hashem: a renewed ebola outbreak and a sharply increase in coronavirus deaths. how can the health care systems help, and could fare access to covid-19 vaccines help the continent? this is "inside story." ♪ hashem: hello, welcome to the program. i am hashem ahelbarra. a resurgence of ebola in guinea

is raising fears of an uncontrolled spread of the disease. it has already been detected in the democratic republic of congo, neighboring sierra leone and liberia also tracking cases. the world health organization has asked six countries to be on high alert. the crisis comes as many african nations are struggling to contain the coronavirus. africa is seeing a sharp rise in covid-19 deaths, and health care systems are overstretched. it is feared there could be more for thales if ebola is -- more fatalities if ebola is left unchecked. the who has shifted 11,000 vaccines to help fight the disease in guinea. south africa is leading the rise in coronavirus deaths on the continent, accounting for nearly half. a more contagious variant has pushed hospitals to the limit and it has spread across other nations. the mutation is feared to

reduce the impact of vaccines. south africa has just switched from astrazeneca doses to johnson & johnson shots over concerns. they emphasize the dominance of major pharmaceutical companies over access to covid-19 vaccines. it is representative of the wto, saying structural change is needed for countries to manufacture their own vaccines. vaccine access support nations has been raised by french president emmanuel macron. he has urged the united nations to hand over 5% of their current supplies to developing countries in africa. macron's comments came after the u.s. secretary-general denounced the uneven distribution of covid-19 shots. pres. macron: we must respond to what is a moral duty and the

situation of glaring inequality, and to do so out of solidarity, but also if i may say so out of interest. if we do not eradicate this virus from the entire globe through an appropriate vaccination strategy and let it thrive on the african continent and elsewhere in the poorest countries and continue to circulate to make variants and variants probably resistant to the vaccines being deployed. hashem: let's have a look at other african nations that have started to roll out vaccines. zimbabwe is using the sinopharm jab that china has distributed to several african countries. senegal has received its first 200,000 doses jab from the same country, but there are concerns about the efficacy after a study found it produced a weaker immune system response against the mutation.

deaths across the african continent have reached 100,000, with the contagious variant and limited access to vaccines. many are concerned the figure could get much higher. ♪ hashem: let's bring in our guests. from johannesburg, helen rees. she is a member of the south african ministerial advisory committee for covid and covid vaccine. from brazzaville, dr. richard mihigo, coordinator of the immunization and vaccine development program at the world health organization. and from paris, john johnson, vaccination and epidemic response reverend at doctors without borders. thank you all for joining us. helen, your country has stepped in criticizing vaccine inequality globally, but at the same time, we are seeing the same pattern, which is wealthy

nations hoarding hundreds of millions of d doses which they possibly will not be using. how do you see this disconnect? helen: i think the disconnect is obvious, and we just heard president macron make statements from france's point of view that they are beginning to understand that, and recognizing that from a global health perspective this makes absolutely no sense at all. the african union, as you said, has made very strong statements about this. in the 2009 pandemic flu, the african region was the last continent to get any vaccines. by the time we got vaccines, they would be of little use in terms of pandemic invention. -- prevention. the whole effort, and now i am pleased to say many large countries are both manufacturing vaccines and have these stores

of vaccines. i think we have got to change the dialogue to say that really has to be the norm. sharing has to be the norm and access for poor countries in particularly in the african region, we need to change the pattern of distribution that has so far prevailed, which has been limited. hashem: richard, there is this issue of changing mindsets to be able to convince people it is about time to share the stockpiles they have. but at the same time, at the current pace, it seems that millions of people in africa will not be able to get a vaccine by the end of this year. how concerned argue about this particular thing? -- how concerned are you about this particular thing? richard: we are very concerned, and as professor helen rees says, the promise of international solidarity has been so far is elusive. we believe until people in africa as well are protected and immunized, no one will be safe

anywhere else. i think it is time for the international and public health perspective, that we understand all that unless people are immunized everywhere, i think nobody will be really safe, even in places where vaccination is currently going on. it is not only a moral imperative to do the right things, but it just makes public health science to make sure vaccines also reach people in africa. hashem: this looks like an uphill climb for the african continent, john, because they are underfunded. they are far behind western countries, having their own political-economic problems, they are tackling covid, they are overstretched, and now they are faced with a new thread, which is the outbreak of ebola.

