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Burundi will take advantage of a World Bank financing mechanism to allow developing countries to purchase Covid vaccines collectively through Covax. Photo Ebrahim Hamid/AFP


Burundi, one of the last countries in the world to start inoculating its population against Covid-19, said it has agreed to take Covax vaccines -- but with a condition.

The change of heart came a day after the IMF agreed in principle to a $78 million aid package to help Burundi deal with the fallout of the pandemic.

Health Minister Thaddee Ndikumana announced Wednesday that Burundi would accept Covax vaccines offered by the World Bank, but would refuse to sign a waiver he said was demanded by pharmaceutical companies.

Burundi along with Eritrea and North Korea are the only countries yet to start Covid-19 immunisation campaigns, after Tanzania began rolling out vaccinations on Wednesday.

Until now, the government had refused to be part of the Covax initiative, saying it did not want vaccines that were still "at the experimental stage". 

In a major about-turn last year, President Evariste Ndayishimiye declared the coronavirus the country's "biggest enemy".

Ndayishimiye and his predecessor Pierre Nkurunziza, who died suddenly in June 2020 amid speculation he had contracted Covid, had previously downplayed the gravity of the pandemic, saying God had spared Burundi from its ravages.

But the country still only rarely gives data on coronavirus infections. The latest, issued on July 13, show a total of 5,723 cases and eight deaths.

"When the vaccines are here, any Burundian who wants to can go (and get a jab)," Ndikumana said.

Burundi will take advantage of a World Bank financing mechanism to allow developing countries to purchase Covid vaccines collectively through Covax.

But the minister insisted Burundi would not sign a form he said would commit the government to compensate victims of "undesirable" side effects from the jabs.

Details of the document and its demands were not known and it was not immediately clear if Burundi would not take the vaccines if it was obliged to sign the waiver.

Asked about the issue, Africa CDC director John Nkengasong said he had not seen the document and could not comment on the specifics, but that they were ready to assist in monitoring the vaccine rollout.

"We stand ready to work with Burundi to provide them with the technical assistance so that they can deploy the vaccines in all dimensions and not just look at the immunisation but also monitor the effects of the vaccines going forward," he said at a joint press conference with the World Health Organization's regional office for Africa.

The International Monetary Fund meanwhile said Tuesday it had agreed in principle -- subject to higher IMF approval -- to a $78 million credit facility to address the "economic and social impact" of the pandemic in Burundi.

The country's economy shrank by about one percent in 2020, the IMF said. - AFP/Daily Nation

Kenya become the first African country to roll out PrEP as a national program, in the public sector, in May, 2017. Photo via The Star

Sixty-five Kenyans have contracted HIV while consistently taking the preventive drugs called Prep, the Ministry of Health has said.

If taken as prescribed, the pre-exposure prophylaxis drugs provide 100 per cent protection against HIV, so it is difficult to prove why the infections happened. 

Nam-Aidsmap, a UK-based charity, in its analysis of the findings said some could have acquired HIV during a period of poor adherence or drug supply interruption. 

Kenya rolled out Prep as a national programme in the public sector in May 2017, becoming the first African country to do so. 

The last count done in Kenya in 2019 showed that 25,000 people were using Prep.

Medical experts say that there is no consistent data on how many people are using Prep, as a significant number takes it only to have risky and unprotected sex and then drop out. 

The 65 cases happened between 2017 and 2021, but there could be more people who have become infected and were not documented.

The findings were presented online last week at the 11th International Aids Society Conference on HIV Science.

The authors said most of the people who turned positive had drug resistance mutations to the Prep drugs Emtricitabine and Tenofovir.

The researchers were unsure if the resistance came as a result of taking Prep or it may in some cases have already been there in the HIV that people acquired.

This drug resistance in the people who became positive was higher than seen in the general population.

“The high frequency of HIV drug resistance in HIV-infected individuals on PrEP exceeds background levels,” the researchers say in the study, also conducted in Zimbabwe, Eswatini and South Africa.

Some 79 Prep users in South Africa also turned positive within the same period, 36 in Zimbabwe and 28 in Eswatini.

All the infections came from among an estimated 104,000 people taking Prep in the four countries since 2017.

Researchers from the Kenya Medical Research Institute and the Ministry of Health's National Aids and STIs Control Programme were involved in the study.

Principal researcher Dr Urvi Parikh of Pittsburgh University said 35 per cent acquired HIV in the first three months on Prep, 40 per cent from three months to a year on it, and 18 per cent in people who had taken it for more than a year.

“But it does suggest that HIV infection on Prep is proving to be rare,” Nam-Aidsmap, a UK-based charity said in an analysis of the study.

The Prep users who turned positive were also tested for Prep drug levels in their blood, but this showed high drug levels, indicating good adherence.

“So some could have acquired HIV during a period of poor adherence or drug supply interruption, but when diagnosed had good adherence,” the Aidsmap analysis says.

The participants who provided a blood sample for analysis had a median age of 24 years, from a range of 16 to 67 years and 74 per cent were female.

Key populations included HIV serodiscordant couples (21 per cent), female sex workers (10 per cent), men who have sex with men (nine per cent), and transgender individuals (six per cent).

Prep failure is extremely rare if taken along with other prevention tools.

With hundreds of thousands of individuals using PrEP worldwide, only six cases have so far documented HIV infection among those with high adherence. - John Muchangi, The Star

The US was the first to impose sanctions on Ethiopia. JA editing: ALEX BRANDON/AFP; Mistrulli/Fotogramma/ROPI-REA

At the beginning of his term in office, Ethiopia’s Prime Minister Abiy Ahmed was hailed by the international community. However, he has been subjected to strong diplomatic pressure since the beginning of the conflict in Tigray. The US was the first country to impose sanctions on Ethiopia. Will others follow suit?

Will US secretary of state Antony Blinken be able to make Abiy bend to his will? After seven months of conflict in Tigray, the US secretary of state decided to engage in a showdown with the Ethiopian prime minister by announcing, on 23 May, that visa restrictions would be implemented against several officials.

Blinken said these sanctions are aimed at all actors involved, specifically, “Ethiopian or Eritrean government officials, members of the security forces, or other individuals”. But there is no doubt that the most unexpected target is Ahmed’s administration. By Romain Gras, The African Report

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