Read this article in German.
Read the first part of our series here.
After the problems with protective masks and PCR tests in the spring of last year, the sluggish vaccination campaign in France is once again causing anger and incomprehension. The number of those vaccinated as of 13 January was shockingly low: around 250,000, which corresponds to a vaccination rate of 0.37 per cent. The fact that France only ranks in one of the last places in the international vaccine race has devastating consequences for the country’s spirit and the already badly tarnished self-image. Doctors, economists and politicians from the opposition are blaming the government for this calamity, the loss of human life and economic growth.
But as loud and unanimous as the criticism of the government’s ‘disastrous crisis management’ is, the debate over the causes behind the French vaccination failure is fuzzy at best. The problems with vaccine procurement have so far faded into the background. For example, the discussion that had flared up in Germany – whether the EU Commission had ordered too little Pfizer BioNTech vaccine at the insistence of the French government – fizzled out immediately in France when not only ministers but also journalists almost automatically labelled the revelations from der Spiegel as ‘fake news’.
In fact, the dispute revolves around the government’s strategic mistakes. In Phase 1 of the campaign, the executive branch decided to administer the vaccine first and exclusively in old-age and nursing homes. When combined with lengthy bureaucratic procedures for obtaining declarations of consent, this meant a much slower process than in other countries. In the meantime, the government has made a course correction, so that vaccinations will go not only to the residents of homes for the elderly, but also those over 50 years of age in the health sector and people over 75 in general.
The government’s slow vaccination drive, which was allegedly intended for the first few weeks of the campaign, also need to be seen in the context of the widespread vaccination scepticism among the population. Surveys show that only about half of the French people are prepared to have the anti-corona injection. Nowhere in the world are people more sceptical of vaccinations than in France. This attitude can be traced back to comparably deep mistrust that the French have had of political institutions for years, decades even. This in turn has been exacerbated by the executive branch’s corona policy, which in recent months has been perceived as infantilising and authoritarian.
In an almost ironic turn of events, however, the government is now under fire because its strategy was oriented too much towards the ‘anti-vaxxer’ movement and not towards those who need and want the vaccine. For the same reason, its last-minute decision to convene a council of 35 randomly chosen citizens to provide politicians with recommendations on the vaccination campaign has also been met with harsh criticism.
However, there is also another, more structural explanation: the French state apparatus has simply become incapable of organising a rapid, massive vaccination campaign on its own. This is because of underfunding, complex and interwoven responsibilities, as well as growing competition between government agencies. For example, severe logistics problems have resulted in the distribution of vaccine doses being delayed by several weeks in the various areas of France. This gives rise to another sore point for the French people, who expect so much from their state.
France aims to have one million people vaccinated by the end of January. Even considering the (still lengthy) path to herd immunity, however, there are great doubts as to whether the backlog can even be made up at all, despite the government’s reaction. One thing is already clear: with this new series of slip-ups, France has once again missed an opportunity to point a way out of the inveterate pessimism about the future and its citizens’ exasperation with politics.
Benjamin Schreiber, FES Paris
‘Everything has gone quite well so far.’ That is the impression that many have gained from the first wave of the coronavirus pandemic in Nigeria. To be sure, there have been over 100,000 cases since the pandemic began, but Africa’s largest nation has so far been spared the images of long lines of coffins. Rising electricity prices and the government’s repressive reaction to last year’s #endSARS protests have tended to dominate the headlines, as have rising crime and the threat of terrorism. And so, with both tension and a wait-and-see attitude, people are looking at the second wave – which has finally reached the country with rising numbers in Abuja and Lagos – and at the start of vaccinations in the US and Europe.
The Nigerian government has announced that the first 100,000 doses of vaccine will reach the country in late January and early February. The first doses are to be given to 50,000 frontline workers in the health sector. In addition, the public vaccination of President Buhari and his deputy as well as the governors of the individual states is also planned. There is conflicting information about the origin of these 100,000 doses, but it is usually assumed that the vaccine will come from BioNtech-Pfizer.
100,000 is a miniscule number for a country of around 200 million people. Nevertheless, the government is saying it still plans to provide 40 per cent of the population with the vaccine by the end of the year, with a 70 per cent vaccination rate to then be achieved by the end of 2022. After medical personnel, there will be a prioritisation according to age groups and previous illnesses.
Nobody can say whether these figures are realistic. Although news reports repeatedly mention all of the vaccines that have been or are about to be approved, it’s completely unclear to the public with which manufacturers the government is negotiating or whether contracts already exist. There’s little information about joint procurement strategies within the African Union or ECOWAS. After delivery, Nigerian authorities plan to do some kind of a test and occasionally there are reports of doubts about the compatibility of foreign vaccines.