you have been working in one of the epicenters of ebola in the past. how concerned are you about the new outbreak, which seems to be stretching from guinea to many other countries in west africa? john: first of all, it is not spreading yet. what we have is a cluster of seven cases, three that were confirmed and four that are probable cases. we have not confirmed them biologically, but it is assumed they were cases. it is not a huge number of cases, and it is in guinea at the moment. it is concerning because we see this is happening in a city that is the second largest city in guinea, and it shares a border very close with sierra leone and the coat divorce -- the cote d'ivoire. we are making sure we are ready to respond quickly because the

best time to respond to an outbreak is the beginning to stop it quickly. hashem: helen, we have been talking about the inequality gap here when it comes to the vaccine. let's talk a little bit about south africa. you have switched from astrazeneca to johnson & johnson because of the reports of the south african variant and johnson & johnson is one single dose. as you know, we are learning on a daily basis about this disease. is this something that could potentially have an impact of the way to choose a particular vaccine in the future? helen: yes and not only in south africa, there are huge global discussions going on including in the manufacturers and the developers about how are we going to respond. you probably read that globally there are variants occurring all over the world.

if you have lots of people infected, it is much more likely to get variants emerging. we are also hearing these variants are starting to move toward each other in terms of the changes. so we will probably see that certain changes, certain mutations in the virus, are an advantage for the virus in terms of spread and in terms of resisting the body's immune system. we will see this convergence of variants probably worldwide. south africa is rattling with the variant -- is grappling with the variant. for most of the new vaccines, the variants are relatively new as well, so we do not have a lot of data on which to judge if one vaccine will be better than the other. there is a very careful discussion going on to say what can we understand from the laboratory? what can we understand from animal models? and how much clinical data do we need to get to really understand

the impact of the variants on how effective the vaccine is going to be? because clearly we cannot keep these huge clinical trials every time we get a new variant. it is simply not feasible. so we are trying to find alternative ways to give us a good idea of how effective a vaccine is likely to be as we get these new variants. for south africa, we changed to the johnson & johnson because we do have some clinical data generated from south africa in a clinical trial early on alongside lab data that suggests this vaccine will be effective. that was one of the reasons why we made that switch. hashem: when president emmanuel macron said it was about time for the european countries and the u.s. to set aside 5% of their own vaccines to be distributed amongst poorer nations, do you see those countries responding positively

when you know that ultimately every leader would say it is safe to wait until the last citizen in my own country gets a vaccine before i start handing out to other nations? richard: i think the announcement by president macron yesterday i think is a very good step in the right direction. but we are yet to see the reaction of other high income countries. we know that today at the g7 meeting there would be a discussion around this same topic, on how each country can step in and start to share some of the doses they are hoarding, which at the end of the day will not make sense to keep when we know very well that people in developing countries are still waiting for the vaccine. and it is important here to mention, and professor helen

rees mentioned this, we tend not to learn from the past. in 2001 during the h1n1 pandemic, we were in the back of the queue to get the vaccine when the disease was not anymore prevalent. it is for that reason that we are working with other partners, not the covax facility, to really make sure that the global solidarity should be at the core for vaccine deployment globally. so we do hope that is the announcement that was done by the french president, but also other high income countries will be translated in concrete action so we can see vaccines starting to flow as soon as possible in developing countries and in africa. hashem: if you remember back in

2014, 2015, and 2016 when there were concerns that the ebola outbreak in west africa could turn into something dramatic, that is when the international initiative brought about significant changes. first of all, we have the vaccine, and number two, a stockpile to tackle any future outbreak. it is this something that world readers could learn from now -- world leaders could learn from now as they are grappling with covid-19? john: certainly the response to any epidemic shares some similarities. one of the things we learned during the past ebola outbreaks is you have to carry out research and science during the epidemic, and just as helen said earlier, we need to be able to study these vaccines in a way that is both careful and scientific and appropriate and ethical, and at the same time we need to advance the science as quickly as possible to be able to respond. so what we saw in the outbreak

in west africa is they started evolving therapeutics and vaccines for ebola at the same time the outbreak was occurring. during the outbreaks we saw last year in the democratic republic of congo, we were able to use this vaccine to respond, to reduce the number of cases, and we were able to use the monoclonal antibodies, the therapies that were developed for ebola, for the first time to treat patients and reduce mortality. there is definitely similarities and things we can learn. i think we have a long way to go for ebola as well as for covid in terms of how we use these tools because that is what is important. a vaccine is a vaccine, but the way it is distributed, the timing of people to get it, that is the most important thing. this goes into the conversation about global equity, making sure there are not other areas that are immunized. what we have seen in other

epidemic responses is any response that is not organized, not cohesive, and fractured not succeed. hashem: in latin america and africa, decades of civil wars, corruption, embezzlement have undermined the chances for those countries to set their own priorities. now to look after the need to think about ways to put more money into scientific research, have their own platforms, and have their own pharmaceutical companies that would be able to sell drugs which are efficient at a reasonable price. on the african continent, with south africa as one of the leaders, how do you see that happening in the near future? helen: ife are focusing for the moment on vaccines, a few years ago there was what was called a declaration which involved health minister's under the auspices of the

