“As academics, our role in society is teaching, research and outreach,” declares Dr John Phuka, taking a seat at Kamuzu University of Health Science (Kuhes) guesthouse in Blantyre. The exhausted public health emergencies expert is returning from Mulanje District where he was monitoring some of the field teams praised for utilising 714 000 Covid-19 vaccination doses within two months.
Since September, he has been tracking the vaccinators that use vans, boats, motorcycle and bicycles to put the perishable vaccines closer to people who need them.
The vaccine express initiative supported by Unicef, has spurred the Ministry of Health to ultilise the doses that would have expired in November and December had access been confined to health facilities located far apart.
“Outreach is important for any university because the knowledge and innovations we generate are meant to improve public well-being,” says Phuka.
The ex-leader of Malawi’s Covid-19 response is interested in disease outbreaks that leap from one country to another.
The Covid-19 pandemic struck in December 2019 when the School of Public Health he leads at Kuhes was preparing for possible episodes of Zika virus from east African neighbours.
The university swiftly switched to the new virus, recalls Phuka.
“At Kuhes, we started fighting Covid-19 way before it arrived in Malawi [in April 2020]. We set aside a team to fight the pandemic for as long as we have known about it. As intellectuals, it’s our duty to influence policymaking and innovation,” he explains.
Following the crowd-pulling vaccination strategy, Phuka is convinced that myths and misinformation were not the main trigger of a dramatic drop of Covid-19 vaccination uptake three months after the rush seen at the beginning in March.
President Lazarus Chakwera openly took the first AstraZeneca dose at the launch on March 11 2021. A photograph of the President receiving the prick adorns the 30 vans Unicef deployed in the nationwide vaccination express campaign, assuring onlookers that the jab is safe.
The vaccine gives the body prior exposure to the virus, teaching the immune system to avert possible infection and deaths, according to Phuka.
“If the virus goes beyond the barrier created by the vaccine, the body can fight it accordingly. If one is unvaccinated, the body will be overpowered,” he elaborates.
The epidemiologist reckons that the vaccine express eases access to the weapon against severe Covid-19 illness that overwhelmed treatment centres before the jab arrived.
“Then we didn’t know much about Covid-19. Our bodies didn’t know it. Our brains and immunity were still learning,” he says.
The mobile vaccination vans boosted access to the vital vaccine and accurate information from their public address systems. The teams vaccinated people in shopping malls, busy rural markets and other meeting places.
Expanded Programme on Immunisation (EPI) director Dr Mike Chisema calls it a“game changer” for dialling up access to Covid-19 vaccines even in hard-to-reach communities, including during weekends.
The daily count of people vaccinated in all 28 districts and four cities rose from “as low as 1000 to 29 000”, according to him. This more than doubled the proportion of those who have received at least a single dose from three percent to 6.5 percent since the trial phase last September.
“We need to take vaccines to the people. We have to find simple ways to do this without solely relying on health facilities,” he states.
Chisema says the express is worth emulating to boost national efforts to ensure every child gets all routine vaccinations.
“This approach could be vital to enhance supplementary immunisation campaigns, catch-up exercises and periodic intensification of routine immunisation for defaulters,” he observes.
Unicef Malawi representative Rudolf Schwenk says Unicef remains committed to support upcoming vaccination activities and strategies.
He states: “Unicef is working with the Ministry of Health to address critical obstacles in Covid-19 vaccination.
“We assisted in developing a vaccine express strategy and generating funding to reach Malawi’s most remote populations with Covid-19 vaccines. As a result, all of the Covid-19 vaccines that were due to expire in December 2021 were utilised.”
At Zomba district health office, EPI coordinator Simeon Chizimba says the district’s van, boat and motorcycles have helped health surveillance assistants (HSAs) put Covid-19 vaccines beyond routine immunisation’s reach.
“By improving mobility and providing incentives for every HSA who finished a vial [a bottle containing doses for 10 clients], Unicef and Kuhes helped us take Covid-19 vaccines to tricky communities far from health centres instead of waiting for people to come to us,” he explains.
Linley Maluza, an HSA at Namikango Health Centre, says the involvement of community health workers and leaders helped her vaccinate up to 30 people a day when the van visited her community.
She states: “Previously, I used to vaccinate just two or three at my health centre.
“It is great to be part of the community outreach. People were encouraged to get vaccinated because they know and respect the local HSAs, village heads and religious leaders. When we say do this for your well-being, they do it.”
Maluza was spotted vaccinating Emiles Mmala, 22, when the van stopped in Chibibi, a rural village located about 10 kilometres from the old capital city, Zomba.
“Covid-19 has killed many Malawians, including ministers and lawmakers, so there is no reason not to protect ourselves. With the truck bringing vaccines near our homes, I didn’t lose time or money,” said the girl as Malawi’s Covid-19 deaths exceeded 2 300 from over 77 600 confirms cases.
The van saved Emiles and her neighbours from spending K2 000 to get vaccinated at the nearest health facility. This perfectly exemplifies the global and national push to ensure people get health services close to where they live without financial concerns or competing needs.
States Phuka: “Universal health coverage is about access and acceptability. Vaccinating 11 million people aged 18 and above is 10 times more challenging than immunising newborns, so you don’t stop good things.