Editor’s note: This article was updated on June 23, to reflect the WHO’s unveiling of plans to establish Africa’s first mRNA vaccine hub in South Africa; and on Sept. 16, to reflect Kenya's announcement that it's preparing to manufacture COVID-19 vaccines in 2022.
Following the persistent struggle for most African countries to secure COVID-19 vaccines, attention has turned to the continent's capacity to produce its own vaccines.
The majority of vaccines already received by Africa have been provided by the COVAX facility, which works to make sure vaccines reach low- and middle-income countries and is co-led by the World Health Organisation (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi, the Vaccine Alliance.
But, so far, Africa doesn't yet have enough vaccines to reach herd immunity against COVID-19 in 2021, and this has ignited a discussion on what it would take for Africa to manufacture its own vaccines.
South Africa’s President Cyril Ramaphosa made a call for the continent to have its own manufacturing facilities during a conference in April on COVID-19 vaccine production, and was backed by Rwanda’s President Paul Kagame.
While vaccine nationalism (which has seen rich countries secure enough doses for their populations several times over in some cases) is a key reason for Africa’s slow rollout, the vaccination effort is also being held back by India halting exports of vaccines to protect the domestic population as it faces soaring COVID-19 cases. That's because India is home to the world's largest vaccine manufacturer, the Serum Institute of India, which is also the biggest supplier to the COVAX facility.
Richer countries that have plentiful access to the vaccine — either through buying more than their population's need, and/or by having the resources to fund research and manufacture of their own vaccines — are the most likely to recover economically sooner from COVID-19 and other potential pandemics, according to the Organisation for Economic Co-operation and Development (OECD).
Vaccine producing countries such as the UK and the US are likely to reach their COVID-19 vaccination targets by the end of 2021, while at this rate, Africa as a continent won't have widespread accrss to the vaccine until 2023.
These instances have highlighted the need for Africa to be able to produce its own vaccines and medication, begging the question, what capacity does the continent have to do so?
What are 5 key facts people should know about Africa’s vaccine production capacity?
- Africa currently imports 99% of its vaccines.
- Just five of Africa’s 54 countries have the facilities to produce vaccines.
- By 2040 the Africa CDC hopes to establish five new vaccine manufacturing sites.
- Fewer than 10 countries are self-sufficient in terms of vaccine procurement.
- Plans to produce the continent's very first vaccine hub in South Africa are underway.
What is Africa’s capacity to make its own vaccines?
Africa currently produces just 1% of its vaccines, however it’s not far away from being able to produce more of its own pharmaceutical products.
While Egypt, Morocco, Senegal, South Africa, and Tunisia are home to the continent’s 10 vaccine manufacturing facilities, the current vaccine production capacity has mainly been focused on supplying internally to each country, with very few exports taking place.
These facilities have taken decades to be at a place where they can produce safe and effective medication, and even still, mostly produce medication that are packaging-formulated and imported from abroad. For instance, while South Africa produces COVID-19 vaccines, they’re not produced from scratch in the country. The vaccine itself is made overseas, leaving the country’s manufacturing facilities to put it into vials and package for distribution
However, the development of the Moderna COVID-19 vaccine, which uses mRNA technology — where rather than producing antibodies that prevent us from getting sick as traditional vaccines do, teaches our cells to create proteins that prompt an antibody response — has given the continent hope that it could potentially build more vaccine production facilities sooner rather than later.
This is because traditionally, vaccines had to be produced in specialised facilities. However, Moderna's mRNA vaccine was able to be safely produced on a site that had been transformed into a lab in just a few months, encouraging experts to believe similar steps could be taken elsewhere. The mRNA technology used in the vaccine also requires bioreactors (the key bit of infrastructure for making vaccines) a fraction of the size needed for traditional vaccine production.
What all of this means is that, should Africa decide to produce mRNA vaccines, it could construct facilities relatively quickly.
On June 21, the WHO unveiled plans to establish the continent's first mRNA vaccine hub in South Africa, vaccines from which will benefit the entire continent. Getting around the need to share patents, South Africa will be leaning on French company Biovac for vaccine development, with the manufacturing of the vaccines to be led by a South African company called Afrigen Biologics & Vaccines.
