Concerns are rising about the impact that the catastrophic situation in India could have on the COVID–19 pandemic on the African continent. Africa’s vaccine supply relies heavily on India’s Serum Institute, the source of the AstraZeneca vaccines distributed by the global COVAX project which is supposed to provide vaccines to poor countries. India’s export ban on vaccines has severely impacted the predictability of the rollout of vaccination programs and will continue to do so for the coming weeks and perhaps even months.
Combined with the myriad of problems with the rollout of the AstraZeneca vaccine, it is not difficult to imagine the potentially catastrophic consequences this could have for Africa as a whole. In addition to the Johnson & Johnson vaccine, South Africa has begun to roll out the Pfizer vaccine, but the special freezing storage facilities needed for the Pfizer vaccine are not accessible for most other African countries.
An official of the World Health Organisation in Africa called the delay “quite devastating for everybody” and said most African countries that received their first vaccine doses via COVAX will experience a “gap” in supply while waiting for second doses.
John Nkengasong, director of the Africa Centers for Disease Control and Prevention says his officials were “watching with total disbelief… We are living in a world that is extremely uncertain now.”
The disruption of vaccine supplies from India comes at a time when the pandemic is becoming worse across Africa. A new wave is threatening to overwhelm fragile healthcare systems across Africa after months in which the continent has been relatively mildly impacted. Hospital capacity and oxygen supplies are currently running out as the mortality rate across the continent surpassed the global average for the first time. Mortality rates in twenty African countries are now higher than the global average of 2.2 percent.
The danger of leaving Africa behind
While official figures for COVID-19 in Africa talk of 3 million cases and around 80,000 deaths, these cannot be relied upon. Only eight out of over 50 African countries have a compulsory register of deaths. Those that register them do so only partially. For instance, while official COVID-19 deaths in South Africa are recorded at 50,000, the official number of excess deaths is 150,000!
The arrival of faster spreading variants (from India, the UK, or Brazil) can have a catastrophic impact.
But a major stumbling block to fighting the virus in Africa is the lack of capacity and resources. Just 17 million vaccine doses have been administered across the African continent, according to the Africa Centre for Disease Control, catering for a population of 1.3 billion. Officially, only 43 million tests for the virus have been conducted across Africa since the pandemic began. One-quarter of those have been carried out in South Africa alone.
This means that it is difficult to form an accurate account of the real situation. The question of reliable statistics is a major obstacle. The danger of undercounting and the lack of reliable data gives a false impression that there isn’t the same urgency to supply African countries with vaccines as other countries. This could increase the risk of the disease spreading far and wide, hindering the rollout and uptake of the vaccine.
Undiagnosed transmission of the virus in African countries increases the risk of new variants taking hold in the population before they have been detected and before they can be prevented from spreading. Ultimately this could threaten global efforts to control the pandemic.
Earlier this year, a spokesperson for COVAX said that the initiative aims to vaccinate 20 percent of people in its member countries by the end of the year. This was before the deterioration in India. In other words, full immunisation in Africa won’t be reached anytime soon. This increases the threat of new mutations as the virus is allowed to spread unhindered through large swathes of the continent’s population. Without concurrent, worldwide vaccination, the virus will continue to spread. Nowhere is safe until all countries are safe.
There is no solution to the pandemic within national boundaries. The problem is that we live under capitalism which means that what determines the policy of the ruling classes are profits and narrow self–interest. As wealthy nations swallow up much of the existing supply, poor countries are left largely without access to vaccines. Some countries are way ahead in vaccinating the vast majority of their population, while a swathe of countries haven’t received a single dose.
More than 700 million doses of Covid vaccines have been distributed worldwide according to the UN, but those numbers are heavily skewed towards rich countries. As of April, rich countries have secured more than 87 percent of doses. “On average in high-income countries, almost one in four people has received a vaccine. In low-income countries, it’s one in more than 500,” said the World Health Organization’s director general, Tedros Ghebreyesus in April.
According to Duke University’s Global Health Innovation Center, which is tracking vaccine procurement worldwide, high– and upper–middle–income countries have collectively reserved nearly five billion vaccine doses. These doses are largely the product of bilateral deals between governments and vaccine makers, known as ‘advance market commitments’, in which governments commit to purchasing doses upfront in exchange for priority access once the vaccine is approved. In other words, they are literally buying their way to the front of the line.
