The Algerian campaign of vaccination against the A/H1N1 flu has finally started on December 30th, 2009 for the medical staff; and pregnant women will be the first among the public to be vaccinated. Their vaccination should start on January 5th, 2010.
The way the Algerian authorities and population handled this issue and all the rumours around it tell a lot on the level of confidence of the population in their rulers and in their ability to do things correctly.
Revisiting some of the phases of this saga:
At the beginning the Algerian government announced that there were no risks of infection for the Algerian people. The Algerians are indeed Muslim and have minimum contact with pigs. But they seemed to have forgotten that Algeria was not a closed country and many people moved in and out all the time. Soon we started hearing reports of infected people in many parts of the country, but most of them were either Algerian immigrants living abroad or Algerians who were outside of Algeria and came back home. There raised the first accusations to the Algerian government of lying to the people at best, and being stupid at worst because unable to give its real measure to the situation .
The population on its side didn’t react in the best way and some of the infected people refused to be quarantined and some others even fled from hospitals because they didn’t want to ruin their holidays.
The episode of the pilgrimage was interesting too. Many Muslim states considered cancelling the pilgrimage of 2009, and this made the Algerian population wonder what to do. The minister of religious affairs announced very early (July) that the Algerian pilgrims will go to Mecca and shouldn’t worry. The minister promised that all the pilgrims will take their vaccines against the A/H1N1 virus before heading to KSA. And despite this early clarification, and because the ministry kept silent for some time, some voices launched rumours about cancelling the pilgrimage and many accused the state of being an enemy of Islam and all the usual related talk. At the end, the Algerian pilgrims fulfilled their religious duty, but they only received the anti-seasonal flu vaccine as the promised H1N1 one wasn’t available yet. The Algerian authorities also increased the number of the accompanying medical staff, and declared that the few flu cases they detected while in KSA had been treated using Tami-flu.
It seems here that the pilgrimage went relatively well, or at least not differently from the past ones, but the bad communication (silence) of the government created rumours which caused the population to worry and confirm its idea that the government is careless.
The events before the arrival of the vaccine raised some other questions about the deals with the pharmaceutical firms and the competencies of the minister of health and his staff.
The first comments were about the delays to sign the contracts with the providers, and at some point the press reported that Bouteflika himself had to take over the task which finally reached an end. This proved that the minister of health and his services were not able to lead the negotiations.
Then some other comments came out on the choice of GSK for this first big contract instead of other firms such as Novartis or Sanofi. The government declared that GSK was the readiest but many were not convinced and rumours about bribery spread. The suspicion grew even bigger after Pasteur Institute’s director was fired.
And the tests made by the Pasteur Institute proved that the jab from GSK was toxic. GSK of course denied it and declared the vaccine is not dangerous and many doses of it have already been used.
All this made the Algerians panic even more and the news we read today will not reassure them. Echourouk announced today the death of a medical doctor in Setif one day after taking the vaccine. The article mentions that the specialists don’t think her death was caused by the vaccine, but at the same time gives the rate of only 13/2700 among the medical staff of the hospital where she worked who accepted to take the vaccine so far. The other Algerian tabloid, Ennahar, publishes news of some Algerian high ranked officials, former ministers and doctors who decided to take their vaccines in the French consulate in Algiers. They obviously are French citizens but their move is telling of the confidence they have in France and the one they lack in Algeria.
The minister of health declared that “The vaccine is effective. It is recognized by the World Health Organization (WHO), homologated by Canadian health authorities and validated by the National Laboratory for Pharmaceutical Product Testing”, but I am afraid this won’t be enough to convince the population. Nor will his public vaccination.
To put all this in perspective, it is interesting to consider the situation in France. The French government very quickly ordered many tens of million doses of the A/H1N1 vaccine to add them to the already existing Tamiflu stock (from the avian flu period). And like in Algeria, many criticised the government: some accused him of working hand in hand with the pharmaceutical firms which created the virus especially after the public learnt that the French government freed them from responsibility over any side effects of the vaccine; some others declared that this flu is not dangerous and buying all these doses is just a waste of money; and many others expressed their fears about the vaccine’s effectiveness and risks.
So when the vaccination campaign started, only a few people took the vaccine despite the encouragements of the ministers who took theirs before the TV cameras. The press announced some cases of serious side-effects and one death. But after the number of H1N1 related deaths increased, the population rushed into the vaccination centres and all rumours stopped.
Will the same happen in Algeria?
The ministry of health declares that 1.3 million from the initially planned 20 million doses (65 millions should in total be acquired) are available and reports 47 deaths over 746 confirmed cases. Is this figure big enough to push the Algerians to trust the government and the vaccine, or shall they wait for a bigger number to recover some of the very shaken confidence they have in the rulers?
The Algerian government proved recently that it is able to organise big-scale things when they really wanted to (transportation of 10k Algerian supporters to Sudan in three days), so why would they not be able to handle the H1N1 case correctly?
And lastly, is there a vaccine against distrust?