Averting a public health crisis through rapid coordination and strategic partnerships
The COVID-19 pandemic has taken a devastating toll globally, jeopardizing the health, security, and livelihoods of communities worldwide, particularly in developing nations struggling with poverty and limited economic opportunities. As the world raced to secure and distribute life-saving COVID-19 vaccines, a concerning challenge emerged – the short shelf life of many donated vaccines threatened to undermine critical vaccination efforts in Africa.
The Africa Centres for Disease Control and Prevention (Africa CDC) recognized this pressing issue and swiftly developed the “urgent support mechanism,” a streamlined rapid response system to assist African countries in accelerating COVID-19 vaccine uptake and preventing millions of doses from expiring. This innovative approach, implemented in partnership with the Mastercard Foundation, AFENET, and key in-country stakeholders, demonstrated the pivotal role of regional public health institutions in coordinating effective pandemic response efforts.
Identifying the challenge and designing a targeted solution
As COVID-19 vaccines began to arrive in African countries through global initiatives like COVAX and bilateral donations, Africa CDC leadership noted a troubling trend – many of these vaccines had a short shelf life of only 4-6 weeks upon delivery. With slow vaccine uptake rates in several member states, there was a significant risk of these precious doses expiring before they could be administered.
To address this urgent challenge, Africa CDC rapidly deployed teams to meet with the ministries of health in countries facing impending vaccine expiration. Working closely with national implementing partners, they quickly developed tailored operational plans and strategies to scale up the urgent use of these at-risk vaccines.
“The time between the initiation of alerts to the start of the implementation was typically within 2 weeks,” explained Dr. John Nkengasong, the U.S. Global AIDS Coordinator who also leads the Africa CDC’s efforts. “This demonstrated a highly optimized process that serves as a successful example for the acceleration and integration of vaccination into different healthcare delivery points.”
Implementing a multifaceted, community-centered approach
The urgent support mechanism employed a range of innovative strategies to boost COVID-19 vaccination coverage and prevent dose expiration in the participating countries. These efforts were guided by four key criteria:
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Large quantities of vaccines nearing expiration: Countries with significant stockpiles of vaccines set to expire in the near future were prioritized for urgent support.
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Reported adverse events following immunization: Areas experiencing challenges with vaccine safety perceptions or hesitancy were targeted to address community concerns.
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Low COVID-19 vaccination coverage: Regions struggling to achieve high vaccination rates were supported to increase uptake.
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Delayed COVID-19 response measures: Countries that were slow to initiate any COVID-19 vaccination efforts received additional assistance.
The on-the-ground implementation of the urgent support mechanism involved a multipronged approach that included:
Establishing COVID-19 vaccination centers (CVCs): Temporary or permanent vaccination sites were set up to expand access and accelerate immunization efforts.
Building health workforce capacity: Training was provided to both routine and surge healthcare workers to enhance their skills in effective vaccine administration and community engagement.
Procuring and distributing vaccine supplies: Ancillary items such as personal protective equipment (PPE), syringes, and cold chain equipment were supplied to ensure smooth vaccine delivery.
Conducting targeted risk communication and community engagement (RCCE): Advocacy and sensitization events, including the use of trusted religious and community leaders, were organized to address vaccine hesitancy and build confidence.
Integrating COVID-19 vaccination into routine healthcare: The urgent support mechanism worked to seamlessly incorporate vaccination services into existing health systems and delivery points.
“The urgent support has also contributed to the increased COVID-19 vaccination coverage in the Member States from 16.1% at the initiation to 25.3% at the end of the urgent support,” noted Dr. Nkengasong, highlighting the tangible impact of these coordinated efforts.
Saving millions of doses and strengthening regional resilience
Through the urgent support mechanism, Africa CDC was able to prevent the expiration of approximately 2.5 million doses of COVID-19 vaccines, valued at $900,000, across eight African countries: Cameroon, Kenya, Lesotho, Liberia, Sierra Leone, South Sudan, Tanzania, and Zambia.
In Zambia, for example, the urgent support mechanism administered 96.1% of the 549,182 vaccine doses with a short shelf life before their expiration. This was achieved through expanding vaccination centers, implementing targeted community outreach, and engaging influential local leaders to promote COVID-19 vaccination. Similarly, in Cameroon, 99.9% of the 23,001 near-expiry doses were administered through the establishment of vaccination centers and healthcare worker training.
The urgent support mechanism’s success extended beyond just vaccine preservation – it also strengthened regional resilience and coordination. Dr. Nkengasong emphasized that the initiative “demonstrated the role of regional institutions, political commitment, and strong leadership at all levels for optimized processes” in pandemic response.
Lessons for the future: Strengthening global health security through innovative partnerships
The urgent support mechanism provided valuable insights that can inform future efforts to enhance global health security and pandemic preparedness. Key lessons include:
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Importance of regional coordination: The Africa CDC’s central role in identifying the issue, mobilizing resources, and supporting rapid country-level implementation underscores the pivotal function of regional public health institutions in coordinating effective pandemic response.
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Community engagement is critical: Tailored risk communication and community outreach, including the strategic involvement of trusted local leaders, were essential in addressing vaccine hesitancy and boosting uptake.
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Integrated service delivery is more efficient: Embedding COVID-19 vaccination services within existing healthcare systems and delivery points helped streamline operations and maximize limited resources.
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Sustainable capacity building is crucial: Investing in training and equipping the health workforce, from routine providers to surge teams, strengthened long-term resilience and pandemic preparedness.
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Innovative funding mechanisms enable agile response: The Mastercard Foundation’s partnership and flexible funding enabled the Africa CDC to rapidly deploy the urgent support mechanism and adapt to evolving needs.
As the world continues to grapple with the ongoing COVID-19 pandemic and prepares for future health emergencies, the urgent support mechanism stands as a shining example of how regional collaboration, community-centered strategies, and innovative funding can save lives and strengthen global health security.
Conclusion: A blueprint for pandemic preparedness
The urgent support mechanism implemented by the Africa CDC, in partnership with the Mastercard Foundation and national stakeholders, demonstrates the power of coordinated, community-driven action to overcome global health challenges. By rapidly mobilizing resources, deploying targeted interventions, and leveraging regional expertise, this initiative prevented the expiration of millions of COVID-19 vaccine doses and significantly boosted vaccination coverage in participating countries.
The lessons learned from the urgent support mechanism offer a blueprint for future pandemic preparedness efforts, highlighting the critical role of regional public health institutions, the importance of community engagement, and the need for integrated, sustainable health systems. As the world continues to confront the COVID-19 crisis and prepares for emerging health threats, initiatives like the urgent support mechanism will be essential in saving lives, building resilience, and securing a healthier future for all.
