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Dr Christian Mayala and Dr Rodin Nzembuni Nduku are sitting together on a bench outside the Covid ward at Mama Yemo hospital in Kinshasa.
They discuss the health of their father, Noel Kalouda, who contracted coronavirus weeks before, and is now lying in a hospital bed, breathing through an oxygen mask.
Despite the brothers’ medical knowledge and the vaccines available in the capital of the Democratic Republic of Congo (DRC), the three men had chosen not to be vaccinated for fear of the potential side effects of the only vaccine available, the AstraZeneca vaccine.
“On social media, there was a story about a guy who died 20 hours after being vaccinated. Things like this scare me about getting vaccinated, ”Nduku said.
Just over 86,000 doses have been administered – enough to immunize less than 0.1% of the country’s 90 million people.
Already facing shortages and enormous logistical challenges to distribute vaccines to people living in remote areas, experts fear that mistrust of pharmaceuticals will further undermine the global fight against Covid.
As anger grows over the failures of rich countries to provide enough vaccines to the poorest, citizens’ reluctance to vaccines has been overlooked, epidemiologists warn.
Professor Pascal Lutumba, Department of Infectious Diseases at the University of Kinshasa, said: “If people in Congo remain unvaccinated, the South African variant could encounter the Delta variant and the virus could mutate into a resistant variant. some vaccines.
“If a variant of the Congo arrives in a country like the UK, which has high vaccination rates, it could put them back in the same position they were at the start of the pandemic. They should get vaccinated again with a new vaccine, ”said Lutumba.
“We would be back to square one,” said Dr. William Schaffner, professor at Vanderbilt University Medical Center in Nashville, United States.
The Delta variant accounts for up to 79% of sequenced infections in the DRC, according to figures released by the World Health Organization last month.
The country had officially recorded 50,529 cases and 1,045 Covid-related deaths as of August 4, according to the Johns Hopkins University tracker, but the virus has torn the DRC’s elite apart. In May, the vice president of the Congolese National Assembly said the pandemic had killed up to 32 MPs, or about 5% of the total.
Setting the tone for vaccine skepticism, DRC President Félix Tshisekedi admitted last month that he had yet to receive the vaccine.
“We were ready to launch the vaccination campaign. The day before, I saw this [misleading] news on television first, then on social networks, ”Tshisekedi told reporters.
The DRC has so far only received AstraZeneca vaccines, but according to Dr Jean-Jacques Muyembe-Tamfum, responsible for the country’s Covid response, new vaccines are expected to arrive this month, which are expected to include different brands. – which both Muyembe-Tamfum and the president said they would take.
Nduku said: “The president said he didn’t trust AstraZeneca, so that makes me doubt… I would die of anxiety if I took this vaccine, because of the way the president described it. . I would be afraid of dying.
On March 2, the DRC received 1.7 million doses of Covax, the global vaccine-sharing program, but delayed deployment until April after several European countries suspended use of the AstraZeneca vaccine in response to reports of side effects involving rare blood clots. About 75% of the shots were transferred to other African countries for use before they expired. Deployment has been slow since then.
Providing vaccines in a vast forested country divided by large rivers and with poor infrastructure is a challenge in itself. The DRC is almost the size of Western Europe, but has less than 3,000 km of paved roads, less than 1% of the UK total.
The will to have a Covid vaccine in the DRC is said to be lowest in 15 countries surveyed by the African Union between August and December of last year, with 38% of those surveyed in the DRC not wishing to be vaccinated against only 4 % in Ethiopia. .
More than 70% of healthcare workers nationwide have said they will not take the vaccine, according to a study published by the journal Vaccines in February.
The failure of health messages has historically had catastrophic consequences here. An Ebola outbreak in eastern DRC in 2018 killed more than 2,200 people as international aid agencies and health authorities failed to communicate effectively with people and communities, to train properly health workers and explain consent in local languages, according to the World Bank.
Health workers who spoke to the Guardian in Kinshasa said these mistakes were repeated with Covid as the government failed to adequately explain the severity of the virus, allowing misinformation to spread.
“People were getting all kinds of messages from churches – for example, that Covid was created to end Africans. Small churches were broadcasting many messages that Covid was not real,“ said Dr Cris Kacita Osako, an epidemiologist who worked on the government’s response to Covid last year.
Meanwhile, as they hope for their father’s recovery, Nduku and his brother are torn apart. “People did not believe it,” said hospital doctor Jean-Paul Nsimba. “They resisted, they doubted its existence. They thought it was a disease that killed white people.
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