european union, where they said we want to be able to manufacture our own vaccines. vaccine manufacturing takes time. if you are going to manufacture a vaccine and there are other parts of the manufacturing that countries can get too quickly. i think this is a wake-up call. we have few sites in the african region that can manufacture vaccines and the vulnerability of that is playing out. in the u.s., russia, china, where they have their own manufacturing sites, they have the science to back up and develop vaccines, they have been able to develop vaccines and manufacture them and roll them out and create the data that is required to understand if they work and if they are safe. because we don't have that, we are sitting waiting, and we are very vulnerable to the responses

in rich countries. i just want to mention one thing i think is really important. we mentioned post ebola what we learned. we learned a couple of things, and one of them is that we really need to create different ways of getting vaccines rapidly produced and rapidly out there. and the covax facility we mentioned already here, the intent of that facility which has been rapidly put together under the auspices of another group called sapi, the facility has got over 190 countries now, including the poorest countries in the world, middle income countries, and bigger countries, and that is trying to get vaccines from the manufacturers and get money into these countries. it is starting to show real success. we just heard that they secured 1.1 billion doses of the vaccine and $4 billion in the

last 24 hours from the white house. that kind of initiative is the kind of thing that we need to see to really fill the gap. but attached to that is a very strong move toward manufacturing. hashem: we will talk a little later more about covax. for the time being, richard, this is exactly what i think you have been trying to do at the who, which is as a coordinator of immunization and vaccine development looking into ways these countries could come together and integrate their logistics to be able to manufacture their own vaccines. i have been talking to people in north africa, sub-saharan africa, east africa, and they are saying we should come together as communities, have our own platform. we can do outsourcing with the european pharmaceutical companies, but ultimately africa needs to have a sophisticated, state-of-the-art research center

that will pave the way to manufacture vaccines, and this should happen anytime soon because we will continue to grapple with the same health issues in the near future. richard: absolutely. i think and would hope that after covid-19 in terms of research and vaccines in africa, and i think this is a big wake-up call. the lack of infrastructure to purchase a vaccine. but even more importantly, the research and element capacity and platform can adjust very quickly for the development of a novel product, including vaccines. i think we have been working in cooperation with many countries now to see. there has been a strong push from the government themselves in africa to make sure they

cannot rely anymore on the outside and the study that was done in south africa with the new variant, we need to have this capacity established in countries in the region to make sure that when products from outside our coming into africa, we can have the capacity to not only conduct those clinical trials but also to adjust strategy based on the findings. we do believe that one important element, an additional one, is the regulatory pathway. we are working quite hard in that area. we are working to strengthen authorities in order to be able to permit this type of development to go forward. hashem: we have very few minutes left and many issues to tackle. covax is aiming to provide

vaccines for people across the world. now they have more financial support, but they are hoping to be able to see 2 billion doses delivered by the end of 2021. do you think that would be possible? john: you know, i think i have been surprised this whole pandemic what has been possible because last year we were saying we would not see any vaccines come to market before march of 2021. what we saw was at the end of 2020, we had vaccines and we started vaccination. i think the resourcefulness of the scientific community corresponding to this pandemic is quite impressive, and i will not be surprised if covax succeeds. they have been working very hard. have a good plan and good collaboration with a lot of different countries, and i would like to see it succeed. i think if they have the financing they will be able to do it. hashem: helen, do you see the world being able to vaccinate 70% of its population to be able to say we have immunity to

defeat covid-19? helen: that is the million-dollar question. that depends on the response, as you just said, of rich countries to both giving vaccines, giving financial support to initiatives such as covax and the african union, but it also depends on a country's political willingness to be prepared for this. i would say if all of those things aligned, i think we could do it. it would be an extra ordinary global achievement if we could. hashem: less than 30 seconds, richard. many companies such as pfizer are contemplating a third dose, a booster, to deal with the new variants. this will put us in a new mindset where we have to think about how to design the trials for the third booster. is this something that could undermine the chances to get to all the people very soon? richard: i think it is a bit early to say that.

i think we still see research going on, on how to adjust to the new situation, and we will see more of that in the future. but i think our objective and attention now is to provide the current vaccines, which are showing some very good level of efficacy, to as many people as possible. and this is what will help to minimize the occurrence of the new variants. if people are left without being vaccinated, we will see the occurrence of new variants, and that will have impact even in places where vaccination has already occurred. hashem: i think just the fact that we managed to get a vaccine within a year when usually it takes years and years could be an indication that when we come together we can really make miracles. helen rees, richard mihigo, john johnson, i really appreciate your insight.

visit our website, aljazeera.com . for further discussion, go to facebook.com/ajinsidestory. you can also join the conversation on twitter. our handle is @ajinsidestory. for me, hashem ahelbarra, and the entire team here in doha, bye for now.

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