Time for Africa to shed reliance on external vaccine producers

A healthcare worker vaccinates a woman during the Launch of Covid-19 Mass Vaccination Drive in Dagoretti on February 3, 2022. [Stafford Ondego, Standard]

The question as to why Africa must produce its own vaccines has been persistent but it has not been decisively addressed.

The result of this indecision is Africa’s disproportionately low quantum of vaccine manufacturing at the global scale.

Only 1 per cent of the global vaccine manufacturing happens in the continent. The participation of the 10 African vaccine manufacturers involved in Covid-19 vaccine manufacturing has been limited to fill-and-finish processes with minimal participation higher up in the manufacturing pipeline.

Africa’s bargaining power in acquiring these vaccines has as such been very low with much of the power centred around four companies that manufacture about 90 per cent of all Covid-19 vaccines.

Africa’s precarious position has been compounded by vaccine nationalism. Some High-Income Countries (HICs) have over-procured and hoarded Covid-19 vaccines. This has resulted in some of the HICs having enough doses to vaccinate their populations five times over while several Low-and Middle-Income Countries (LMICs) cannot access enough vaccines to provide the first dose to their citizens.

This has resulted in Africa falling behind on global vaccination targets. At the end of 2021, Africa had vaccinated only 10 per cent of its population of about 1.3 billion, yet 70 per cent of the developed countries had vaccinated over 40 per cent of their populations. Africa should begin to explore the possibility of manufacturing Covid-19 vaccines.

Local vaccine manufacturing in Africa faces several challenges, primarily the lack of sustainable financing mechanisms and limited political and fiscal prioritisation. These challenges can be circumvented by leveraging several emerging solutions such as vaccine bonds.

The investment imperative in Africa is particularly strong given that the continent's vaccine market is projected to increase dramatically from $1.3 billion today to between $2.3 billion and $5.4 billion by 2030 driven by population and economic growth.

Despite the prevailing challenges, it is time Africa seizes the moment to address its vaccine needs. Moderna has opted not to enforce their intellectual properties during the pandemic presenting an opportunity for Africa's vaccine manufacturers to replicate their mRNA vaccine.

Other global vaccine manufacturers are collaborating with some African governments on technology transfer initiatives. Governments should seize this opportunity to start vaccine manufacturing.

Building capacity for vaccine manufacturing in Africa will have positive and sustained benefits. Empirical research has shown that the cost-per-dose of vaccines produced in developing markets is 84 per cent lower than the cost in industrialised-country markets due to economies of scale.

This means that local manufacturing will help Africa to better take care of its vaccine needs within the limited available resources as well as facilitate better pandemic response in the future.

Investing to enhance Covid-19 vaccine manufacturing in the continent will also benefit the manufacture of other vaccines. It is estimated that about 9.4 million children do not get fully vaccinated for diphtheria, tetanus and, pertussis annually, resulting in two to three million deaths in Africa.

Local vaccine manufacturing will address a big part of this problem, thus unlocking significant productivity benefit from the averted mortality. Beyond these immediate benefits, capacity building for vaccine manufacturing will also have a knock-on effect of enhancing the discovery of diagnostics, vaccines, and therapeutics to combat diseases that are of high public health priority for Africa such as malaria and Ebola.

As next steps, Africa’s regional economic communities should emulate Senegal and come up with strategies and alliances to build capacity for regional vaccine manufacturing and initiate technology transfer, for instance, by learning from the recently ratified partnership between CEPI and Institute Pasteur - Dakar. Subsequently, African states should fast-track the development of and submission of schedules for concessions on trade in goods.

This will fast track the implementation of the African Free Trade Area (AfCFTA) paving the path for the smooth supply of quality, cost effective vaccines throughout Africa given that AfCFTA will reduce tariffs significantly for intra-Africa trade.

Additionally, this agreement would enhance customs cooperation which will significantly reduce lead time, thus lowering supply chain costs incurred through warehousing and other related costs. This should closely be followed by the swift implementation of the African Medicines Agency treaty which will ensure that member states are well equipped to effectively leverage on mutual regulatory recognition to enhance intra-Africa trade and access to vaccines.

These steps will contribute to moving Africa towards vaccine self-sufficiency. The need for  Africa to produce its own vaccines is clear. What is needed now is action.

Dr Rono is a managing partner at E&K Consulting Firm and a member of the WHO Technical Advisory Board on Vaccines and Antimicrobial Resistance. Mr Rotich is a final year student at Strathmore University and an Intern at E&K Consulting Firm.