The Economist - UK (2022-03-19)

The EconomistMarch19th 2022 MiddleEast&Africa 45

Covid-19vaccination

Behindbya

countryvial

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t islittleovera yearsincethefirstdos­
es oflife­savingvaccinesweredelivered
to AfricaundertheCovid­19vaccinesGlo­
bal  Access Facility (covax), a scheme
aimedathelpingpoorercountriesgetin­
oculated.Yetwhatshouldhavebeena cele­
brationoftheregion’sfastest­evervaccine
rollout—with 400m doses jabbed into
waitingarms—wasinsteadmarredbydis­
appointment at how much more could
havebeenachieved.
AsofMarch15th,nolessthan57%of
world’spopulationhasbeenfullyvaccinat­
edagainstcovid.YetinAfricathatshare
fallsto13%,accordingtoAfricacdc, the
continent’s main public­health body. A
yearagomany African countriesrightly
complainedthattheyhadbeenpushedto
thebackofthequeueasrichercountries
boughtupmostoftheworld’svaccinesand
producingcountriesbannedexports.
Now supplies are no longer a con­
straint.InJanuarycovaxhad436mdoses
toallocate,butreceivedrequestsforjust
100mdoses,thefirsttimethatsupplyhas
outstrippeddemand.It hasalsosteppedup
its deliveries. According to the World
HealthOrganisation(who), thenumberof
dosesshippedeverymonthtoAfricadou­
bledbetweenNovemberandJanuary.
Insteadofcomplainingaboutnotget­
ting vaccines, some countries are now
protestingthattheyarebeingdrownedina
delugeofthestuffandareunabletouseit
all.LastmonthAfricacdcappealedtodo­
norstostaggerthesupplyoftheirshots.
“Wehavenotaskedthemtopausethedo­

nations,buttoco­ordinatewithussothat

thenewdonationsarriveina waysothat

countriescanusethem,”saidJohnNken­

gasong,thedirectorofAfricacdc.

Increaseddeliveriesareexposinglogis­

ticaldefectsindistributionwithincoun­

tries,whileweakhealth­caresystemshave

beenunabletojabdosesintoarmsasfast

astheygetthem.AcrossAfricaasa whole

just62%ofdeliveredvaccineshavebeen

administeredand 29 countrieshaveused

lessthanhalfoftheirsupplies,saysthe

who. Amongtheworstlaggards arethe

DemocraticRepublicofCongo,whichhas

used15%ofitsconsignmentsandjabbed

lessthan2%ofitseligiblepopulation,and

Burundi,whichhasusedlessthan2%.

Alsohiddenintheaveragesarebiggaps

invaccinationratesbetweencitiesandthe

countryside.Althoughcontinent­wideda­

ta arenot available,Githinji Gitahi, the

chiefexecutiveofficerofAmrefHealthAf­

rica,anngo,saysthistrendisclearacross

manycountries,includingGhana,Kenya,

Rwanda and Tanzania. In Kenya51% of

adultsinNairobi,thecapital,hadbeenful­

lyvaccinatedbyMarch16th.ButinMande­

racounty,a poorsemi­aridregionnextto

the border with Somalia, only10% had

beenfullyjabbed.

Partofthereasonislogistical.Freezers

forstoringvaccinesareinshortsupply.But

thisshouldbesurmountable.TakeUgan­

da.ByNovemberjust14%ofitseligible

population hadreceivedtheirfirst dose.

Butina pushsupportedbydonorsinclud­

ingtheAmericangovernment,itbumped

thatrateupto47%injustsixweeks.InIvo­

ryCoast,wheremanypeoplewerenervous

aboutthejab,thegovernmentbumpedup

thevaccinationratefrom22%to36%inthe

monthofDecemberbyrunningradiocam­

paignstoallaypeople’sfears.Thesespeedy

successessuggestthatinmanyplacesthe

biggestshortageisnotoffreezersornur­

ses,butofzealonthepartoftheauthori­

tiestogooutandgetinjecting. n

C APE TOWN

Why Africatrailsinadministeringjabs

Covid-19vaccinations,March16th 2022

Totalpopulationwithatleastonedose,%

510 20 40 60 80 90 100

No reported

Source:OurWorldinData vaccinations

Burundi0.1

Kenya21.6

Rwanda68.0

Tanzania6.0

Ghana28.3

UnitedStates6.9 China 88.2

Somalia 9.3

S

tate-licensedprostitutioninTuni­

sia dates back at least as far as the

Ottoman conquest nearly half a millen­

nium ago—and has persisted to the

present day. In 2011 at least 300 sex

workers were operating legally under

the government’s auspices. Almost

every big city had a licensed brothel,

regulated by the interior ministry’s

bureau of morals. Prostitutes could be

registered as fonctionnaires—civil ser­

vants. The system, however, is being

phased out—much to the detriment of

the prostitutes.

The first setback was the overthrow

of the authoritarian but largely secular

government in 2011, since it empowered

Islamists with puritanical attitudes.

Most brothels were forced to close. Only

two well­known ones are thought to

have survived the Islamist purge: one in

the city of Sfax, the other in Sidi Ab­

dallah Guech, the red­light district of

Tunis, the capital. 

The sex business was buffeted even

more fiercely in 2020 when a wholesale

lockdown in the face of covid­19 meant

that the remaining brothels had to

close. Women who worked in them

were forced to ply their trade illicitly, in

public parks and hotels. They often

became prey to exploitation, extortion

and violence at the hands of police,

pimps and criminals.

“There were reasons why we pre­

ferred working with the government,”

says a prostitute from Sfax. Even if the

pay was less generous in a licensed

brothel, where the going rate was 10.5

Tunisian dinars ($3.60) per client, it

was preferable to the 30 dinars you

might make on your own, because it

was safer. “At least in the brothel I had

police protection. They could control

the clients and make sure they used

condoms,” she says. 

With state oversight unclear, many

Tunisian prostitutes now rely on volun­

tary associations to safeguard their

health and welfare. “Rapes and attacks

against women have risen since the

brothels closed,” says Bouthayna Aous­

saoui, who runs an organisation that

helps the women. In 2018 a survey

found that around 6% of Tunisia’s sex

workers had hiv. By last year, after the

brothels had closed, the figure had

risen to 11%, she says. The puritans,

predictably enough, had merely made

matters worse.

PayingforsexinTunisia

Game over

T UNIS

Licensed prostitution is banned