Read Part I, II, III , IV , V, VI and VII of our series 'Global vaccination'.
Mongolia
The Covid-19 pandemic in Mongolia is like a ride on a rollercoaster. The successes achieved at the beginning of the pandemic through determined prevention were squandered as the pandemic progressed because of pandemic fatigue in the population, economy and politics. While Mongolia managed to prevent local transmissions until November 2020 by closing borders, schools and large parts of public life, two violent waves kept the country on tenterhooks in spring and summer 2021 after extensive easing.
The pandemic reached its preliminary peak on 18 June 2021, when 2,746 new infections were registered in the country of around 3 million inhabitants. The number of unreported cases is likely to have been many times higher. The proportion of positive Covid-19 tests was at times over 25 per cent. The weak health system was at risk of collapsing. Intensive care beds became scarce while doctors and nurses protested against overwork and poor pay.
The fact that the situation has improved since then has to do with the vigorous vaccination campaign. There are plenty of vaccines and hardly anyone refuses to get jabbed. In the meantime, about 55 per cent of the population have received at least two vaccine doses. Mongolia’s stable vaccine supply comes down to the country's skilful foreign policy. As a democracy situated between Russia and China, Mongolia has always succeeded in balancing the interests of its two difficult neighbours and in forging close ties with the democracies of Asia, North America and Europe. Those who have many friends competing with each other for power and influence in Asia also get plenty of vaccines. The backbone of Mongolia’s vaccination campaign is China's Sinopharm/Verocell vaccine, which is used for the general population. High-risk groups and people in essential jobs receive Western vaccines, mainly through the Covax initiative. The Russian Sputnik V is used in smaller quantities.
However, the government's popular strategy of controlling the pandemic through vaccination instead of prevention is risky. In the last wave in particular, a strikingly large number of people who were vaccinated twice contracted Covid-19. Although most of them remained symptom-free, they infected family members, friends and work colleagues. The larger public now becomes more sceptical of the effectiveness of Chinese vaccines in particular.
Many also consider the election campaign in the run-up to the presidential elections to have been the reason for the surge in infections in June. This has led to harsh criticism of the government. As a result of public pressure, most of the celebrations for the 100th anniversary of the Mongolian People’s Revolution were cancelled. It is also suspected that the Delta variant could be responsible for recent infections. This could not be confirmed so far, as there are no sequencing facilities in Mongolia. In July, 50 samples were sent to Japan, five of which tested positive for the Delta variant. According to the Ministry of Health, these were all quarantined travellers. For the time being, Mongolia's pandemic response remains a blind flight in terms of virus variants and a risky bet on a successful vaccination campaign.
Niels Hegewisch, FES Ulaanbaatar
Tanzania
With its attitude of leaving aside the pandemic in the country, Tanzania held a somewhat isolated position across the world – until recently. As one of six countries worldwide that have not yet started vaccinating, Tanzania applied to the Covax initiative in mid-June. Vaccines are now expected to arrive in the country within six months. Beyond the big question of how keen the population is on getting the jab, this approach presents a U-turn. However, the semi-autonomous part of the United Republic of Tanzania, Zanzibar, had already gone ahead with the promise that the island would provide vaccines for the Hajj pilgrimage. Vaccination has also been taking place there since this week.
Tanzania’s new president, Samia Suluhu Hassan, who has ruled since 19 March 2021 after the death of her predecessor, warns almost daily of the third wave of Covid-19 as it appears in neighbouring countries, emphasising the completely new situation because of the ‘far more deadly’ Delta variant. That’s clever messaging – because until recently, Tanzania kept quiet about the issue. It also means that, socio-politically, the country is not facing its third wave, but its first. On the one hand, one can see this on the streets: changes in behaviour in the public sphere are very slow. Masks are found where companies or organisations had decided early on to take precautionary measures. On the other hand, dis- and misinformation in dealing with Covid-19 is widespread, like rumours about vaccinations. Now, the Ministry of Health has agreed with some partners on educational measures.
