By Chidi Victor Nweneka, Tolu Disu
Reminiscent of the 2009 H1N1 Influenza pandemic, the COVID-19 pandemic is perpetuating the stark reality of vaccine insecurity in Africa. Less than 1 percent of all vaccines used on the continent are locally produced—a statistic that reveals the region’s intense vulnerability and overdependence on foreign supplies. Compounding these challenges are other obstacles such as the high cost of vaccine development, vaccine market fragmentation, and need for building workforce capacity, to name a few. When these challenges are juxtaposed with the absence of a long-term mobilizing vision, paucity of political will to invest in public health goods and technologies, and absence of enabling policies to incentivize investment and maintenance of vaccine manufacturing infrastructure, the skepticism of a bright future for vaccine manufacturing in Africa appears justified.
Although there are no silver bullets to fixing the future of vaccine manufacturing in Africa, much has changed since 2007 when the Pharmaceutical Manufacturing Plan for Africa (PMPA), an African Union-led tool for catalyzing local pharmaceutical production, was adopted. Furthermore, in addition to several technological innovations reducing the cost of continental production, national governments and allied agencies are beginning to stake a claim on initiatives such as the launch of the African Continental Free Trade Area, the establishment of the African Medicines Agency, and the development of the Framework For Action (FFA) by the Partnership for African Vaccine Manufacturing (PAVM) of the Africa Centers for Disease Control.
Less than 1 percent of all vaccines used on the continent are locally produced—a statistic that reveals the region’s intense vulnerability and overdependence on foreign supplies.
Given increased collaboration among the bodies of the FFA, national pharmaceutical agencies, and independent, private companies, there is cause for productive optimism. Indeed, capacity building is occurring at various stages through technology transfer partnerships at existing, developing, and prospective manufacturing facilities as exemplified by Aspen in South Africa, Institut Pasteur in Morocco, and the government of Ghana, respectively. Installed-base scale-up efforts by Biovac in South Africa and first-of-its-kind vaccine production initiatives in Nigeria by Innovative Biotech, in collaboration with Merck, are also manifesting. At the international agency level, the World Health Organization has established a global mRNA technology training hub in Africa. The African Vaccine Manufacturing Initiative (AVMI) is providing leadership, building on its experience and expertise over more than 10 years of advocacy for local vaccine manufacturing in Africa.
So, the sun may yet shine on vaccine manufacturing in Africa. We have the galvanizing vision and the mobilizing strategies of the PAVM with the unprecedented engagement of all major stakeholders in Africa and beyond—including politicians and funding institutions. Fundamental elements critical to securing a bright future—and ensuring its sustainability—should focus on a long-term Africa-led multi-stakeholder agenda that allows for scientific potential actualization and local ownership, as articulated in a three-point agenda in a 2014 paper on HIV vaccines:
- Agenda 1: Development of a long-term, focused, well-coordinated, Africa-initiated, Africa-led vaccine research and development (R&D) advocacy targeting the highest ministerial level in Africa, corporate bodies, African philanthropists, and all the major stakeholders.
- Agenda 2: Institution of deliberate strategies to address the limited vaccine pipelines such as diversifying the players on the field through the establishment of several vaccine related freedom to discover grants with very transparent and liberal eligibility criteria, and establishing regional biotechnology incubation centers in Africa to encourage small groups of scientists to develop their potentials.
- Agenda 3: Building genuine local ownership of vaccine projects through effective partnerships, effective communication, and enactment of policies to compel externally funded vaccine-related projects to demonstrate adequate local involvement at all stages of the project before granting final approval.
Africa’s vaccine production destiny must transform beyond the current “fill and finish” model to full end-to-end manufacturing and include vaccine research and development.
Quality vaccines are being produced in Africa; that effort now needs to expand. We have no choice but to do it ourselves.
There is a promising future for vaccine manufacturing in Africa. Bottlenecks (e.g., weak investments in vaccine manufacturing by African governments; weak regulatory capacity for vaccine research, development and production; low interest in vaccine production in Africa by global vaccine stakeholders; and uncertainties in the demands for Africa-made vaccines by African countries) that caused previous efforts to fail must be fixed. Current and future opportunities must be exploited maximally through diverse partnerships and the creation of an enabling multi-centered vaccine development and manufacturing ecosystem in Africa. In the end, it is only Africans that can change the narrative for Africa. Quality vaccines are being produced in Africa; that effort now needs to expand. We have no choice but to do it ourselves.