Africa Can't Rely On Goodwill, Targets 60 Percent of Local Vaccine Manufacture By 2040

President Cyril Ramaphosa joins healthcare workers in receiving the Johnson & Johnson coronavirus vaccination (file photo).

African leaders, healthcare experts, biotech companies and pharmaceutical multinationals on Tuesday met for the second day of a virtual conference on ramping up the local manufacture of Covid-19 vaccines. The initiative will give impetus to the continent's challenging quest of securing adequate supplies and provide a template for other treatments in the future.

"People who do not have their own freedom for vaccine manufacturing, diagnostics and therapeutics do not guarantee their own health security," said Dr John Nkengasong, head of the Africa Centres for Disease Control and Prevention (CDC).

"I think we have learnt that over and over in the last couple of months," said Nkengasong, talking about the challenges in vaccinating the continent's 1.3 billion people against the coronavirus.

Almost all the vaccines used on the African continent are imported, with only 1% of vaccines actually manufactured in African countries, representing some 12 million doses, according to conference slides from Africa CDC and the African Union bloc.

"The production of vaccine and access to vaccine is an absolute necessity for our continent," said African Union head Moussa Faki Mahamat, outlining the need for a "new world health order".

Support existing facilities

Seven sites currently produce vaccines: the Pasteur Institute in Algeria, Morocco, Senegal and Tunisia, Egyptian state-backed Vacsera, Biovac supported by the South African government, and Aspen Pharmacare listed on Johannesburg Stock Exchange.

Three additional sites are expected to start vaccine production, according to the conference materials, including the Ethiopian Public Health Institute.

The African continent faces many challenges in ramping up local vaccine manufacture in terms of harmonising medical regulation, accessing finance, developing talent and local knowledge, as well as creating the relevant infrastructure.

South African President Cyril Ramaphosa said the two-day conference was taking place at a critical moment as inequalities across the world hamper efforts by African countries to protect their people.

"Not all countries can share equally in the hope of having access to vaccines at the time they need them most," said Ramaphosa, who has been leading an African Union initiative to secure supplies of Covid-19 vaccines.

Lessons learnt from Covid-19

The South African leader was pivotal in helping Africa secure some 220 million doses of the Johnson & Johnson vaccine that will be manufactured by Aspen Pharmacare in South Africa.

The African Vaccine Acquisition Trust (AVATT) has made valuable progress for increasing Covid-19 vaccine doses, "but that is only the beginning", said Ramaphosa, noting new initiatives that have increased access to medical equipment and therapeutics.

"We must strengthen our ability to both respond to future health emergencies and to achieve health security for the people of our continent," Ramaphosa added, describing a vision of existing capabilities being expanded into regional vaccine manufacturing hubs.

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The Covid-19 pandemic has highlighted the continent's weak position relative to more wealthy countries over access to vaccines, making it difficult to negotiate with big pharmaceutical companies.

Before the launch of AVATT, the majority of African countries could only rely on the COVAX facility, a global initiative designed to provide equitable access to vaccines, although this provides insufficient coverage for each country's population.

Some 4.3 million cases of Covid-19 have been confirmed on the African continent and 115,970 deaths have been registered, according to statistics from Africa CDC from Tuesday morning. Although some studies suggest the prevalence of Covid-19 is much higher.

The conference said the aim is to vaccinate at least 60% of Africa's population against Covid-19 by 2022, while beyond the coronavirus pandemic, African leaders and institutions have ambitious targets for local vaccine manufacture as a whole.

Going beyond coronavirus

Ideally, the initiative will help strengthen research and development for vaccines targeting unknown pathogens and increase preparedness for future pandemic response, as well as helping manufacturing for known African pathogens and routine immunisation.

By 2040, it is hoped that up to 60% of total vaccines will be produced locally and the continent will manufacture 100% of the vaccines needed for at least three African emerging diseases: Ebola, Lassa fever, and Rift Valley fever.

The goal is also to manufacture up to 60% of the vaccines needed for annual immunisation campaigns, according to a conference handout.

The continent must further develop public-private partnerships to increase the capability for vaccine manufacture, plus the production of other medical products, according to Rwanda's President Paul Kagame, who is heading up the financing needs for locally manufactured vaccines.

He said it was important to focus on RNA vaccine technologies that teach our cells how to make proteins that trigger an immune response inside our bodies, such as those developed by Pfizer-BioNTech or Moderna for Covid-19.

African countries must move on from "feeling sorry for ourselves", said Kagame. "Vaccine equity cannot be guaranteed by goodwill alone," he added, making the case for locally manufactured vaccines.

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