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South Sudan Beat the Odds to Deliver COVID-19 Vaccines: Here’s How The 10-Year Old Nation Did It

Leaders in the community like Dr. Emmanual Ojwang turned tragedy into triumph over the course of the summer.

The richest and most well-resourced nations in the world are under intense scrutiny for bungling their domestic COVID-19 vaccine rollouts. So, when COVAX, the coordinated global effort to distribute COVID vaccines, donated 132,000 doses to South Sudan — a low-income country in its infancy without a fully-funded health care system and currently facing violent conflict, pockets of famine, biblical flooding, and economic distress — it was no surprise that the 10-year-old nation had to return every one of those precious doses. The logistics did not exist to get the doses from the capital city Juba into the arms of the South Sudanese people across the country who need them most.

But the people of South Sudan refuse to be defeated. Led by community members like CARE’s Health & Nutrition Coordinator Dr. Emmanuel Ojwang and CARE’s Health and Nutrition Manager Dr. Kawa Tong, South Sudan solicited investments in the South Sudanese healthcare system after those 132,000 life-saving doses went to waste in May. They quickly secured surge funding from CARE’s Fast & Fair Campaign, South Sudan’s Health Pool Fund, UNHCR, and UNICEF, and were able to change the story by the time the next round of doses arrived in July.

Registering for seeds and tools distribution in South Sudan.
Before community leaders like Dr. Emmanuel Ojwang stepped in, the logistics did not exist to get doses from the capital city Juba into the arms of the South Sudanese people across the country who need them most. Photo: Andrea Campeanu, CARE

“With this newfound funding, South Sudan spent the summer heavily investing, building staff capacity, addressing staff gaps and confidence of the communities they serve in the vaccines — training health workers and addressing gaps, educating communities on the benefits of vaccines   — to avoid the distribution bottleneck they faced in May,” said Dr. Ojwang.

Dr Ojwang

By July 18, the country had administered all 60,000 doses provided in the subsequent COVAX delivery. The critical investments that made these vaccinations possible, however, were drastically more expensive than what COVAX currently budgets for.

What CARE’s Our Best Shot report predicted and CARE’s recent vaccine cost case study from South Sudan show is that vaccine distribution is six times more expensive than COVAX estimates. COVAX currently budgets $1.41 per dose for vaccine delivery, but South Sudan had to spend about $10 per dose to successfully deliver vaccines. And low- and middle-income countries like South Sudan can’t afford to pay for these deliveries by themselves. In fragile health care systems like South Sudan’s, COVID-19 vaccination work requires filling existing gaps in the current health care systems to make vaccinations possible. Rather than setting up a temporary system specifically for COVID-19 vaccinations, investing in low- and middle-income countries’ existing health care systems ensures care and vaccine coverage today, and creates a sustainable system that can meet future health needs.

Investing in delivering vaccines to the 20% of people around the world who are most vulnerable to COVID-19 by the end of 2021, and to 80% of the population as quickly as possible, is the only way to slow the pandemic.

In South Sudan’s case, it requires a minimum investment of $63 million, and potentially as much as $126 million, for delivery alone. South Sudan cannot do it without extra investment in delivery. If we want South Sudan to gain resilience against health challenges, it must be provided through grants, not loans with interest.

No one is safe until everyone is safe. We must fund additional delivery costs for weaker health systems to ensure that we stop the COVID-19 pandemic and reduce the spread and emergence of new variants.

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