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With South Africa's vaccination campaign moving at a snail's pace, President Cyril Ramaphosa has been forced to tighten lockdown restrictions in a bid to contain a third wave of the coronavirus pandemic.

South Africa has vaccinated less than 2% of its population of about 59 million since it started its programme in February.

This is in contrast with the US where almost 46% of the population of more than 330 million has been fully vaccinated.

"Covid is down. The economy is up. America is on the move again," boasted US President Joe Biden in a recent tweet.

In contrast, President Ramaphosa has been forced to:

  • Order the closure of all schools
  • Advise people to work from home where possible
  • Ban all indoor and outdoor gatherings, including weddings
  • Limit funerals to 50 people
  • Ban the sale of alcohol to ease pressure on hospitals
  • Order the closure of all non-essential establishments at 20:00
  • Introduce a curfew from 21:00 to 04:00.

Hospitals admissions are rising fastest in the economic heartland of Gauteng, and in many places beds have run out.

But producing vaccines is only half the challenge, and what matters crucially is getting the jab into people's arms.

Devastating wave

A slow vaccination rollout has left millions of people vulnerable to infection.

image copyrightAFPimage captionLess than 2% of South Africans have had the jab

The main opposition Democratic Alliance (DA) has condemned it as "sluggish", saying the government would fail to meet its target of vaccinating 40 million people by the end of the year.

The second-biggest opposition party, the Economic Freedom Fighters (EFF), condemned what it called the "utter failure of this government to vaccinate even a million people in the space of over a year". It organised a march last week, demanding Russian and Chinese-manufactured vaccines in addition to the Pfizer and Johnson & Johnson vaccines already in use.

"We are in the grip of a devastating wave," Mr Ramaphosa said in an address to the nation on Sunday night.

"By all indications [it] seems like it will be worse than those that preceded it," he added.

Mr Ramaphosa said the government was concerned about the "rapid spread" of the Delta variant, but evidence suggested that the vaccines being used in South Africa were effective.

He defended the vaccination campaign, saying that nearly 2.7 million people had received a dose and the daily vaccination rate had surpassed 100,000.

Real and rising threat

Other African states – including Namibia, the Democratic Republic of Congo and Uganda – are also witnessing a surge in cases.

Uganda's President Yoweri Museveni has called out "vaccine selfishness" in the world but said it would "wake up" Africans to be self-sufficient.

Currently, only five African countries are involved, in a limited way, in the productions of vaccines.

Tunisia and Morocco have companies that can package and label, meanwhile South Africa, Egypt and Senegal can "fill and finish" – which entails big pharmaceutical companies using third parties to fill and prepare vials for distribution.

In Africa less than 1% of the continent's 1.3 billion people have been vaccinated and as a result the pandemic is far from over – in fact it is escalating.


mapped

Confirmed cases around the world

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The world
Africa
North America
Latin America & Caribbean
Asia
Europe
Middle East
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181,102,393 cases

3,923,132 deaths

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Circles show number of confirmed coronavirus cases per country.

Source: Johns Hopkins University, national public health agencies

Figures last updated

28 June 2021, 09:49 BST

"The threat of a third wave in Africa is real and rising," Dr Matshidiso Moeti, World Health Organization (WHO) regional director for Africa, said last week.

"It's crucial that we swiftly get vaccines into the arms of Africans at high risk of falling seriously ill and dying of Covid-19," she added.

South Africa and India have been pushing the World Trade Organisation (WTO) to waive intellectual property rights for coronavirus vaccines so that they can become more easily available in the developing world.

"We are tired of waiting in the queue, we want to be at the front," said Mr Ramaphosa in a meeting with French President Emmanuel Macron last month.

image copyrightAFPimage captionHospital admissions have been rising sharply in South Africa's economic heartland of Gauteng

The European Union (EU) plans to invest €1bn ($1.1bn; £0.8bn) in vaccine production and access on the continent, while a $50bn world vaccination plan has been proposed by the International Monetary Fund chief Kristalina Georgieva.

"Pandemic policy is economic policy. Unless we get out of the health crisis, we cannot see the world economy fully recovering," she told the BBC.