In general, it is difficult to assess how the vaccinations, if they are available, will be accepted by Nigerians. There have recently been great successes in the fight against polio, but many vaccine conspiracy myths persist, including the allegation that the vaccines are secretly intended to render ‘the Africans’ sterile in order to control population growth.
In any case, vaccination will not be compulsory for the population. But it will be free of charge. Recently, reports emerged that 20 per cent of the vaccines needed are to be financed through ‘donations’ – presumably from programmes of the international community or donor countries, with the rest coming from the national budget. As an oil-exporting country, Nigeria should not have any problems meeting these costs – in principle. The opposition in parliament rightly pointed out that the budget for 2021 evidently did not include any funds for the procurement of vaccines on the international market.
In addition to procurement, distribution is likely to pose another major hurdle. For the first 100,000 doses, a key was provided strictly according to the population of the 36 states and the capital Abuja. Considering that the second wave is now particularly rampant in Lagos, Abuja and a few other states, this template-like approach has already been questioned. The general inefficiency of the administration and the population’s low level of trust in the government’s ability to implement plans are likely to make the planned vaccination campaign more difficult.
Daniel Mann, FES Abuja
Brazil has just launched its vaccination campaign. However, the vaccination debate has been politicised right from the start, especially with the dispute between President Jair Bolsonaro and the governor of São Paulo, João Doria. Obtaining vaccinations is actually the responsibility of the national government. But in parallel with the government’s chaotic crisis management, the state of São Paulo has purchased millions of doses of Coronavac, a vaccine developed in China. Bolsonaro initially boasted that Brazil would not use a ‘China vaccine’. Instead, his government has opted for the vaccine from AstraZeneca and Oxford University, inviting criticism for staying with this one bilateral agreement with a single vaccine manufacturer for such a long time. The government has now given in and signed an agreement on the use of Coronavac as well.
Since then, 100 million vaccine doses of Coronavac have been purchased. Moreover, two million doses of AstraZeneca’s vaccine have been procured and over 210 million doses of AstraZeneca vaccination are to be produced in Brazil in 2021. Furthermore, Brazil is part of the international COVAX agreement, which secures the country the right to 42 million doses. Of this total of 354 million vaccine doses, 11 million are currently available, according to press reports.
Results on the effectiveness of Coronavac were recently presented. At 50.4 per cent, its effectiveness is lower than initially announced, but still in line with the WHO’s recommendation. The vaccination has yet to be officially approved by the national health agency ANVISA; as with other areas of health care, in recent years this agency has also lost funding and staff.
The big challenge in the vaccination programme lies in organising the logistics, as it is to begin in all states in parallel. The vaccination will be carried out in several stages, initially for employees in the health sector, indigenous peoples and quilombolas (Afro-Brazilian residents of so-called quilombo settlements, which were originally founded by escaped slaves). The other vaccinations will be staggered according to age groups. With its Programa Nacional de Imunizações (PNI), Brazil has long experience and good preconditions in place for mass vaccination. However, transparency has been poor with regard to the effectiveness of the vaccinations and the communication of the vaccination strategy. Health Minister Eduardo Pazuello (a general) has so far held rather erratic press conferences that have fed doubts about the government’s vaccination campaign. In addition, it failed to get millions of syringes and ampoules for the vaccination campaign, which now have to be ordered in a hurry.
Meanwhile, the population’s willingness to be vaccinated has declined. In December, 22 per cent of Brazilians said they did not want to be vaccinated, while in August 2020 the figure was only 9 per cent. Moreover, 50 per cent do not want to accept a vaccination from China. The Supreme Court has meanwhile declared compulsory vaccination to be permissible.
Bolsonaro himself is partly responsible for the scepticism in the population. He has been sowing doubts about the Chinese-produced vaccine to achieve a putative victory over his adversary Doria, who is considered a promising candidate for the 2022 presidential election. The pandemic was used for political debate in Brazil from the very beginning and even now it is all about symbolic images.
Meanwhile, Brazil is experiencing its second wave. The holidays and summer have drawn many Brazilians to their families and to the beaches. The number of cases is rising rapidly and hospitals have been overloaded for weeks. The situation is dramatic in Manaus, where hospitals have run out of oxygen, so that doctors need to decide who can and who can’t be treated. Urgent appeals are being made to the population to donate oxygen cylinders.
Christoph Heuser, FES São Paulo