CAPE TOWN, South Africa (AFP) — The struggle to get a COVID vaccine to the world’s population has often been likened to a race, in which case Africa finds itself hobbled by an array of financial, technical and cultural problems.

Of these, funding is predictably hurdle number one for Africa, home to some of the world’s poorest countries.

The Africa director of the World Health Organization (WHO), Matshidiso Moeti last week identified the goal of vaccinating three per cent of Africans by March 2021 and 20 per cent by the end of next year.

Getting the vaccine to “priority” population sectors will cost US$5.7 billion, plus 15-20 per cent for delivery, syringes and other injection material, the WHO’s Africa region estimates.

But of the 47 countries in the region, “only around a quarter have adequate plans” for resources and financing, it says.

Lower- or middle-income African countries can look for help from COVAX Facility, an international coalition which is negotiating lower vaccine prices with Big Pharma.

So far, the continent – home to endemic diseases from malaria to HIV – has been relatively spared by COVID-19.

It has recorded around 2.2 million cases, of which 52,000 have been fatal, in a population of 1.25 billion.

South Africa, which with 800,000 cases is the worst-hit country, hopes to acquire its first vaccines through COVAX “in the middle of next year”, said eminent epidemiologist Salim Abdool Karim, who also advises the Government.

“Even if we can target vaccinating roughly 30-40 per cent of the population, or at least the adult population, that would assist us greatly in terms of managing the transmission of the virus,” said Shabir Madhi, a professor at the University of the Witwatersrand in Johannesburg.

So far three vaccines, each with important differences, have been announced by their makers as a success after phase III trials.

The first, Pfizer/BioNTech, has to be kept chilled to -70 degrees Celsius (-94 Fahrenheit) — a task that is costly and onerous even for rich countries, but especially so in Africa.

The second, Moderna, can be kept in long-term storage at -20 C (-4 F), which is still a major challenge in hot, poor countries.

The third, made by AstraZeneca and Oxford University, can be stored, transported and handled at normal refrigerated conditions of between two and eight degrees Celsius (36-46 F) for at least six months.

That’s a plus and, from Africa’s viewpoint, so is its cost.

AstraZeneca says it will be sold at cost price of 2.5 euros, or around US$3, which is far cheaper than its rivals.

The downside is that the trial results give this vaccine 70 per cent effectiveness compared with more than 90 per cent for the other two.

Some African countries are ambivalent about the vaccine, aware of scepticism or fear among their public. Madagascar is one of them.

“We haven’t adopted a position about the vaccine yet,” said a Government spokeswoman.

In South Africa around a third of the population has reservations about the vaccine, according to Karim.

“If communities are not associated and convinced that the vaccine will protect their health, we will make little progress,” the WHO’s Moeti warned.