Decision making on allocation of Covid-19 Vaccines in Africa

Abstract

The COVID-19 pandemic has overwhelmed health systems and hugely influenced economies around the world. An effective and efficient control can only be reached through sustained public health measures and equal access of populations at different income levels to affordable, safe and assured quality vaccines among other health products. The fast track development of Covid-19 vaccines was a great success of modern science, however there have been justified fears that richer countries could hoard the vaccines at the expense of poorer ones. Highlighting inequalities in January, the World Health Organization’s (WHO) head said that more than 39 million doses had been administered in at least 49 higher-income countries, but only 25 in one of the lowest-income countries. Therefore an ambitious international scheme called Covax (Covid-19 Vaccines Global Access Facility) aims to make sure vaccines are shared among the poor and rich countries equally. It was launched in April 2020 and is led by the WHO, together with the Global Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations. A total of 92 low- and middle-income countries and economies will be able to access COVID-19 vaccines through Gavi’s Covax Advance Market Commitment (AMC). At the first phase of the distribution of vaccines to member countries, Covax aims to vaccinate 20% of all country’s populations. Once 20% of population per country is covered (i.e. Tier 1), Phase 2 of the allocation process will gradually expand access to cover a larger portion of the population in all countries. In this study we use the framework of the aforementioned organization to create strategies for allocating resources (vaccine doses) to 3 different regions in Africa because the studies show that cases of the pandemic vary geographically across Africa with notably high incidence in neighboring countries. Therefore, regions have to be prioritized for vaccination rather than countries alone. From this point of view, the problem was considered as a resource allocation problem and the regions were prioritized according to their threat level, health system vulnerabilities and logistics costs. In our model we created 3 different strategies as to address the needs and weaknesses of relative regions. These strategies include the vaccination of a) 10%, b) 20% or c) 30% of a region’s population.