Central African Republic

Situation Report
  The Ministry of Health Pierre Somse received the COVID-19 vaccination at the kick-off ceremony of the national vaccination campaign in the capital Bangui. ©MINISTRY OF HEALTH/Jean-Louis DA, Bangui, CAR, 2021.
The Ministry of Health Pierre Somse received the COVID-19 vaccination at the kick-off ceremony of the national vaccination campaign in the capital Bangui. ©MINISTRY OF HEALTH/Jean-Louis DA, Bangui, CAR, 2021.

COVID-19 vaccination campaign launch

The Central African Government on 20 May 2021 launched the COVID-19 vaccination campaign with the support of partners, notably WHO, UNICEF and GAVI. The campaign began with the symbolic vaccination of members of the government and health workers. The Ministry of Health reported that 351,316 people have been vaccinated as of 23 November. Frontline health personnel, vulnerable people aged 50 and above, religious leaders, traders, community liaison volunteers, transporters and journalists were targeted first by the campaign. The country benefits from the global roll-out of vaccines through the COVAX facility with at least 372,000 doses, according to the latest distribution forecast, in additional to bilateral donations that have been announced. On 6 July, the Central African Republic (CAR) received for example 150,000 doses of the Sinovac vaccine through bilateral support from the Government of China.

The United Nations on 21 April 2021 started a vaccination campaign for its personnel and staff from eligible international NGOs in CAR as part of its duty of care. Until 23 August, 19,454 personnel were vaccinated.

Response to the second wave

On the vigil of the campaign launch, President Touadéra on 19 May announced that a public health emergency will be declared and a number of measures taken to intensify efforts to contain the second COVID-19 wave, that has hit the country since mid-March. Stricter barrier measures at gathering places such as restaurants, bars, places of worship, weddings and funerals, and public transport would been announced, as well as their more rigorous reinforcement.

As of 23 November 2021, the Ministry of Health has recorded 11,757* COVID-19 cases, including 101 deaths. In the first four months of 2021, six times as many cases were confirmed as in the last four months of 2020 – 1,571 cases compared to 259 – and the death toll has risen by 44 per cent from 63 to 91. The worsening of the epidemic concerns the entire country. Several towns that were previously spared have also reported cases, including Kabo (Ouham Prefecture), Kouango (Ouaka), Bangassou (Mbomou), Ndélé (Bamingui-Bangoran), Birao (Vakaga) and Obo (Haut-Mbomou). Beyond the urban areas, COVID-19 is spreading deep into the villages. 

Conducive environment

A recent survey conducted by the NGO Ground Truth Solutions indicated that Central Africans are ready to be vaccinated against COVID-19 and believe that the vaccine will help to eradicate the virus, despite some scepticism and misinformation that persist. Humanitarian and development partners have been supporting the Ministry of Health in elaborating a communication campaign to inform and encourage people to get vaccinated and to counter the spread of false information about the vaccine.

Challenges on all fronts

The Central African Republic looks back at a year during which humanitarian needs soared. Never in the past five years have there been so many people in acute need as today. COVID-19 hit a country already ravaged by decades of armed conflict and underdevelopment. According to the WHO, CAR was among the least prepared to face the pandemic. A series of aggravating factors render the country both vulnerable and the response to the pandemic difficult:

The health system is barely functioning, due to a chronic shortage of skilled health workers, medical equipment and basic medicines. Seventy per cent of health services are provided by humanitarian organizations and over 2.5 million people, half of the population, need health assistance. One in four Central Africans walks for over an hour to reach the nearest clinic and for many, the bills for consultations and medications are unaffordable. Only one in three Central Africans has access to clean water and for many, soap is a luxury good. Access to water and sanitation is particularly problematic at the many sites where 181,000 internally displaced people (IDPs) live, often in crowded makeshift shelters where physical distancing is not practicable.

The provision of protective equipment and medical devices to diagnose and treat COVID-19 patients posed a serious challenge, particularly at the onset of the pandemic. Poor road infrastructure and the six-month rainy season disrupt supply chains to large parts of the country. Insecurity further hinders access to services and the possibility of humanitarians to reach people in need of assistance. A severe lack in cold chain infrastructure further impedes the safe supply of medicines across the country.

Unprecedented humanitarian response

Faced with these challenges, humanitarian and development organizations have scaled up support to the Ministry of Health since March 2020 to provide a comprehensive and decentralized response and to strengthen the public health system and access to water and sanitation. Nearly a third of the US$ 553.6 million budget for humanitarian assistance in 2020 was dedicated to the COVID-19 response.

As a result, humanitarian partners improved access to health care for 938,000 people in 2020 and made access to water and sanitation possible for 770,000 people, including many IDPs.

To mitigate the effects of COVID-19 on food security, humanitarian organizations in 2020 assisted 900,000 vulnerable people with food and over 170,000 farmers were able to produce their own food and increase income thanks to agricultural support.

Adapting the modality of assistance

Cash-based interventions became a preferred modality of assistance that avoids large crowds and provides a safer space for humanitarian assistance in times of an epidemic. With 48 per cent more beneficiaries reached in 2020 compared to the previous year, cash-based assistance experienced a surge. Over 375,000 people received US$ 11.6 million for COVID-related multisector assistance in cash or vouchers, first and foremost, to improve hygiene standards and access to water.

* Given limited testing capacities, the government’s diagnostic strategy since July 2020 limits tests to suspected cases and people at risk. Thus, the number of confirmed COVID-19 cases should be interpreted with caution. For illustration, 71,819 people have been tested for COVID-19 as of 23 November 2021.