Covid-19, AIDS and no vaccines: this has been the perfect storm for omicron to break out in Africa

  • The South African variant has emerged on a continent that drags several health crises beyond a pandemic

  • The hypothesis that this lineage comes from an untreated patient with AIDS or HIV emphasizes the enormous gap in access to health in the region

The next variant of the coronavirus could have sprouted in any corner of the world. But the fact that the worrying omicron lineage emerged in Africa is not just a matter of chance. The virus has developed the highest number of mutations detected to date in a continent where there is a huge gap in access to health and where, in addition, the covid-19 pandemic has been overlapped with other health crises such as HIV and AIDS. According to the experts, this is how the Perfect storm to sprout a lineage of the virus that, as the World Health Organization has argued, once again exposes the world to high risk.

The first key to understanding the why of omicron is to see that this variant has emerged from a world deeply divided by the gap in vaccines against covid-19. While Europe is already approaching 70% of the population vaccinated against the coronavirus and Twenty-seven are already working to apply booster doses, in Africa it is estimated that on average only 7% of citizens have received a complete guideline against this disease. In countries such as the Democratic Republic of the Congo, Chad or Guinea-Bissau, the percentage of vaccinated does not even reach 1%. On Botswana, where the first cases of this variant were detected, the population with a full dose barely reached 20%. And in South Africa, where the largest explosion of cases of this lineage has been registered, the percentage of immunized does not exceed 24%.

While the lack of vaccines against the coronavirus has given wings to the virus to continue expanding, the covid-19 pandemic has continued to advance in a continent affected by multiple health crises. In fact, one of the main hypothesis about the origin of this variant is that, seeing the constellation of mutations that accumulates, it is possible that it originated in a immunosuppressed patient exposed to persistent covid. Probably in a person with untreated or undiagnosed AIDS or HIV. “It is a plausible hypothesis because these types of situations are the perfect breeding ground so that the virus develops a large number of mutations “, explains the immunologist Julià Blanco, from the IrsiCaixa AIDS Research Institute.

In countries such as Botswana, South Africa or Zimbabwe it is estimated that at least 10% of the population is infected with HIV. According to a report from the Joint United Nations Program on HIV and AIDS (UNAIDS), beyond these figures it is worrisome that 40% of infections are not being detected and it worries, even more, that a large percentage of those diagnosed do not have access to antiretroviral drugs. From the ‘Salud por Derecho’ platform they also point out that the pandemic has reduced diagnostic tests by at least 22% HIV. In the last year, it is estimated that the number of people who had access to prevention programs and the number of mothers under treatment to prevent the transmission of HIV to their babies.

“Ómicron has not only demonstrated the problem posed by the lack of access to vaccines against covid-19; it has shown that we are facing a much more structural crisis. The gap in vaccines against the coronavirus is a reflection of what has been happening with other diseases for decades and that, unfortunately, is not fixed by putting patches, “says Blanco. According to the scientist, the structural lack of resources that prevents covid-19 injections from reaching the entire African population is the same as, in the long run, also makes access to healthcare difficult and excludes thousands of patients from proper diagnosis or treatment. Hence, as experts argue, this crisis overlap has become the perfect breeding ground for a new coronavirus lineage to sprout.

“Ómicron has not only demonstrated the problem of lack of access to vaccines; it has shown that we are facing a much more structural crisis”

Julià Blanco, immunologist

Global vaccination

“The emergence of this new variant shows, once again, that it takes a global defined action to bring vaccines to the whole world “, emphasizes Rafael Vilasanjuan, member of the board of directors of the Global Alliance for Vaccination (GAVI). According to the expert, this paradigm shift would involve” rationalizing the vaccination strategy and understanding that it is better to deliver first doses in Africa than third doses here& rdquor ;. So far, Vilasanjuan explains, the countries of the global south have only received 550 million doses of the 2 billion vials promised by rich states. In theory, by this time all the countries of the world should already have at least 20% of their population vaccinated. But, as the records show, only 5.8% of people in low-income regions has received at least one dose against covid-19.

“The emergence of this variant shows that a defined global action is needed to bring vaccines to the whole world”

Rafael Vilasanjuan, member of GAVI

According to Vilasanjuan, Africa is receiving a ‘mosaic vaccine donations‘which, far from helping, complicates sanitation work even more. First, because it is difficult to draw up an immunization plan if, beyond these batches, a constant flow of vials is not achieved. And second, because part of the population receives with great suspicion receiving “leftover vaccines” from rich countries. “The vaccine gap is not solved with promises and good words. We need a firm commitment so that vaccines reach the whole world, “says the expert.” If a global agreement is reached, in six months we could vaccinate 70% of the global population And then yes, we could say that the pandemic is more under control, “he adds.

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Speaking about the future of the pandemic, Vilasanjuan points to the importance of placing these debates as a priority for everyone: “The public health concept is right now the most important concept to ensure global security. The future of humanity depends more on how we deal with the covid-19 pandemic in Africa than on any military campaign that is carried out around the globe. If there is no global health there is no security“, ditch the expert.

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