COVID-19: Focus and funds must pivot to Africa as countries reel from deadly second wave

Save the Children is warning that the lives of thousands of children across Africa are at risk as the hard-hitting second wave of COVID-19 surges across the continent. The agency fears many African countries will be forced to wait months before they can vaccinate even the most vulnerable people and essential frontline health workers, deeply impacting the lives of children.

Africa has six of the top ten countries with the fastest increase in the numbers of confirmed cases[1]. The continent’s COVID-19 mortality rate is also now higher than the global average, marking a grim development from previous phases of the virus. The case fatality rate across Africa is now at 2.5 percent, above the global average of 2.2 percent[2], with the rapid spread of the highly contagious South African variant of particular concern.

Save the Children is urgently calling for wealthier countries to prioritise global equitable access to all COVID-19 medical tools, including oxygen and vaccines. Medical oxygen is universally available in rich countries, while across much of Africa it is not available or is a luxury item[3].

Any delays in vaccinating health workers could further disrupt nutrition, immunisation and other essential health services for children if health workers fall ill, or families needing healthcare stay away from hospitals because of fears of contracting COVID-19.

Malawi now has the second highest rate of increasing confirmed cases in the world, with cases doubling in just twelve days, from 9,991 on January 14 to 20,830 cases on January 26[4].  Malawi is in the “Least Prepared” group in the 2019 Global Health Security Index, with particularly low scores on response to an epidemic (176^th out of 195 countries). The surge in demand for oxygen coupled with a chronic oxygen undersupply is undermining the health system’s ability to cope with the increasing COVID-19 caseload, as well as its ability to respond to other illnesses such as childhood pneumonia.

In West Africa, Nigeria continues to have the largest number of COVID-19 cases, with nearly 125,000 confirmed cases. In Lagos, the demand for oxygen has surged amid the second wave of COVID-19 infections, with one of the main hospitals reporting a fivefold increase in demand in recent weeks. In response, the federal government in January approved the equivalent of US $17 million to establish 38 oxygen plants across the country.

Save the Children is calling on governments to stop vaccine nationalism, and to support countries in Southern Africa through the provision of oxygen and other supplies as they reel from extremely high rates of spread of the disease.

Save the Children’s Country Director for Malawi, Kim Koch, said:

“Our staff are working tirelessly to deliver support for children in an increasingly challenging situation. People are sick or in quarantine, many are caring for sick family members, balancing child-care at home, or facilitating funerals or memorials. Our teams are hit as well, and have to adapt their plans in order to work as safely as possible, taking into account the regulations for working in a pandemic. Whenever safe and necessary, we will continue to carry out lifesaving support to address the immediate healthcare crisis in the country.”

Save the Children’s Regional Director in East and Southern Africa, Ian Vale, said:

“High-income countries are currently securing vaccines that could potentially be at the expense of COVAX[5]. They are competing for the same vaccines as low-income countries, and currently, they are winning.

 “We understand it will be difficult to ensure equal access of the initial supply of vaccines, but governments must do what they can to make sure it’s as fair as possible and not further accelerate the huge global inequities we face today. This pandemic has stressed that our own protection is rooted in the protection of others - no one safe until everyone is safe.”   

Save the Children remains deeply concerned by the longer-term impact of the pandemic on children’s education. The longer children are out of school, the less likely it is for them to return.  Research by the charity last year found that globally, 10 million children may never return to school.

Save the Children is urging governments to follow World Health Organisation Strategic Advisory Group of Experts on Immunization (SAGE) guidelines[6] when making vaccine allocation decisions. This includes ensuring teachers and school staff are recognised as a priority group for vaccinations, once frontline health workers and high-risk populations are vaccinated. This will be vital for keeping education staff safe at school once they reopen and to help reduce the unprecedented level of disruption to children's learning and wellbeing due to school closures.