African countries from Uganda to South Africa are buckling under a ferocious third wave of coronavirus infections as the continent falls far behind the rest of the world in vaccinations.

The rolling seven-day average of new African cases rose to about 25,000 a day last week from 7,000 in the middle of May, according to data from Africa’s Centres for Disease Control and Prevention.

Doctors have warned of dwindling hospital beds and oxygen supplies as more than a dozen nations are reporting their worst levels of infection since the pandemic began, just as they are struggling to launch mass rollouts of vaccines.

“We are not winning for sure. Each time you get a wave the peak is worse than the previous one,” said John Nkengasong, director of Africa’s CDC.

Chart showing seven-day rolling average of new deaths in Africa

“What haunts me a lot is the Indian scenario which could very well happen in Africa . . . we are not out of the woods yet,” Nkengasong added, referring to a deadly second wave in India that overwhelmed the country. Out of just over 5m confirmed cases in Africa to date, about 1m cases were recorded in the past month, according to Africa CDC figures. About 138,000 deaths have been officially recorded on the continent since the start of the pandemic last year.

South Africa, where the health ministry said recorded infections have surged from 800 per day at the start of April to more than 13,000 per day in June, has dominated the resurgence with what President Cyril Ramaphosa has called an “extraordinarily rapid and steep” rise. With estimated excess deaths rising in South Africa in recent weeks, Ramaphosa has imposed restrictions on movement.

The province of Gauteng, which includes Johannesburg and Pretoria and is South Africa’s economic motor, has driven the latest surge by recording about 7,000 cases a day on average in the past week — one-third higher than its peak in a second wave at the start of the year, according to the health ministry.

“The house is under fire” and hospital admissions are rising rapidly, David Makhura, Gauteng’s regional premier, said on Monday.

“It’s a pretty gloomy picture. The combination of the third wave, and winter, at the same time as trying to drive an aggressive vaccination rollout is of concern,” said Martin Kingston, head of a South African business steering committee for the vaccine rollout.

The world’s richest economies have secured enough planned deliveries of approved doses to cover their populations more than four and a half times over, but the poorest have only procured enough for 10 per cent of theirs, according to Barclays analysts.

Scatter plot chart showing vaccination rates in Africa have fallen behind

Sub-Saharan African countries have procured just over one in 10 of the world’s roughly 8bn doses of approved vaccines on order, according to Barclays, largely through an African Union initiative. Countries from Malawi to Rwanda are reaching the end of supplies they have received from Covax, the global vaccine procurement body that has shipped just under 90m doses worldwide so far.

Getting these doses delivered and distributed has been hard. South Africa has ordered vaccines for about three-quarters of its population of about 58m, including 31m doses from Johnson & Johnson. But a month into a mass campaign targeting the over-60s, just under 4 per cent of South Africans have received doses.

Ramaphosa’s government has fumbled some of the rollout’s logistics, including a sluggish electronic registration system that is difficult for people in rural areas to access. South Africa has also been hit by global supply problems. This month it had to destroy 2m J&J doses after a contamination scandal in the US. J&J has pledged to replace the doses but this will take time.

With China’s Sinovac jab and Russia’s Sputnik in the final stages of South Africa’s approval process, the health regulator is trying to select vaccines shown to be most effective against the more infectious Beta variant, dominant in the country. It has opted not to use the AstraZeneca vaccine after it was found not to be effective against milder forms of illness. The Pfizer vaccine has so far led the mass rollout. Incoming larger deliveries from Pfizer and J&J should soon help South Africa to begin administering more than 250,000 doses a day, up from 85,000 a day currently, said Kingston.

Other countries are still battling with testing infrastructure, including Uganda where President Yoweri Museveni has warned that “the hospitals are full” and has imposed a 42-day lockdown in response to rising cases.

“We have no way to know how far the virus has spread in Uganda because of the low testing capacity in the country,” said Edward Simiyu, country director for Mercy Corps, an aid group.

Recently more than one in three daily tests in Namibia, South Africa’s neighbour, have been positive, indicating that the rapid spread of infections is swamping capacity to monitor them.

Even with limited testing, there is no escaping the signal from the death tallies among Africa’s political elites. In the Democratic Republic of Congo the third wave has killed more than 30 members of the national assembly, said Jean-Marc Kabund, the first vice-president of the lower house of parliament.

In Namibia recent cases have included President Hage Geingob and his wife. Mburumba Kerina, the liberation struggle veteran who gave Namibia its name, died from the virus this month.

“This is indeed a sombre period in our country’s history,” Geingob said last week as he announced a partial lockdown centred on the capital, Windhoek. “The loss of so many lives is difficult to bear.”