.

Will people still be able to access vaccines?

No and yes.

No why A vaccine cannot be used in the country without its use being registered and authorized. The normal process is for experts, as well as regulators, to review the data on the vaccine and approve its use if they are convinced of its effectiveness and safety.

For the covid-19 vaccine, this is done according to the WHO Emergency Use List procedure. The review is carried out by an international team of experts with the participation of other specialists from national authorities.

But If the Tanzanian government refuses to register the vaccine for use, no one will be able to access it.

However, the country could register the vaccine, but refuse to import it. This would allow the private sector to import it, although that would not be enough. Covid-19 vaccination programs in any country involve massive management, and if the private sector takes the lead, many will not be able to afford or access the vaccines.

Those who could be vaccinated would be people belonging to the Tanzanian elite (or those who can afford it), who could leave the country and be vaccinated elsewhere.

Other Tanzanians who can access vaccines are border communities who in the past entered neighboring countries and benefited from vaccination programs. This could happen if widespread vaccination starts to occur in Kenya, Uganda, Rwanda and Malawi.

But it will be in a few years.

Tanzania still has the option to register and import vaccines in the future. Magufuli has sent mixed messages. On the one hand, the government has said it does not plan to order vaccines through COVAX (a global initiative to achieve equitable access to covid-19 vaccines) or any other mechanism. In reality, the recently published COVAX distribution list does not include any doses for Tanzania.

On the other hand, he said Tanzanians should only trust vaccines that have been reviewed by experts in the country and found to be safe.

Does Tanzania have a history of vaccine opposition?

Not that I know.

Tanzania, like other countries, has implemented routine immunization programs. They are aimed in particular at children under five and act against diseases such as tuberculosis, polio, whooping cough, measles, rubella and diphtheria. In recent years, these programs have expanded to include vaccines against bacterial pneumonia, diarrhea and hepatitis B.

In Tanzania, immunization coverage, that is, the percentage of people who receive the vaccine, is very high: around 80% or 90%. This means that there is no history of opposition to vaccines.

Differences between Tanzania and neighboring countries like Kenya and Uganda

Kenya, Uganda, Rwanda and Malawi have desperately tried to get their citizens vaccinated. All were integrated into the COVAX service and developed vaccine distribution plans, calculated costs and submitted them. Rwanda even went ahead and got vaccines outside of the COVAX service.

These four countries have also started to inform the population about these plans. For example, they confirmed that the first phase of distribution will primarily target health workers and people at high risk.

The biggest problem facing African countries today is the shortage of vaccines in the global market to immunize a significant portion of the population. Many wealthy countries will have vaccinated all who need it by the end of this year. But African countries will not have full availability of the vaccine until the end of next year or even until 2023.

If the countries that have researched so much for vaccines are so far behind, imagine a country like Tanzania that hasn’t even started yet.

What is the risk for the country and the region?

The risk to the country has already become apparent. The method followed by Tanzania allowed the virus to spread uncontrollably among the population. People die from what is categorized as “pneumonia” and “difficulty breathing”.

People living in Tanzania are not adequately prepared or protected as there are no protocols on what to do to prevent the spread of the virus if someone becomes ill. Most of the information is about spraying to prevent covid-19, but that doesn’t stop the virus from spreading from person to person.

The second big problem is the impact on health workers. Even in countries where strict measures have been enforced, health workers have fallen ill and many have died. Misinformation in Tanzania could lead to insufficient precautions by health workers in outpatient clinics, emergency rooms and even patient care practices. If health workers get sick, other health services will also be affected.

A great danger for the region and for the world.

In the first place, As long as there are cases of COVID-19 in Tanzania, it will be impossible for neighboring countries (with which it shares permeable borders) to be free from the disease.

Second, and perhaps more important, there is a risk that new variants will develop in the country with no one watching. New variants emerge due to uncontrolled spread.

If a new variant emerges later in Tanzania, the danger is that it will spread throughout the region and invalidate any vaccination that has been administered if it is not effective against that variant.

The pandemic will not end for anyone anywhere until it is controlled in all countries. Tanzania’s position will make it much more difficult to return to normalcy.

* Catherine Kyobutungi is a Ugandan epidemiologist who is currently the Executive Director of the Center for Population and Health Research in Africa. It is funded by Sida, BMGF, Carnegie Corporation in New York, the African Academy of Sciences and the Hewlett Foundation.

Originally posted by The Conversation

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