Nigeria could need about 400 million doses of Pfizer and BioNTech’s COVID-19 vaccines, according to experts, which might cost the nation up to $15.6 billion.
In July 2020, Pfizer agreed to sell its vaccine to the US government at $39 for a two-dose immunisation or $19.5 per dose. Experts say a Nigerian may need at least a two-dose immunisation, which could rally the cost to $15.6 billion.
This is 45 percent of the country’s N13.082 trillion 2021 budget, meaning that certain projects could be set aside to vaccinate all Nigerians.
Some experts suggest, however, that it could cost up to $145 for a two-dose immunisation due to logistics cost to Nigeria, meaning that the country could spend up to $58 billion to vaccinate over 200 million population.
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Africa’s most populous nation is in dire fiscal straits due to low oil prices and may not be able to afford it unless help comes from international NGOs and multilateral agencies.
“If you are looking for an estimate of numbers of doses we need, you are looking for the impossible. For a vaccine with 100 percent efficacy and lifelong immunity, you require covering 60-72 percent of your population. Therefore, with this assumption, you will need to vaccinate between 120 and 150 million Nigerians out of our 206 million to achieve desired herd immunity,” Oyewale Tomori, professor of virology and former vice-chancellor of Redeemer’s University, told BusinessDay.
“Since we need two doses per person, we are looking at between 240 to 300 million doses. However, with Pfizer’s COVID-19 vaccine of estimated 90 percent efficacy, and no information on the duration of immunity, we can estimate between 300 million to 400 million, accounting for wastage, poor cold chain facilities, logistics and other associated issues. Then you have another problem, if the immunity does not last, then it may be annual vaccination,” he explained.
He noted that the calculations would also be limited by inaccurate population figures and the fact that many Nigerians might come back for the second dose.
Pfizer and BioNTech announced on November 9 the 90 percent efficacy of their mRNA-based vaccine, raising stock prices around the world.
The data came from a study of 94 patients cherry-picked from 44,000 volunteers in the third phase of the vaccine trial believed to have displayed safety signals.
Pfizer, which is only one of the companies trying to prove the efficacy of a vaccine, on Monday said it could manufacture 50 million doses by the end of the year and 1.3 billion by the end of 2021.
Observers in developing countries, including Nigeria, are wondering the difference that the availability of a vaccine could make in the coronavirus situation, given that Africa has particularly witnessed lower death rates compared with the awry trends in Europe, United States of America or the United Kingdom.
Nigeria, Africa’s largest economy, has witnessed 1,158 deaths, 1.8 percent of a total of 64,184 confirmed cases despite a lean system of testing countrywide.
Richard Ajayi, board chairman, Lagos State University Teaching Hospital (LASUTH), told BusinessDay that a lot of consideration needs to be given to the cost and benefit analysis to understand where developing countries stand in the scheme of things.
“There is so much information we don’t have. We don’t know its efficacy for us or its cost. We need to know what the cost is because if it is targeted at the developed world first, then it may be beyond the means of countries like Nigeria. I’m not sure it will make a big difference to us,” said Ajayi, who is also the board chairman of Synlab Nigeria.
In mid-September, Bill Gates gave considerations to cost of obtaining the vaccine in poorer countries when he made a case for equitable distribution, even while priorities should be given to the origins of production.
His theory is that hoarding of the vaccines by rich countries while neglecting poorer countries with lack of the capacity to develop and manufacture vaccines will only prolong hardship and not end the pandemic quickly.
Similarly, a demonstration from Northeastern University, reflected on the 2020 Gatekeepers report by the Bill and Melinda Gates Foundation, shows that if rich countries buy up the first 2 billion doses of the vaccine instead of equitable distribution, then almost twice as many people could die from COVID-19.
According to Pfizer, about half of the 25 million people to get the vaccines first will be in the US. The target of the Pfizer vaccine is attacking the protein spikes on the virus which enable a virus to invade human cells and start infection. Through a biotechnology named mRNA, researchers are aiming to instruct the body cells to build proteins found specifically in SARS-CoV-2— the virus that causes COVID-19.
Once an individual gets a shot of the vaccine, it triggers cells to produce the proteins that trigger the immune cells that lead to the production of antibodies.
Health researchers in Thailand, in a report published by Nature’s journal, advised that lower-middle-income countries (LIMC) can adopt five steps to COVID-19 vaccination including using pre-qualification.
Several barriers delay the national registration process for vaccines and other health technologies in LMICs as manufacturers might focus on registering their products in high-income countries first, where they stand to make a larger profit, their analyses show.
Companies can be hesitant to engage with divergent regulatory requirements and processes, especially if procedures are unfamiliar or onerous. Also, bodies that are equivalent to the US Food and Drug Administration in LMICs often lack the resources and expertise required to review industry submissions quickly.
Together, these factors can result in long delays in registering vaccines.
One 2016 study showed a typical lag of four-seven years between a company’s first regulatory submission and the vaccine’s final approval in sub-Saharan Africa, for example.
“This timeline is untenable for a COVID-19 vaccine. It would be more efficient to make use of the WHO pre-qualification programme. This assesses the safety, quality and efficacy of vaccines for distribution by organizations such as Gavi, the Vaccine Alliance in Geneva, Switzerland,” they say.
Thankfully, one of Gates Foundation interventions for an equitable outcome includes the launch of the Access to COVID-19 Tools (ACT) Accelerator, which is considered the most serious collaborative effort to end the pandemic in that it brings together proven organisations like Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria.
However, the need for cautious optimism has also trailed the Pfizer’s progress.
Hopeful preliminary vaccine news is not a cure and not a reason to let up on prevention, people familiar with workings of pharmaceutical productions say. It will be months after the vaccine before most people will be inoculated.
A return to pre-pandemic normalcy is expected late 2021, experts say.
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