Kenya had also ignored other countries’ worries about being used as “guinea pigs” and participated in vaccine trials, raising expectations for earlier shipments.

“The clinical trials resulted in vaccines,” said Dr. David Ngira, a postdoctoral researcher in global health law at Cardiff University, who has been tracking vaccine rollouts in Africa. “And on this premise, the Kenyan participants, as well as the surrounding communities and country at large, should have been given some priority in vaccine access.”

But that has not happened. Even Kenya’s low expectations have been scaled back: A promised 4.1 million doses from Covax by May has been cut to 3.6 million doses. The country has ordered a total of 24 million doses.

Health officials say they are grateful, but even Covax shots come with a hitch. Vaccines covering the first 20 percent of Kenya’s population were free, but only on the grounds that the government pay for enough doses to cover another 10 percent of its people.

global economy could suffer losses exceeding $9 trillion, nearly half of which would fall on rich countries like Britain, Canada and the United States.

heart specialist in Zimbabwe — a mentor to younger doctors and a pillar of the country’s health system — was killed by Covid-19. That same month, a senior doctor in northern Nigeria died from the virus, confined to an isolation center.

Kenya’s health system was already hobbled last year by mistreatment of doctors and nurses. Many health workers, unpaid for months in some cases and often given inadequate protective equipment, walked off the job, forcing some hospitals to go months without nurses. One had to close its Covid-19 isolation unit and send patients home. In December, a 28-year-old doctor died from Covid-19 after having worked without a salary for months.

“It’s a moral emergency to protect health workers worldwide,” Gavin Yamey, associate director for policy at the Duke Global Health Institute, said. “Sickness and death of health workers in systems that are already weak could exacerbate those problems even further.”

For Nyachira Muthiga, a public hospital doctor who worked on a Covid-19 ward in Nairobi last year, the arrival of Kenya’s first vaccines brought a sense of relief. But the crushing experiences of the last year have made her wary.

Before contracting the illness herself, she lost many patients. Substandard protective equipment left her vulnerable, she said. And reports of corruption that cheated hospitals of much-needed money, she said, broke something in her.

Though she got the vaccine last week, she worries that those same endemic problems in the health system — combined with vaccine hoarding by rich nations — could put shots out of the reach of ordinary Kenyans for much longer.

“I am still hopeful,” she said, “that the health of our citizens will be a high priority at some point.”

Abdi Latif Dahir reported from Nairobi and Benjamin Mueller from London.

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