It may be one of the most-vaccinated countries on earth, but the Seychelles has seen an explosion in cases – and the imposition of crippling new lockdown restrictions – since rolling out the Covid-19 jab. As the rest of the continent races to follow its lead, with Burundi and Tanzania receiving their first shipments in recent days, investigative reporter Sonia Elijah asks what lessons, if any, can be learned from the Seychelles’ apparent vaccine failure.

Ex-World Health Organization (WHO) scientist Dr David Bell, and historian Toby Green, on why Africa needs to stop following Western policies and learn from its own experience.

Medical colonialism is back. After two decades of increasing life expectancy across Africa, the last year has seen control of the continent’s public health goals return to distant global institutions more reminiscent of the European imperialist era.

Despite low Covid-19 mortality across most of the continent, African societies and economies have been subjected to one externally promoted and mis-directed public health response after another – even though, in contrast to countries in the West, Covid-19 is a minor disease among many others that must be weighed in the balance of public health.

What has driven these catastrophic responses? Wealthy donors and global health bodies have advocated policies leading to the destruction of day-labourers’ livelihoods through lockdowns, the removal of children’s education through school closures, and an obsessive focus on Covid-19.

This is reversing years of effort in reducing mortality from malaria, tuberculosis (TB) and HIV-Aids.

Now, their new target is a vaccine passport.

Aviation agencies on the continent have already been talking up the possibility of introducing them by the end of 2022, while in Morocco a vaccine passport has been created, allowing vaccinated people to break the curfew and travel abroad without restrictions. Though the Africa Centres for Disease Control has said that vaccine passports are currently inappropriate on the continent, pressure appears to be growing to roll out this response.

This is not a private digital health record – but a Pass. A Pass provided by others, to enable access to basic freedoms.

Pushed by a small but very wealthy group of corporations and individuals who stand to gain greatly from management of pharmaceuticals, this technology can monitor the travel and freedom of movement of ordinary people.

All of this on the basis of a disease that barely rates on most African countries’ mortality statistics.

Mass vaccination is not medically justified in Africa. Much of the population is already immune. A February study of blood donors in South Africa found antibody levels of 63 per cent in Eastern Cape province, 46 per cent in Free State, 52 per cent in KwaZulu-Natal, and 32 per cent in Northern Cape. Further north, high rates of immunity have been shown in Malawi, Kenya and Nigeria.

And even if antibody rates weren't so high, more than 50 per cent of people in sub-Saharan Africa are under 19 years, an age at which Covid-19 is nearly always mild and mortality exceedingly rare.

Less than one per cent of the population is over 75 years, above which most mortality occurs elsewhere.

The vulnerable minority of Africans can be protected without vaccinating the majority.

But even if mass vaccination was medically justified in Africa, there are plenty of other downsides to a vaccine passport.

In the first place, this will clearly be discriminatory.

Reports are showing high levels of vaccine hesitancy on the continent, especially among poorer populations.

Discriminating between those who have and have not been vaccinated will target those who have already suffered disproportionately from the catastrophic economic impacts of lockdowns.

Perhaps even more significantly, using data to identify between different 'groups' is something that has been misused in the past – and could be again in the future.

In Apartheid South Africa, the ‘Pass Laws’ were used to determine who could and could not enter certain areas and participate in certain activities. In Nazi Germany, so-called ‘punch cards’ supplied by the American company IBM were vital in collating data on ethnicity and in ‘processing’ Jews, who were ultimately sent to the death camps.

In post-colonial Africa, too, such misuse of identity passes has been known, with passports used to identify – and thus easily butcher – Tutsis in Rwanda in 1994 and Igbos in Nigeria in the 1960s.

Vaccine passports may seem harmless, but history shows that they could be a ticket to discrimination, marginalisation and even genocide.