The US, for example, has entered into at least six of these bilateral deals, totaling more than one billion doses – more than enough to inoculate the entire American population. The European Union, Britain, and Canada have each entered into seven bilateral deals, with the potential of securing enough doses to cover their populations two, four, and six times over.
Duke found that the US has secured more doses than it will ever need. In its most recent report, it found that even if you exclude doses that the US will likely need for booster shots and to vaccinate children when they become eligible, they could be in possession of as many as three hundred million surplus doses by the end of July.
Meanwhile, the situation in Africa is dire.The Africa CDC has ordered 220 million doses of the Johnson & Johnson vaccine with an option for another 180 million. Since this is a single–dose shot, it would enable the continent to vaccinate 400 million people. But these vaccines won’t be enough to meet Africa’s target of vaccinating 750 million or 60 percent of its population by the end of 2022 to achieve immunity. So far African countries have administered only 13.9 million doses.
Big pharma’s juicy profits
Meanwhile, big pharma is laughing all the way to the bank. Pfizer, Johnson & Johnson, and AstraZeneca — three of the world’s top coronavirus vaccine manufacturers — have paid out a combined $26 billion in dividends and stock buybacks to their shareholders over the past year.
According to the People’s Vaccine Alliance, a coalition of advocacy organisations including Oxfam and Amnesty International, this sum could fully fund the cost of inoculating Africa’s entire 1.3 billion population. Released just ahead of Pfizer and Johnson & Johnson’s annual shareholder meetings, the report notes that Pfizer/BioNTech and Moderna are projecting revenues of $33.5 billion this year from their mRNA vaccines, which have largely been sold to rich nations.
The Vaccine Alliance estimates that Pfizer has paid out $8.44 billion in dividends, Johnson & Johnson $10.5 billion in dividends and $3.2 billion in share buybacks, and AstraZeneca $3.6 billion in dividends. The demand for vaccines, at a time when much of the global economy is at a standstill, has been responsible for the creation of a wave of new billionaires. Uğur Şahin, the founder of BioNTech, which partnered with Pfizer to produce the vaccine his and his wife’s firm invented – with lavish aid from German taxpayers – now has shares worth $5.9 billion. Stéphane Bancel, the CEO of Moderna, which produced a vaccine with similar mRNA technology, is worth $5.2 billion. Big pharma is raking in fat profits when most of Africa and many poor countries around the world cannot get the vaccines they need.
Pfizer brought in $3.5 billion in revenue in the first three months of this year from this vaccine, nearly a quarter of its total revenue. At a profit margin of 20 percent, that is roughly $900 million in vaccine profits in the first quarter.
Another aspect is the issue of patent and intellectual property protections on coronavirus vaccines. One of the reasons pharmaceutical companies have been able to generate such large profits is because of intellectual property rules that restrict production to a handful of companies. The fact is that these vaccines were funded by public money but now a small group of corporations are allowed to keep the vaccine technology and knowhow under lock and key while selling their limited doses to the highest bidder and leaving poor countries in the cold.
India and South Africa are pressing the World Trade Organisation to waive an international intellectual property agreement that protects pharmaceutical trade secrets. The proposal by India and South Africa would exempt World Trade Organisation member states from enforcing some patents, trade secrets, or pharmaceutical monopolies under the body’s agreement on trade–related intellectual property rights, known as TRIPS. The idea would be to allow drug companies in other countries to make or import cheap generic copies.
This would seem like a fairly reasonable proposal but until recently the United States, Britain, and the European Union have blocked the plan.
Yesterday the Biden administration shifted their position in support of lifting some of the protections. Predictably the pharmaceutical industry is dead set against it, and Biden can expect a lot of pushback. The Pharmaceutical Research and Manufacturers of America has rejected the proposal. After all, they ask, if we waive intellectual property rights for COVID drugs, why not for cancer drugs or heart disease drugs? But Biden has reassured Big Pharma that that is absolutely not the plan.