This means that the patents to produce already approved vaccines will not be shared with the country, and rather Biovac will be in charge of most of the vaccine development. However the UN-backed Medicines Patent Pool will provide assistance and guidance to the hub on intellectual property management and licensing. The hub will also receive guidance from the Africa Centers for Disease Control and Prevention (CDC) as well as a network of universities that will provide academic support.
The reason for the hub placement in South Africa is due to the country's experience with vaccine production as well as its capacity to have conducted COVID-19 vaccine clinical trials. There is no set timeline on when this hub will be ready to produce vaccines, however WHO Chief Scientist, Dr. Soumya Swaminathan has said that if large pharmaceutical companies share their approved technologies with the hub, it could produce vaccines within the next year.
On Sept. 16 Kenya announced that it is also preparing to manufacture COVID-19 vaccines for local inoculation, with the aim to start producing them in the first quarter of 2022. The country's Cabinet Secretary for Health, Mutahi Kagwe, explained that the move would help to boost vaccine capacity in an effort to produce enough vaccines for the country's inoculation programmes by 2024. The country has yet to announce further detail on this plan.
The Africa CDC and the African Union have also heard the call for the production of the continent’s own vaccines and have put in place a plan to increase vaccine capacity from 1% to 60% in the next 20 years. While not an immediate solution for the current COVID-19 pandemic, it will help to prepare the continent for future public health scares.
What will it take for vaccines to be produced in Africa?
The most important thing that African countries need in order to increase vaccine production capacity on the continent is capital. The US could afford to financially back the Moderna vaccine’s production (which cost upwards of $210 million), in exchange for the right to control exports of the vaccine. African countries may not be able to afford the same luxury.
African leaders have strongly been considering going down the mRNA vaccine production route, with Rwanda’s Kagame confirming that he’s been in discussions with an unnamed producer, and Moderna’s CEO, Stéphane Bancel, confirming that he has met with several African leaders about the potential of a Moderna plant in Africa.
Looking at the Africa CDC’s plans to establish new vaccine manufacturing centres in the next 20 years, current predictions show that it’ll cost an estimated $400 million to invest in the technology needed to produce at least two manufacturing sites.
The African Development Bank has committed to help with funding the technology needed for two centres, but this will not be enough to reach the Africa CDC’s hope for five new centres overall.
There is currently no publicly available information on what more capital it will take and what skills are outstanding in the journey to building more vaccine production plants.
Current vaccine producers also need to be willing to share their knowledge with new producers on the continent. However, currently, no government that backs the production of COVID-19 vaccines has the power to tell pharmaceutical companies to share their information with new producers.
This is why 100 countries are supporting the proposal of a waiver on COVID-19 vaccine patents, so that pharmaceutical companies can share their vaccine formulae, and doses can be easily and more affordably produced everywhere that they are needed.
This proposal was presented to the World Trade Organisation by India and South Africa in 2020, and has yet to receive a thumbs up from the organisation and all 164 of its member states. If waiving the patents is approved, however, it could help relieve the developing world of vaccine shortages and empower equitable distribution.
How does this relate to ending poverty?
During past health crises — as well as this one — people in Africa have had to wait for aid or imported medication in order to deal with health threats on the continent. This has the potential to slow down the eradication of threats such as COVID-19, and can cost African countries millions of lives, as well as the added cost of importing medicines and stabilising their economies.
The production of vaccines on African soil could make it easier and faster to treat and prevent diseases, so that the continent’s countries can recover from health crises a lot quicker.
This is essential in removing the barriers leading to Africa’s development towards the UN's Global Goals and the mission to end extreme poverty. According to the UN Economic Commission for Africa, Africa's development has fallen behind by up to five years due to the pandemic and vaccine inequity specifically.
How can Global Citizens help?
What African countries need immediately is COVID-19 vaccines and capital. Global Citizens can take action here to call on wealthy nations to share the COVID-19 vaccines that they have hoarded with countries that need them most.
You can also take action here to help leaders of African countries focus their energies on purchasing vaccines and potentially kicking off the beginning stages of vaccine production, by calling on the African Union to commit to spending Special Drawing Rights — set to be given out by the International Monetary Forum — on vaccines.
This article was written in partnership with the Bill and Melinda Gates Foundation, a funding partner of Global Citizen.
As part of the Recovery Plan for the World campaign, Global Citizen is calling on world leaders to support vaccine equity in several ways, including calls to donate excess vaccines doses to lower-income countries. You can join the campaign by taking action here.