The international community sprung into action after yellow fever suddenly began to spread in Angola. More than 6 million vaccines against the mosquito-borne disease were sent to the country to stop the outbreak in its tracks. That’s where things began to go wrong, according to an investigation by the Associated Press.
According to the report: Vaccines ended up in parts of Angola where there are no cases; in other parts of the country the vaccines showed up, but no syringes; perhaps worst of all, as many as 1 million doses went missing amid a global shortage of the vaccine.
The Angolan government disputes the findings. Angola Health Minister Luis Gomes Sambo told the AP, “There has been no diversion (of the vaccines) whatsoever.”
The current outbreak has infected an estimated 5,000 people and killed 450. It spread from Angola to neighboring Democratic Republic of the Congo and its capital city of Kinshasa, home to more than 10 million people. There is an estimated shortfall of 22 million vaccines. The World Health Organization has recommended rationing the vaccine by diluting it down to one-fifth of the usual dosage.
The AP report draws comparisons between the yellow fever response in Angola and the Ebola response in West Africa in 2014. Internal documents and emails at the World Health Organization show that it struggled to work with the Angolan government. The AP suggests that the missing doses is evidence of the lack of oversight in the outbreak response.
In emails obtained by the AP, WHO staffers hypothesized that the missing vaccines were taken by political and military leaders to be resold on the black market. Organizations involved in the vaccine distribution told the AP that as much as 10 percent of vaccines can be expected to be lost due to various reasons when carrying out such campaigns. The 1 million exceeds that threshold.
Internal conversations between staff at the WHO and partner organizations show frustration over the lost vaccines. Attempts to locate the vaccines were unsuccessful. The fact that vaccines were turning up in places not experiencing the outbreak hurt rapid response efforts.
The WHO is under scrutiny after its handling of the spread of Ebola in West Africa. Poor communication and a slow response may have contributed to its unchecked spread. Reforms are under way to prevent it from happening again.
And while parallels are being drawn to the yellow fever outbreak, the cases are not entirely the same. The WHO acted quickly after declaring the outbreak in February. This time around, the issues have more to do with monitoring and accountability, rather than speed of response. The vaccine is very effective against yellow fever, but it is limited because the global supply is not set to respond to this kind of emergency. Doses were mobilized, but problems began once they arrived in country.