An effective COVID-19 vaccine could help us emerge from isolation and end the social distancing required during this pandemic; but it will only work if people are willing to be vaccinated.

We conducted a survey in June of 2020 that addressed whether people’s willingness to use a COVID-19 vaccine and adopt other preventive healthcare measures was associated with trust.  The survey was conducted in nine countries: China, India, Indonesia, Italy, Japan, South Africa, Sweden, the United Kingdom, and the United States. A thousand individuals were surveyed in each country, and the responses were weighted to the most recent census data.

While an average of 86% of the respondents had increased the number of times they washed their hands in April and May of 2020, an average of 21% said that they would not get vaccinated. These figures were highest in Sweden (31%) and South Africa (30.6%), but were not much better in the United States (28%) and Italy (23%) (Figure A). Unfortunately, many of these levels barely reach the cusp of vaccine coverage needed to achieve population-wide herd immunity against COVID-19

Sources show that the public is most concerned with vaccine effectiveness and the risk of vaccine side effects. Worry about side effects has historically had a big influence on vaccine acceptance. In the UK, concern about reported neurological complications from common childhood vaccines lowered the vaccination rate from 81% in 1974 to 31% in 1980, leading to a resurgence of pertussis that resulted in over 100,000 cases . In 2018, 20% of respondents to the Wellcome Global Monitor survey in the UK said they believed that the risk of vaccine side effects was fairly high or very high

Interestingly, our survey showed that respondents who said they would get vaccinated had more education than those who said they would not get vaccinated. These results were highest in the U.S. and Sweden (Figure B). This may mean that people with more education have more information, but this correlation will need to be further explored before it can be explained.

Dr. Bruce Gellin, U.S. Deputy Assistant Secretary for Health and Director of the National Vaccine Program in the Department of Health and Human Services, has said that the foundation that underpins vaccination acceptance is trust [9]. Our survey explored respondents’ trust of both their national government and the medical profession (Figures C and D). With the exception of China, India, and Indonesia, most respondents had relatively low levels of trust in their national government, but most of the respondents said they trusted the medical profession. Trust in both entities, but especially in the medical profession, was generally higher among those who said they would get vaccinated. These findings emphasize the importance of having medical professionals lead messaging about vaccine safety, effectiveness, and benefits.

A recent piece in the Journal of the American Medical Association [12] on flu vaccination during the COVID-19 pandemic stated that strong, unified messaging is essential to vaccine compliance. The article cites the CDC’s call to action that urges physicians to make every effort to get their patients vaccinated and acknowledges that physicians and healthcare professionals are the most trusted source for accurate information on vaccine risks. The role of medical professions in preventing larger public health crises that could overwhelm the world’s healthcare resources cannot be overestimated.

We suggest that healthcare professionals partner with their national governments and international healthcare experts, such as the World Health Organization, to create consistent, accurate messages about the benefits of vaccination for COVID-19. These messages should use simple language that people with no more than an elementary education can understand; acknowledge peoples’ fears about vaccine side effects and cite accurate, verifiable data on side effect risks; and state whatever data is available on vaccine effectiveness. This will ensure that the greatest number of people will get vaccinated as soon as a vaccine is ready leading to a potential end to the current COVID-19 pandemic.

After demonstrating its resilience during the Ebola outbreak and the global financial crisis, Africa is once again facing a severe test of its strength and agility because of the coronavirus pandemic. The good news is that the continent has entered this crisis in reasonably good shape following decades of progression in health, education and economic outcomes.

As of early 2020, macroeconomic fundamentals in Africa were improving, with investments, rather than consumption, accounting for more than half of the region’s growth. Inflation was falling and the continent was making impressive strides towards accomplishing the United Nations Sustainable Development Goals (SDGs). Africa must build on the momentum and strive to prevent the coronavirus pandemic from reversing the gains of the past 20 years.

Admittedly, that’s easier said than done: despite their best efforts, many countries still struggle with fragile health systems, high debt levels, weak external balances, as well as high rates of poverty and unemployment. The African Development Bank now projects that Africa will fall into a recession in 2020 with economic growth contracting by at least 1.7 per cent. In a worst-case-scenario, this figure could turn out as high as 3.4 per cent.

Cumulative losses in gross domestic product (GDP) across the continent could range between $173.1 billion and $236.7 billion in 2020 and 2021. The coronavirus pandemic threatens to increase the debt burden of African countries from 60 per cent to 70 per cent of gross domestic product, heightening the likelihood of a sovereign debt crisis. The additional financing required to cushion the consequences of the crisis could be in excess of $150 billion.

In a part of the world where 85 per cent of the population earn their living in the informal sector, unemployment as a direct result of the coronavirus pandemic could push an additional 28 to 49 million people into extreme poverty. Moreover, if we fail to take adequate action, the impact of the crisis on food insecurity and malnutrition may be even worse than anticipated.

What can be done to support African economies?

To counter the fallout of the coronavirus pandemic, Africa needs robust policy responses from every country on the continent, paired with strong support from Africa’s development partners. In the short term, African countries should prioritise healthcare spending for the provision of essential personal protective equipment (PPE) and materials, acceleration of local production of medical supplies including PPE and vaccine and drug discovery.

Targeted cash transfers and subsidies for vulnerable households as well as subsidies and tax relief for businesses should be high on the agenda. Central banks must inject liquidity into the economy, turning to unconventional policy tools such as quantitative easing if necessary. In the longer term, countries should seize the imperative of building resilience to future crises. As good times return and economies get back on track, it should become a priority to build domestic and external buffers against any potential exogenous shocks.

More money should be earmarked for scientific, economic and social research. Countries should pursue global and continental partnerships to prepare for eventualities. Private sector growth and revamping education and labour markets for the future of work are also key.

The role of development partners

At the onset of the coronavirus pandemic, multilateral development institutions took immediate action to help Africa’s poorest countries navigate the crisis and help them on the road to recovery. The African Development Bank is playing its part through its USD 10 billion COVID-19 Rapid Response Facility (CRF). The CRF offers immediate relief to African countries to address the crisis by providing additional resources for public health interventions, social protection programs and liquidity and budget support to affected sectors of their economies.

Civil society and think tanks have a useful role to play by helping to build trust, solidarity and uptake of COVID-19 prevention and containment measures. They can also help to ensure that COVID-19 interventions are carried out equitably and that governments are held accountable for their policies and actions.

The African Development Bank stands ready to work with other multilateral financial institutions and wealthier nations to alleviate the impact of the pandemic on African countries. For example, we welcome partnerships to establish dedicated donor-financed COVID-19 trust funds. We also urge G20 nations to consider debt forgiveness for low-income countries.

Reasons to remain optimistic

The continent’s youthful and innovative population, its growing middle class, its value addition to the abundant natural resources and its ever-improving governance systems give us plenty of reason to be confident that Africa will overcome the ravages of the coronavirus pandemic.

This year marks the first time the continent has entered a recession in more than half a century. Over the past two decades, Africa has boasted some of the highest growth rates in the world, setting the region up as the next investment frontier in a post–COVID-19 world.

The level of cooperation in Africa has been encouraging. But beyond the crisis, we need to continue working together to help rebuild our economies and prepare them for the future. Africa will emerge from this episode stronger and more resilient than ever before.