The UK’s proposed vaccine passports, which are currently being trialed at sporting events like the UEFA Euro 2020s, Wimbledon and Ascot horse races, have ‘special categories’ with the option to record people’s ‘racial and ethnic origins’. These functions may not currently be active, but it doesn’t take much imagination to realise how such information could be used to discriminate against people if activated in the future.

Putting race aside, vaccine passports are especially dangerous in a continent like Africa, where mass vaccination against Covid-19 is unnecessary and, in fact, enormously counter-productive, distracting from the management of other more deadly diseases.

The WHO may have sided with wealthy donors who profit from mass vaccination and vaccine passport technologies, implying that without mass global vaccination the whole world is at risk – but in doing so it is sacrificing African health needs for those of the richer world.

Every nurse vaccinating young Africans against Covid-19, is one less nurse inoculating against real child killers.

This is a tragedy on many levels. Agencies tasked with ensuring equality of humanity – and with human rights – should be stepping in to support the people whose freedoms and health have been under assault for over a year, not those who profit from this misery while entertaining each other among Swiss mountains and lakes. 

Dr David Bell is a public health physician and former medical officer and scientist at the World Health Organization (WHO). Toby Green is a Professor of African History at King’s College, London, and author of The Covid Consensus: The New Politics of Global Inequality.

He may have been ridiculed in the West for rejecting lockdowns and encouraging prayer-a-thons. But as ex-World Health Organization scientist Dr David Bell explains, Tanzania's late president John Magufuli is not seen as a pariah by many in the scientific community – he’s seen as a life-saver.

If you read the BBC website, you probably think Tanzania’s late president was either a rebel, a ‘Covid denier’ or just plain stupid.

In reality, he was none of these.

President Magufuli was actually a highly educated scientist with a PhD in chemistry, who probably saved thousands of lives by refusing to embrace lockdowns and other knee-jerk reactions foisted on the people in much of Africa and the West. 

Magufuli’s decision not to lock down was consistent with the evidence-based pandemic guidelines released by the World Health Organization (WHO) in 2019.

He rightly predicted that Covid-19 mortality in Africa would be very low compared to other major killers like malaria, tuberculous (TB) and HIV-Aids, and followed good public health principles in prioritising these higher burden diseases that particularly afflict the young, while telling Tanzanians not to panic.

He also prioritised keeping the economy growing, which is in the long term the most effective way of improving life-expectancy and health. In short, he acted as you would expect a well-trained scientist and rational public health expert to act in the Tanzanian context. 

Throughout the Covid-19 pandemic, the media has demanded longer and harder lockdowns, as if they were normal – or helpful.

But they rarely point out that no pandemic plan recommended mass business closures and restrictions on religious freedom, travel, or normal societal function before 2020, because removing these is expected to cause greater harm, and impinges greatly on fundamental human rights.

We never implemented any of these measures during the SARS, MERS or swine flu outbreaks of recent years. People attended places of worship, caught packed buses and trains, the young went clubbing and danced and sang and kissed.

The same was true for Tanzanians during this pandemic too.

And rightly so. 

Most Tanzanians are young and not obese, and so are at very low risk from Covid-19.

President Magufuli received a lot of bad press for telling his countrymen to go to church at the start of the pandemic to ‘pray’ Covid away.

But mass gatherings would not be expected to put the vast majority of the Tanzanian population at significant risk.

Tens of thousands of sports fans went to stadiums in Florida and Texas recently, and there was no noted uptick in cases afterwards.

Of course, protecting the vulnerable from harm is important in any epidemic, and it’s difficult to say whether the mass prayer-a-thons were a good idea from a purely transmission standpoint, as they may have increased risk to older people early on in Tanzania’s outbreak.


Building so-called ‘herd immunity’ in young people rapidly through such gatherings would however be expected to exert a protective effect, if the vulnerable are well protected until such transmission-suppressing immunity is achieved.

The policy overall was probably far better for public health than strict lockdowns, which led to the first recessions in a quarter of a century in many African countries, as well as a reduction in treatment for major killers like malaria, tuberculous (TB) and HIV-Aids.  

