For Doctors in Poor Countries, Covid Vaccine Comes Too Late

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For Doctors in Poor Countries, Covid Vaccine Comes Too Late

JOHANNESBURG—Between treating patients at a hospital in northern Zambia, Kelvin Moonga closely followed the accelerating rollout of Covid-19 vaccines in countries like the U.S. and the U.K. Suffering from asthma and hypertension, Dr. Moonga knew he was at high risk if he caught the coronavirus as infections surged across the southern African nation.

“If the vaccine comes here, I’ll be the first one to get it,” Dr. Moonga told a friend.

But the 51-year-old surgeon, who was also a prolific author, never got his Covid-19 shot. He died on Jan. 24, days after testing positive for the virus and without saying goodbye to his wife and seven children, the youngest of whom had just turned 2 years old the day before.

The global scramble for Covid-19 vaccines has left developing countries in Latin America, Asia and Africa far behind rich nations in inoculating their citizens. That means months after colleagues in developed countries have been immunized—and as some governments are now making shots available to their entire populations—healthcare workers in nations like Zambia are still risking their lives in the fight against the pandemic.

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They often do so without the protective gear that reduces the likelihood of infection, and knowing that sophisticated treatments, such as laboratory-made antibodies or at times even ventilators and oxygen, won’t be available to them should they catch the disease.

Nowhere is the vaccine shortage more acute than in sub-Saharan Africa, which has administered fewer Covid-19 shots per capita than any other continent and where most countries are dependent on free immunizations provided by a World Health Organization-backed facility known as Covax.

Since the start of the year, more than 500 healthcare workers, among them well-known public-health experts and experienced surgeons like Dr. Moonga, have died of Covid-19 in sub-Saharan Africa, according to the WHO. South Africa’s health ministry, one of the first in Africa to start vaccinating healthcare workers in mid-February, said they were three to four times as likely to catch Covid-19 as the general population.

The cost of these deaths goes beyond the personal loss experienced by their families and friends. Because of limited training capacities and brain-drain to richer nations, sub-Saharan Africa has only about two doctors for every 10,000 people—about one-tenth of the WHO-recommended minimum and far below the 26 doctors per 10,000 people working in the U.S. That means the death of a surgeon like Dr. Moonga, who spent time treating patients in rural Zambia and was known to operate at no charge when people couldn’t afford hospital fees, can affect patient care for years to come.

“Many more people are going to die because he can no longer provide these services,” said Francis Mupeta, who heads the infectious-disease unit at the University Teaching Hospital in Zambia’s capital, Lusaka.

Dr. Kelvin Moonga knew he was at high risk if he were to get Covid-19; he died Jan 24.

Photo: Moonga family

Dr. Mupeta recalled being sick at home with Covid-19 in January, and going on social media where doctor friends in the U.S. and other countries were posting pictures of themselves getting their Covid-19 shots. Meanwhile, he received news of colleagues in Zambia being transferred to intensive care or dying.

“The risks we are exposed to are the same, but we are not protected yet,” said Dr. Mupeta, who said he struggled going back to the Covid-19 ward after he recovered and has had to counsel younger doctors terrified of having to declare one of their colleagues dead. “It’s not fair.”

Funded by donations from rich nations such as the U.S. and charitable organizations like the Bill & Melinda Gates Foundation, the Covax facility aims to vaccinate 20% of the populations of the world’s 92 poorest nations by the end of the year. But with governments in developed countries having bought up much of the early supplies, Covax has so far shipped 14.9 million doses to 22 countries in Africa, a continent of 1.4 billion people. Slow local approvals in some countries, and some governments’ decisions to give priority to other professions have also delayed getting shots to healthcare workers.

Covax has so far shipped 14.9 million doses to 22 countries in Africa, a continent of 1.4 billion people.

Photo: Agence France-Presse/Getty Images

Officially, Africa has recorded far fewer cases of Covid-19 than Europe or the Americas, but limited testing suggests that the true toll is much higher. In one study recently published in the peer-reviewed British Medical Journal, the authors, which included Dr. Mupeta, found that nearly one in five corpses in Lusaka’s main morgue tested positive for Covid-19, with only a fraction having been diagnosed before they died.

Dr. Mupeta said he worried that without vaccines, a mutating coronavirus would continue killing Africans long after it has been brought under control elsewhere, similar to malaria, tuberculosis or the virus that causes AIDS.

“We have to make sure that Covid doesn’t become an African problem,” he said.

Even before large numbers of Covid-19 infections had been identified in Zambia, Dr. Moonga, who had done part of his training in China, started warning friends and relatives about the coronavirus. A writer who was constantly taking notes, he meticulously tracked the pandemic from the outbreak in the Chinese city of Wuhan, where the first confirmed cases emerged in December 2019.

“Four months into the outbreak, I realized my story was becoming a documentary,” Dr. Moonga wrote in the foreword of the novel he started in early 2020.

As highly transmissible coronavirus variants sweep across the world, scientists are racing to understand why these new versions of the virus are spreading faster, and what this could mean for vaccine efforts. New research says the key may be the spike protein, which gives the coronavirus its unmistakable shape. Illustration: Nick Collingwood/WSJ

In “Undying Memory: A Covid-19 Tale,” which he self-published last July and dedicated to those who lost their lives to the virus, Dr. Moonga followed a group of graduate doctors thrown onto the front lines just as the pandemic reaches Zambia. Early in the book, the young doctors are warned by their supervisor not to expect N-95 respirator masks, which can filter out virus particles.

Pulling extra shifts in a hospital some 500 miles away from his family, Dr. Moonga never spoke much about the conditions at work, family members and friends said. But he had often said that his novels were partly autobiographical, and other Zambian doctors say it is common for healthcare workers outside Covid-19 wards to rely on regular surgical masks, which provide only limited protection.

Dr. Moonga’s younger brother, Benedict, a pediatrician in Lusaka, said there is little doubt that he picked up Covid-19 at work, since he lived on his own on the hospital grounds. Within days of testing positive, Dr. Moonga’s oxygen levels had dropped to 60%. His wife traveled to see him but wasn’t allowed to enter the intensive-care ward where he was kept.

In the days after his death, comments from bereft friends and former patients filled Dr. Moonga’s Facebook wall, many recalling how his surgeries saved their lives. His brother, meanwhile, went back to work at his Lusaka hospital. “It’s hard,” he said. “But at the same time, patients need to be seen.”

Covid-19 Vaccines

Write to Gabriele Steinhauser at gabriele.steinhauser@wsj.com

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