The pressure is yielding results, with Mr Ramaphosa and Mr Macron announcing last week that South Africa would become the continent's first major manufacturer of vaccines.

image copyrightAFPimage captionFace coverings are mandatory in South Africa

South African vaccine manufacturer Biovac will partner with Afrigen Biologics, a network of universities, and the Africa Centres for Disease Control and Prevention to establish Africa's first Covid messenger RNA vaccine technology transfer hub – where innovation, production and training will happen.

But it could take at least a year to complete, and there is a growing global consensus that in order to beat the pandemic countries in the global south needs greater support – and fast.

Both India and South Africa say the only way to allow for a "fair, equitable and affordable access" to life-saving vaccines is for the WTO to waive an agreement to protect international property rights, called Trade-Related Aspects of IP Rights (Trips).

HJIYou can't defer only to vested interests and well-funded lobbies."Fatima Hassan
Director, Health Justice Initiative

The proposal has gained traction after receiving backing from the US, but there is no guarantee that it will go ahead, and there are concerns that businesses hold too much sway.

"You can't defer only to pharmaceutical interests and to vested interests and to well-funded lobbies in the negotiations," said Fatima Hassan, the director of civil society organisation the Health Justice Initiative.

"It needs to be transparent, civil society needs to have a seat at the table", she adds, and wants the waiver expanded beyond vaccines so that testing kits, ventilators and oxygen treatments and more can be made locally by and for poorer nations.

Vital to transfer skills

The EU does not support a Trips waiver and wants compulsory licensing agreements instead – whereby governments produce vaccines without the patent owners' consent, but the owners still exert rights over the patent and are entitled to compensation. Under a patent waiver these restrictions are not in place.

"The EU and other nations opposing this waiver need to stop blocking other countries' efforts to protect their populations in a public health emergency," said Dimitri Eynikel of the medical charity, Médecins Sans Frontières.

He called compulsory licensing "a safeguard that can only bypass patents but not all IP [intellectual property] barriers".


data in detail

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*Deaths per 100,000 people

Filter:

The world
Africa
North America
Latin America & Caribbean
Asia
Europe
Middle East
Oceania

