Monday , April 12 2021

Behind doubts about vaccines in Africa, a deeper legacy of mistrust



For months, many African governments have struggled to secure vaccines in a system in which rich countries occupy most of the place, focusing on global inequalities. But as campaigns begin to unfold across the continent, a persistent problem of mistrust is coming to the fore.

The reasons vary. In South Africa, distrust of the crunchy and overburdened public health system and the government that manages it is deep. However, the skepticism that people’s lives here really matter to foreign companies and countries that are behind most of the COVID-19 research, concerns rooted in a long history of inequality.

Some fears “have roots in colonialism, oppression and exploitation that can be easily removed in situations like this, especially when it comes to global vaccine inequality, where some countries have been able to buy a disproportionate number of vaccines.” , says Indira. Govender, doctor and health activist in South Africa.

Hesitation can mean a longer path to herd immunity and a slower economic recovery in the middle of a second wave. But community health leaders say there is a window to help address issues, provide information, and cure mistrust.

“We have the tools. We just need to turn them on, ”says Tunji Funsho of Rotary International.

Lagos, Nigeria; and Johannesburg

Ahmad Mansur has decided. The vaccines have not yet arrived in Nigeria, but Mr Mansur has decided that he will not receive any, nor his three young children.

In northern Kano State vaccines are said to cause problems and Mr Mansur believes these rumors. “Instead of being cured of a disease, you will end up getting something else,” says the pedicab driver.

Nearly 4,000 miles south, pediatric nurse Rich Sicina is treating patients with COVID-19 at a hospital near Johannesburg. He grew up in the shadow of a pandemic, HIV / AIDS, and is now fighting on the front lines of another. But he also suspects. How can a vaccine developed in such a short time be safe or effective, one wonders, and how can South Africans be sure that Western pharmaceutical companies have their best interests at heart?

For months, many African governments have struggled to get vaccines in a system where rich countries occupy the lion’s share, focusing on global inequalities. For most of the region, this challenge continues. But as campaigns begin to unfold across the continent, a persistent problem of mistrust comes to the fore.

The reasons vary. In South Africa, distrust of the crunchy and overburdened public health system and the government that manages it is deep. However, the skepticism that people’s lives here really matter to foreign companies and countries that are behind most of the COVID-19 research, concerns rooted in a long history of inequality. And the continent’s lower death toll, compared to many other regions, has given many Africans a false sense of immunity, doctors say.

As of December, about a quarter of Africans surveyed considered vaccines unsafe, according to the African Centers for Disease Control and Prevention. A recent Ipsos survey found that only 61% of South Africans would get a vaccine, inferior to any of the other 14 countries surveyed, with the exception of France and Russia.

Hesitation can mean a longer path to herd immunity and a slower economic recovery in the middle of a second wave. But community health leaders say there is a window to help address issues, provide information, and cure mistrust. In particular, they argue, strong recruitment of local leaders is critical to promoting acceptance.

The first batch of Oxford / AstraZeneca vaccines against Nigeria’s COVID-19 arrives at Abuja International Airport, Nigeria, on March 2, 2021.

Rumors say

Across Africa, conspiracy theories about vaccines were popular even before COVID-19. Long-running gossip in parts of Nigeria, for example, claims that the shootings make people sterile or contain surveillance chips. In Ghana, Ebola vaccine trials stopped in 2015 due to rumors that scientists planned to infect people with the disease.

With COVID-19, new conspiracy theories have grown headlong. At the beginning of the outbreak, many WhatsApp users sent with dizzying allegations that COVID-19 was manufactured in a Chinese laboratory or that radiation from 5G Internet towers caused the disease.

Some fears “are rooted in colonialism, oppression and exploitation that can be easily shaken in situations like this, especially when it comes to global vaccine inequality, where some countries have been able to acquire a disproportionate number of vaccines. “and others are left without, says Indira Govender, a doctor and health activist in South Africa. “This plays with people’s fears about Western colonialism and Western medicine.”

