Is Uganda ready to acquire the Covid-19 vaccine?

A nurse holds a phial of the Pfizer-BioNTech Covid-19 vaccine at Guy’s Hospital, in central London on December 8, 2020. PHOTO | AFP

The world’s population, years over, has been affected by a number of viral diseases such a Ebola and Influenza which, in some cases, have caused millions of deaths.

The severity of the attacks is often assessed ‘country by country’ or ‘continent by continent’.

To date, the most dangerous and severe viral disease outbreak has been Covid-19, which has affected the economies of almost all countries.  So far, about 68,703,109 cases have been registered worldwide. Of these, 1,566,088 have died while recoveries stand at 47,642,036.

No known cure has been developed. However, scientists have been tasked with  developing an effective and safe vaccine as opposed to providing a random treatment for corona patients.

According to the World Health Organisation (WHO), there are 48 vaccines under clinical evaluation in various countries with prospects of release next year.

Hopes are high that one or two will eventually pass all the tests and be made available on the market in time to ease the global crisis.
Most developed countries have in that regard already put in place funds to purchase the vaccine for their citizens.  But this is not the case for some countries in Africa, Uganda inclusive.

The virus, the hosts
Health experts say coronavirus comes in different types, with its natural hosts majorly being humans, pigs, dogs, cats, camels, bats, snakes, birds and the pangolin, among others.

Prof Omu Anzala, a lead researcher at the Kenya Aids Vaccine Initiative at the Institute of Clinical Research (KAVI-ICR), University of Nairobi, notes that there have so far been seven types of human corona occurrences.

They include HCoV-229E, HCoV-OC43 (which is Endemic world-wide), HCoV-NL63, HCoV-HKUI, MERS-CoV (which occurred between 2012 and 2013. Then, 2,500 cases were reported with about 800 deaths in the Middle East).  
SARS-CoV experienced between 2002 and 2003 registered 8,098 cases and 774 deaths in mainland China and Hong Kong.

The current strain is SARS-CoV-2  or Covid-19, which was reported in late 2019. It presents with symptoms such as fever, cough, tiredness, shortness of breath with an incubation period is from two to 14 days.
According to Prof Omu, the reason Covid-19 is a concern is that the signs and symptoms are not distinct, yet it can be spread even by a person  without symptoms. Besides, there is no specific antiviral drugs or vaccines.

He contends that some companies are already executing phase III of the vaccine but it is not clear if what will be produced will be able to serve the world population.

Already, developed countries such as US, under the government’s Operation Warp Speed Initiative has pledged $10 billion and aims to develop and deliver 300 million doses of a safe, effective coronavirus vaccine by January 2021.  The United Kingdom has preordered 195 million doses of the AstraZeneca vaccine for its citizens.

WHO is also coordinating global efforts, to develop a vaccine, with an eye toward delivering two billion doses by the end of 2021.
As for Africa, there haven’t been clear plans on how leaders will allocate funds to purchase vaccines for its citizens. As usual, countries are relying on donations from the developed world, which is a disadvantage.

Prof Omu says there are concerns about the expedited approach scientists are using to develop a Covid -19 vaccine, which to him, should not raise doubts because scientists have done this before, especially in finding an Ebola vaccine.

“It can typically take 10 –15 years to develop a vaccine but scientists can expedite vaccine development depending on the need and emergency. Vaccines go through a three stage clinical trial process before they are sent to regulatory agencies for approval. This is a lengthy process but for Covid-19, this is not the case,” he said in a press briefing organised by Africa Science Media Centre (AfriSMC) about the status of Covid-19 vaccine development. “The fastest ever vaccine developed was for mumps in the 1960’s,” he added.

Even after a vaccine is approved, it faces potential roadblocks when it comes to scaling up production and distribution, which includes deciding which population should get it first and at what cost.

Prof Omu urges the international community and African countries to take tangible actions to ensure the continent has equitable access to Covid-19 vaccines.