Country

Deaths

Death rate*

Total Cases

New Cases

0

10
100
1k
10k

**

US

600,464

183.6

33,438,579

Brazil

509,141

243.1

18,243,483

India

393,310

29.1

30,134,445

Mexico

232,068

183.9

2,493,087

Peru

191,073

597.3

2,036,449

Russia

129,869

89.1

5,346,005

UK

128,048

190.7

4,684,572

Italy

127,362

210.1

4,255,700

France

110,906

170.6

5,764,329

Colombia

102,636

206.7

4,060,013

Argentina

91,438

206.1

4,350,564

Germany

90,687

109.1

3,732,969

Iran

83,473

102.0

3,140,129

Spain

80,766

173.0

3,777,539

Poland

74,953

197.7

2,879,470

South Africa

59,406

102.8

1,877,143

Indonesia

55,949

20.9

2,053,995

Ukraine

54,429

123.0

2,295,873

Turkey

49,417

60.0

5,393,248

Romania

32,771

168.0

1,080,457

Chile

31,797

169.8

1,531,872

Czech Republic

30,292

284.0

1,666,686

Hungary

29,980

308.8

807,910

Canada

26,162

70.6

1,419,198

Belgium

25,152

219.1

1,081,908

Philippines

24,152

22.6

1,385,053

Pakistan

22,152

10.4

952,907

Ecuador

21,377

125.1

449,483

Bulgaria

18,022

255.6

421,401

Netherlands

17,752

104.1

1,683,215

Portugal

17,079

166.5

869,879

Iraq

16,999

44.2

1,311,093

Bolivia

16,414

144.6

429,178

Egypt

16,002

16.3

279,184

Sweden

14,619

146.6

1,088,896

Japan

14,572

11.5

792,731

Tunisia

14,406

124.6

395,362

Bangladesh

13,868

8.6

872,935

Greece

12,604

119.8

419,909

Slovakia

12,505

229.3

391,490

Paraguay

12,086

173.7

413,457

Switzerland

10,880

127.6

702,398

Austria

10,697

120.3

649,922

Jordan

9,703

97.4

748,685

Bosnia and Herzegovina

9,653

290.4

204,936

Morocco

9,265

25.7

528,180

Nepal

8,918

31.7

629,431

Guatemala

8,894

51.6

286,708

Croatia

8,192

197.1

359,403

Lebanon

7,835

114.2

544,002

Saudi Arabia

7,730

22.9

479,390

Serbia

7,019

100.5

716,096

Honduras

6,879

71.7

256,818

Panama

6,500

155.6

397,727

Israel

6,429

76.7

840,522

Moldova

6,180

152.5

256,387

North Macedonia

5,481

263.1

155,655

Uruguay

5,413

156.9

361,994

Georgia

5,237

130.8

362,183

Ireland

4,989

103.5

270,097

Azerbaijan

4,965

49.9

335,676

China

4,846

0.3

103,651

Malaysia

4,721

15.0

716,847

Costa Rica

4,581

91.6

359,266

Armenia

4,505

152.6

224,635

Afghanistan

4,452

12.0

109,532

Slovenia

4,417

212.6

257,164

Lithuania

4,378

156.3

278,608

Ethiopia

4,296

3.9

275,601

Dominican Republic

3,781

35.6

320,136

Algeria

3,669

8.7

137,403

Palestinian Territories

3,555

73.1

313,015

Kenya

3,538

6.9

181,239

Kazakhstan

3,518

19.2

471,498

Myanmar

3,275

6.1

150,714

Libya

3,185

47.7

191,660

Belarus

3,082

32.6

413,139

Venezuela

3,023

10.5

265,642

Oman

2,848

59.0

256,542

Sri Lanka

2,814

13.3

248,050

Sudan

2,750

6.6

36,558

Denmark

2,531

44.0

292,352

Latvia

2,501

129.7

137,130

Albania

2,455

85.2

132,499

El Salvador

2,356

36.7

77,484

Kosovo

2,260

122.5

107,299

Nigeria

2,118

1.1

167,401

South Korea

2,009

3.9

153,789

Kyrgyzstan

1,964

31.2

118,981

Kuwait

1,903

46.0

346,560

Syria

1,859

11.0

25,287

Zambia

1,855

10.7

140,620

Thailand

1,819

2.6

236,291

United Arab Emirates

1,775

18.4

620,309

Zimbabwe

1,709

11.8

44,306

Montenegro

1,609

256.3

100,131

Yemen

1,356

4.8

6,905

Bahrain

1,334

85.0

264,405

Cameroon

1,320

5.2

80,487

Namibia

1,279

52.2

78,723

Estonia

1,269

95.9

130,908

Cuba

1,209

10.7

174,789

Malawi

1,178

6.5

35,219

Senegal

1,159

7.3

42,677

Botswana

1,095

48.6

67,492

Jamaica

1,049

35.7

49,841

Finland

969

17.5

94,719

Australia

910

3.7

30,424

Madagascar

905

3.4

42,166

DR Congo

896

1.1

38,936

Angola

881

2.9

38,091

Mozambique

863

2.9

73,652

Luxembourg

818

135.4

70,586

Ghana

794

2.7

95,259

Norway

792

14.8

130,270

Uganda

781

1.8

75,537

Trinidad and Tobago

775

55.8

31,429

Somalia

775

5.2

14,875

Uzbekistan

725

2.2

108,184

Eswatini

678

59.7

18,947

Taiwan

605

2.5

14,389

Qatar

587

21.1

221,378

Mali

525

2.8

14,396

Cambodia

509

3.1

46,065

