This is the 14th post in a blog series to be published in 2021 by the Secretariat on behalf of the AU High-Level Panel on Emerging Technologies (APET) and the Calestous Juma Executive Dialogues (CJED)

Globally, populations wait in earnest for the effective eradication of the coronavirus. The COVID-19 pandemic has brought unprecedented distress to the African continent through continual COVID-19 related sicknesses and loss of lives. In addition, the pandemic has negatively impacted several socio-economic sectors such as health, education, economy, agriculture, and trade. As such, the pandemic has altered the cultural and social dynamics of how people live. For instance, numerous countries have put measures in place, such as partial national lockdowns, and have recommended minimal socio-economic activities to sustain social distancing.

To effectively fight against the coronavirus, governments have prioritized developing and administering COVID-19 vaccines. There are mainly four types of COVID-19 vaccines that have currently been developed: whole virus, protein subunit, viral vector and nucleic acid (RNA and DNA), with 170 candidates in trials.[1] The most common COVID-19 vaccines that have been approved and currently being distributed worldwide include vaccines developed by manufacturing companies Johnson and Johnson, Pfizer, and AstraZeneca.

African countries have prioritized vaccine roll-out towards their citizenry in utilizing it to improve herd immunity against COVID-19 and subsequently reduce hospitalization and deaths from COVID-19 related sicknesses. Through various agreements and mechanisms, such as the COVID-19 Vaccines Global Access (COVAX),[2] several African countries have acquired vaccine shots for their national campaigns, although inadequate. Vaccine manufacturing delays and the subsequent unavailability of adequate vaccines to meet demands is a global problem. To mitigate this, the available vaccines are being prioritized towards Africa's populations' riskier sectors, such as health workers and frontline workers.

As more vaccines are being procured to meet demands, lessons have been learnt from the initial vaccination roll-out targeted towards frontline and riskier sectors. These challenges will be exacerbated when scaling up the vaccination programme to cover their entire population, if not mitigated. Besides current vaccine supply shortages, some African countries are falling short on accelerated vaccination programmes within their countries. African governments are faced with the dilemma of systematically and effectively implementing distribution mechanisms of the vaccines to reach every community in their countries. For example, there are potential complexities associated with scheduling management systems for vaccinations and tracking systems of vaccine recipients for efficient follow-up sessions to ensure that most people are vaccinated.[3] Other challenges include the unavailability of reliable ultra-cold supply chains, ensuring the quality of vaccines, and risks of vaccine shipment delays across borders and shores.

As of April 8th 2021, WHO reports that less than 2% of the world's COVID-19 vaccines have been administered in Africa.[4] According to the New York Times' tracking of coronavirus vaccinations worldwide, several African countries, except for Morocco, have only managed to vaccinate less than an average 3% of their populations.[5] Countries like South Africa and Nigeria have managed to inoculate 288,368 and 964,387 people, respectively, as of April 12th, 2021. This equates to approximately 0.5 per 100 people in both countries. On the other hand, Ghana has inoculated 647,380 people out of approximately 31 million people; this is approximately 2.2 per 100 people of the entire population. Rwanda has inoculated 348,926 people out of approximately 13 million of the entire population; this is approximately 2.8 per 100 people.

Comparatively, the United States of America has inoculated approximately 180 million people out of approximately 331 million people (i.e., 54 per 100 people). Canada has inoculated approximately 7.5 million Canadians of the 38.44 million people (i.e., 20 per 100 people). These differences in inoculation rates between Africa and the rest of the world demonstrates that the vaccination roll-out mechanisms in Africa need to be addressed. It has been identified that innovative and digital technologies have a role to play.

The organization and distribution mechanisms in other parts of the world - which is a challenge in Africa - have been identified to be significantly hastened by the incorporation of digital technologies. The World Health Organization Digital Health Flagship initiative has recommended the utilization of digital technology towards the COVID-19 pandemic, more especially within the vaccination roll-out management systems.[6] Incorporating digital technologies into existing pandemic management systems can significantly improve communications between people and health services and encourage individuals and patients to return for second doses of vaccines. It would also bolster essential public healthcare functionalities, including COVID-19 disease surveillance and vaccine management systems. Consequently, digital technologies can assist Member States' governments build trust among their citizens and promote vaccination programmes within at-most-risk African communities.

As the African continent is anticipating one of the most massive vaccination campaigns ever implemented, the utilization of digital technologies can be incorporated into the COVID-19 vaccine roll-out management and surveillance systems. Such digital technology management systems can help African countries best plan, disburse, and manage the vaccination programme.

South Africa, as a case in point, has developed effective monitoring and evaluation systems incorporated within digital technology platforms. The electronic vaccination data system (EVDS) developed by South Africa is ascertaining its efficient and effective vaccine roll-out programme. The EVDS can potentially provide and track vaccine information such as the type of vaccine administered and the batch number. The system is also equipped to capture patient information such as the demographics and number of doses administered. In addition, follow-up information such as safety information and possible adverse events following immunization can be captured and monitored through this digital system. Most importantly, this application provides details of vaccine administration sites within South African communities and towns.[7]

Other African countries such as Rwanda, Nigeria, Egypt and Ethiopia are also utilizing digital social media campaign platforms to enhance the public understanding of COVID-19 vaccination and address misconceptions about vaccines. These countries are utilizing popular online social media platforms such as WhatsApp, Facebook, and Twitter to reach out to their populations. Furthermore, traditional media platforms such as community and national radio platforms and television programmes are being used to inform the citizenry about vaccines. As the swiftest smartphone usage growth is being observed within the African continent,[8] digital platforms offer promising avenues for sensitization and information dissemination.

