par Paul, Elisabeth ;Bell, David;Ridde, Valéry
Référence European Congress on Global Health (ECTMIH 2023) (13th: 20-23 November 2023: Utrecht)
Publication Publié, 2023-11-23
Poster de conférence
Résumé : Introduction: While Covid vaccination coverage is high in rich countries, Sub-Saharan Africa lags behind. Numerous global health institutions and academics have embraced the objective of “vaccine equity”, viewed as increasing Covid-19 vaccine coverage in low- and middle-income countries (LMICs). This is presented as a “moral imperative”, a step towards decolonisation.Methods: We performed a critical analysis of the literature on Covid-19 vaccines and health equity.Results: Billions of dollars have been committed to Covid-19 vaccine coverage in LMICs. This does not necessarily build health equity, which refers to equal access to healthcare for equal needs. Half of the African population is below 19 years of age, comorbidities are relatively infrequent, and 9/10 of people have been infected by SARS-CoV-2. This further reduces the expected benefits from vaccines on top of the rapidly waning and reduced effectiveness against variants, and the significant risk of adverse events. Investing health systems’ scarce resources in Covid-19 vaccines diverts them from other important priorities for African people, such as the burdens of malaria, tuberculosis, HIV/AIDS, malnutrition, reproductive health and universal health coverage.Conclusions: Such a diversion of resource to a relatively low disease burden is likely to reduce health equity. The administration of Covid-19 vaccines should be targeted to those for whom the benefit clearly outweighs risks, to free budgets to support higher priorities. It is high time African countries chose their own health priorities – based on their specific epidemiological situation and preferred health interventions– rather than imposed global targets. This would constitute genuine decolonisation.

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