The new president revealed her desire to take a science-based approach to infection control immediately after taking office by convening a commission of experts, which in mid-May presented 19 comprehensive recommendations on how to deal with the then already imminent third wave and with vaccination prioritisation. These are cautious steps into a new terrain. Samia Suluhu Hassan herself is aware of her function as a role model and has been wearing a mask in public for some time now. Her focus is on making people aware of public health measures.
Nevertheless, no reliable statement can be made about the spread of Covid-19 in Tanzania. Furthermore, the last – publicly available – data reported to the WHO stems from May 2020. Shortly after the president’s unanimously positive 100-day assessment, which included her new pandemic policy, Samia Suluhu Hassan herself announced a figure for the first time at the end of June: there were 100 cases in hospitals, 70 of which were dependent on oxygen. At the end of last week, the health minister reported 408 new Covid-19 cases and said that the third wave becomes visible in cities and ‘many other regions’. Since then, hospitals have warned that there is not enough oxygen to supply all of their patients. At the same time, the population is called upon to take all precautions to avoid a dire situation in the country.
Tanzania is now seeking the trust of international development partners and investors to, among other things, mobilise financial resources for medical equipment, training and vaccinations. On the other hand, it should not be forgotten that global vaccine distribution has created immense irritation. Of course, no African country wants to be perceived as in need for charity. And who wants to start vaccination campaigns without being able to make a vaccination offer? Tanzania has found its own answer to this question: along with the announcement that Covid-19 vaccines – thanks to Covax – will be available and voluntary from December onwards, the government announced that it would start local production of various vaccines including a possible Covid-19 vaccine.
Elisabeth Bollrich, FES Dar es Salaam
Uruguay
On the global rollercoaster ride that the Covid-19 pandemic has started, the small South American country of Uruguay added a few more loops: While infection figures remained low for so long in 2020 that the authorities wanted to declare the country Covid-19-free by June 2020, Uruguay broke the world ‘record’ in April 2021 with a 7-day incidence of 790.
At the same time as the pandemic began and after 15 years of progressive government under the centre-left coalition Frente Amplio, the right-wing conservative government under President Lacalle Pou had taken the helm. In line with its neoliberal doctrine, the government wanted to rapidly reduce public spending and market intervention. Even with the Covid-19 outbreak, it didn’t alter course.
The government initially reacted to the onset of the pandemic with a lockdown and the convening of a scientific advisory board. After a few weeks, however, and due to low infection figures, their recommendations were discarded – especially since business always took precedence over health. Shopping malls, restaurants, and sports studios have been open ever since, and masks are only compulsory indoors. While the civil service was sent to the home office and schools were temporarily closed, this never applied to the private sector. Without bans and closures, the idea was to rely fully on the ‘responsible freedom of the individual’. It’s only trade unionists – who are allowed to go into a fully packed bar – that run the risk of being arrested at a rally, as this type of gathering is prohibited under Covid-19.
The receipt for this kind of approach came promptly in April 2021: Uruguay reported the highest incidence in the world at 790. The fact that the number of deaths remained relatively low with an infection rate of 11 per cent (by comparison, Germany 4.5 per cent) can only be attributed to the continuous investment in the public health system by the three previous governments. Moreover, the Lacalle Pou government had been completely complacent and not even bothered with purchasing vaccines for a long time. Only under pressure from the rise in infections, it quickly reached a trade agreement with China – as elsewhere, contracts and conditions were never made public. In only four months, 56 per cent of the adult population were fully vaccinated. That made Uruguay again a world leader, but it also only has 3.5 million inhabitants. Today, the 7-day incidence is 111. It is unclear how much of this is because of the vaccination campaign and how much to the government's recent decision to halve the number of PCR tests offered free of charge – according to the motto: less tests, less cases. And since border traffic with neighbouring Brazil has never been restricted, the Delta variant – even if not officially confirmed – should have arrived long ago.
How the neoliberal reduction in state intervention and austerity are to go together with a post-Covid reconstruction remains a big question. According to the Economic Commission for Latin America and the Caribbean (CEPAL), Uruguay is the country in the region that invests the least in combating the economic and social consequences of the pandemic.
Dörte Wollrad, FES Montevideo
