Morocco leads the continent in Covid response

The much-feared news finally came on the morning of March 3, 2020. An official government release said:  “The Ministry of Health announces the first confirmed coronavirus case by the Institut Pasteur of Morocco. The person is a Moroccan citizen living in Italy”.

Six months earlier the pandemic had started cutting a deadly swath through four corners of the globe, causing confusion and panic as health authorities and governments scrambled to try and slow its relentless march.

As Morocco raised the alarm, the country went on a war-footing to try and stem the advancing tide of illness and death. By March 20 last year, a nationwide state of emergency was declared to halt the pandemic’s spread, which continues to be in place.

At the same time, a comprehensive set of mitigating measures was rapidly planned and deployed: The country’s health system was made more robust and flexible; regulation was rolled out aimed at sustaining the economy, and livelihoods, which would be severely impacted by lockdowns; and assistance was provided to the most vulnerable.

The Kingdom’s ruler, King Mohammed VI immediately issued a decree creating a special fund to help manage the pandemic.

The fund initially received $1.1bn (10bn Moroccan dirhams) from the state budget, with contributions added from other bodies, institutions, businesses and individuals. Setting an example, King Mohammed contributed 2bn dirhams of his own. Eventually, the campaign raised more than 33.7bn dirhams ($3.6bn).

Cut-throat race for vaccines

Armed with the substantial war chest which the fund provided, Morocco entered the cut-throat race for vaccine supplies to immunise its population.

Having anticipated that the global demand for vaccines was as urgent as it was massive, Morocco became one of the very first countries to place orders with a number of laboratories in August.

This was at a time when many other countries were not even seriously looking towards obtaining vaccines.  Even in Europe, countries did not count on a vaccine being available at the end of last year.

Morocco’s diplomatic community was transformed into a task force in charge of leading negotiations with the countries and laboratories who were, at the time, not completely sure of the outcome of their research.

As early as January, the Kingdom announced an order for 65m doses, 25m of the British AstraZeneca and 40m doses of the Chinese Sinopharm vaccines. An agreement was also reached with Russia for the delivery of 8m doses of the Sputnik vaccine to immunise its population of around 37m.

This diverse strategy has paid off. The country has so far received a total of 8.5m doses of vaccine (1.5m Sinopharm and 7m AstraZeneca). More than 4.2m Moroccans have been vaccinated and 3.8m have received a second dose.

As of 25 April the country stood high in the global rankings for the share of its population fully vaccinated against Covid-19. At 11.4%, Morocco was ahead of France (8.1%) and Germany (7.1%) according to Our World in Data, an online publication specialised in statistics. And with 13% of the population having received at least one dose, the country was far ahead of any other African country, as Reuters Covid-19 vaccination tracker shows. 

While the risk of a shortage of vaccines in view of the global pressure on supplies is very real, Morocco has been reassured by Dr Moulay Saïd Afif, member of the National Technical Committee for Vaccination and President of the Moroccan Society for Medical Sciences, that an additional 4.2m doses of anti-Covid-19 vaccines will be received by Morocco in the near future. This will bring the total delivered to the Kingdom so far to 12.7m.

Successful roll out

The vaccination programme was launched on Thursday 28 January by King Mohammed VI, who set an example by being the first to be vaccinated.

 “The royal example has reassured even the most sceptical as to the efficacy of the vaccine and has made our citizens more receptive and even enthusiastic,” says Dr Tayeb Hamdi, a doctor and a researcher in health systems. 

Vaccines are free of charge and currently target those most exposed to the virus (medical staff, teachers, police force etc) the elderly and those suffering from chronic illnesses, whether they are Moroccan or foreign.

The final objective is to vaccinate 25m Moroccans and residents as soon as possible in order to achieve herd immunity, the only way to stop the pandemic’s spread.

To reach the target, a total of 25,631 people have been mobilised for the vaccination campaign, including 14,423 in urban areas. Similarly, 3,047 fixed centres and more than 7,000 mobile units have been deployed. 

Public-private partnerships (PPPs) have deployed refrigerated trucks to facilitate vaccine distribution by after they land in airports in Casablanca and Marrakesh.

These trucks are equipped with GPS navigation allowing authorities to track their routes, stopovers and arrivals in the different towns in the country. A police escort ensures safe dispatch to their destinations, while the temperature is checked along the chain, up to the point of injection.

Not a single vial of vaccine is allowed to be mislaid or lost; a daily computerised report is drawn up to avoid any possibility of fraud. It is based on a comparison between the number of vials used in any given centre compared to the number of people actually vaccinated, officials say.

“It only took the disappearance of 10 vials from a clinic in El Jadida for a legal inquiry to be triggered,” comments Dr Tayeb Hamdi. 

“And let’s not forget that some influential (but not priority) individuals have felt the force of the law because they were trying to jump the queue,” he adds.

Public authorities did not wait for the vulnerable to make themselves known.

Using the national identity card registers, voter cards and the data on certain groups such as medical and teaching staff, it is very often the authorities who contact those being offered vaccination.

For those suffering chronic illnesses, the health insurance case files are used, while elderly people and those in rural areas are informed directly at their homes by social workers.

Third wave?

According to the latest figures, Morocco has registered nearly 500,000 cases and 8,800 deaths to date.  The fear now is that of a third wave of the virus hitting Morocco including the new, more virulent and contagious variants of Covid-19.

To reduce this risk, Morocco has closed its borders. Since March, flights to and from France and Spain have been suspended until further notice. These two countries have been added to a long list of destinations, including in Europe, Africa and the Middle East, where air links are currently suspended. 

“The Kingdom can also create more room for manoeuvre by extending the period between the two injections of the AstraZeneca vaccine, which is currently four weeks,” says Dr Tayeb Hamdi.

“In fact, it appears that the period can be extended to 12 weeks, which would make it possible to give more people the first dose pending further deliveries”, recommends the doctor. 

Another cause for concern is that the funds allocated for the campaign may be running out. Currently, funds stand at 3.5bn dirhams – not enough to cover future vaccine purchases.

“It’s not a question of means, but of time,” argues Mehdi El Fakir, a financial analyst.

“And the more time we lose, the more we will be penalised on the economic front”.

This will require an injection of public funds, he says:

“This will be a purely technical issue and a rapid return to normal economic conditions will soon bridge the gaps. Fortunately, we are experiencing an exceptionally good year for agriculture. All we have to do is restart sectors like tourism and car-making, which have been hit by the pandemic, in order to get back to normal and see a resumption in consumption and investment”, he adds. 

Medical manufacturing hub

Meanwhile, Morocco will have won another battle: that of reducing its dependence on imports of medical equipment.

Many Moroccan production facilities have been converted for the manufacture of protective masks. The Kingdom is now self-sufficient and has just exported 18.5m units in less than a month (21 May to 8 June 2020).

Morocco has also designed and produced a Sars-CoV2/Covid-19 testing kit, which is now on sale.

A commitment has also been made by China to set up a production facility for the Sinopharm vaccine in the Kingdom in partnership with a private laboratory after the Kingdom took part in the clinical trials that led to the success of the vaccine.