Mongolia

493

15.6

104,900

Suriname

490

85.1

20,723

Mauritania

483

11.0

20,512

Guyana

458

58.8

19,565

Malta

420

95.6

30,598

Rwanda

402

3.3

34,143

Haiti

388

3.5

17,603

Cyprus

374

31.4

74,174

Belize

329

85.9

13,104

Lesotho

329

15.6

11,168

Ivory Coast

309

1.2

48,058

Cape Verde

285

52.4

32,257

Guadeloupe

266

66.5

17,427

Bahamas

244

63.3

12,407

Réunion

226

25.6

29,502

Maldives

207

40.1

72,678

Niger

193

0.9

5,475

Nicaragua

189

2.9

7,920

Gambia

181

7.9

6,054

Mayotte

174

67.0

19,402

Chad

174

1.1

4,951

Papua New Guinea

173

2.0

17,079

Guinea

168

1.4

23,615

Burkina Faso

168

0.9

13,474

Congo

164

3.1

12,404

Gabon

159

7.5

24,958

Djibouti

155

16.2

11,597

Comoros

146

17.5

3,912

French Guiana

142

50.2

26,799

French Polynesia

142

51.1

18,992

Togo

128

1.6

13,749

Andorra

127

164.9

13,877

Curaçao

126

77.4

12,327

Equatorial Guinea

120

9.2

8,712

South Sudan

115

1.0

10,812

Liberia

110

2.3

3,265

Aruba

107

101.1

11,125

Benin

104

0.9

8,170

Martinique

99

26.4

12,199

Central African Republic

98

2.1

7,139

Gibraltar

94

278.8

4,335

Tajikistan

90

1.0

13,371

San Marino

90

266.4

5,090

Sierra Leone

87

1.1

5,155

Channel Islands

86

50.4

4,150

Saint Lucia

84

46.2

5,238

Vietnam

72

0.1

14,323

Guinea-Bissau

69

3.7

3,844

Seychelles

59

60.8

14,620

Liechtenstein

59

155.6

3,031

Barbados

47

16.4

4,057

Antigua and Barbuda

42

43.6

1,263

Sao Tome and Principe

37

17.5

2,364

Singapore

35

0.6

62,493

Saint Martin

33

88.6

2,594

Monaco

33

85.3

2,562

Bermuda

33

52.6

2,504

Iceland

29

8.6

6,555

Isle of Man

29

34.5

1,603

New Zealand

26

0.5

2,726

Eritrea

21

0.6

5,664

Tanzania

21

0.0

509

Timor-Leste

20

1.6

8,889

Turks and Caicos Islands

18

47.8

2,424

Mauritius

18

1.4

1,779

Fiji

14

1.6

3,063

Diamond Princess cruise ship

13

712

St Vincent and the Grenadines

12

10.9

2,216

Burundi

8

0.1

5,334

Laos

3

0.0

2,080

Saint Kitts and Nevis

3

5.7

425

Brunei

3

0.7

256

Cayman Islands

2

3.1

609

MS Zaandam cruise ship

2

9

Bhutan

1

0.1

2,006

Saint Barthelemy

1

10.2

1,005

Faroe Islands

1

2.1

770

British Virgin Islands

1

3.4

298

Grenada

1

0.9

161

Montserrat

1

20.0

20

Vanuatu

1

0.3

4

Dominica

0

0.0

192

New Caledonia

0

0.0

129

Anguilla

0

0.0

109

Falkland Islands

0

0.0

63

Greenland

0

0.0

50

Vatican

0

0.0

27

Saint Pierre and Miquelon

0

0.0

26

Solomon Islands

0

0.0

20

Marshall Islands

0

0.0

4

Samoa

0

0.0

3

Kiribati

0

0.0

2

Micronesia

0

0.0

1

Palau

0

0.0

0

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This information is regularly updated but may not reflect the latest totals for each country.

** The past data for new cases is a three day rolling average. Due to revisions in the number of cases, an average cannot be calculated for this date.

Source: Johns Hopkins University, national public health agencies and UN population data

Figures last updated: 25 June 2021, 11:08 BST

For Africa generally, even if the waiver is implemented, it is unlikely it will be able to produce vaccines on a massive scale for some time, said Dr Stavros Nicolau of Africa's largest pharmaceutical manufacturer, Aspen Pharmacare, and current chairman of Pharmaceuticals Made in South Africa (Pharmisa).

"Patents are only one step. You've got to get what we call technology and know-how transfer. Know-how includes everything from the formulation, how you produce the product, the manufacturing processes, the machinery and equipment that is used. A patent is not going to give you that on its own," he told the BBC.

The African Union has belatedly acknowledged the gap in Africa's vaccine manufacturing capability for all illnesses and has pledged to increase the share of vaccines made in the continent from 1% currently, to 60% in 2040, calling the pandemic a "unique opportunity" to boost production because "this level of interest and commitment may not last".