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Better Late Than Never: Can China Help Kenya Break The 2% Vaccine Wall?

A medical health worker injects the Oxford/AstraZeneca Covid-19 vaccine to a woman as they visit door-to-door to deliver the vaccines to people who live far from health facilities in Siaya, Kenya, on May 18, 2021. Brian ONGORO / AFP

After walking out of the COVID-19 vaccination clinic in Nairobi, with my arm slightly sore after receiving my first free dose of the AstraZeneca vaccine, I felt hopeful that this reflected a new stage in Kenya’s COVID-19 response. However, a few weeks on, it has become clear that our vaccine rollout has not been smooth sailing, having only received enough doses to cover 1.6% of our population.   

But before I delve into this, it is important to note Kenya’s achievements in its handling of COVID. After reporting its first COVID-19 case in March 2020, Kenya adopted rapid response measures, with the government implementing social distancing measures before recording over 50 cases. These measures have played a huge role in easing pressure on our healthcare infrastructure, and with only  156,787 cases and 2,622 deaths recorded, a significant achievement compared to South Africa with 1.58 million cases and 54,148 deaths.

International partners also provided support during the initial COVID-19 response, with the US government, for example, donating 200 ventilators. China was also among the first countries to lend support, with, for instance, the Jack Ma Foundation providing PPE donations, and the Zhejiang Business Association Kenya, an association of Chinese business owners in Kenya, donating 70,000 face masks.

But when it comes to vaccines – there has been a significant delay in vaccine procurement, with our government only very recently procuring vaccines from China in mid-May. So, what difference – if any at all – will this make to our rollout?

Currently, our government is still only using the Oxford-AstraZeneca vaccine, procured from COVAX and India. According to government estimates, by late April our vaccine resources were rapidly declining, with just over 1 million doses had been administered – and only 21,000 doses left in stock. The rollout had only just begun in March 2021, but as with many African countries, it has lagged behind the rest of the world. Indeed, only 1.42% of the continent’s population have received a vaccine dose so far – that’s less than 1 in 100 people. Comparatively, this figure stands at 32 in 100 people in North America, and 19 in 100 in Europe. This leaves African countries, including Kenya, to prolong protective measures which hinders economic recovery.

We are expected to receive a further 24 million AstraZeneca doses through COVAX, with another 10.8 million from the African Union and 12 million from bilateral agreements. Our government also recently ordered 30 million doses from Johnson and Johnson, which is being manufactured in South Africa, planned to be delivered within the year. Additional Pfizer and Johnson and Johnson are also planned to be procured through the African Union. In total, at least 30 million doses are needed to vaccinate 60% of our population, the minimum goal according to GAVI.

Clearly the global supply chain is not working. Despite these orders, we have only received enough doses to cover under 2% of our population, with only 1.12 million doses from COVAX, and 100,000 vaccine doses donations from India actually delivered. Kenya is not alone in this situation, as only three out of Africa’s 54 countries have received enough doses to cover over 10% of their population (Seychelles 76%, Djibouti 16% and Morocco 12%). Delays by the Serum Institute in India, which plan to reduce vaccine exports following a surge in infections domestically, also necessitates procurement from other sources.

Whilst the number of vaccines procured from China has not yet been made public, the procurement still comes at a crucial point in time, as our vaccine supplies become acutely exhausted. There had initially been plans to obtain doses from Chinese partners in December 2020, with our President directing the health ministry to explore ways of obtaining the Chinese vaccines. However, these plans were non-conclusive and efforts to procure Chinese-made vaccines fizzled away.

The turning point was unmistakably the approval of China’s Sinopharm vaccine by the WHO for emergency use, which likely boosted the confidence of our government regarding the safety and efficacy of Chinese-made vaccines. Additionally, the approval also significantly expands COVAX vaccine supply, which is crucial since China possesses extensive vaccine manufacturing capacity equating to around 5 billion doses per year. Sinovac is also set for WHO review in early May and if also approved, this would provide an additional impetus for our government to procure further doses from China.

As a Development Partner, There Are Numerous Additional Ways China Can Further Its Support to Kenya During This Critical Time.

One method is increasing the supply of vaccines and PPE. This, of course, involves our government making further commitments to vaccine procurement, with China being one potential source. Diversifying vaccines is becoming more critical as vaccine hesitancy is increasing following reports of blood clots linked to AstraZeneca, which is still the only vaccine available.

China would be an essential partner for bilateral procurement, especially considering its advantage in manufacturing capacity. For instance, China’s COVID-19 vaccine production capacity could total to 4 billion doses by the end of 2022 –covering around 40% of world demand. Further, the production capacity of PPE supplies has also been drastically scaled up, with China’s daily outputs of N95 masks jumping from 200,000 to 1.6 million. Chinese partners should look to subsidise the procurement of vaccines and PPE supplies, which would provide Kenya with additional fiscal space to finance economic recovery.

This suggestion is not farfetched, especially since China has provided vaccines through donations and commercial measures to numerous African countries, not all of which are classified as low income. For instance, Algeria and Egypt, received 200,000 and 300,000 doses of SinoPharm donations, respectively. Another example is Zimbabwe, which received 200,000 of its second batch of SinoPharm donations, with the Zimbabwean government taking active steps to procure an additional 1.2 million doses of Sinovac. These are steps we should also be taking.

Procurement of both vaccines and PPEs should be a priority, as our vaccination rate is highly unsustainable. Prolonged COVID-19 measures will continuously push our economic recovery further and further back, with the World Bank recently reporting that an extra two million Kenyans will be pushed into poverty due to COVID. We need to be taking further action now.

Looking longer-term, Chinese investors should support capacity building in Kenya’s local pharmaceutical manufacturing sector. Currently, Kenya cannot manufacture vaccines, yet, our government offers a plethora of incentives for pharmaceutical investment, including 100% foreign ownership, free allocation of land and/or plans for a pharmaceutical industrial park, and tax incentives. Perhaps most importantly, our government also offers guaranteed purchases from local manufacturers through The Kenya Medical Supplies Authority. Supporting the development of the Kenyan health sector will contribute towards Kenya’s development agenda, Vision 2030, which aims to establish a universal health care system by 2030.  

Whilst China’s role in Kenya’s COVID-19 response has relatively delayed, there are still avenues where China can assist. I still hold hope that our vaccination rollout will speed up and that my inclusion in the ‘2%’ category will no longer be the case. But for this to be a reality, international actors – including China – must play their part.

Patrick Anam is International Trade Policy and Trade Law Expert based in Nairobi.

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