Much of Africa is struggling with vaccine access. Should Western nations rethink boosters?

Read the Full Transcript

• Judy Woodruff:

  As the U.S. and other Western countries discuss the rollout of COVID vaccine boosters, in Africa and other parts of the world, millions are still waiting for their very first shot.

  COVID has killed 200,000 people across the African continent, where there are nearly eight million confirmed cases. While South Africa is on track to have a majority vaccinated by the end of the year, for many other sub-Saharan countries, fewer than 3 percent of their populations have been vaccinated.

  Earlier today, William Brangham spoke with the head of Africa's CDC, Dr. John Nkengasong.

• William Brangham:

  Dr. John Nkengasong, thank you so much for joining us.

  I wonder if you could briefly just give us a sense, continent-wide, how is the pandemic going in Africa right now?

  Dr. John Nkengasong, Director, Africa Centers for Disease Control and Prevention: Unfortunately, we are not winning the war against this pandemic in Africa.

  As we speak, at least 32 countries are going through a very severe third wave. And about four or five other countries are actually witnessing a fourth wave.

  And the background of this is that we have very limited vaccines that have been introduced on the continent. A population of 1.2 billion people have only seen one about 3 percent of the population fully vaccinated, which is unfortunate, if we imagine that our goal was to at least vaccinate up to 60 percent of our population by next year.

  So, I think it is a very unfortunate situation we are witnessing in Africa.

• William Brangham:

  I would love to talk about the vaccines in just a moment.

  Before then, though, is it your sense that the Delta variant is the primary variant of the virus across Africa now?

• Dr. John Nkengasong:

  It is.

  As we speak, over 30-something countries have now reported the Delta variant. And Africa is a continent of 55 member states, so it's at least about 20 countries have not yet reported the Delta variant.

  But the speed at which the variant is evolving suggests naturally that, in the next couple of weeks or months, it will become the predominant variant.

• William Brangham:

  I know that testing is not as widespread across Africa as it is elsewhere.

  Do you share the concern that you might be possibly missing even more cases simply because you don't have good eyes on the ground?

• Dr. John Nkengasong:

  We are absolutely missing cases. There's no doubt about that, because of lack of broad testing, as we would love to.

  And it's not because countries don't want to do testing. I think it's lack of really access to large-scale testing. And we have made significant progress if you compare it to where we were last year. Last year, around April, as a continent of 1.2 billion people, we had just tested under 300,000 people.

  So, but, today, we are way past that marker. But testing has to be the cornerstone of the rest on the continent, because if we do not test, we do not find.

• William Brangham:

  On this vaccination front, the global — the COVAX effort and many Western nations say that they are doing everything they possibly can to try to increase production and get vaccines elsewhere into the world.

  But it sounds like you clearly don't believe that effort is happening fast enough.

• Dr. John Nkengasong:

  Well, let's admit it.

  I mean, the spirit of COVAX and the principle were sound, and they were based on our need to cooperate and to express solidarity. The reality is that it has not translated into action, where — in Africa, where, as we speak, as I indicated earlier, just under 3 percent of our population of 1.2 billion people have been vaccinated.

  If you recall, when this was COVAX set up, it was very clear that we wanted to have a basket where vaccines will be dumped into. And the vaccines that are effective will be accessible at the same time to everyone in the world who needed the vaccines.

  But that is not what we are seeing today.

• William Brangham:

  And, certainly, here in the United States and in other parts of Western Europe and in Israel, they're talking about introducing booster shots and giving booster shots, which could be hundreds of millions of third doses going to wealthier nations, while you all are still waiting for so many of your first doses.

• Dr. John Nkengasong:

  That is absolutely correct.

  My greatest concern with the concept of a booster is that I have not seen the signs yet that justify that. For example, there are at least a couple of conditions that or scenarios that — evidence is a better word that I'm looking for.

  One is that we should be able to define that when vaccine protection actually wanes to the point that somebody actually needs a booster. We haven't seen that data. Second is that, even if the immunity of that vaccine drops to a certain level in people that have received it, do you still get protection from disease or — and hospitalization?

  If the answer is that you still get enough protection there, then you don't need urgently to get a booster.

• William Brangham:

  And, certainly, within the U.S., the Pfizer and Moderna, which are two of the most commonly used vaccines here, the evidence, as you say, does seem to indicate that we are still getting good protection from hospitalization and death with those two vaccines, which seems to reinforce the point that you're making, that it is not that urgent for Western nations to be giving boosters, when you compare it to continents, entire continents like Africa that are waiting.

• Dr. John Nkengasong:

  No, absolutely.

  I think, if we look at the United States and also look at Israel, I mean, Israel was one of those countries that — perhaps the first country that vaccinated at least 60 to 70 percent of its population.

  But the beauty of the situation in Israel is that, even though most people that have received the vaccine were infected, they were not hospitalized, and they were not having severe illness there. So, that is — so, the situation in Israel teaches us two things.

  One is that, by vaccinating your entire population and neglecting other parts of the world from being vaccinated, you are not safe, because it will bring new variants. And the variants will challenge even your own vaccines that you receive. I think that is one.

  Lesson number two is that vaccines do, of course — the vaccines protect from disease, and — but they do not protect them from infection. So I think that is just very, very clearly messages that we should be taking home there, and that we truly don't know when — if we need a second dose and how soon we need that — sorry — the booster dose, and how soon we need it.

• William Brangham:

  All right, Dr. John Nkengasong, director of the Africa Centers for Disease Control and Prevention, thank you so much for your time. And best of luck to you.

• Dr. John Nkengasong:

  Thank you. Thank you for having me on your program.