Within the next six weeks Egypt is aiming to vaccinate over 6 million people with at least one shot of the five vaccines currently in use in Egypt. The rush to vaccinate coincides with the expected arrival of a fourth wave of Covid-19 infections in Egypt, including the Delta Plus variant. Minister of Health Hala Zayed says one goal is to ensure all students, teaching staff and administrators in schools and universities have received at least one dose of vaccine before the start of the new academic year, scheduled to begin on 9 October. In press statements this week Zayed said staff and students would be denied access to state-run universities should they refuse the vaccine. The health minister said that of the 10 million citizens who had registered for vaccinations, 7.5 million had received at least one dose. These figures are roughly confirmed by international organisations monitoring the spread of Covid-19 in Egypt. The rollout of vaccinations began in Egypt at the end of January, almost a year after the first case of coronavirus was reported. So far, the vaccination campaign has progressed at best sluggishly, a pattern that urgently needs to be reversed if Egypt is to escape the worst repercussions of the expected fourth wave due to start in October. According to Zayed, locally produced Sinovac vaccines will be available for use this week, helping to boost vaccination numbers, and the ongoing monthly production of the vaccine is scheduled to come in at 15 million doses. The Ministry of Health's goals for the next ten weeks include ensuring 5.5 million students and staff receive a first dose of vaccine, and that healthcare workers — among whom vaccine take up has plateaued at less than 25 per cent — receive a similar level of coverage. A source at the Ministry of Health, speaking on condition of anonymity, said providing a first dose for these six million is an ambitious but possible target which would not compromise the provision of vaccines to high risk groups of for those seeking to travel. "The plan is to work on parallel tracks," said the source. He revealed that in addition to locally produced Sinovac, Egypt has also secured supplies of the Sinofarm, Astrazenca, and Johnson & Johnson's single shot vaccines. The minister of health, of finance, and the prime minister have all reassured the public that resources have been made available to ensure at least 40 per cent of the population is vaccinated before the end of the year. The 40 per cent target is shared by other African countries, many of which lag far behind rich states' vaccination rollouts. The targets, however, could easily be compromised as developed nations rush to buy up vaccines to provide their citizens with third booster shots, leaving developing nations even further behind. A report by Oxfam, issued on 29 July, said "the cost of vaccinating the world against Covid-19 could be at least five times cheaper if pharmaceutical companies weren't profiteering from their monopolies on Covid-19 vaccines." Anna Marriott, Oxfam's Health Policy manager, said: "Pharmaceutical companies are holding the world to ransom at a time of unprecedented global crisis. This is perhaps one of the most lethal cases of profiteering in history." Public health expert Alaa Ghannam says that the "very obvious inequality in the sharing of vaccines worldwide" had resulted in low vaccination rates in Egypt, as in other developing countries. Ghannam thinks vaccinating 40 per cent of Egypt's population by the end of the year is ambitious, and 30 per cent would be a more realistic figure. He also says healthcare workers, and those employed on public transport, education and other public services should be prioritised. Ahmed Azzab, public health coordinator at the Egyptian Initiative for Personal Rights, believes "Egypt can make a major leap forward by utilising the local production of Sinovac and it's the cumulative experience of the health system in vaccination programmes". "I think it is doable, but we need to follow the priorities specified by the World Health Organisation (WHO) to guarantee there are no loopholes through which Delta Plus or other variants can spread," says Azab. Among those priorities, the authorities must ensure frontline health workers are vaccinated. The Doctors' Syndicate reports that more than 500 doctors have died due to Covid-19 since the pandemic first hit Egypt. Azzab acknowledges that some doctors are reluctant to get vaccinated but notes "it is within the legal mandate of the competent authorities to insist on vaccinating all health workers." He also says that providing vaccines through temporary health units, which "proved really successful with the recent campaign against the spread of Hepatitis, would make a difference". Such units would help address problems of accessibility: at the moment people must register online for a vaccination, a process that can exclude the elderly and those without Internet access. According to Azab, Egypt also needs to focus more on using "easier to access and cheaper to get vaccines". "Whatever the debate about the efficiency of one vaccine compared to another, developing countries need first and foremost to secure a higher vaccination take-up," he argues. Of the Ministry of Health's recent announcement that it is engaged in securing supplies of medication to better treat serious cases of infection with the new Delta variant, Azab warns that this should not be seen as a reason to abandon preventative measures. "I think awareness is a key here. We need to regain the rigour that we had in spring last year when the media was really invested in getting people to be vigilant. Lower numbers of infections have led to laxity when it comes to precautions and this must end as we enter the fourth wave." Meanwhile, sources at WHO and the World Bank have been arguing that Egypt has to keep an eye on surveillance. While conceding that no country has a record of every single infection, they argue that Egypt needs to do more to accurately monitor the spread of the new variant if it is to avoid being seen as a high-risk country. *A version of this article appears in print in the 26 August, 2021 edition of Al-Ahram Weekly
