In October, Burundi began administering COVID-19 vaccinations, breaking its status as one of only three countries (along with North Korea and Eritrea) not administering the vaccines. Across the Pacific, Haiti received its first vaccine shipments in July, becoming the last country in the Americas to receive them. Though vaccine campaigns are now underway in the country, earthquakes and civil upheaval have kept Haiti’s vaccination coverage rate below 0.5%.
Although each country’s situation is distinct, epidemiologist Dr. Adele Daleke Lisi Aluma is charged with what they have in common: helping countries boost their vaccination coverage rates and the surveillance of COVID-19 vaccine and immunization safety. As a regional field epidemiologist, Daleke Lisi Aluma supports Francophone countries as part of The Task Force’s COVID-19 Vaccine Implementation Program (CoVIP), which works with more than 35 low- and middle-income countries to develop immunization systems and administer COVID-19 vaccines.
From her home country of Democratic Republic of Congo (DRC), Daleke Lisi Aluma reports on the situation there and in countries like Burkina Faso and Côte d’Ivoire, where she worked with partners to provide technical support on developing a national COVID-19 vaccine roll out plan and vaccine safety monitoring. Many of the Francophone countries she supports are in Africa and all are below 10% vaccination coverage.
“The situation of COVID-19 typically differs from one country to another depending on the country setting, the number of cases, and the mortality rate,” she said. “Furthermore, not all countries possess a similar level of disease surveillance system, including the COVID-19 surveillance system. Besides the capacity to detect cases, the decentralization of the COVID-19 diagnosis, either due to lack of skills and/or equipment, also prevents standardization of the result.”
Globally countries are tackling the third and fourth waves of COVID-19. Due to variants these waves seem to be more severe than previous ones, making the need for vaccines essential for all countries and especially those with low coverage.
While the Seychelles leads vaccine rates among Francophone countries in Africa with 80.6 % of the population fully vaccinated, 16 of the 21 official and multilingual Francophone African countries remain at or below 5% full vaccination coverage. In contrast, the majority of Western European countries have fully vaccinated more than half of their populations.
Daleke Lisi Aluma cited three main challenges that have stunted immunization coverage in many African countries.
First, she said, efforts are stalled because of the delay and insufficient delivery of COVID-19 vaccines across the continent in part due to developed countries taking up most of the vaccine supply.
Second, a high level of reluctance to be vaccinated in many communities, amplified by rumors spread on social media and few known cases and deaths of COVID-19 in some places have sparked concerns and doubts that have undermined prevention measures. Third, insufficient financial resources to deliver vaccines, primarily in the early stages of the pandemic when financing mechanisms were not yet in place and some political leaders were slow to commit to immunization as part of their COVID-19 control strategy.
Ministries of health, the WHO and the COVAX initiative (COVID-19 Vaccines Global Access partnership) are working to improve supply of vaccines to low- and middle-income countries. At the same time, Daleke Lisi Aluma and CoVIP’s other regional epidemiologists in West Africa, East Africa, and Central Asia are helping countries build immunization plans, monitor and evaluate COVID-19 activities, train health workers, and advocate for vaccine uptake at the government level and in communities.
Daleke Lisi Aluma has more than 12 years of experience in vaccination and surveillance of vaccine-preventable diseases like measles, polio, diphtheria, tetanus, and yellow fever. She has seen the important role that clear and effective communication has in successful vaccination efforts to control and prevent new outbreaks.
“I’m optimistic that we will get vaccines to people in the countries I work in, including my home country of DRC,” she said. “Effective vaccination is the greatest hope for disease control and the return to normality. It will require greater political and financial commitments from policymakers and improved acceptance of vaccines and understanding of the risks of COVID-19 by citizens but it will be possible.”
In addition to working with Francophone African countries, Daleke Lisi Aluma will soon travel to Haiti to support vaccine activities there. The country received its first shipment of 500,000 doses in July from a U.S. pledge of 12 million doses, but it still remains at only 0.5% full vaccination coverage, as efforts were complicated by the August earthquake that killed more than 2,000 people and destroyed critical infrastructure.
Header photo courtesy of Dr. Adele Daleke Lisi Aluma