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Morocco’s Covid response ‘an example to emulate’

COVID-19 in Africa

Morocco’s Covid response ‘an example to emulate’

Women in face masks chat in the street in Casablanca.

Morocco’s response to the Covid-19 crisis has so far been exceptionally efficient. It reacted very quickly and effectively to stem the spread of the disease in the first place, then moved swiftly to put place measures to protect livelihoods, build up a war chest and roll out a comprehensive vaccination programme. The way it has dealt with the disease is an example for other countries to emulate, says Omar Dahbi, our Special Correspondent in Casablanca.

The much-feared news finally came on the morning of Tuesday 3 March, 2020. An official government release said: “The Ministry of Health announces the recording of the first confirmed case of the new Coronavirus by the Institut Pasteur of Morocco in the evening of Monday 2 March 2020. The person is a Moroccan citizen living in Italy.”

For six months before this date, the pandemic had made its malevolent way to the four corners of the globe, spreading the vicious, deadly disease and causing confusion and panic as health authorities and governments scrambled to try and halt, or at least slow down, its relentless march.

In Morocco, the alarm was taken very seriously. The country went on a war footing to try and keep the advancing tide of illness and death at bay. On 20 March 2020, a nationwide state of emergency was declared to combat the spread of what was, at that time, only the start of the epidemic. It is still 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 was to be severely impacted by the necessary lockdowns and assistance was provided to the most vulnerable.

King Mohammed VI immediately issued a decree creating a special fund to help manage the Coronavirus pandemic. The fund initially received 10bn dirhams from the State’s general budget, to which were added contributions from other bodies, institutions, businesses and individuals. Setting an example, King Mohammed contributed two billion dirhams. Eventually, the campaign raised more than 33.7bn dirhams (€3.2bn).

Cut-throat race for vaccines

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

Having anticipated that the global demand for vaccines was as urgent as it was massive, Morocco, in August 2020, became one of the very first countries to place orders with a number of laboratories.

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

Morocco pulled out all the stops. Its diplomatic corps was transformed into a veritable task force in charge of negotiations with the countries and laboratories who were, at the time, not completely sure of the outcome of their research.

As early as 8 January this year, 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.

This diversification strategy has paid off. The country has so far received a total of 8.5m doses of vaccine (1.5m Sinopharm and 7m AstraZeneca). At time of writing on 7 April, more than 4.3m Moroccans have been vaccinated and nearly 4m have received a second dose. The country is in 10th place worldwide in terms of vaccination doses administered per 100 people according to Our World in Data, an online publication specialised in statistics.

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, who has said 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 once again set the 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. 

“For the time being, we are seeing a great success in Morocco in terms of vaccination. The whole process has been thought through in a scientific way, so that the entire country can be covered, and to ensure fair treatment for all, with the strictest respect for international recommendations.” 

Vaccination is free of charge and currently targets 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 spread of the pandemic.

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 have been created to ensure distribution of the vaccines after they arrive at the airports of Casablanca and Marrakesh, by refrigerated trucks to make sure that they are available throughout Morocco, and at the same time.

Another golden rule that has been set: discipline. these trucks have GPS navigation allowing the authorities to track their routes, stopovers and arrivals in the different towns in the country. They are also escorted throughout their respective journeys by the police until they reach their destinations. The temperature of the vaccines is constantly checked right along the chain, right up to the point of injection.

This discipline can even be felt in the vaccination centres themselves. 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.

“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.” 

The success of the vaccination campaign is also a result of the fact that the public authorities did not wait for the people in the target groups 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 evidence enough. Certain elderly people and others who live in rural areas, for example, are informed directly at their homes by social workers.

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 Tuesday 30 March, flights to and from France and Spain have been suspended until further notice. These two countries have been added to an already long list of destinations, including in Europe, Africa and the Middle East, where, for the time being, air links have been 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.”

Another cause for concern is that the funds specifically targeted towards the campaign may be running out. Currently, the fund stand at 3.5bn dirhams ($390m) by no means enough to cover future purchases of vaccines.

“It is 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”.

He explains that the government will certainly need to use public money: “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.”

In the meanwhile, Morocco will have won another battle: that of reducing its dependence on imports of medical equipment. Many Moroccan production facilities have been converted to manufacture protective masks. The Kingdom is now self-sufficient and last year 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. And a commitment has been made by China to set up a production facility for the Sinopharm vaccine in the Kingdom in partnership with a private laboratory (the Kingdom having taken part in the clinical trials that led to the success of the vaccine).

That the rate of attrition from Covid-19 has been far less severe in Morocco than anticipated is due very much to swift decision making and action from the highest office of the land to the workers and officials at street level. It is an example of efficient response to a deadly crisis that Africa can be proud of.

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