How do you vaccinate a small African nation? Rwanda’s health minister explains
An outlier in Africa’s slow rollout, Rwanda has raced ahead and vaccinated more than 90 per cent of adults in its capital. Minister of Health Dr Daniel Ngamije tells the Evening Standard’s Vaccine for the World project how Rwanda did it
ABOUT THIS PROJECT
Within an hour, the vaccines reached the health ministry’s central warehouse, where vehicles from the country’s 47 district hospitals were waiting with fridges on board. In a deployment that had already been tested and tweaked, the trucks fanned out across Rwanda’s green hills and valleys, and army helicopters lifted off to deliver the vaccines to the most remote pockets.
“It was all about preparation. Our experience of preparing for outbreaks of contagious diseases in the past has helped us develop detailed crisis plans, which we were able to put into effect as soon as Covid-19 was identified,” says Dr Daniel Ngamije, Rwanda’s Minister of Health.
“Planning the logistical elements of our vaccine rollout, similarly, was set in motion shortly after a state of emergency was declared.”
On a continent where fewer than 5 per cent of people are fully vaccinated, Rwanda’s vaccine rollout stands out as a success, not just in Africa but by any global comparison. In a Covid Performance Index compiled by the Lowy Institute, Rwanda ranked 7th in the world.
It’s not a competition, Dr Ngamije insists. “We are all part of the same fight to defeat this pandemic, and given the interconnectedness of our continent, we are not safe until everyone in Africa is safe.”
Nevertheless, Rwanda’s experience could provide lessons for other African nations, both in their response to Covid-19 and to future pandemics.
“One of the important things is that our vaccine programme was not born in the time of Covid. From the central planning, the warehousing, logistics and transport to the communities - the whole supply chain - the foundations were already there,” says Dr Sabin Nsanzimana, Director General of the Rwanda Biomedical Center, which coordinates the rollout.
“We just had to strengthen them because not only were Covid vaccines coming in big numbers, we also had other vaccination programmes for children that were continuing,” he explains.
As well as preparing regular refrigerators used for other vaccines, Rwanda also purchased ultra-low temperature freezers able to store the Pfizer vaccine at -70 degrees Celsius, becoming the first African country to use Pfizer’s doses that require ultra-cold storage.
Without the resources to front up funds to make large pre-orders, many African countries had to stand by last year as the world’s richest countries reserved doses to vaccinate their populations against Covid-19 several times over.
Rwanda, like most African nations, has received supplies from the vaccine-sharing facility COVAX. But when those supplies dried up in April – as vaccines were diverted to combat India’s massive infection wave - Rwanda cut deals directly with manufacturers Pfizer and AstraZenca to secure 4 million doses, says Health Minister Dr Ngamije.
Once on the tarmac, the shots reached people’s arms within hours. In power for 27 years since the 1994 genocide, the administration of President Paul Kagame prides itself on efficiency and technological expertise.
“We have a saying here that we don’t store vaccines in fridges or warehouses, we store vaccines in people’s arms,” says Dr Nsanzimana.
Known as The Land of a Thousand Hills for its lush, mountainous terrain, Rwanda deployed “helicopters from day one and we had purchased vehicles for each of the district hospitals, so they could transport vaccines overland to the health centres,” he says.
