Monkeypox vaccination in the global south: Fighting a war without a weapon.

Background: The Mpox outbreak awakened countries worldwide to renew efforts in epidemiological surveillance and vaccination of susceptible populations. In terms of Mpox vaccination, various challenges exist in the global south, which impede adequate vaccine coverage, especially in Africa. This paper reviewed the situation of Mpox vaccination in the global south and potential ameliorative approaches. Methods: A review of online literature from PubMed and Google Scholar concerning Mpox vaccination in countries belonging to the 'global south' category was done between August and September, 2022. The major focus areas included inequity in global vaccine distribution, challenges impeding vaccine coverage in the global south, and potential strategies for bridging the gap in vaccine equity. The papers that met the inclusion criteria were collated and narratively discussed. Results: Our analysis revealed that, while the high-income countries secured large supplies of the Mpox vaccines, the low- and middle-income countries were unable to independently access substantial quantities of the vaccine and had to rely on vaccine donations from high-income countries, as was the case during the COVID-19 pandemic. The challenges in the global south particularly revolved around inadequate vaccine production capacity due to lack of qualified personnel and specialized infrastructure for full vaccine development and manufacturing, limited cold chain equipment for vaccine distribution, and consistent vaccine hesitancy. Conclusion: To tackle the trend of vaccine inequity in the global south, African governments and international stakeholders must invest properly in adequate production and dissemination of Mpox vaccines in low- and middle-income countries.

Can Africa achieve herd immunity?

The World Health Organization described herd immunity, also known as population immunity, as the indirect fortification from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous exposure to infection. The emergence of COVID-19 vaccine is a step towards the achievement of herd immunity. Over one billion people across the globe have been vaccinated and Africa recorded only 2%. The objective of this article was to develop a forecast of the number of people to be vaccinated to achieve herd immunity in the 13 WHO-identified priority African countries for COVID-19. Herd immunity is achieved when one infected person in a population causes less than one secondary case on average, corresponding to the effective basic reproduction number (R0). Vaccine delivery and distribution infrastructure including the cold chain remains weak. Vaccine hesitancy is also one of the limiting factors that may hinder herd immunity in Africa. In order to achieve herd immunity globally, African countries should not be excluded in fair and equal distribution of vaccines. Relevant stakeholders should foster commitment as well as community sensitization on COVID-19 vaccines and integration of COVID-19 vaccines in existing healthcare services.

The use of antibiotics in COVID-19 management: a rapid review of national treatment guidelines in 10 African countries.

Antimicrobial resistance is a hidden threat lurking behind the COVID-19 pandemic which has claimed thousands of lives prior to the emergence of the global outbreak. With a pandemic on the scale of COVID-19, antimicrobial resistance has the potential to become a double-edged sword with the overuse of antibiotics having the potential of taking us back to the pre-antibiotic era. Antimicrobial resistance is majorly attributed to widespread and unnecessary use of antibiotics, among other causes, which has facilitated the emergence and spread of resistant pathogens. Our study aimed to conduct a rapid review of national treatment guidelines for COVID-19 in 10 African countries (Ghana, Kenya, Uganda, Nigeria, South Africa, Zimbabwe, Botswana, Liberia, Ethiopia, and Rwanda) and examined its implication for antimicrobial resistance response on the continent. Our findings revealed that various antibiotics, such as azithromycin, doxycycline, clarithromycin, ceftriaxone, erythromycin, amoxicillin, amoxicillin-clavulanic acid, ampicillin, gentamicin, benzylpenicillin, piperacillin/tazobactam, ciprofloxacin, ceftazidime, cefepime, vancomycin, meropenem, and cefuroxime among others, were recommended for use in the management of COVID-19. This is worrisome in that COVID-19 is a viral disease and only a few COVID-19 patients would have bacterial co-infection. Our study highlighted the need to emphasize prudent and judicious use of antibiotics in the management of COVID-19 in Africa.

COVID-19 pandemic: impacts on the achievements of Sustainable Development Goals in Africa.

