An outlier in Africa’s
slow rollout, Rwanda has raced ahead and vaccinated more than 90 per cent of
adults in its capital. Minister of Health Dr Daniel Ngamije tells the Evening
Standard’s Vaccine for the World project how Rwanda did it.
When the first Covid-19
vaccines landed in the Rwandan capital Kigali on March 3rd, the country was
ready.
Within an hour, the
vaccines reached the health ministry’s central warehouse, where vehicles from
the country’s 47 district hospitals were waiting with fridges on board. In a
deployment that had already been tested and tweaked, the trucks fanned out
across Rwanda’s green hills and valleys, and army helicopters lifted off to
deliver the vaccines to the most remote pockets.
“It was all about
preparation. Our experience of preparing for outbreaks of contagious diseases
in the past has helped us develop detailed crisis plans, which we were able to
put into effect as soon as Covid-19 was identified,” says Dr Daniel Ngamije, Rwanda’s
Minister of Health.
“Planning the
logistical elements of our vaccine rollout, similarly, was set in motion
shortly after a state of emergency was declared.”
On a continent where
fewer than 5 per cent of people are fully vaccinated, Rwanda’s vaccine rollout
stands out as a success, not just in Africa but by any global comparison. In a
Covid Performance Index compiled by the Lowy Institute, Rwanda ranked 7th in
the world.
It’s not a competition,
Dr Ngamije insists. “We are all part of the same fight to defeat this pandemic,
and given the interconnectedness of our continent, we are not safe until
everyone in Africa is safe.”
Nevertheless, Rwanda’s
experience could provide lessons for other African nations, both in their
response to Covid-19 and to future pandemics.
“One of the important
things is that our vaccine programme was not born in the time of Covid. From
the central planning, the warehousing, logistics and transport to the
communities - the whole supply chain - the foundations were already there,” says
Dr Sabin Nsanzimana, Director General of the Rwanda Biomedical Center, which
coordinates the rollout.
“We just had to
strengthen them because not only were Covid vaccines coming in big numbers, we
also had other vaccination programmes for children that were continuing,” he
explains.
As well as preparing
regular refrigerators used for other vaccines, Rwanda also purchased ultra-low
temperature freezers able to store the Pfizer vaccine at -70 degrees Celsius,
becoming the first African country to use Pfizer’s doses that require
ultra-cold storage.
Without the resources
to front up funds to make large pre-orders, many African countries had to stand
by last year as the world’s richest countries reserved doses to vaccinate their
populations against Covid-19 several times over.
Rwanda, like most
African nations, has received supplies from the vaccine-sharing facility COVAX.
But when those supplies dried up in April – as vaccines were diverted to combat
India’s massive infection wave - Rwanda cut deals directly with manufacturers
Pfizer and AstraZenca to secure 4 million doses, says Health Minister Dr
Ngamije.
Once on the tarmac, the
shots reached people’s arms within hours. After the 1994 Genocide against
Tutsi, the administration of President Paul Kagame prides itself on efficiency
and technological expertise.
“We have a saying here
that we don’t store vaccines in fridges or warehouses, we store vaccines in
people’s arms,” says Dr Nsanzimana.
Known as The Land of a
Thousand Hills for its lush, mountainous terrain, Rwanda deployed “helicopters
from day one and we had purchased vehicles for each of the district hospitals,
so they could transport vaccines overland to the health centres,” he says.
First in line were the
elderly and most vulnerable, followed by jabs for those most exposed to
infection – key workers, moto-taxi drivers and hospitality staff. Next came a
mass campaign across the capital city.
“Kigali has been the
most significant hub for transmission,” says Dr Ngamije. “By vaccinating over
90 per cent of adults in the city, we can reduce transmissions and protect the
entire nation.”
On a continent where
misinformation and hesitancy around the Covid-19 vaccine is rife, again Rwanda
has trodden its own path.
Building on trust built
over years of routine vaccinations for children, Rwanda mobilised everyone from
heads of households and village elders to district and provincial leaders to
disseminate accurate information on the Covid jab, says Dr Ndoungou Salla Ba,
the World Health Organisation’s Representative in Rwanda.
Radio and TV channels
hosted interviews and answered questions about the vaccine in local languages
and daily updates are posted on social media.
“Our top leaders, the
president himself, religious leaders, teachers, scientists and celebrities have
also come forward to take the vaccine in public,” says Dr Nsanzimana of the
RBC. “So in Rwanda we have not had the issue of vaccine hesitancy. Actually,
it’s more about the pressure on us to bring in more vaccines.”
Rwanda’s target now is
to vaccinate at least a third of its population by the end of the year, rising
to 60 per cent next year. And it is laying the foundations for a longer term
solution by positioning itself as Africa’s vaccine manufacturing centre.
“We hope that before
long, and with support from the international community, we can become a hub
for the home-grown vaccines that Africa needs in order to be self-sufficient in
the fight against future pandemics and outbreaks of infectious diseases,” says
Dr Ngamije.
The country is in talks
to establish the first mRNA vaccine plant in Africa, with Rwanda, Senegal and
South Africa on the shortlist for U.S. drugmaker Moderna’s planned factory.
“When the Rwandan
government commits, it makes it happen,” concludes WHO’s Dr Salla. And the
government is really committed to ending this pandemic.”
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