May 30, 2023

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Cholera resurgence in Africa amid vaccine shortages worrisome

Many diseases that were abandoned over the past three years due to the Covid-19 pandemic are resurfacing in Africa, taking their toll. Cholera currently affects many countries in sub-Saharan Africa, particularly in central and southern Africa.

By 2022, cholera was reported in about thirty countries worldwide, including much of Africa. Since the beginning of 2023, 24 countries have reported cases of cholera, according to the UN. South Africa, Malawi, DRC, Cameroon, Mozambique, Nigeria, Eswatini, Kenya, Ethiopia, Zambia, Burundi, Tanzania, Zimbabwe, South Sudan…

According to the most recent data, 19 new cases, including 10 deaths, were reported in Hammanskraal on Sunday 22 May in Gauteng province, the country’s most populous province, along with Johannesburg and Pretoria.

Between 1.3 and 4 million cases of cholera are reported worldwide each year, the majority of which result in between 21,000 and 143,000 deaths in Africa.

Transmission is mainly through contaminated food or water. As in the Horn of Africa, where climate change causes natural disasters (floods, cyclones, etc.), the situation is likely to worsen in other countries due to conflicts and their groups of displaced people.

Cholera causes severe diarrhea, vomiting and can lead to death within hours without proper treatment. Unfortunately, there are fears that the morbidity rate will increase due to the lack of cholera vaccines.

The warning was issued by the Global Alliance for Vaccines and Immunization (GAVI), which brings together private partners and UN agencies (WHO, Unicef, etc.) and the World Bank in Geneva. The latter is explained by the lack of these cholera vaccines due to the emergence of other epidemics, especially Covid-19, which have driven efforts to produce vaccines. This is even more so because cholera is a disease that occurs mainly in the poor countries of the world today.

As a first consequence, this shortage prevents large-scale preventive vaccination campaigns in African countries where cholera is endemic. “This trend is alarming: around 10 million more vaccines will be needed to fight epidemics in 2021 and 2022 than in the previous decade,” GAVI said in its report.

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However, the situation should change by 2025-2026, according to GAVI, thanks to increased investments and the arrival of new manufacturers in the vaccine market.

This new situation illustrates the imperative need for African countries to take their destiny into their own hands and secure the supply of vaccines, especially for diseases that now appear almost exclusively at the continent’s level, like cholera.

Unfortunately, the continent continues to depend on imports. In fact, Africa produces only 1% of its vaccine needs annually.

However, the situation should evolve positively due to several plans to set up vaccine production units in several countries like Morocco, Rwanda, Senegal, Egypt etc. In Morocco, the mega-project Sensio Pharmatech is a real response to reducing Africa’s dependency. In vaccine imports.

By 2025, the unit will ensure production of more than 20 vaccines and bio-therapeutic products covering a significant portion of the continent’s needs. In Rwanda, six mobile vaccine production units are operating to produce messenger RNA vaccines in collaboration with the German laboratory Biontech.

Similar installations are under construction in Senegal and South Africa. For Kenya, American Moderna wants to invest $500 million to produce messenger RNA-based vaccines.

If all these projects are completed, the African continent will significantly reduce its dependence on vaccine imports. By 2025, vaccine imports should be drastically reduced and only certain vaccines that are complex to manufacture should be considered.