His administration is very much a government for American corporate interests, and he has no problem with Big Pharma profiting off from the suffering of the sick in general. But in this instance, Biden has to carefully weigh the interests of American capitalism as a whole against the interests of Big Pharma in particular. But to intervene in the general interests of American capitalism, they once again are having to throw out the old orthodoxy of leaving things to the ‘invisible hand’ of the market.
The ongoing circulation of the virus and the threat of it returning to the US in a mutated form is a serious concern for the strategists of American capital. The relative success that Russia and China are having with ‘vaccine diplomacy’ is another, and his latest move is certainly calculated to undercut American capitalism’s rivals. Undoubtedly Biden’s administration will ensure that Big Pharma is adequately compensated for any relative loss of profits that they might ‘suffer’.
However, this announcement by itself does not change the situation much. As long as other parties to the WTO like the EU reject the proposal, not much will be done in the short run, as Katherine Tai, the US trade representative at the WTO admitted: “Those negotiations [in the WTO] will take time given the institution and the complexity of the issues involved.” In other words, not much will change in the short term. On top of this, the mere waiver is not enough. Really fighting the virus would mean actively disseminating the technical means for manufacturing the vaccine. Big Pharma intends to do no such thing, of course.
Swimming in cash, drowning in debt
While the big pharmaceutical monopolies in the West are swimming in money, African countries are drowning in debt. This is compounding an already terrible situation. Before the pandemic struck it would have taken the average person in Africa around 45 years to double their income. Then, when the pandemic hit, nearly 15 years of income progress disappeared. African countries south of the Sahara will be the world’s slowest–growing region in 2021 at a pace of barely one percent on a per capita basis.
Poverty records are being shattered. Using the 1.90 dollars per day international definition, an estimated 50 million people have been pushed into extreme poverty in the region in the past year. This is the most significant change ever recorded. Around 350 million children have not gone to school. There are growing levels of hunger and malnutrition. Around half of the population is currently affected by food insecurity.
Even when domestic stimulus and all forms of external assistance are combined, the average person in the region has benefited from around 40 dollars in emergency support since the start of the crisis. Compare that to $2,400 for citizens of G20 countries. On top of this, African countries are being bled dry through debt. Before COVID–19, 16 of the poorest governments in sub–Saharan Africa were spending more on servicing debt than on the combined social sectors.
The difference was threefold in places like Chad and the Gambia, and as high as elevenfold in South Sudan. Despite the G20’s Debt Service Suspension Initiative (DSSI), around $2.5 billion continue to flow to creditors outside Africa’s borders. According to a Unicef report called ‘the Looming Debt Crisis’, for every cent spent on servicing debt, one less is spent on healthcare, social protection, education, and other essential services.
Unlike the coronavirus, Africa's debt crisis is nothing new. It is one of the weapons with which the imperialist countries have kept the continent in servitude and which prevents its development. This debt has, in fact, nearly doubled on average over the past decade. Now, with a pandemic–induced global recession and an unthinkable collapse in public revenue, an appalling situation has worsened.
Break the stranglehold of imperialism!
This state of affairs is a direct result of imperialism. The colonial subjugation of Africa and the wholesale looting and plundering of the resources of the entire continent for centuries by imperialist countries are the direct reasons for the structural underdevelopment of the continent. The fight against the coronavirus in Africa is therefore a fight against imperialism. The ravages of centuries of imperialist domination have left the entire African continent vulnerable to even more suffering.
Imperialism’s crushing dominance means that countries in Africa, Asia, and Latin America are increasingly exploited, resulting in pandemics, wars, climate catastrophes, and famine. Yet from these countries, massive quantities of capital are channeled to the imperialist nations.
The weak and degenerate bourgeoisie in Africa is too dependent on foreign capital and imperialism to carry society forward. It is tied, hand–and–foot, not only to foreign capital, but to the class of landowners, with which it forms a reactionary bloc, representing a bulwark against progress. The only way out of this barbaric nightmare for the 1.3 billion people in Africa is to struggle against imperialism. But the struggle against imperialism is the same as the struggle against capitalism as a whole. In Africa and elsewhere in the ex-colonial world, we see the true face of the system. It must be overthrown in a socialist revolution.