The virus that leads to Covid-19, SARS-CoV-2, is likely to become endemic, and as herd immunity is reached through natural infection or through vaccination, severe disease and death will become increasingly uncommon.

Multiple studies have shown very limited impact of stricter lockdowns on Covid-19 mortality.

Therefore, one would expect Tanzania, like Sweden, Croatia, Belarus and other ‘non-lockdown’ countries, to have similar overall Covid-19 deaths and epidemic trajectories as comparable lockdown countries in the end. 

The vehement criticism of President Magufuli in the media is therefore disappointing and highly ignorant. It does appear that Western journalists find it easier to smear leaders in African countries than European leaders. Sweden's leaders, for instance, have never been labelled 'Covid deniers'.

This is not new, but perhaps shows how much hypocrisy and prejudice persist in Western society.

Tanzania appears to have done better from a health point of view than most other low-income countries through this last year. While millions of Africans have been thrown into hunger and poverty, Tanzania has seen GDP rise throughout 2020.

Falls in GDP and general impoverishment are associated with increases in all-cause mortality.

This is particularly the case in sub-Saharan Africa, where food security is often a real problem and control of endemic diseases such as malaria, tuberculosis and HIV-Aids is fragile.

It is therefore highly likely that, in maintaining a well-functioning economy, he and his government were responsible for greatly reducing mortality. UNICEF estimate almost a quarter of a million additional child deaths in South Asia in 2020 due to the responses to Covid-19 there.

It is likely that similar tolls will be seen in sub-Saharan Africa but we would expect that Tanzania will now be relatively protected from this. 

Let us hope, for Tanzanians’ sake, that this continues with his successor.

Western media may have had a good laugh at President Magufuli – and Tanzanians in general – for thinking they could ‘pray’ away a virus.

But, rhetoric aside, by refusing to lockdown, and by refusing to divert health resources away from malaria and TB to test people with no symptoms for a virus with a very low fatality rate, Magufuli was following an orthodox pandemic response. 

He was also orthodox in his approach to human rights. Religious freedom was considered an important human right by most Western journalists only 18 months ago, and fear should not change fundamental human rights. 

Honest journalists should acknowledge the benefits of Magufuli’s approach, however much it may contradict their current preferred world view.

Ridiculing religious observances that fall outside their experience, and denigrating public health science that they clearly don’t understand, is not good journalism.

It just highlights how ignorant they are. 

The government says John Magufuli died of heart problems, but questions abound over what really happened to the 61-year-old, who had a doctorate in chemistry and warned against devastating Covid-19 lockdowns in Tanzania.

After spending the last year disputing the global narrative about Covid-19, lockdowns and vaccines, Tanzanian President John Pombe Magufuli was pronounced dead from a heart attack on March 17 at the age of 61. 

The official announcement came on March 17, when Vice President Samia Suluhu Hassan disclosed Magufuli’s death to the nation during a television address.

‘Dear Tanzanians, it is sad to announce that today 17 March 2021 around 6pm we lost our brave leader, President John Magufuli, who died from heart disease at Mzena hospital in Dar es Salaam where he was getting treatment,’ proclaimed Hassan. 

Hassan said Magufuli had been admitted to the hospital on March 6 but discharged the next day.

A week later, he was taken in again for his heart condition, which Hassan and government authorities have insisted was the cause of his death. 

Magufuli made headlines for defying the global narrative and response to Covid-19 since the virus was found in Tanzania.

He rejected closing churches and businesses, calling on people to pray to God instead of being afraid.

Contrary to the majority of the Western world and other African nations who have seen their economies collapse and other health conditions spiral out of control after embracing Chinese-style lockdowns, Magufuli declined to lock the country down, and the country has not reported any information about Covid-19 to the World Health Organization (WHO) since April 29, 2020.

On that day, 509 cases and 21 deaths were reported.

In June, Magufuli declared that the country had eradicated the virus.

Nor is this the only way that Tanzania’s former president is likely to have angered globalist politicians.

