Private Covid-19 vaccine plan a big deal

Let’s talk about vaccinations as a case study in how to get the most for Kenyans. For, as at today, Kenya has apparently given some 934,000 first doses of Covid-19 vaccinations, with the Ministry of Health announcing second doses for the first one million inoculated Kenyans from early next month.

So, with an official 1.78 of every 100 Kenyans having had a first dose by May 2021, is it possible, in any way, to go any faster than we are?

For sure, there are plenty of reasons to suppose a timely second dose for those 933,000 will not happen, let alone a rapid new round of first doses.

For, the horrible bottleneck that has emerged is the Indian ban on exports from its AstraZeneca Covax programme facility, which was supplying vaccinations to middle and lower income countries and was the source for our first one million doses. As the new Indian variant has raged, causing havoc in India and now its neighbouring countries too, all the locally manufactured vaccinations are being deployed locally, in a situation where bodies are being rounded up with drag nets from the main river.

The situation is very different in Kenya, for it has only ever recorded 165,000 cases of Covid-19. Certainly, 165,000 is a lot of people, and underreporting is a definite factor in that number. With an infection that causes no symptoms for over a third of sufferers and mild symptoms for many more, there will have been many people who have had Covid-19 but never got tested or diagnosed.

Yet, even with underreporting, at just over 3,000 deaths, Covid-19 has killed fewer people in Kenya throughout its long and repeating progress than HIV/Aids in our nation every single month.

Now, that’s no reason to pull back from vaccinations. Just because 43,000 of our citizens a year die from Aids isn’t cause to argue that the average 250 deaths a month from Covid-19 does not merit prevention.

But it does raise the question of why we have moved into the top tier of Aids sufferers globally, as now the joint third most infected nation in the world, when we can close our nation down for an infection that kills barely one twelfth of that number.

Indeed, to me, these figures speak to a gap around priorities, which is also driving our strategy on vaccinations. For where is the rubric we use to decide how much to invest in what, and why, and to whom, in public healthcare? For, honestly, there is an element of this vaccinations race that makes me wonder if we even have one, and that’s the banning of the import of private Covid-19 vaccinations.

Now, here’s a thing: if you have only a small and limited supply of vaccinations, do you stretch that one supply over everyone? Or, in a situation where many with enough money will buy their own vaccinations, do you let them, and thereby mean the whole one million goes to those who could not otherwise access a vaccination?

Surely a million vaccinated by COVAX plus a half million vaccinated because they paid themselves is a 50 percent greater step.

Of course, the government has explained the ban on privately imported doses as a move to prevent counterfeits, and our track record on counterfeit medicines is, indeed, abysmal. It’s clearly a local and a well-established one.

THINKING GAP

But what if we invested just a dollar or three in authenticating private supplies, and thereby took the pressure off our COVAX supplies to mean they go as far as possible into the populations that could never normally afford to pay for them at full price?

Or maybe not. Maybe we use COVAX to feed a new revenue stream into private hospitals and public pockets and maybe private pockets, too, and worry not about the total number vaccinated, or strategy, or priorities, or who to get the most for Kenya.

And maybe there lies the reason we have close to the worst Aids epidemic in the world too: a thinking gap that simply causes tens of thousands of deaths versus far fewer, strategy.