Delta lessons and why vaccines should be locally manufactured

Once bitten, twice shy. Strange infectious diseases are frequently reported in Africa. Let’s talk about the Delta variant of concern, which caused widespread devastation during Covid-19 pandemic.

First, new and emerging variants with different characteristics may cause breakthrough infections. As is now widely known, the evolution of Covid-19 around the world resulted in many variants and sub-variants.

Delta first detected and reported in the Indian subcontinent, caused significant devastation worldwide, leaving many casualties in its wake. During its decline, it morphed into the sub-variant Delta Plus. Among all the variants and sub-variants of coronavirus reported globally, Delta caused the most severe outcomes among infected patients.

India’s strong health infrastructure was overrun. At that time, India—often referred to as the “pharmacy of the world”—had been performing relatively well in vaccination and medical supply distribution until Delta struck. The waiver of vaccine patents to save lives allowed India to manufacture the AstraZeneca vaccine, ostensibly to help low- and middle-income countries (LMICs). According to Indian authorities, it was also a way of keeping India safe.

Authorities feared that people from Africa would flood Indian medical facilities seeking Covid-19 treatment. The idea was to vaccinate them to prevent severe cases that might necessitate travel to India.

India was also manufacturing and exporting Remdesivir, a much-needed antiviral for Covid-19 treatment. However, by April 12, 2021, the final day of the Kumbh Mela festival, India imposed a ban on vaccine and antiviral exports to 126 low- and middle-income countries—India needed these supplies more. Almost all African nations were on the list of the 126 LMICs.

In Kenya, the AstraZeneca vaccine arrived on March 6, 2021, and the first dose was administered on March 25. By the time Delta was reported in Kisumu on May 12, 2021, only 11,000 out of 8 million eligible adults in the Lake Region Economic Bloc (LREB) had received at least one dose. Reports of Delta variant cases in other parts of the country surfaced on June 23, 2021.

Like India, Kenya suffered significant devastation. Unlike India, Kenya’s weak and fragile health infrastructure was stretched but not entirely overrun. Nevertheless, the socioeconomic strain was immense. Families struggled to afford treatment for their loved ones. The National Health Insurance Fund (NHIF) excluded pandemics from its coverage. Most patients who required high-flow oxygen could not afford private hospital care, while oxygen supplies in public facilities were severely strained.

An assessment by the LREB Covid-19 Advisory Committee revealed these gaps in the region and worked with governors to address them.

Had a larger proportion of Kenya’s population been vaccinated, the severity of Delta’s impact would have been reduced. This underscores the urgent need to increase vaccine access through local manufacturing. Given the existing gaps in public health today, another Delta-like outbreak could be apocalyptic.

Odhiambo is a Professor of Statistics at Great Lakes University of Kisumu.