After Covid tests yielded ‘positive’ results from a goat and a pawpaw, Magufuli rejected them as unreliable, saying they had ‘technical errors’. His words have since been supported by an independent group of 22 scientists, who identified ‘10 fatal problems’ with the widely used PCR tests, noting that each problem on its own was enough to render the tests ‘useless’ in identifying Covid-19.

Magufuli, who had a doctorate in chemistry, also warned Tanzanians against becoming ‘guinea pigs’ for the various experimental Covid vaccinations, saying: ‘If the white man was able to come up with vaccinations, then vaccinations for Aids would have been brought, tuberculosis would be a thing of the past, vaccines for malaria and cancer would have been found.’ 

He was replaced by Hassan, who was sworn in March 19 with her hand on the Koran.

She will serve the remainder of Magufuli’s five-year term, which began in November 2020. 

Magufuli casket. Edited

Mystery surrounding Magufuli’s death

After Magufuli had disappeared from the public eye for a number of days, by March 11 rumours surfaced that he had died.

Then by March 12, the rumours intensified, with a number of social media posts and media reports claiming he had died.

Opposition leader Tundu Lissu claimed that Magufuli was being treated for Covid-19 and flown to Kenya and then to India for treatment.

However, this was ardently denied by government sources.

By March 13, Magufuli was still missing, not having been seen since February 27, and rumours were running amok.

However, on March 12, former Tanzanian intelligence officer and political analyst Evarist Chahali announced that Magufuli was confirmed dead earlier that evening.

Chahali wrote that the president had been put on life support in order to prevent Vice President Hassan from announcing his death and assuming power.

The attempted coup was being orchestrated by a group called ‘Lake Zoners,’ Chahali wrote, which was looking to place General Venance Mabeyo in Magufuli’s place.

The official announcement rejects Chahali’s assertion, however, and the government narrative remains that Magufuli died March 17.

Aside from confusion and secrecy surrounding the date, the leadup to his death was marked by growing international pressure on Magufuli to change his response to Covid-19.

At the start of February, the country’s health minister once again refused to accept any Covid vaccinations, prompting the World Health Organization to increase its pressure on the country to rejoin the fold and take part in the organization’s response to the infection.

WHO Director-General Tedros Adhanom Ghebreyesus issued a statement urging Tanzania ‘to scale public health measures against Covid-19 and to prepare for vaccination’. 

Describing the situation as ‘concerning’, he reissued his call for Tanzania to take part in the global vaccination rollout, demanding Tanzania implement the public health measures that we know work in breaking the chains of transmission’.

Then, just one day after the Director-General’s statement – and in the wake of the death of Maalim Seif Sharif Hamad, the first vice president of the semi-autonomous Zanzibar region – Magufuli signalled a slight change in policy and commented on the use of masks, and acknowledged the presence of the virus.

‘I have not said people should not wear facemasks, don’t misquote me, however, some facemasks are substandard, if you have to wear them, please consider those locally made,’ he said.

‘Most people who have been affected are in urban areas. We will defeat this virus by faith.’

Magufuli swearing in. Edited

Some days before, on February 8, an article appeared in the left-wing British newspaper The Guardian attacking Magufuli’s response to Covid, calling it ‘a danger to public health’ and calling for Magufuli to be reined in.

The op-ed claimed that the president was ‘fuelling denialism and conspiracies’, and ridiculed his rejection of lockdowns and mask wearing. 

The article was sponsored by the Bill and Melinda Gates Foundation, which invests and makes billions of dollars on the global vaccination drive. The Foundation, along with the WHO, has been accused of profiting from DTP vaccines in Africa, which some scientific studies have alleged led to more deaths than the diseases they are supposed to protect against: diphtheria, tetanus and pertussis (whooping cough). 

In an attempt to curry favour with the liberal movement, Melinda Gates proclaimed last June that the experimental Covid-19 vaccines should be given first to ‘black people’ and ‘indigenous people’ in America. 