“Africa should start planning logistics and distribution of vaccines instead of being skeptical and hesitant. The emerging global issue right now is acceptance of the vaccines, availability and its access,” he notes.

In this case, vulnerable communities, persons with previous history ailments such as diabetes, high blood pressure, asthma and the elderly who would easily succumb to the virus will be considered first.

Dr Phiona Atuhebwe, a New Vaccines Introduction Medical Officer at the WHO Country Office in Congo Brazzaville, notes that Africa has gone for the vaccine developed by Covax.

 This is because Covax targets to produce two billion vaccine vials to cover 20 per cent of the population in each country worldwide.

 “African Heads of State should have allocated funds to pay for this vaccine because some countries in the developed world have done so. This clearly shows that there is already scramble for the vaccine before it is released in the market,” she notes.

Prof Omu urges East African nations to come together and negotiate for vaccines as a consortium so that they can get price concessions due to large quantities ordered. 

The Ugandan status
In Africa, two countries; South Africa and Kenya, are participating in testing the Oxford University vaccine.

Uganda submitted a COVAX application on December 7 under the Covax facility where we shall be able to access approximately nine million doses of the vaccine to cover 20 per cent of the population. Plans are underway to secure additional doses of the vaccine to cover more people.

The deputy executive director UNCST,  Dr Martin Patrick Ongol, notes that so far, his team has issued permits to 41 research activities related to Covid-19, two being clinical trials where scientists are testing if hydrochloquine can be used as treatment to reduce the virus in the human body.

The other is where scientists are extracting Convalescent Plasma from patients who have recovered to establish if it contains antibodies to treat persons with Covid-19 virus.

The director Uganda Virus Research Institute (UVRI), Dr Pontiano Caleb,  while giving an overview of Covid -19 situation in the country notes that his team is participating in research activities with scientists from London College University and others but mainly in determining the efficacy of appropriate testing.

He notes that UVRI, in collaboration with Ministry of health have secured PCR testing kits, which can be used for instant testing and tests that can give results after some time.

 Scientists are studying whether they give test results according to the recommended WHO organisation guidelines before embarking on using them. This is because some testing instruments give wrong results.

The vaccine development, initiative and types
Experts state that the Covid-19 vaccine candidates aim to instruct the immune system to mount a defense, which is sometimes stronger than what would be provided through natural means.

To do so, some vaccines use the whole coronavirus but in a weakened state. Others use only part of the virus whether a protein or a fragment. 

Some transfer the coronavirus proteins into a different virus that is unlikely to cause disease or even incapable of it. Finally, some vaccines rely on deploying pieces of the coronavirus’s genetic material so that human cells can temporarily make the coronavirus proteins needed to stimulate the immune systems. 

There are few vaccines that have reached phase III, the most prominent being ChAdOx1 nCoV-19 developed by University of Oxford in UK in collaboration with the biopharmaceutical company AstraZeneca.

This is known as a viral vector vaccine presented to the immune system. Oxford’s research team has transferred the SARS-CoV-2 spike protein which helps the coronavirus invade cells into a weakened version of an adenovirus, which typically causes the common cold. When this adenovirus is injected into humans, the hope is that the spike protein will trigger an immune response.

According to the information on the official WHO website, it is stated that on November 23, Oxford and AstraZeneca announced interim results from two of its phase three trials. 
One conducted in the United Kingdom showed the vaccine was 90-per cent effective in preventing Covid-19 when given as a half dose followed by a full dose one month later. But in a second trial conducted in Brazil, in which volunteers received two full doses one month apart, the effectiveness dropped to 62 per cent. 

On average, the efficacy is 70 per cent. Project members say their candidate can be stored in normal refrigeration and they plan to seek an emergency use listing from the World Health Organisation, which would set up their candidate for distribution in lower income countries.

Oxford and AstraZeneca are expected to produce up to three billion doses of the vaccine in 2021.