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A new era of vaccine sovereignty in Africa beckons

Africa launched a new era of vaccine sovereignty this week, when government and industry leaders convened in Addis Ababa to map out a vaccine manufacturing strategy for the continent

At the meeting, the AU announced a partnership with the Coalition for Epidemic Preparedness Innovations to establish five vaccine production sites (one each in North, East, West, Southern and Central Africa). John Nkengasong, the head of the Africa Centres for Disease Control and Prevention, said that within 20 years Africa must endeavour to manufacture 60% of vaccines used on the continent.

This initiative is vitally important.

Covid-19 has made it clear that Africa cannot depend on donors to meet its vaccine and medicine needs. It is time to do things differently: to assemble the partnerships and commit the resources to develop African vaccine-manufacturing capacity. This can be done as quickly and effectively as the rise of the African telecommunications industry, which in one generation moved Africa from obscurity on the telecoms map to being fully integrated into the digital and telecoms world.

As a public health and development expert who has worked on every major infectious disease epidemic the continent has faced in the past 20 years, I am keenly aware of Africa’s current vulnerability. The continent, with 1.3-billion people, produces less than 1% of the human vaccines it needs. This capacity deficit, coupled with the mad rush for available Covid-19 vaccines produced elsewhere, has left Africa with very little to rely on. As a consequence, whereas some rich countries are set to vaccinate their entire adult populations in half a year’s time, the majority of Africa’s low-income countries will not have widespread vaccination coverage before 2023.

This is not the first time that Africa has been last in the queue to access life-saving medication. Early in the HIV pandemic, although 95% people living with HIV were in Africa, the continent had no access to life-saving antiretroviral drugs (ARVs). It took nearly 10 years and thousands of lives lost every day before ARVs were readily available in Africa. Pharmaceutical companies opposed making the medicines available at low cost or free of charge, claiming that profit loss would destroy their drive towards innovation.  

Similar protests are being heard today from pharmaceutical companies and wealthy countries opposed to sharing vaccine patents and technology to allow for generic vaccine production. The “vaccine nationalism” which marks the global response to Covid-19, forces Africa to find workarounds. The AU’s vaccine acquisition task force has secured 270-million doses for member states. It expects an additional 400 million doses, with another 114-million doses being arranged for 16 countries through the African Vaccine Acquisition Task Team.

Meanwhile, Covax, a consortium of global organisations dedicated to equitable Covid-19 vaccine access, has pledged to deliver 600-million vaccine doses to African countries by the end of 2021— enough for only 20% of the continent’s needs. At best, it could take three years for Africa to reach the 60% vaccine target.

The African Vaccine Manufacturing Initiative, a group of scientists and pharmaceutical companies with members in 12 African countries, is pushing to get the African vaccine-manufacturing plan off the ground as the most sustainable and dependable way to ensure a robust supply of essential vaccines.

To develop its vaccine-manufacturing capacity, Africa must address three main challenges:

  • Build on the capacity of countries with production potential, such as Senegal, Tunisia, Egypt, Ethiopia and South Africa, as well those with the political will, such as Ghana, Nigeria, Rwanda, Kenya and Democratic Republic of Congo.
  • Increase investment by African governments into vaccine research and development, infrastructure development, and training and capacity-building for the vaccine trials. Increase government support for the creation of vibrant public-private partnerships to secure investments and technology transfer; and 

Currently, only a handful of countries across the continent make vaccines. They include Senegal’s Institut Pasteur de Dakar, which makes yellow-fever vaccines. In North Africa, Egyptian manufacturers finish off production (a process called fill-finish) of diphtheria vaccines; companies in Tunisia produce rabies and BCG vaccines; and a pneumococcal vaccine is formulated and finished in South Africa. But other companies are in the wings.

A state-backed South African vaccine company, the BioVac Institute, recently signed a contract with US-based ImmunityBio to manufacture coronavirus vaccines. It plans to use the agreement as a springboard for developing a vaccine-export industry. For its part, Egypt is about to start clinical trials on a locally produced Covid-19 vaccine. Meanwhile, a research and development drive has picked up in Nigeria; and Ghana, Rwanda, Kenya and Ethiopia are also planning to enter the industry.Some advocates may say Africa has more pressing health priorities, including rolling out universal health coverage. But this is not an either/or situation. Vaccination is a crucial component of universal health coverage, and without home-grown vaccines, Africa cannot break the cycle of depending on outside sources to meet its urgent health needs. By 2050, Africa’s population will reach 2.5-billion, constituting a quarter of the world’s total. The continent’s people must be protected.

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Robert Agyarko
Robert Agyarko is the lead adviser on outbreaks and epidemics for the Africa Risk Capacity, a specialised agency of the AU.

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