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Delivering COVID-19 vaccines with 4–6 weeks shelf life remains one of Africa’s most pressing challenges. The Africa Centres for Disease Control and Prevention (Africa CDC) leadership recognised that COVID-19 vaccines donated to many African countries were at risk of expiry considering the short shelf life on delivery in the Member States and slow vaccine uptake rates. Thus, a streamlined rapid response system, the urgent support mechanism, was developed to assist countries accelerate COVID-19 vaccine uptake. We describe the achievements and lessons learnt during implementation of the urgent support mechanism in eight African countries. An Africa CDC team was rapidly deployed to meet with the Ministry of Health of each country alerted for COVID-19 vaccine expiry and identified national implementing partners to quickly develop operational work plans and strategies to scale up the urgent use of the vaccines. The time between the initiation of alerts to the start of the implementation was typically within 2 weeks. A total of approximately 2.5 million doses of vaccines, costing $900 000, were prevented from expiration. The urgent support has also contributed to the increased COVID-19 vaccination coverage in the Member States from 16.1% at the initiation to 25.3% at the end of the urgent support. Some of the effective strategies used by the urgent support mechanism included coordination between Africa CDC and country vaccine task forces, establishment of vaccination centres, building the capacity of routine and surge health workforce, procurement and distribution of vaccine ancillaries, staff training, advocacy and sensitisation events, and use of trusted religious scriptures and community influencers to support public health messages. The urgent support mechanism demonstrated a highly optimised process and serves as a successful example for acceleration and integration of vaccination into different healthcare delivery points.

Objectives: We examined associations between accelerators (interventions impacting ≥2 SDG targets) and SDG-aligned well-being indicators among adolescents 16–24 years old in Zambia.Methods: We surveyed adults from 1,800 randomly sampled households receiving social cash transfers. We examined associations between accelerators (social cash transfers, life-long learning, mobile phone access) and seven well-being indicators among adolescents using multivariate logistic regressions.Results: The sample comprised 1,725 adolescents, 881 (51.1%) girls. Mobile phone access was associated with no poverty (adjusted Odds Ratio [aOR] 2.08, p < 0.001), informal cash transfers (aOR 1.82, p = 0.004), and seeking mental health support (aOR 1.61, p = 0.020). Social cash transfers were associated with no disability-related health restrictions (aOR 2.56, p = 0.004) and lesser odds of seeking mental health support (aOR 0.53, p = 0.029). Life-long learning was associated with informal cash transfers (aOR 3.49, p < 0.001) and lower school enrollment (aOR 0.70, p = 0.004). Adolescents with disabled head-of-household reported worse poverty, good health but less suicidal ideation.Conclusions: Social cash transfers, life-long learning, and mobile phone access were positively associated with well-being indicators. Adolescents living with disabled head-of-household benefited less. Governments should implement policies to correct disability-related inequalities.

Fleas (Siphonaptera) are important vectors of several animal and human disease pathogens, while rodents are considered as reservoirs of most pathogens, including Yersinia pestis Factors that influence the parasitism rate of fleas, ecological aspects that modulate their distribution, and host-flea relationship in Eastern Zambia remain unknown. Furthermore, there is little information on the biodiversity and abundance of rodents and fleas in the study area. A total of 1212 mammals were sampled and examined. These included rodents (n=329), Crocidura (n=113), domestic pigs (n=254), small ruminants (n=346) and carnivores (n=168), and 1578 fleas, where five species were identified. There were nine genera and species of rodents with one genus of Crocidura captured. The results showed that 27(8.2%) and 19(5.8%) rodents and 8(7.0%) and 2(1.8%) Crocidura were positive for antibodies and pla gene for Y. pestis, respectively. Echidnophaga larina were the most mean abundant (MA=8.58), while Xenopsylla cheopis had the least mean abundant (MA=0.14), nevertheless it was the most infected with Y. pestis. Mastomys. natalensis was highest in plague positivity 31/56, followed by Crocidura spp 10/56 and Rattus rattus 6/56. The results indicated that three flea species were infected with Yersinia pestis. Shannon-Weiner (H) and dominance (D) indices of rodents were 1.5 and 0.2789, while the flea indices were 0.5310 and 0.8389, respectively. There was a strong association between richness of fleas and plague disease (p=0.01; x2=65.3). It’s established that rodents were more biodiversity than fleas while both were unevenly distributed. It’s recommended that control measures of fleas be intensified and sustained to lessen the spread of their associated diseases.

Competing Interests: Competing interests: None declared.