Since the launch of the Sustainable Development Goals (SDGs) in 2015, Africa has made some progress towards its achievements, particularly in the area of gender equality- SDG 5, climate change -SDG 13 and preserving life on land- SDG 15. Although, some African countries have made tangible impact on the other goals such as health, food production and economic growth; these efforts experienced some setbacks with attention shifting to curbing the spread of the novel coronavirus. As much as mitigating the spread of the spread of COVID-19 is important, so is ensuring efforts made on other goals are not lost, as the SDGs are much interconnected, and failure in one impacts others. For the African continent to achieve sustainable development beyond COVID-19, strategic actions which will involve innovations, evaluations and strong political will towards implementations must be taken by relevant stakeholders, so the continent is not left behind in the global goals achievement by 2030.

While flattening the curve and raising the line, Africa should not forget street vending practices.

Street vending practices are common in Africa and cater to a large portion of the continent's population. Since the identification of coronavirus disease 2019 (COVID-19) in Africa, various governments have implemented measures to control the spread of infection. These measures may have an adverse effect on street vending practices. This paper demonstrates the extent to which COVID-19 measures of control and prevention affects street vending practices in Africa and how it can be remedied. There has been reduced economic growth and increased hunger among individuals involved in street vending practices due to the prohibitions put in place by governments. Measures directed at curbing the spread of the virus inadvertently affect street vending practices and vendors. Current and future pandemic response plans should reflect the integration of measures directed at reducing potential hardship and a further economic set back for individuals involved in street vending practices.

Impact of COVID-19 pandemic on antenatal healthcare services in Sub-Saharan Africa.

Many Sub-Saharan African countries have been known to suffer various challenges which threaten the quality of health services that are offered to the population. With the emergence of COVID-19 outbreak, it is not impossible that access to quality antenatal care services would be further threatened in the region due to the competition for limited health care resources. This paper seeks to highlight the impact of COVID-19 pandemic on antenatal healthcare services in Sub-Saharan Africa. It is imperative for all African countries to put up measures to ensure antenatal care services, which are just as important and needed, are not disrupted due to the urgent need to shift limited resources to contain the COVID-19 pandemic.

COVID-19 Misinformation and Infodemic in Rural Africa.

The world has witnessed rapid advancement and changes since the COVID-19 pandemic emerged in Wuhan, China. The significant changes experienced during these times remain unprecedented. The African continent has initiated significant responses to curb the spread of the pandemic. However, there is an increasing concern that rural Africa is facing serious challenges in their responses to the COVID-19 pandemic. This is due to the uncertainty if the populations are detached from or in synch with information on COVID-19. The findings reported here suggest that rural Africa is burdened with misinformation and infodemic regarding COVID-19 due to widespread misconceptions and anecdotal reports. It is, therefore, necessary to engage with community leaders to provide awareness campaigns in rural communities to ensure access to reliable information issued by local and international health authorities. It is pertinent to set up avenues that improve health literacy in communities in rural Africa as it is a major determinant of information assimilation.

Impact of COVID-19 on access to healthcare in low- and middle-income countries: Current evidence and future recommendations.

The COVID-19 pandemic continues to be a major public health threat globally and low- and middle-income countries (LMICs) are not an exception. The impact of the COVID-19 pandemic is far-reaching on many areas including but not limited to global health security, economic and healthcare delivery with a potential impact on access to healthcare in LMICs. We evaluate the impact of the COVID-19 pandemic on access to healthcare in LMICs, as well as plausible strategies that can be put in place to ensure that the delivery of healthcare is not halted. In order to mitigate the devastating effect of the COVID-19 pandemic on the already weak health systems in LMICs, it is much necessary to reinforce and scale up interventions and proactive measures that will ensure that access to healthcare is not disrupted even in course of the pandemic.

Rural communities in Africa should not be forgotten in responses to COVID-19.

Rural areas in Africa make up a large proportion of the continent. Since the emergence of COVID-19 on the continent, major attention and responses have been placed on urban areas. Rural areas are typified by certain challenges which may serve as limitations to the provision of resources and tools for COVID-19 responses in these areas. These major challenges include limited access to these areas due to poor road networks which may hamper the possibility of conveying resources and manpower. Shortage of healthcare workforce in these areas, poor health facilities/structures and limited access to COVID-19 diagnostics services may also make containment challenging. It is therefore important that investment should be made in these areas towards providing the necessary tools, resources, and manpower to ensure effective containment of COVID-19 and to alleviate the plight caused by the pandemic in rural Africa. Rural communities in Africa should not be left behind in COVID-19 responses.