[News] South Sudan: How to deliver Covid vaccines in a country with few roads

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https://www.bbc.com/news/world-africa-58911911

Image caption,Food aid (above) is often dropped by planes to people in remote villages
"You need to reach the po[CENSORED]tion and make sure they come within the time frame. Based on their availability, you have to wait," said Dr Nay.

Coordinating the entire operation, getting the timing right, and hoping for good weather, are key to success, though things don't always work out perfectly.

"It's not an easy thing given that our health system is not strong. Most health workers are not well paid," said Dr Victoria Majur, a senior official at the Ministry of Health

She said they had to be given "incentives" to inoculate people.

Vaccines 'dumped in Africa'
While logistics is a problem, there is also a shortage of supply for South Sudan's 11 million people.

The country has so far received two consignments of AstraZeneca vaccines.

The first one arrived on 25 March. It had 132,000 doses.

"The deployment was informed by the ease of reaching counties. There were challenges of logistics and the motivation of health workers as well as insecurity and the weather," said Dr Rumunu.

But just 60,000 doses were used.

It was decided to send the remaining 72,000 doses to neighbouring countries in July.

"We thought rather than they expire here, we distribute to other countries and let them use it and hope that when we are ready, we will be given an equivalent amount of vaccines to protect our people," added Dr Nay.

A second consignment of 60,000 doses of AstraZeneca vaccines, donated by France through Covax, arrived on 31 August.

It had a much shorter shelf-life of just four weeks but they were all used within that time.

The World Health Organization's Dr Richard Mihigo said the short period to expiry was lowering people's confidence in the vaccines.

"It's like dumping products to Africa when other people have used the majority of them," he told the BBC.

The Covax facility was intended to ensure countries like South Sudan got a good chance of receiving vaccines.

But so far, out of 470 million doses promised to African countries by the end of 2021, only around 89 million doses have been delivered, according to Dr Mihigo.

India's decision to shut down supply due to a severe wave of Covid 19 earlier this year affected supply.

In addition to this, "most of the wealthier countries grabbed most of the supply in the market, leaving the Covax facility facing shortages of vaccines that had been promised by manufacturers", said Dr Mihigo.

On 8 October, South Sudan launched a new vaccination campaign following the arrival of about 60,000 Johnson & Johnson vaccines donated by the US government.

Performers dressed in brightly coloured costumes, feathered headgear and dried gourds cut in half led the crowd, just outside Juba, in celebrating their arrival.

As it is a single-dose vaccine, it will ease the huge logistical challenges of getting jabs into arms.

But many more will be needed.

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Update: This article has been amended after Unicef clarified that air-dropping vaccines was not currently being considered.