African countries have been notified of their estimated dose allocation for the first phase of COVID-19 vaccine delivery by COVAX. It said it intends to start shipping nearly 90 million doses of the COVID-19 Vaccine AstraZeneca (formerly AZD1222) to the continent in February 2021.

COVAX is the global initiative led by the World Health Organisation (WHO), Gavi – the Vaccine Alliance and The Coalition for Epidemic Preparedness Innovations (CEPI) to ensure equitable access to COVID-19 vaccines for all countries, regardless of income.

“Africa has watched other regions start COVID-19 vaccination campaigns from the side-lines for too long. This planned roll-out is a critical first step to ensuring the continent gets equitable access to vaccines,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We know no one will be safe until everyone is safe.”

The countries were notified of their estimated allocations by letters, sent on the 30 January 2021. However, the final shipments will be dependent upon production capacities of vaccine manufacturers and the readiness of countries. Recipient countries are required to submit finalised national deployment and vaccination plans to receive vaccines from the COVAX facility. Distribution of doses is also subject to the vaccine being listed for emergency use by the WHO, which is currently reviewing the product.

In addition to the AstraZeneca vaccine, around 320,000 doses of the Pfizer-BioNTech vaccine have also been allocated to four African countries – Cabo Verde, Rwanda, South Africa and Tunisia. While the vaccine has received WHO Emergency Use Listing, its storage and distribution requirements (approximately -70°C) have limited where it can be disseminated to. To access an initial limited volume of Pfizer vaccine, countries were invited to submit proposals. Thirteen African countries submitted proposals and were evaluated by a multi-agency committee based on current mortality rates, new cases and trends, and the capacity to handle the ultra-cold chain needs of the vaccine.

“This announcement allows countries to fine-tune their planning for COVID-19 immunisation campaigns. We urge African nations to ramp up readiness and finalise their national vaccine deployment plans. Regulatory processes, cold chain systems and distribution plans need to be in place to ensure vaccines are safely expedited from ports of entry to delivery. We cannot afford to waste a single dose,” said Dr Moeti.

The initial 90 million doses should enable countries to immunise the three percent most in need of protection, including health workers and other vulnerable groups, in the first half of 2021. As production capacity increases and more vaccines become available, the aim is to vaccinate at least 20 percent of Africans by providing up to 600 million doses by the end of 2021.

To complement COVAX efforts, the African Union has secured 670 million vaccine doses for the continent which will be distributed in 2021 and 2022 as countries secure adequate financing. The African Export-Import Bank will facilitate payments by providing advance procurement commitment guarantees of up to $2 billion to the manufacturers on behalf of countries.