With Delta ravaging hospitals, Africa and Asia need both Covid treatments and vaccines

To the extent sub-Saharan Africa was largely spared the brunt of the first few waves of Covid-19, the most recent findings from the World Health Organization (WHO) make clear Africa’s reprieve has come to an end.

Just within the month of July, the global health body found that deaths from Covid shot up 80%, as the Delta variant took hold across the continent and international vaccine shipments largely failed to materialize. While Delta already accounts for 95% of sequenced cases in South Africa, neighboring Namibia last month saw the highest Covid death rate on the planet, with 28 people dying of Covid for every one million people in the country. In second place: Tunisia in North Africa, where public outrage over the government’s failure to control the pandemic has helped throw the country’s young, fragile democracy into crisis.

African countries are the not only ones whose health systems are buckling under pressure from the new variant. In Iran, one physician described the state of the pandemic to the New York Times as “beyond disastrous,” with official government figures showing Covid is killing at least 500 people a day and doctors in major cities reporting the true numbers are twice as high. Indonesia, where a poorly-controlled outbreak has pushed the overall death toll past the 100,000 mark and turned the Southeast Asian nation into the pandemic’s newest epicenter, health experts fear the country could give rise to the virus’ next major mutation.

“The world doesn’t care about us”

In an interview with the Washington Post, Ayoade Alakija – a Nigerian epidemiologist who co-chairs the African Union’s Africa Vaccine Delivery Alliance – captured the boiling frustration felt across low-income and middle-income countries towards the unequal treatment that has left them at the mercy of the Delta variant, all while industrialized countries in Europe and North America rapidly vaccinate their way out of their pandemic. As Alakija told the Post’s Karen Attiah: “it feels like the world doesn’t care about us... the global community does not care about whether we live or die.”

Much of the global outcry surrounding Covid inequality has focused on vaccines, with the World Health Organization (WHO) lambasting plans by the US and European governments to start administering booster shots while a lack of supply in low-income countries has kept their average vaccination rate to just 1.5 doses for every 100 people. As the WHO’s director-general Tedros Adhanom Ghebreyesus said earlier this month: “we cannot accept countries that have already used most of the global supply of vaccines using even more of it.”

While Tedros’ comments are backed up by public health experts who point out the dangers of leaving much of the global population unvaccinated, harrowing scenes from hospitals overwhelmed by Delta patients in countries such as Iran, Indonesia, and India make clear that health systems in less affluent countries also need treatments alongside vaccines. In each of these countries, doctors and hospitals have been left fighting the virus without adequate supplies of medication, oxygen, and ventilators, fueling black markets for any drugs perceived as helpful in fighting Covid.

With many parts of Asia and Africa months, if not years away from securing the vaccines they need to reach collective immunity, the availability of safe, effective, and accessible therapeutics represents a matter of life and death.

The need for more and better treatments

Even as it unsuccessfully lobbies Western governments to redirect vaccine supplies, the WHO is also undertaking massive trials to expand the arsenal of effective medical treatments beyond dexamethasone and tocilizumab. With Tedros insisting the hunt for therapeutics “remains a critical need,” the global health body has just launched the second phase of its ongoing Solidarity trial, which will test the drugs artesunate, imatinib, and infliximab across 52 countries and over 600 hospitals to evaluate their effectiveness against Covid.

Nor are these the only treatment options to show promise in the battle against the pandemic. US-based Partner Therapeutics has progressively advanced with trials of its drug sargramostim (commercialized as Leukine), which is already used to stimulate the production of white blood cells in leukemia and bone marrow transplant patients and which could also be used to improve the lung function of individuals hospitalized with Covid.

A trial of Leukine conducted across five hospitals in Belgium demonstrated that it improved levels of oxygenation by at least a third in over half of participating patients, all while helping their immune systems produce the same anti-viral T-cells seen in vaccinated individuals. Leukine has also been the subject of a trial sponsored by the US Department of Defense, which covered patients in 11 American hospitals and which confirmed the results of the prior Belgian study. Leukine is currently undergoing additional Phase II studies in the US as well as Mexico, Argentina, Brazil, Colombia, Japan, and Singapore.

The advantage of seeking out effective Covid therapeutics among existing drugs – such as dexamethasone and tocilizumab, as well as promising candidates such as Leukine – is that their longstanding approval as treatments for other health issues and existing stockpiles allow for rapid deployment. Dexamethasone, for example, saved the lives of an estimated one million Covid patients in just its first nine months of use, according to the UK’s National Health Service (NHS).

Provided they can access these treatments, doctors and patients from Johannesburg to Jakarta should still have a fighting chance against the Delta variant, even as vaccine distribution remains a point of global contention.

(Devdiscourse's journalists were not involved in the production of this article. The facts and opinions appearing in the article do not reflect the views of Devdiscourse and Devdiscourse does not claim any responsibility for the same.)