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Tanzania has taken a very particular approach to controlling SARS-CoV-2. Last year, just a few months after the pandemic began, President John Magufuli declared the East African country free of covid-19 after three days of national prayers. Since then, has refused to impose a lockdown, has reopened schools, allowed the holding of major sporting events, continued with religious meetings, stopped testing and suspended public communication campaigns on the virus. The country too has stopped reporting cases and deaths.
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The argument was that people should stop living in fear, and trust in God and in traditional African remedies to prevent contagion. Tanzania may be the only country in the world that has taken this approach, which goes against everything that has been recommended by scientists, other national health agencies and the World Health Organization (WHO). Therefore, it is not surprising that the authorities have said they have no plans to vaccinate the population, or at least, not for now.
Will people still be able to access vaccines?
No and yes. No, because a vaccine cannot be used in the country without its use being registered and authorized. The normal process is for experts, in conjunction with regulatory bodies, to review immunization data and approve its use if they are convinced of its efficacy and safety. For the covid-19, this is being done through the procedure of the WHO emergency use list. The review is carried out by an international team of specialists with the participation of other national authorities. But if the Tanzanian government refuses to register it for use, no one will be able to access it.
However, the country could register some, but refuse to import it. This would allow the private sector to import it, although it would not be enough units. Immunization programs against the new coronavirus in any country involve massive management and, if the private sector takes the reins, many will not be able to afford the doses or have access to them. Those who could access them would be the people belonging to the Tanzanian elite (or those who have the means), as they could leave the country and obtain it elsewhere.
People living in Tanzania are not sufficiently prepared or protected
Other Tanzanians who may have access to vaccines include those border communities that, in the past, have crossed into neighboring countries and they have benefited from health programs. This could happen if widespread immunization begins to occur in Kenya, Uganda, Rwanda, and Malawi. But that will be in a couple of years.
There is still the possibility that Tanzania will register and import vaccines in the future. Magufuli has sent mixed messages. On the one hand, the Government has said that it does not plan to order them through COVAX (a global initiative aimed at achieving equitable access to doses against covid-19) or any other mechanism. In fact, the recently released COVAX mailing list does not include any for Tanzania. On the other hand, has affirmed Tanzanians should only trust dosages that have been reviewed by national experts and deemed safe by Tanzanians.
Does Tanzania have a history of opposition to vaccines?
Not that I know. Tanzania, like other countries, has launched vaccination programs routine. They are especially aimed at children under five years of age and act against diseases such as tuberculosis, polio, whooping cough, measles, rubella and diphtheria. In recent years, these programs have been expanded to include those for bacterial pneumonia, diarrhea, and hepatitis B. In Tanzania, vaccination coverage she’s very tall: about 80% or 90%. This means that there is no history of opposition to others.
Differences between Tanzania and neighboring countries like Kenya and Uganda
Kenya, Uganda, Rwanda and Malawi have desperately tried to get the vaccine for their citizens. All of them have been integrated into the COVAX service and they have developed distribution plans, calculated costs and presented them. Rwanda has even gone ahead and has obtained doses outside the mechanism. These four countries have also started to inform the public about their plans. For example, they have confirmed that the first phase of distribution will be aimed primarily at healthcare personnel and people at high risk.
Right now, the biggest problem facing African countries is to shortage in the global market to vaccinate a significant part of the population. Many rich countries will have inoculated doses to all who need it by the end of this year. But African countries will not have full availability until the end of next year or even until 2023. If the countries that have sought them so hard are so far behind, imagine a country like Tanzania that, right now, has not even started.
What is the risk for the country and the region?
The risk to the country has already become apparent. The method followed by Tanzania has allowed the virus to spreads uncontrollably among the population. People are dying from what is being categorized as “pneumonia” and “breathing difficulties.”
People living in Tanzania are not sufficiently prepared or protected, as there are no protocols on what to do to prevent the spread of the virus if someone falls ill. Most of the information is about vaping to prevent covid-19But that doesn’t stop the virus from spreading from person to person.
The second big problem is the impact on health personnel. Even in countries where strict measures have been implemented, this has fallen ill and many have died. Misinformation in Tanzania could cause healthcare professionals to take insufficient precautions in outpatient clinics, emergency rooms and even patient care practices. If they get sick, other health services will also be affected.
A great danger for the region and for the world
First of all, as long as there are COVID-19 cases in Tanzania, it will be impossible for neighboring countries (with which it shares permeable borders) are disease free. Second, and perhaps more importantly, there is a risk of new variants being developed while no one is tracking. The new strains emerge due to uncontrolled spread.
If one arises later in life in Tanzania, the danger is that it could spread throughout the region and invalidate the vaccinations that have been administered if they are not effective against that variant. The pandemic will not end for anyone anywhere until it is controlled in all countries. Tanzania’s stance will make it much more difficult to get back to normal.
Catherine Kyobutungi is Executive Director of the African Center for Population and Health Research. This article was originally published on The Conversation Africa and translated with the collaboration of Africa House for The Conversation Spain. Translation: Clara León.
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