In success stories, Uganda has successfully implemented a nationwide measles-rubella campaign targeting 18.1 million children using digital technologies.[9] The country has also administered an oral polio vaccine campaign targeting 8.2 million children since October 2019. This was facilitated through a national response team that consolidated the data collection abilities of an Open Data Kit with a District Health Information Software dashboard. These digital systems enabled Uganda to promptly consolidate, visualize, and analyse the data through real-time management systems empowered by digital technology. The digital real-time management mechanisms have enabled timely campaign monitoring programmes progress with prompt results and feedback in Uganda. In turn, such feedback helped Uganda facilitate, monitor, and cost-effectively evaluate immunization and vaccination frameworks. Zambia has also implemented real-time management systems for cholera, measles-rubella, and polio immunization campaigns in the past five years. These real-time management systems enabled nationwide and targeted campaigns under varied scope, delivery methods, and targeted populations.

Based on the observations as mentioned above, the African Union High Level Panel on Innovation and Emerging Technologies (APET) recommends to African governments that adopting digital technologies can afford African Member States with the appropriate tools towards robust COVID-19 vaccine management and surveillance systems.[10] Furthermore, APET recommends that Member States develop real-time digital management and population surveillance systems to efficiently and cost-effectively manage vaccine roll-out frameworks. These digital systems can source information from vaccination data generated in healthcare centres and improve reporting on vaccination allergic reaction cases diagnosed by clinicians. Through the coordinated identification of these COVID-19 vaccination reaction cases, African countries could easily quantify and monitor the magnitude and characteristics of the pandemic outbreak and vaccination processes.

Digital technologies can also help African countries with early reporting and rapid case identification of potential negative vaccination reactions that could cause panic among potential vaccine recipients. This would enable African countries to swiftly identify negative vaccine reaction cases and appropriately assist such patients. Such digital mechanisms can also curb the onward spread of the virus and enable African countries to understand the significant risks of not taking vaccines. Digital technologies can supplement clinical and laboratory diagnosis using symptom-based case identification. They can further enhance community testing, self-testing, automated management systems, and accelerated reporting to national public-health database systems. As an added advantage, digital technology management systems can be utilized in addressing future pandemics or outbreaks that may arise, thereby strengthening our disease surveillance systems.

In conclusion, the digitally enabled real-time monitoring for vaccination activities can be adapted and upscaled across the African continent, based on successful existing and past initiatives. Adopting and adapting digital real-time monitoring vaccination systems can accelerate the sharing, analysis, and utilization of vaccination data to improve campaign quality within countries. Furthermore, such systems can augment the quality of supplementary vaccination activities and campaigns. This can also help immunization and vaccination implementers seamlessly review vaccination progress against targeted milestones. It can also help African governments easily identify vaccination challenges and gaps, monitor and evaluate vaccine supplies, track qualified human resources, and schedule vaccine sessions for follow-up patients. Finally, Africa's national governments can easily execute evidence-based and timely decisions to generate corrective measures and corresponding actions. The COVID-19 vaccine roll-out programmes require African governments to decisively consider adopting real-time management systems empowered by digital technologies to support vaccination programmes and campaigns.

Featured Bloggers – APET Secretariat

Justina Dugbazah

Barbara Glover

Bhekani Mbuli

Chifundo Kungade

[1] https://www.gavi.org/vaccineswork/there-are-four-types-covid-19-vaccines-heres-how-they-work?gclid=Cj0KCQjw38-DBhDpARIsADJ3kjmCwuZNjM5m-IMiud-bJWtHieZddQtA2O1TZL7s_ONb0QLLTilfRqEaAj9qEALw_wcB

[2] https://abcnews.go.com/Health/covax-global-initiative-helping-covid-19-vaccines-poorer/story?id=76106981.

[3] https://blogs.worldbank.org/digital-development/digital-technologies-and-vaccine-deployment-opportunities-and-challenges

[4] https://reliefweb.int/report/world/less-2-world-s-covid-19-vaccines-administered-africa

[5] https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html.

[6] https://www.thelancet.com/journals/landig/article/PIIS2589-7500(21)00061-3/fulltext.

[7] https://www.logupdateafrica.com/how-south-africa-is-preparing-for-its-covid19-vaccine-introduction-logistics.

[8] https://www.thelancet.com/journals/landig/article/PIIS2589-7500(21)00061-3/fulltext.

[9] https://www.unicef.org/media/93781/file/gavi-unicef-digital-technology-immunization-2021.pdf.

[10] African Union Development Agency - NEPAD. 2020. White Paper: Harnessing Innovation and Emerging Technologies to address the Impact of COVID-19 in Africa. AUDA-NEPAD, Midrand, South Africa.