“We are at a pretty critical stage in terms of fighting Covid. And I can’t say that I’m particularly optimistic about the way things are going, “said Mihir Mankad, a senior political adviser at Doctors Without Borders. “It has almost always been the case that countries took care of themselves first during a pandemic. Now it’s only getting worse, especially because … the deadly threat to Covid has receded in places with higher levels of coverage. “

The intensity and urgency with which the global health community has struggled with Covid-19 over the past two years is diminishing, although millions remain unvaccinated. And it is unclear that the passion will return if more affluent countries decide that the threat of a pandemic is dissipated. This concern has been permeating for several months in the World Health Organization and among other groups, namely those serving the population in Africa.

“Vaccines remain incredibly important for those at greatest risk in all countries because they continue to save lives,” Maria Van Kerchowe, WHO’s technical director for COVID-19, told reporters earlier this month. “But they can save lives only among the people who accept them.”

Other health advocates argue that Covid-19 should no longer be considered a health emergency because there is enough basic immunity through prior infection and vaccination to treat hospitalization. While they continue to help increase immunization and improve therapeutic costs to combat the pandemic, organizations are turning to fundraising for pandemic preparedness – with a focus on ending the next Covid.

Various strategies have led to the global health community disagreeing on how to deal with the next step in the fight against Covid-19. And this reality has made people in African countries cling to clues as to whether additional funding or assistance is coming. Even in Ghana, where the government has recently received significant funding for vaccination – more than in many other countries in the region – the prospect of losing global attention to health is daunting, especially as the world’s health systems and infrastructure pledged to help improve those at risk.

Meanwhile, the number of Covid infections and hospitalizations is growing in Europe and China as Omicron and its subvariants are spreading, and vaccination levels, including boosters, are stagnant in many parts of the world. In the face of declining vaccine effectiveness and the completion of other health mitigation measures, WHO officials say vaccination is more important than ever and countries must keep their promises to help low- and middle-income countries vaccinate their people.

“There is not enough focus on what is really needed to expand vaccination programs, especially for adults, in which, by the way, we do not really have global models of vaccination of the entire adult population for a long time,” said Ernest Darko. , co-founder of BroadReach Group, a medical company working to expand Africa’s healthcare system. “It’s not something you need to back down from now.”

Covid-19 cases and hospitalizations are now at a controlled level in much of the western world and in Ghana. But many Ghanaians are worried about what will happen if this West African country is hit by another outbreak. Much of its 31 million population does not live near the hospital and relies on the help of local community centers, most of which do not have adequate tools to treat Covid-19. Although the Ghanaian government has purchased tens of millions of doses, it is still struggling to get gunshots. And officials here say they need help in the last mile.

This is the situation in many low-income countries, especially in Africa. However, part of the global health community has changed course, focusing on vaccinating 90 percent of each country’s vulnerable populations, rather than 70 percent of the total population, the original goal set by the WHO last year. And international consortia that help deliver vaccines to low- and middle-income countries, including COVAX, the global vaccine complex, are moving forward with a country-led approach: each country will decide how many doses to order and where to send them. This means that many young people living in rural areas may not get an injection.

The WHO has launched a messaging campaign that fights any slowdown in response, and officials are urging more affluent countries to meet their commitments to promote vaccination in regions such as Africa.

Meanwhile, on Capitol Hill, lawmakers are still trying to help fund international efforts to combat Covid-19, but they are finding it difficult to fight the vote and come up with a mechanism to raise additional funding. The White House is also preparing to hold a global Covid-19 summit with plans to ask other countries to put more money into stepping up last mile efforts. But high-ranking Biden officials aren’t sure the May 12 event will make significant financial promises, especially if the U.S. is reluctant to give its own, according to two people familiar with the issue.

In countries with low levels of vaccination, it is hoped that community outbreaks, particularly the distribution of BA.2 Omicron, remain limited – although this is not certain. Even in regions with high levels of vaccination, senior global health officials are concerned about declining vaccine immunity and the ability of stimulants to support Covid-19 cases and hospitalization at a controlled level in the long run. This has led people like Anthony Foci, chief physician to President Joe Biden, to think about a short-term strategy for Covid-19 without a vaccine that not only does not block infection but also becomes less effective against serious disease over time.

“I don’t think we will be able to withstand vaccination every four months,” Foci said. «[But] I think it’s likely that we’ll stop at periodic stimulation until we get a vaccine with a strong degree of protection, whether it’s mRNA followed by an increase in protein or mRNA followed by an increase in nanoparticles. “

In Ghana, very few people, including in Accra, have received a regulatory dose – and many may refuse to do so, officials say, largely because of vaccine fluctuations that have occurred around the third dose. As a result, in countries such as Ghana, a part of the population with weakened immunity and a population that will refuse third vaccinations may soon appear. In these cases, booster campaigns are unlikely to help protect against future jumps. Even in countries with higher primary vaccinations, such as Canada, people en masse do not sign up for vaccinations.

“About 80 percent of all Canadians took two doses. Despite all this, we are on the fifth wave with a lot of hospitalizations across the country, ”said Jean-Yves Duclos, Canada’s health minister. “We are concerned that only about 48 percent of all Canadians have received a third dose. We absolutely need to increase the booster dose rate if we want to maintain proper overall preparedness. ”

So what’s next? Foci’s answer: this is not a definite result, but it is likely that the world will enter a pandemic phase when enough people will be immune to vaccinations and previous infections, and the number will remain relatively low on average.

“It will, in fact, be decided where most people will have some degree of protection, just as we have some degree of protection against many other respiratory diseases we come in contact with so you don’t have as many diseases, so the high mortality rate is that it dominates society, ”Foci said.

However, officials such as Foci and Duklo are concerned that the virus will continue to mutate and evade immunity in the coming months until stronger vaccines are developed. Several pharmaceutical companies are working on shots that protect against certain options, and others that protect against more than one, but it’s unclear when they will appear on the shelves.

“There is a high degree of uncertainty as to what will happen next from an epidemiological point of view,” Mancad said. “It’s very likely that it will come back to haunt us like it has for the past two years.”


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