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Witness to Ebola, med student calls for more COVID-19 vaccines in Africa

Stanford medical student from Sierra Leone calls for urgent improvements in efforts to protect the people of African nations against COVID-19.

Abu Bakarr Rogers, from Sierra Leone, witnessed the devastating consequences of the 2013 Ebola outbreak in Western Africa -- but he also saw the power and success of widespread vaccination in helping end a deadly outbreak.

This and other experiences motivated him to pursue a career in medicine in the United States, while keeping a focus on the needs of his home country. Today, he's a rising second-year medical student at Stanford, pursuing his passion for public health through teaching, his research on Ebola and Global Surgery, and as operations manager at the Cardinal Free Clinics.

In a perspective piece published recently in the American Journal of Tropical Medicine and Hygiene, Rogers and his coauthors make the case that the COVID-19 Vaccines Global Access (COVAX) initiative -- the main source of vaccines for many nations in Africa -- has "critical limitations, including limited funding and the failure to account for the special epidemic risks and needs of its participating nations."

The COVAX plan to vaccinate only up to 20% of participating African nations' populations could be disastrous for Africa, said Rogers. Ultimately, he wrote, "Successful vaccination campaigns, including the West African Ebola outbreak, have shown that vaccinating all of Africa is possible and feasible, and that infrastructure and human resources can support mass vaccination."

I connected with Rogers over email to learn more about his research, his motivation and his connection to Sierra Leone.

What motivated you to write this perspective about COVID-19 vaccines for Africa?

It's something everyone should care about and advocate for, not only because it is the humane thing to do, but because no community is safe until everywhere is safe. I would rather be on the ground directly helping with pandemic response, but since that is not feasible, this perspective piece is my way of doing my part.

Stanford medical student Abu Bakarr Rogers argues that vaccinating all of Africa against COVID-19 "is possible and feasible" despite current challenges. Photo courtesy of Rogers.

We wrote this piece to emphasize how dire and time-sensitive the situation is. We discuss the drawbacks to the COVAX plan and address major concerns about vaccine deployment in Africa and tangible steps COVAX can take to ensure equitable vaccine distribution in Africa.

My co-authors have vast experience in public health work -- in both the COVID-19 and Ebola responses -- to support our case that vaccinating all of Africa is feasible and in the best interests of the rest of the world. I'm extremely grateful to my co-authors for their mentorship and guidance throughout this process and to Amy Markowitz for her editorial support.

I believe we need to approach situations in Africa with the same concern and urgency as we do in Western countries. Without a swift response, African nations will become the new face of the pandemic, where the virus will continue to mutate to more dangerous variants and spread to the rest of the world.

Also, I am Sierra Leonean and African, so I see value in advocating for my country and continent first.

The world saw the devastating consequences of the COVID-19 surge in India recently. What makes the situation in Africa unique?

Priority for vaccine dissemination should be given to India and other countries approaching a similar fate. What is happening in India and what we've experienced in the U.S. should serve as a warning for why it's so important to address the situation in Africa before it is too late.

African nations should receive the same magnitude of commitment and support when it comes to COVID-19 vaccine distribution as high-income countries have, but this has not been the case. Less than 4% of the reported confirmed vaccine purchases by COVAX have been designated to countries in Africa, with countries like Nigeria reporting vaccination rates of less than 1% of its population.

Furthermore, the socioeconomic infrastructures in many African communities make it difficult to enforce Western public health recommendations to prevent the spread of COVID-19. Often, folks live in big community houses where quarantine or self-isolation is not feasible.

Some folks work in congested areas and survive on a day-to-day basis, which makes lockdown difficult. COVID-19 tests are not accessible and there are many clinical deserts. Many of these communities are already overwhelmed with other communicable and noncommunicable diseases. Because of these issues, providing 100% vaccine coverage to these communities is the only way to prevent a surge in cases.

Our goal is not to ask COVAX to prioritize African nations at the expense of others. Instead, we want to highlight the fact that COVAX can -- and should -- do better. If we are to combat the pandemic, then we need a plan where no nation or community is left behind.

Can you describe some experiences that inspired you to pursue a career in medicine and public health?

When I was in Sierra Leone, little moments and experiences became ingrained in my memory, but also big ones like the Ebola outbreak. When I moved to the United States, I had the opportunity to look at the system from a new lens and I realized some of the things that occurred in health care settings were not normal.

As I gained more experience, I began to better understand where I could fit into the equation and how I could help through medicine. It was not a straightforward process. It took great mentors and active reflection of my experiences and interests. The defining moment for me was when I began working at a Free Clinic and in an actual lab. After that, things began coming together.

What are some takeaways from your experiences in medicine and working on this project?

Medicine is politics and is extremely hierarchical. Thus, it is vital that health care professionals understand policy and continue to advocate for change in both the health care system and other systems that impact the health of patients and their communities.

COVAX has played such a prominent global role in equitable distribution of COVID-19 vaccines, but the shortcomings of this initiative reflect bigger flaws in global health. Systemic forces are at play that we can't address by sending COVID-19 vaccines into communities, even though this step is essential. We also need to better equip communities with the skills and resources they need to create a sustainable system. 

How do you envision your future impact in medicine and public health?

There are so many things I find fascinating so it is going to be hard to select one path, and I don't think I will. For now, I know that clinical and community work, advocacy, research and teaching will play an active role in whatever path I choose. I also know that I want to pay forward to Sierra Leone and Africa in any way that I can.

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