Covid-19: 10 reasons Kenya’s vaccination plan nose-dived

Ministry of Health mandarins have in the last month demonstrated a paralysing incompetence that could roll back future gains in the war against the coronavirus which has so far claimed more than 2000 lives in Kenya.

Turf wars, internal bureaucracy and failure to implement set out plans has left Kenya’s Covid-19 response badly affected even as the most basic of activities, such as the rollout of a national vaccination plan, failing to take off as envisioned.

And like many other government initiatives during the pandemic, disorder and dishonesty have characterised what ought to signify a turning point in the Kenya’s war against the virus. Instead, Kenyans stare at uncertainty, vaccine hesitancy and general confusion over who really needs to get the vaccine, when and where.

For the rest of the world, the vaccine arrivals have been a matter of when, not if scientists working around the clock would deliver. But as nations made elaborate plans to access the vaccines, Kenya’s Ministry of Health, it seems, remained preoccupied with other things.

Everything seemed well taken care of by the National Covid-19 Vaccines Deployment and Vaccination Plan but this, it appears, was only on paper.

“The targeted populations in order of priority will be healthcare professionals, older persons above the age of 65. Additional target groups will be based on those deemed most at risk. The country targets to have the vaccine by end of February 2021 and initiate vaccination by March of 2021,” the ambitious, plan reads.

Its objectives were even better thought out. “The objectives of Kenya’s National Vaccine Deployment plan is to outline a strategy for deployment, implementation and monitoring of the Covid-19 vaccine(s) in Kenya and ensure the plan and related financing is well aligned to the overall national Covid-19 recovery and response plans,” its drafters say.

With these key objectives and well laid our target populations, nothing, it seemed could go off plan. After all, the Ministry of Health was not re-inventing the wheel. Dozens of countries had rolled out their own vaccine programmes with varied successes. At the very least, Kenya would pick what parts of a successful implementation had worked for countries such as Ghana and shun what had not worked for other regions.

Kenya’s vaccine rollout plan began on Tuesday March 2, almost a year to the day when the first Covid-19 case was recorded in the country, when Qatar Airways Flight QR1341 touched down on Kenyan soil.

On board were some 1.02 million doses of the AstraZebneca- Oxford Covid-19 Vaccine. On hand to receive them were Health CS Mutahi Kagwe, UNICEF Representative to Kenya Maniza Zaman and World Health Organization Representative to Kenya Rudi Eggers.

“This is a historic day for Kenya, marking an important milestone in our fight against Covid-19,” Kagwe said.

With the vaccine were an additional 1,025,000 syringes and 10,250 safety boxes courtesy of UNICEF.

This looked to be the first step towards vaccinating an important segment of the society. However, a look at the deployment plan shows arrival of the vaccine was the fifth of a seven-point plan to vaccinate the public. The previous four steps, according to some members of the deployment taskforce, hardly received the required attention.

Before that March 2, flight, adequate advocacy, social mobilisation and communication ought to have happened. The public should have been told about the vaccine and about it made to communities within which it was first meant to be administered.

This, however, did not happen to the required levels. Even among healthcare practitioners, denial remains a major hindrance to vaccine uptake. A day after the nationwide launch of the vaccination programme, healthcare practitioners in Kakamega kept off the jab.

From 100 healthcare professionals receiving the vaccine, to 23 of them on the second day. By the fourth day, none was turning up. Communication about the efficacy of the vaccine and its importance should have been done to convince healthcare workers to take it.

The second bit of the plan was financing. As soon as countries knew of advances being made by vaccine manufacturers, many looked inwards and quickly made pre-orders of the vaccines from as early as August 2020. By December of that same year, the EU alone had pre-ordered some 600 million doses of vaccines.

By January 2021, with companies backed up by pre-orders, the AU, in conjunction with Afreximbank, pre-ordered  270 million doses of the vaccine through the Africa Vaccine Acquisition TaskTeam.

By this time though, Kenya was far behind other countries on the continent such as South Africa and Ghana with regards to pre-orders. Kenya, considered the third largest economy in sub-Saharan Africa, found itself in a bad place.

Ministry‘s own projections shows that by 2023, only 30 per cent of the population will have received the jab. Some 90 per cent of these vaccines would have been received through donations. Only 10 per cent of the vaccines would have been purchased by government.

“The vaccine introduction will occur over the period January 2021 to December 2023 straddling three government financial years FY 2020/21; FY 2021/22 and FY 2022/23. The population coverage by the end of that period is aimed at 30 per cent,” the strategy reads. For this milestone, of 30 per cent of the population being inoculated, Kenya will require support from Gavi, the vaccine Alliance, that will cater for vaccination of 20 per cent of the population.

A single dose of the AstraZeneca-Oxford vaccine currently sells for around Sh700 or 7USD. Admittedly, the country has been going through a rough financial patch. Depressed revenues and a limping economy from a shrink in the country’s major foreign exchange earners have heralded tough times.

Yet, even amidst this dark cloud, the exchequer found it possible to set aside some Sh4.5 billion for MCAs car grants in what was interpreted as a reward for passing the BBI Bill.

While Sh4.5 billion would not have gotten rid of the virus, it would have been enough to buy just under 6.5 million doses of the vaccine. Key decision makers proved once again that they are not just risk averse, but averse to the wrong risks.

Now, Kenya may fall dangerously behind its vaccination plan and with the third wave hitting home, the 72-hour burial rituals may be with us for longer than is necessary.

The deployment strategy heavily relied on age old health infrastructure around the country. Kenya is not new to vaccination programmes. An incredibly wide network of community health workers and recently retired nurses ought to have been enough to lift the burden of execution of the plan off the central government.

The country’s public healthcare system is broken. Years of neglect and mismanagement have left it exposed, the smallest of shocks capable of knocking it off its wheels.

Also, vaccination came on the backdrop of crippling strikes by healthcare workers on whose shoulders, the national vaccination programme lies.

The sensitivity of the vaccines and its demanding of cold storage facilities have made deployment, especially rural Kenya, almost impossible.

“We have been kept in the dark as usual but we support this roll out if it is protecting the people. We cannot say anything else,” Seth Panyakoo, the secretary-general of the Kenya Union of Nurses said. “We have decided to act responsibly because central to what we do is to ensure the people are leading healthy lives.”