Notorious for its hyperinflation, and its status as the 10th most fragile country on the Fragile States Index, Zimbabwe is perhaps one of the last countries you would have expected to be proactive in vaccination rollout.
Yet, not only was Zimbabwe one of the first African countries to receive COVID-19 vaccine donations but has secured a substantial number of doses due to active procurement measures alongside support from a range of international actors but most significantly, China.
Indeed, as of April 10th, 193,936 people (1.3% of the population) have received their first dose, whilst 28,797 are fully vaccinated (0.2% of the population). Although this is still only a small fraction of the country covered, it is a significant jump compared to March, which saw only 35,901 (0.2% of the population) having received one dose.
What Role Have International Partners, Including China, Played in Zimbabwe’s Vaccine Rollout?
First off, international actors supported Zimbabwe’s with initial COVID-19 response efforts. In April 2020, our government launched a $2.2 billion humanitarian appeal, and received $448.4 million from state and non-state actors by September, affording a degree of fiscal space and humanitarian assistance. Notably, China provided bilateral support through deploying medical teams to Zimbabwe in May 2020, alongside 300,000 testing kits donated by the central government and the International Department of Central Committee of the Communist Party of China donated 220,000 surgical masks and 40,000 medical gloves.
Yet, equally important has been Zimbabwean leadership in containing the impact of COVID-19 from the start. By March 19th, before recording a single COVID case, Zimbabwe launched a US$26 million COVID-19 National Preparedness and Response Plan, which covered measures such as planning and monitoring, risk communication, and procurement and supply management, demonstrating an acute awareness for early response, with President Mnangagwa declaring:
“As Zimbabwe, we cannot continue with a business-as-usual approach, as it is no longer a matter of if but when our country will have these cases”
Proactive measures include imposing social distancing measures before recording 10 cases. Efforts to alleviate hyperinflation were included in the $2 billion Economic Recovery and Stimulus Package, which equated to 9% of Zimbabwe’s GDP, through increasing civil servant wages by 50%, followed by an additional 40% increase, alongside providing a $30 monthly allowance to pensioners, to reduce the loss of purchasing power and boost social security. Such efforts have been impactful, with Zimbabwe recording only 1,535 deaths and 37,273 cases – significantly lower than its neighbor, South Africa, recording 53,256 deaths and 1.56 million cases.
And Zimbabwe, like fellow African countries, has experience in rolling out “mass vaccination campaigns”, due to responding to previous disease threats. This has been an advantageous position for African countries and will enhance rollout efficacy. Zimbabwe is among the 44 African countries that have currently received vaccine deliveries, and among the 29 of these countries which have started vaccine rollouts.
Additionally, China has supported our vaccine deployment from the beginning, with a donation of 200,000 Sinopharm vaccines in February, alongside our government procuring an additional 600,000 Sinopharm doses to supplement this. As the Vice President and Minister of Health Constantino Chiwenga asserted this is “another demonstration of the long bond of friendship and solidarity.”
Such cooperation enabled Zimbabwe to kick off its vaccine program, with the first phase focused on health workers and immigration personnel. The second rollout in March has been strategically located in Victoria Falls, one of Zimbabwe’s tourism cities, where all residents are expected to be vaccinated. This is a move to resuscitate the tourism industry that has taken a hit during the pandemic, with a reported job loss rate of 50%. Others to be vaccinated include teachers and workers in the tourism and tobacco industries. Other vaccines authorised include Sinopharm and Sinovac (Chinese), Sputnik V (Russian), and Covaxin (India).
To supplement the second batch of 200,000 Sinopharm donations by China in March, the government procured 1.2 million doses of Sinovac, costing an estimated US$12 million. Additionally, according to Finance Minister Mthulisi Ncube, Zimbabwe plans to procure a total of 1.8 million doses of the Sinopharm vaccine. Going forward, Zimbabwe is looking to procure vaccines from a variety of sources, especially as new COVID strains are affecting vaccines differently. According to Ncube, there are plans to procure one million COVID-19 vaccines doses per month to speed up vaccinations. Currently, the COVAX initiative is expecting to provide 1 million doses.
Three Ways China Should Support Zimbabwe Going Forward.
1) Subsidizing costs and increasing donations.
As mentioned, Zimbabwe already suffers from hyperinflation and fiscal distress. As the World Bank reports, Zimbabwe’s GDP is estimated to have contracted by 8% in 2020, putting immense pressure on development prospects. The pandemic pushed an additional 1.3 million people into extreme poverty (under $1.90 per day), bringing the total number to 49% of the population (7.9 million).
Further, recent UK sanctions on Zimbabwe, alongside not qualifying for the G20’s Debt Service Suspension Initiative, due to its arrears to the World Bank, IMF and African Development Bank, have created additional financial constraints.
China should look to subsidise costs to reduce fiscal pressure, especially as Zimbabwe plans to continue procuring doses from China commercially. Alongside subsidised procurement, further vaccine donations are needed, to support Zimbabwe’s post-COVID recovery and enhance future development. All international actors, including China, have a role to play in this.
2) Address vaccine concerns
Citizens are sceptical of the safety of all vaccines, including the Chinese-made ones. Concerns have emerged following the spread of false information, with, for instance, fake online pamphlets stating those with health conditions or over the age of 60 could not receive vaccines. Indeed, according to Zimbabwe’s College of Public Health Physicians, 49% of Zimbabweans surveyed do not trust the government to provide a safe, effective vaccine. Additionally, Gao Fu, head of the China CDC, recently noted that some vaccine trails showed lower efficacy rates and mentioned plans to mix vaccines to increase effectiveness, which may contrbitue towards vaccine scepticism.
To address concerns, the government has undertaken public outreach measures. For instance, the deputy health minister, Dr John Mangwiro, announced on TV that Sinopharm has a 76% to 86% efficacy rate. On March 26th, Zimbabwe’s ruling party, ZANU-PF, were vaccinated with Sinopharm, which was promoted publicly through Twitter to boost vaccine confidence.
But is this enough? If people remain unwilling to take the vaccine, Zimbabwe’s post-COVID recovery will be jeopardised. Such attitudes are not limited to Zimbabwe, as a recent report highlighted that Nigeria, also using Sinopharm, faces a similar situation.
China can play a role here by sharing timely clinical information on Chinese-made vaccines with Zimbabwean authorities, especially since China is ahead in its vaccination rollout and is aware of any potential side effects. A second method China could pursue is putting their respective vaccines through the WHO regulatory process for WHO approval, which may reduce safety concerns.
3) Pharmaceutical investment
Long-term, Chinese actors encourage private sector investment into Zimbabwe’s pharmaceutical sector. Zimbabwe imports over $400 million worth of drugs annually, with 75% of such categorized as basic drugs which could be manufactured locally.
Several investment opportunities exist in Zimbabwe, with the government offering tax incentives for local manufacturing, with tax holidays of up to 10 years, alongside zero import duties on imports such as APIs, excipients, and medical machinery on investments over $500,000.
A resilient health sector with high-quality pharmaceutical products will protect Zimbabwe from other health threats. Other spillover effects include reducing transaction costs, facilitating technology transfers, alongside stimulating direct and indirect job creation within a value-added sector.
We cannot afford to lose more economic growth. With rapidly increasing levels of poverty, all international actors, including China, should look to support Zimbabwe’s vaccine rollout.
Despite many perceiving Zimbabwe as a high-risk country, it has done remarkably well in its COVID response and vaccine procurement. However, to ensure economic recovery, more support is needed, fast.
Samu Ngwenya is a research analyst at the Beijing-based consultancy Development Reimagined.