By The Standard
ZIMBABWE is battling against time to administer over 14 million doses of Covid-19 vaccines that are already in its stocks amid concerns of public complacency and hesitancy, it has been established.
There are fears the vaccines might expire before use or become less effective as they draw closer to their best-by date.
The government on March 20 launched a Covid-19 vaccination blitz that includes jabbing children aged 12 and above to revive the faltering inoculation campaign after targets to vaccinate at least 70% of the population in order to reach herd immunity by December 2021 were missed.
In March last year, Zimbabwe set targets to vaccinate 60% of its population of nearly 16 million—translating to herd immunity—to halt the spread of the coronavirus and re-open an economy that has been battered by two years of lockdown restrictions.
The threshold was later reviewed upwards to 70% by the World Health Organisation (WHO) by mid-2022.
Governments in Africa, including in Zimbabwe, have been struggling to roll out the Covid-19 vaccination programme due to logistical problems, hesitancy that is largely blamed on lack of information and misinformation as well as complacency.
Investigations showed that Zimbabwe has received 22.4 million doses of Covid-19 vaccines since March 2020, but had only used eight million of the jabs at the beginning of this month.
The investigations involved tracking vaccination rates and delivery of Covid-19 vaccines since the first batch of 200 000 doses was received on February 15, 2021.
Zimbabwe mainly bought Sinopharm and Sinovac Covid-19 vaccines from China in addition to regular donations from Beijing as we reported from the time the vaccine rollouts began.
The country also received the same type of vaccines from the WHO’s Covax facility. It also received donations from India’s Covaxin and Russia’s Sputnik.
Less than 2% of all received doses have been donated.
The rest have been procured using domestic funding, which means the country has devoted significant amounts of its health budget to Covid-19 vaccination.
Zimbabwe’s vaccines uptake has remained low compared to the doses in its stockpiles, data from the Health and Child Care ministry shows.
According to the ministry’s situational reports, on March 13, Zimbabwe’s first dose vaccine coverage was 45% of the target population and 29% of the total population.
About 35% of the target population was fully vaccinated or had received two doses.
Medical experts said the fact that Zimbabwe had only managed to administer eight million doses of the Covid-19 vaccines in one year meant that exhausting 14 million doses would be a tall order.
Some countries in Africa are being forced to dispose of their Covid-19 vaccines after they expired without being used.
In Nigeria up to one million Covid-19 doses are estimated to have expired without being used in December last year.
South Sudan and the Democratic Republic of Congo last year had to send some of their Covid-19 vaccine doses back to manufacturers because they could not distribute them in time.
Namibia last year warned that it may have to destroy thousands of expired doses due to a low uptake.
Zimbabwe, despite being a beneficiary of donated vaccines, handed 50 000 doses of the Sinopharm vaccines to Botswana in February this year and donated another 20 000 doses to Namibia.
Agnes Mahomva, the national coordinator on government’s response to Covid-19, said the vaccine donations were done because of Zimbabwe’s good relations with other countries when asked if this was meant to get rid of doses that were close to expiry.
“Zimbabwe has very good relationships with its neighbours and some have struggled to get vaccines,” Mahomva said. “It is, therefore, only strategic to help them.”
She said it was unlikely that the vaccines that were already in stock would expire before use.
“Remember access to vaccines needs to be for everyone in order to end this pandemic,” Mahomva added.
“Most of our vaccines expire at the end of 2023 and that is the end of next year.”
Johannes Marisa, the Medical and Dental Private Health Practitioners of Zimbabwe Association president, said ordinarily vaccine manufacturers do not indicate expiry dates on their products, but it was common knowledge in the medical field that vaccines lose their potency a year after being produced.
Zimbabwe’s last vaccine deliveries were received in September 2021.
“(Not indicating expiry dates) is done for security reasons on the part of manufacturers, but we rightfully know that after 12 months, the vaccines lose their potency,” Marisa said.
“So you cannot keep a vaccine for more than 12 months. So ideally, we must try to limit the shelf life of vaccines.”
Mahomva said the government had come up with a new strategy to increase the uptake of Covid-19 vaccines to reach the WHO targets to vaccinate 70% of the population by mid-year.
She said Zimbabwe’s Covid-19 vaccination programme was one of the strongest programmes in Africa.
“The country has, however, had its fair share of vaccine uptake challenges,” Mahomva said.
“This is despite the fact that the country has plenty of vaccines in stock.
“Uptake challenges are mostly associated with low-risk perception, misinformation and access issues.
“The country, therefore, recently went through a re-planning process and put in place additional vaccination strategies to address identified challenges.”
She said innovative approaches, including outreach services and targeted vaccination messages for key community groups, will be used in order to address the challenges.
“The main aim of the campaign is to ramp up the vaccination coverage in order to reach 70% of the total population by end of July 2022 in line with the WHO’s new global target of 70% total population coverage by mid-2022,” she said.
“The campaign is in collaboration with all stakeholders including community and church leaders.”
She said additional vaccine doses had been procured and paid for and were awaiting delivery once the government gives a green light to the manufacturers.
Itai Rusike, director of the Community Working Group on Health, said instead of donating vaccines, Zimbabwe must be pushing for a higher uptake to effectively fight the pandemic.
“Instead of donating our vaccines to other countries, Zimbabwe needs to come up with innovative communication strategies in order to increase vaccine uptake and accelerate towards achieving the required herd immunity of vaccinating at least 70% of the population of about 13 million Zimbabweans,” he said.
Public trust will now have to be rebuilt in the vaccine programme itself and this requires an urgent, widespread communication strategy.
“We need to identify the Covid 19 vaccine champions and ambassadors from the traditional, religious and cultural leaders to encourage their communities, congregants and members to embrace the vaccine.”
John Maketo, a Zimbabwe Coalition on Debt and Development programmes manager, bemoaned what he said was lack of transparency in the procurement and use of stocks of Covid-19 vaccines.
“More should have been done to disclose for example how much the vaccines were being paid for and reasons for procuring them from certain nations instead of the others,” Maketo said.
“It’s a critical issue that undermines transparency in the procurement of the vaccines.
“So in broad terms we feel that transparency levels were not upheld in the procurement of the vaccines.”
Mahomva said procurement and sourcing of Covid-19 vaccines in Zimbabwe was guided by the Medicines Control Authority of Zimbabwe (MCAZ), which is the regulatory body.
“Only MCAZ approved and registered vaccines (procured or donated) are received for use in Zimbabwe,” she said.
“This is the same process that is followed for all other vaccines and medicines in line with the country’s laws.”
Mahomva said the ministries of Health and Child Care and Finance and Development were in charge of procurement of vaccines and they had ensured that purchase and donation conditions were favourable to Zimbabwe “in line with the procurement laws and value for money principles.”
Zimbabwe’s health delivery system is heavily underfunded and lacks basic supplies such as drugs and syringes.
The country has also been witnessing a mass exodus of health workers due to the deteriorating economy.
Frequent power cuts also mean that fridges holding vaccines at remote health centres need to be kept on expensive fuel generators and this hampers rollouts, experts say.