RESPONSE TO TAPE BY ONE DR. SAMUEL OFORI
ON COVID-19 VACCINE IN GHANA
1. The Ghana Public Health Association (GPHA) released a statement on 13th October 2020, contributing to on-going discussions on Ghana positioning itself to benefit from any available safe, affordable, and cost-effective COVID-19 vaccine. The context and rationale were clearly articulated, as well as some conditions to be fulfilled in guiding the government in taking such a decision.
2. Our attention has been drawn to a tape by one Dr. Samuel Ofori … purporting to respond to our statement. As a professional scientific association with public health interest as our key focus, we welcome divergent opinions which shape any discourse for the benefit of all. What is unfortunate, however, are comments full of innuendos, assumptions and unsubstantiated allegations which only fudge the issues under discussion and tarnish the hard- earned reputation of professional people.
3. The statement sought to advocate for Ghana to continue with the currently available preventive measures in place; adequately prepare to benefit from any safe, affordable, and cost-effective COVID-19 vaccine that may be developed and approved by international and national (by the Food and Drugs Authority); and to work towards developing its capacity in vaccine research and development in the long term.
4. The Statement was arrived at following a scientific seminar organized by the GPHA, on the topic Vaccines and Matters Arising, on September 8th, 2020, which was attended by eminent local health and academic experts, including renowned Professors of local and international repute. 5. We wish to put on record that the Association has contributed and shaped Public Health discourse in the country over the years, including statements on the Ebola epidemic, water pollution and environmental degradation, dangers of use of non-biodegradable materials, dangers of aphrodisiacs, use of Genetically Modified Organisms, and construction of a National Infectious Disease Institute for epidemics, including COVID-19. In all these events, the Association funds itself through membership dues and not by any institution.
We shall now respond to some aspects of the contents on the said tape by Dr Samuel Ofori …
- The speaker is worried by our not mentioning prophylaxis as one of preventive measures listed and moves on to assert that it is an indication that our interest is on vaccines. Though the logic is unclear, we are focusing on immunization as it is the most cost-effective of all public health interventions. Prophylaxis comes nowhere near effective vaccination when available, and we in Ghana have examples from Measles, Pertussis, and Poliomyelitis to guide us. Measles cases have dropped from over 80,000 cases a year in the 1980s to near zero, and we have not had a true death from measles for over 10 years now.
- The speaker then wonders why we did not mention a particular COVID-19 vaccine in our statement and jumped to the conclusion that we are promoting a particular mRNA type. (Incidentally, he failed also to mention which particular COVID-19 prophylactic drug he is promoting). That is the point, because we are not promoting any particular COVID-19 vaccine, as there is none currently registered by our local authority (FDA, the body mandated by law to do so). Our proposal is that after all clinical trial protocols have been followed in terms of safety, effectiveness, quality (whether by local and/or international bodies), and the appropriate legally mandated body has evaluated and approved it for use in Ghana (obviously in consultation with relevant authorities in this area), then the country should position itself to ensure that its citizens benefit from such a vaccine, for equity reasons. Points 2 and 3 in our Statement make our position clear on the way forward. This is where the issue about legal immunity can be raised and we can support this issue. The only problem is why only for COVID-19 and not for all other vaccines and drugs manufactured locally or internationally. We shall welcome any such discussion to ensure that the best is obtained for people of Ghana.
- We shall not go into the issue of multiple strains for COVID-19 vaccines as such matters form part of the process for local evaluation. We have examples with HPV and meningitis where different strains exist depending on locality, and yet the type of vaccine approved is informed by dominant local strains.
- We shall not get into the issues raised concerning Bill Gates, as we do not talk for him and we do not work with him. The only mention is to draw the attention of all that though he is a funder of the COVAX AMC facility, he also funds most of the other childhood vaccines in use in Ghana through GAVI. In actual fact, he is also a financial of the Global Fund to fight against Malaria, TB, and HIV/AIDS, which has benefited many people in Ghana.
- The issue about focusing on low- and middle-income countries for any approved COVAX vaccine is basically to do with affordability and financing access, and not the type of vaccine. Developed countries have the funding muscle to take care of themselves while low- and middle-income countries fall short even with raising counterpart funding for routine childhood vaccination programmes.
- The epidemiological question of who is vulnerable: people in low-transmission areas (e.g Africa) , compared with others in high-transmission areas (such as Europe) can be discussed at another time. Historical evidence, however, shows that many Africans succumbed to measles and other epidemic prone diseases from invading white settlers. The Antonine Plague (165 – 180 AD), possibly smallpox or measles brought to the Italian peninsula by soldiers returning from the Near East, killed a quarter of those infected, and up to five million in all. The natives died because of no or low immunity as they had never encountered the microbe before. For the case of COVID-19, by analyzing the data from Ghana it is possible to identify the segments of population at high risk for prioritisation when a vaccine becomes available.
- Lastly, the speaker is concerned about supporting local scientists to manufacture local vaccines. We share this view, and careful reading of our Statement shows that we promote such initiatives. We stated, for instance in the Statement that, “the National Immunization Technical Advisory Group (NITAG) needs to review the portfolio of vaccines to be presented by Gavi, including assessments of the surveillance system in place for monitoring Adverse Events Following Immunization.” Incidentally, NITAG is made up of local experts from academia, public health, and research institutions. We went further in point 7 of our Statement to call on government to work with other African Union countries to explore a collaborative and long-term approach to investment in building capacity in the long run in Research & Development for vaccine production. Unfortunately, who can the speaker trust, and not accuse of receiving funding for personal gains!
A careful reading of our Statement therefore cannot support the innuendos, assumptions and allegations made by the speaker in the recording. In actual fact, we share some of the concerns expressed in the recording. We welcome any constructive ideas to inform policy makers on the way forward for the common good.
Official document :
GPHA 