News of booster shots as soon as September in countries like the U.S. comes as a stark reminder of COVID-19 vaccine equity issues regarding distribution. Many low- and middle- income countries hover at less than 5% vaccination coverage. For example, in Uganda, only 1.6% of people are fully vaccinated, leaving many frustrated and afraid that they’re unable to access the protection millions of others are receiving around the world. Media reports from other countries tell a similar story, describing a “slow trickle” of available doses, causing people to scramble for shots.
While the COVAX initiative and the WHO work to get countries an adequate supply of vaccines to reach the 2021 30% vaccination goal, The Task Force’s COVID-19 Vaccine Implementation Program (CoVIP) is partnering with countries to immunize people when the doses arrive.
In July and August, Central Asian countries like Uzbekistan and Kyrgyzstan had some of their highest daily averages of new infections and deaths due to COVID-19. Yet full vaccination coverage remains at 3.7% and 3.4% respectively. Ministries of health in Central Asia await vaccine shipments and are working diligently to reduce transmission in other ways, but ill-equipped or non-existent systems for vaccine introduction and monitoring, a lack of trained health workers, and vaccine misinformation threaten the countries’ ability to distribute doses to citizens.
That’s where Shalkar Adambekov comes in. He is a CoVIP epidemiologist and vaccine specialist charged with strengthening vaccination systems and supporting the COVID-19 vaccine roll out in Central Asia. From Kazakhstan, he reports on the COVID-19 situation and The Task Force’s approach to strengthening local health systems.
“CoVIP’s support is tailored to what the needs are for each country based on their request. For example, some countries already have some kind of infrastructure and trained people so they have very specific support needs,” said Adambekov, who started working on immunizations as a child health specialist at UNICEF. “Here in Central Asia, they need the financial support first and then the technical assistance to build out the infrastructure for their vaccination campaigns.”
CoVIP works with regional field epidemiologists like Adambekov on vaccine campaign planning, implementation, and monitoring. The immediate goal is to ensure that countries are able to deploy and evaluate COVID-19 vaccines as they become available but these efforts will also strengthen the health system for all future vaccine-preventable outbreaks, epidemics, and pandemics.
For the Central Asia region, one of Adambekov’s current activities is supporting the urgent need to train health care workers. In many of these countries, there is only a small group of infectious disease specialists who can contribute to the COVID-19 response. Adambekov reflected on the extreme hours and wide variety of responsibilities they have, such as communicating to the public, training staff, aligning with policies, and providing public health guidance, all with very little infrastructure to support them.
“What would be a whole department with many employees in other countries like the U.S. is one person doing all of those activities in places like Uzbekistan,” said Adambekov. To provide support, CoVIP and the regional CDC offices led a training in Tashkent which trained 873 specialists on COVID-19 vaccine topics such as cold-chain procedures (storing and transporting vaccines at the appropriate temperature) and monitoring adverse events following immunizations.
The situation in Central Asia has highlighted the need for stronger systems and infrastructure to address infectious disease outbreaks.
“COVID has shown the importance of paying attention to infectious diseases,” said Adambekov. “It also has shown the importance of public health specialists. Public health specialists now have much more power than they used to and, as you know, with great power comes great responsibility, so I think that we as public health specialists need to be very careful with this power and the trust in our expertise and ensure we’re sharing consistent, science-based information.”
Header photo: Central Asia FETP resident Nadeja Volkova preparing serum samples for laboratory testing as part of her planned investigation of prevalence of fevers of unknown etiology in the Tashkent and Samarkand regions of Uzbekistan, September 2012. Photo courtesy of Central Asia FETP Fellow Dilyara Nabirova.