Certainly, in the run-up to his death, Magufuli faced the renewed wrath of both Bill Gates and the WHO, who took issue with his rejection of their lockdown and vaccination measures.

It remains to be seen what further details will emerge to shed light upon Magufuli’s death after he disappeared from public view for 18 days before he was announced to have died at just 61.

His successor, Hassan, praised Magufuli in her swearing-in ceremony and called for unity and an end to ‘finger pointing’.

Hassan, who previously worked for the United Nations’ World Food Program, was warmly welcomed to her new role by the WHO Director-General, in a marked change of tone from his previous comments to Magufuli, saying: 'I look forward to working with you to keep people safe from #COVID19, end the pandemic and achieve a healthier Tanzania. Together!’

This article was originally published on and has been edited for NewsAfrica Magazine.

EXPERT OPINION: Global public health experts Dr David Bell and Muhammad Usman Khan ask whether millions of young Africans need to be vaccinated – and for whose benefit?


Child mortality will almost certainly rise across sub-Saharan Africa this year.

The singular focus on Covid-19 has resulted in an interruption to all other healthcare – as well as growing levels of malnutrition, thanks to lockdown-induced job losses and poverty. 

The World Health Organization (WHO) was at pains to reassure children in developed countries of Father Christmas's immunity to the virus in December, so as not to ruin their year.

Meanwhile, little focus has been given to African children, increasing numbers of whom have been orphaned by HIV/Aids and tuberculosis during the pandemic. 

Sadly, the global health community that, in the past, prioritised HIV/Aids, tuberculosis (TB) and the big child killer, malaria, appears to consider avoidable deaths from such illnesses an acceptable cost in their attempt to reduce transmission of SARS-COV-2.

This paradox is especially true in Africa, where more than 50 per cent of the population is under the age of 19, and additional factors such as the climate, low levels of obesity and other comorbidities, may have left most Africans effectively protected from Covid-19.  

In spite of this, influential organisations in global health are calling for restrictive measures to continue until a Covid-19 vaccine is available and all are vaccinated – sometime in the coming years.  

With wealthy countries and private philanthropy planning to divert large donations to this cause, and a global alliance under the COVAX umbrella gearing up to lead it, there is an urgent need to examine whether this is of benefit to Africa.  

The virus, SARS-COV-2, was initially feared to be highly lethal and capable of killing up to one in 20 infected people.

The initial mortality rates for northern Italy’s elderly looked frightening when transferred to the entire population of the African continent.  

Governments, corralled by the WHO, narrowed their focus on dealing with what was initially presented as an existential threat to medical infrastructure around the world.

But as more data poured in, it became clear that the challenge the virus presented, although serious, was not the global catastrophe previously feared.

Yet seemingly undeterred by emerging data – the infection fatality rate is now estimated at 0.23 per cent, and far lower for those under 65 years of age – global health institutions and governments continue to allocate hefty resources and a blinkered focus on the pandemic with undiminished urgency.  

Half of the billion-plus people in sub-Saharan Africa are under 19 years of age, and we know that most infections in children are barely symptomatic.

Regardless, a climate of fear is being sustained with the media still whipping up fear of a looming ‘catastrophe’ for African countries.  

When most European nations locked down their populations, copying the highly restrictive measures employed in China, the WHO advocated similar measures across Africa.  

This ran contrary to its own prior evidence-based pandemic guidance and with seemingly little regard for the high vulnerabilities to pre-existing epidemics, such as malaria, TB and HIV/Aids, as well as the limited capacity of these populations to absorb income loss.  

The catastrophe currently unfolding in Africa is not due to the coronavirus.

Despite months of community spread in crowded cities, recorded Covid-19 mortality was under 70,000 across the entire continent by January 1, 2021.

If we exclude the Mediterranean countries and South Africa with their differing demographics and high comorbidities, just 13,031 people died of Covid-19 in the rest of the continent in 2020 – that’s approximately one death for every 80,000 people.  