But rumors also have roots in recent trials that have sometimes seen African countries receive unethical medical practices. In 2009, Pfizer reached an out-of-court settlement over a controversial meningitis drug trial in Kano state in the 1990s. Eleven children died and others were paralyzed. The company argued that the deaths were due to meningitis, not the drug, but the parents alleged they had not given informed consent. In South Africa, many recall trials of HIV vaccines in the mid-2000s that ended hastily after authorities discovered that the drug was not only powerless against infection, but potentially caused those who if they took it they would be vulnerable.

In the aftermath of the Pfizer episode, rumors sparked a boycott of the 2003 politically supported polio vaccine in parts of northern Nigeria, where low levels of literacy and conservative Islamic principles often encourage a dubious look at Western interventions. The boycott was lifted more than a year later, but cases skyrocketed and the virus spread to Yemen.

Now, with COVID-19, connectivity makes sharing uninformed information happen much faster. The best politicians, including a seated Nigerian governmentr and a first-rate South African judge, have also spread conspiracies. In East Africa, the President of Tanzania once declared COVID-19 a scam and his government has rejected vaccines.

Fight fear

Some concerns about vaccine safety stem from its rapid development, sparked by unverified claims of deaths after vaccination in Europe.

But these concerns can be counteracted with accurate and specific information, experts say. For decades, groups such as Rotary International worked to overcome the rejection of the polio vaccine in Nigeria by working with local and volunteer health workers, known and trusted by their communities, who helped carry out the promotion of polio. door-to-door immunization across the country. Last year the country was declared free of polio.

“We have the tools. We just need to activate them, “says Tunji Funsho, leader of Rotary International’s polio program in Nigeria.” We need to learn to communicate with people in languages ​​they understand “and find out where the communication gap lies.

It is the superstitions, for a long time, that could be more difficult to fight.

In South Africa, “people are scared because they need more information. They need help to understand science: how vaccines work, how they are tested, ”says Narnia Bohler-Muller of the South African Humanities Research Council. Professor Bohler-Muller wrote a previous study on confidence in the South African vaccine, which found that the most common reasons for doubt were fear of side effects and concerns about efficacy. “The good news is that it is a solvable problem. If people have superstitions about a vaccine, it’s hard to counter. If they just need more information, it can be given. “

According to her, it is now especially important to target people with accurate information, after the South African government stopped the deployment of the AstraZeneca vaccine, after finding that it offered low efficacy against mild to moderate cases caused by a new variant identified in the country.

“We find that the information must come from local and trusted sources, such as community leaders,” says Tian Johnson, who leads the African Alliance, a group that has advocated the vaccine in South Africa from the beginning. of the 2000s. The organization has found that “scientists and researchers should not respond to false claims, because for many people they are seen as the problem,” says Mx. Johnson, who uses gender-neutral titles. Instead, people need to listen to the leaders they respect.

Meanwhile, across the continent, experts warn that information efforts have not been as strong as they should be. Nigeria’s primary health agency has launched campaigns on social media, but public announcements are not yet flooding public radio and television. In Ghana, where mass vaccinations began this week, President Nana Akufo-Addo received the first shot to convince skeptics.

Activists argue that vaccine skepticism will diminish as more Africans are vaccinated, seeing for themselves a safe and effective procedure that, when offered more broadly, could ease movement restrictions and help reopen economies.

But many countries have uncertainty about when and if they will receive a significant number of doses. Most of the region is partially dependent on the COVAX program run by the World Health Organization, which promises a fair distribution for vulnerable countries. As richer countries buy supplies, this deal leaves others waiting for crumbs. In Nigeria, with 200 million people, its deliveries have been slashed several times and it has only received its first 3.94 million doses this week. Only a dozen African countries have launched vaccines, with about 4.5 million doses dispersed. In contrast, more than 150 million vaccines have been administered in the United States, China, and the United Kingdom alone, with millions of doses more insured.

“Our challenge right now is [knowing] if the vaccines come at a certain time, we’re not going to defend and the vaccines don’t come, ”Dr. Funsho says.


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