The COVID-19 experience in Africa and the Middle East

Aims The experience of Africa and the Middle East with the COVID-19 pandemic has been unique, which can be attributed, in part, to disparities within these regions. Methods This review describes COVID-19 emergence, epidemiology, vaccination strategies and uptake, and lessons learned within Africa and the Middle East. Results For vaccines to be effective in curtailing COVID-19, a global approach to vaccination is required. However, vaccine inequities exist in Africa and the Middle East, with countries with better healthcare infrastructure having advantages in acquiring and delivering vaccines. Currently, the greatest challenges to the effective rollout of COVID-19 vaccination in Africa and the Middle East are funding, healthcare resources, infrastructure, and vaccine access and hesitancy. While mechanisms to support vaccine access in low- and middle-income countries are initiated, their success has been limited and vaccine inequity is arguably the biggest hurdle to a successful response. The collection of surveillance data at both regional and global levels is also critical in response to the pandemic and provides the necessary tools and data to drive vaccine development. Conclusion These considerations of the learnings can help refine the pandemic response and inform countries to better prepare for similar public health emergencies. KEY MESSAGES Learnings from previous epidemics enabled African nations to respond rapidly and cohesively to the emergence of the COVID-19 pandemic; similarly, nations in the Middle East also drew on previous outbreaks of other viruses to respond robustly, although perhaps less cohesively than the African nations. The populations of Africa and the Middle East share many of the same comorbidities (with the exception of HIV in Africa) and risk factors as other regions of the world, and both have experienced multiple waves of COVID-19 infections as new genetic variants of SARS-CoV-2 have evolved. African and Middle Eastern nations have had a wide range of success in vaccine rollout and uptake due to several factors including national wealth/income, populations with varying levels of vaccine hesitancy, and a range of access to private and/or public healthcare. Current challenges, some of which are being addressed by governmental and international entities, include a lack of vaccine- and surveillance-related infrastructure, needed improvement in regulatory standards, and persistent financial strains on healthcare systems that hinder improvements in vaccine delivery.