Race for Covid vaccines in Africa is hiding the key role of nutrition

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The writer is president of the African Development Bank

In the global effort to bring the pandemic under control, attention has shifted to ensure that safe and effective vaccines are available to all, including people in poor countries. Yet while vaccines are a game-changer, they are not a quick fix.

The World Health Organization has warned of inequalities of vaccine distribution across Africa. Widespread vaccination will not be achieved until 2023 or 2024. So, inevitably, reservoirs of the virus will persist, threatening us all through the emergence of vaccine-resistant strains. Moreover, in the race to vaccinate, governments are failing to recognise the vital role that nutrition plays in fighting this pernicious disease.

Good nutrition does not prevent infection with Covid-19. Yet malnutrition can make its effects considerably worse. Undernutrition impairs immune function. Obesity that results from cheap and unhealthy diets are also linked to diabetes and cardiovascular disease — both high risk factors for severe illness and death from coronavirus. Finally, good nutrition is important to ensure the vaccine’s full efficacy, and may be associated with the progression of long Covid.

The prevalence of malnutrition, despite considerable efforts, remains high in low- and middle-income countries, especially in Africa and Asia, where 250m and 381m people respectively lack access to adequate food. Covid-19 threatens to create a further 132m undernourished people due to lost jobs, disrupted incomes and ill health. The world has mobilised around vaccination; it needs to mobilise around improving nutrition too. Otherwise, Covid will widen global inequalities.

Improved food systems are key, and they can play a vital role in reducing the threat of future pandemics, too. Wherever wildlife enters the human diet, or where wildlife host and human habitats overlap, diseases can jump from animal to human populations — as with HIV/Aids, Ebola, influenza and almost certainly Covid-19. Better-managed food systems reduce these risks.

The twin goals of faster and more equitable vaccination rollout, and addressing worsening malnutrition levels, are a big challenge for countries already severely affected by the pandemic. Vaccine access has been greatly helped by the development of groundbreaking financing mechanisms. The Gavi Covax advance market commitment, for instance, is supporting access to vaccines in 92 low- and middle-income countries. The African Vaccine Acquisition Task Team has also been established by the African Union to acquire sufficient vaccines for the immunisation of about 60 per cent of the continent’s population, which Gavi calculates will bring herd immunity.

The African Development Bank Group’s investments in agriculture (both public and private) are expected to quadruple from an annual average of $612m to about $2.4bn by 2024 for the transformation of food systems. In March 2020, the bank raised an exceptional $3bn in a three-year bond to help alleviate the economic and social impact of the Covid-19 pandemic on Africa’s economies. The following month, the bank’s board of directors approved a $10bn Covid-19 response facility to help countries reinforce their healthcare systems, stabilise their economies and provide the social safety nets their citizens so desperately need.

No country or region can win the battle alone. A global response is needed to fight a global threat. As part of this fight, a dedicated financing facility is needed to mobilise global and domestic resources so that everyone has access to sustainable, affordable and healthy diets. When world leaders meet at the UN Food Systems summit this year, nutrition and health need to be recognised as central to both the food transformation agenda and to managing Covid-19. Vaccines may protect but it is nutrition that sustains.

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