Prof PONTIANO KALEEBU is the executive director of the Uganda Virus Research Institute (UVRI), the lead agency in Uganda’s race to get the Covid-19 vaccine and at the same time the director of the partner organization the Medical Research Council/UVRI & London School of Hygiene and Tropical Medicine Uganda Research Unit.
In an interview with David Lumu, he said it may take Ugan-da a longer time to get a locally-made vaccine but the effort put in will accelerate UVRI’s efforts to find the elusive vaccine for HIV/Aids and other infections.
At the moment, the biggest debate about Covid-19 revolves around the vaccine, which has already started being rolled out in some countries; what is the current state of affairs as far as Uganda is concerned?
It is exciting that vaccines have started to come in to remedy the situation while many more are still being developed. Even low and middle-income countries are beginning to receive the vaccines, already the vaccines have reached South Africa, they will soon reach Kenya, Egypt and other places.
In Uganda there are efforts to get the vaccines. We have three major ways to this. One is through what we call the COVAX facility. In order to have access to vaccines, different organizations, manufacturers and governments including WHO, The Global Alliance for Vaccines and Immunizations (GAVI) and the Coalition for Epidemic Preparedness Innovations (CEPI) set up the Covid-19 Vaccines Global Access (COVAX) Facility aimed to accelerate the development and manufacture of Covid-19 vaccines, and to guarantee fair and equitable access for every country in the world including low and middle-income countries.
Already, there are 90 million vaccine doses allocated for Africa through COVAX facility and by the end of 2021, there will be about 600 million doses. The aim is to reach about 20% of the Africa population by the end of the year.
The initial supply to Uganda of about 3.6 million doses is expected to be delivered towards the start of March 2021. The ministry of Health set up a COVAX advisory group that is working through the Uganda National Immunization Technical Advisory Group (UNITAG).
It is currently discussing the allocation, criteria on how the Covid-19 vaccine will be prioritized and phased. This team has already come up with a priority list that includes some essential health workers, security forces and vulnerable groups like people 50 years and above and others with diseases like diabetes.
The team will also advise on the efficacy and science of different vaccines. Secondly, we also have the African Union and the Africa Centers for Disease Control who are also aiming for an additional supply to reach an additional 20 per cent of the African population by the end of 2021.
Thirdly, our government is negotiating to bring about 18 million doses using our resources with the expectation of getting the supplies from Serum Institute of India. But considering that there is a lot of global demand for the supplies, any one of the three approaches may not be able to deliver the vaccines on time, hence the need for the different approaches.
As time goes on, there will be private people who will also join in or partner with government to purchase and deliver Covid-19 vaccines. Government has also put together a National high level committee on accessing and deploy-ing the Covid-19 vaccines. It will be coordinated through the Office of the Prime Minister.
So, there is a lot of preparations going on, including training materials and vaccine deployment plans which have been developed.
How soon should we expect the vaccines developed in Uganda?
We are also developing our vaccines through funding from Government, but as you know this is not a quick process it takes time, all the same it’s a good and wise move which will allow to develop more capacity in vaccine development even beyond Covid-19.
I am glad these efforts have been highly supported by government and the president himself, for our scientists to come up with a vaccine quickly. However, it will take us a longer time to get a vaccine than other countries that have developed the vaccine because they started their research much earlier, building on a catalogue of research done on HIV/Aids and other infections over the years.
It not possible to give timelines, and this means that for now, we have to utilize the vaccines that become available and ensure that these existing vaccines are accessible to Ugandans as we build on our own capacity. We have those from Pfizer and Moderna with about 90 per cent protection.
Then there is one from AstraZeneca and Janssen vaccines. Globally more vaccines are coming out. The Russians and Chinese recently published their results showing their vaccines are effective.
So, we are hoping that in the long term, if majority of people are vaccinated plus the additional few who get infections, we shall reach the herd immunity and the transmission of the virus will go down. The other plan is to conduct more trials of new vaccines, since as we now realize, with the mutation of the virus, the more products we have, the better.
We are working with colleagues at Imperial College London to prepare for a trial of a new vaccine in the coming few months.
In Uganda, we have delayed in starting our vaccine trial as the vaccine we are supposed to use is being redesigned to improve on its performance. Why prioritize those above 50 years? How safe are those below that age bracket?
Basing on the data that has been collected, although all ages get infected, those who are most severely affected are in the older age group of 50 years and above.
Even among the older people, the most vulnerable are those who have co-morbidity diseases like diabetes and hypertension.
In December, the Chinese community in Uganda imported a Covid-19 vaccine for its own people. Have you made any effort to tap into this vaccine? Or was the vaccine tailored to work only on the Chinese?
In this case, we as UVRI played no part. But what everyone needs to know is that a vaccine is not tailored to a race or country, but rather to the virus and now there are several Covid-19 variants being reported. What could happen is that a Covid-19 variant may be common in one location and affecting majority of the people there, and may require specific vaccine to match the virus.
So, it is the virus variants that determine which vaccine to be given but not the race. We couldn’t just jump on the Chinese vaccine before getting results from their trials to know how effective. This information is now coming in and decisions will be made.
Seeing the huge effort to get the Covid-19 vaccine within a year since the pandemic broke out, one wonders why such similar effort is not put into the fight against Malaria and HIV/Aids, which kill more people annually than Covid-19. Some critics even suggest that it could be deliberate because malaria and HIV/Aids have not ravaged western nations like Covid-19…
There are a number of reasons why getting a Covid-19 vaccine has moved very fast. A lot of the technology has come from the investments put in research for the HIV/Aids vaccine as well as other infections like malaria and tuberculosis.
Years of working to get these vaccines has really helped a lot in fast-tracking the Covid-19 vaccine. Besides that, Covid-19 has had a lot of funding, much higher than the HIV/Aids vaccine.
About $90 billion has been invested in the Covid-19 vaccine in a short time compared to about $15 billion for HIV vaccines over the past 20 years. But, of course the $90 billion includes large manufacture and delivery where HIV has not yet reached.
Then most of the minds stopped all other activities and concentrated on Covid-19. So, we can see that if we put our energies and resources together, we can move faster. In this generation, we had never seen a pandemic affecting millions of people globally, but the quick availability and use of resources and advances in science helping to come up with a vaccine so quickly. This is now giving us hope of fast-tracking the development of other vaccines.
But it’s very important to know these viruses are different, HIV is much more complicated and developing a vaccine against HIV is not as straight forward as for Covid-19
What explains the reducing numbers of Covid-19 cases in Uganda yet people seem to have abandoned standard operating procedures like wearing masks and social distancing?
It is true Covid-19 numbers are rising globally although here in Uganda we have seen some declines in the past few weeks. The fact is that for now we are not sure why, we need to study this more. On the other hand, such drops are not new and I call upon all Ugandans to heed government's advice in combatting the pandemic. It is too early to celebrate because Covid-19 is still with us for some time.