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220 million doses J&J, will the AVAT initiative be able to activate in time?

John Nkengasong, CDC Director and African Union Special Envoy to WHO

The agreement between the African Union (AU) and the pharmaceutical company Janssen has finally made concrete progress. On Thursday, UNICEF signed an agreement to deliver 220 million doses of the J&J vaccine to Africa, as part of the AU's AVAT initiative.

The AVAT program, initiated by the AU in November 2020, will start delivering vaccines: 220 million Johnson & Johnson (J&J) single-dose vaccines are planned, of which at least 35 million will be delivered equitably to African countries that are AVAT signatories before the end of 2021.

The agreement with the African Vaccine Acquisition Trust (AVAT) and Janssen was signed in March. And with the guarantee of the African Import-Export Bank (Afreximbank), deliveries should be made on time. Then, in order to streamline the process, UNICEF will guarantee the logistics. The UN body has an undeniable ability to transport, save, and even distribute vaccines. In addition, since J&J is administered in a single dose, the AVAT initiative will allow its signatories to quickly gain in effectiveness.

UNICEF Executive Director Henrietta Fore declared : “Access to vaccines in Africa has been uneven and unfair, with less than 1% of the population currently vaccinated against Covid-19. This cannot continue ”. The former American diplomat was behind the proposal. Having distanced herself from Washington since 2009, she took her place at the head of UNICEF in 2018.

A strange arrangement therefore, between an American Republican, the AU, an American-Belgian laboratory and mainly Chinese funds. Not to mention the positive response from the World Bank, which until then had opposed any sale of vaccines on credit to African countries.

A solution against vaccine apartheid?

First, UNICEF led the charge along with Africa CDC. The African Union had not been able to find a consensus on the logistics of transporting J&J vaccines since March. Faced with the introduction of the "vaccine passport" within the European Union (EU), highly criticized in Africa, especially by the CDC, the latter addressed the UN. Within the UN General Assembly, the response was negative regarding the implementation of AVAT with the means of its missions in Africa. The AU could not afford to transport the vaccines either, especially with the COVAX initiative which monopolizes CDC resources.

UNICEF therefore stepped forward, enjoying relative credibility in African states. Globally, it has helped deliver 100 million doses to 135 countries, according to the UN. Nevertheless, according to Fore: "To beat Covid-19 in Africa, we need everyone". Before continuing: "This pandemic has cost everyone something, we can only put an end to it by vaccinating quickly, before the virus mutates again and spreads."

It is clear that since the start of the pandemic in early 2020, the various variants have caused new waves of epidemics around the world. Africa is relatively sheltered, except some countries. The heterogeneous health measures and their jerky imposition have paralyzed normal life. Only a few countries invest in the manufacture of vaccines in Africa (Algeria, Nigeria, etc.). Africans still resort to mass purchasing. AVAT vaccines are said to be a tiny fraction of Africa's needs, but any vaccine that bypasses the active European Union blockade, otherwise known as vaccine apartheid, would be good to take.

Is vaccine apartheid recognized as such?

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