As the figure shows, Covid-19 would likely have gone unnoticed in Africa if we had not been testing for it.

The virus has dominated the policies of donors and international organisations on an unprecedented scale, and while African countries may be easing internally, the focus externally remains on Covid-19, and a vaccine whose roll-out in these populations would defy all previous public health norms.  

This catastrophe goes far beyond health alone.

A generation of children’s schooling has been interrupted. Children from poor and rural families will likely never recover.

Even more alarmingly, girls and young women have been pushed back into the trap of early marriage and poverty.   

Without any serious pushback from its staff, the World Health Organization and wealthy philanthropic foundations have advocated for policies that impoverish, restrict and reduce healthcare access, abandoning previous recommendations advising against such measures.

Testing in South Africa.jpg

In a new form of post-colonial oppression, the rich world, via video meetings on Zoom, have introduced policies that are leading to impoverishment in Africa. 

The rise of large private philanthropies, who arguably dominate the current global public health agenda, has undoubtedly brought great benefits in terms of almost unlimited funding, new ideas and enthusiasm, though this may not always be fully aligned with local priorities.  

Vaccines are a perfect example of this.  

In recent months, the world has been focused on the development and trials of vaccines for SARS-COV-2, in the hope that they will allow a return to normality.  

This had led to a poorly considered campaign of mass immunization being promoted, despite the current lack of evidence that the vaccines have a transmission-blocking effect.

If vaccines don’t stop onward transmission, and just lessen symptoms, it essentially means we will not be vaccinating children for their own health, but in order to protect a small cohort of elderly citizens. 

And given the very low impact of Covid-19 on younger people, and thus on the vast majority of Africans, one has to question why a vaccine for Covid-19 should take precedent over investment in mosquito nets for malaria, for instance.

The King of Morocco being jabbed against Covid-19.jpg

A Covid-19 vaccination programme will inevitably reduce the amount of money and manpower to prevent far worse diseases that African children face.

Foreign aid from increasingly cash-strapped donor countries is already being sought for the COVAX mechanism in the name of global equity, while local health staff, logistics and expertise will be drawn from other pressing areas to help vaccinate against Covid-19. 

To justify this approach, some pressure groups are claiming that people in sub-Saharan Africa need to be vaccinated in order to reduce the risks for those living elsewhere.

If we believe the SARS-COV-2 virus can and should be eradicated globally, but we recognise that diverting resources for this programme will cost lives, then we need to acknowledge that the children who are no longer benefiting from other health interventions, are dying for the benefit of mostly elderly and chronically sick people in far wealthier nations, who wish to reduce their own Covid-19 risk.  

This may not be ‘wrong’, if the benefit to Africans can be shown to outweigh the costs.

But clearly, if this is not demonstrated, then the equity argument behind COVAX and the universal Covid-19 vaccination programme becomes unsustainable.

Those of us in the global health community need to pause, question and think for ourselves.

By any normal measure, we are catastrophically failing the people we were entrusted to serve.

The current approach appears to be causing net harm, and African health is at risk of being crushed under a model designed by and for others.  

Covid-19 is a chance to reset, but not through the deaths of children and the impoverishment of tens of millions.

Fixing this will take humility and self-awareness.  

To build a better future, we first need to avoid doing more harm. Let’s hope, collectively, we have the courage and moral decency to undo the mess we have created.

Then we must support the people of these countries in continuing the broad improvements in health care upon which they, with admirable support from both public and private sectors, had previously embarked.  


Dr David Bell is a clinical and public health physician with a PhD in population health. He was Director of the Global Health Technologies at Intellectual Ventures Global Good Fund in the USA, Programme Head for Malaria and Acute Febrile Disease at FIND in Geneva, Switzerland, and coordinated malaria diagnostics strategy with the World Health Organization. 

Muhammad Usman Khan is a health policy analyst. He has consulted and worked in advisory roles for multiple governments and NGOs.