By Professor Maurice Okoli
The African Union, an organization uniting African states, has made a legitimate decision to establish a vaccine manufacturing facility inside Africa, despite the fierce initial resistance by the World Trade Organization (WTO). The Covid-19 pandemic, the critical period when widespread coronavirus endangered human lives, has rightly taught Africans lessons, especially the heightened discrimination in the supply and distribution of vaccines by Western and industrialized nations we referred to as the Global North.
Until today, Africans vividly remember their sentimental feelings characterized by sudden lockdown and social distancing. In the African context, most cultural group activities were suspended, and small traders and vendors shut behind doors without any revenue-earning employment. In short, the complex and unbearable adverse effects on small- and medium-scale businesses are still felt even as coronavirus has subsided, but not completely disappeared from society.
As part of stringent measures to contain future disease outbreaks and public health risks, for effective future responses, the Africa CDC is developing sustainable mechanisms such as local vaccine manufacturing facilities, strongly supported by African leaders and the African Union. The Africa CDC is mandated to strengthen Africa’s public health institutions’ capacity and capability and seek local and foreign partnerships to ensure a healthy Africa.
According to the Africa CDC report, about a quarter of Africa’s 1.4 billion population will be fully vaccinated against Covid-19 by the end of 2022. In the report, the target for Africa remains to vaccinate 70% of the population. That goal, however, was set by the World Health Organization (WHO) for the overall population. But due to delays in international vaccine deliveries, Africa largely lags behind the rest of the world.
Since Africa has no production facility, the vaccinations have been made mainly with Johnson & Johnson’s vaccine (42%), followed by Pfizer (22%), AstraZeneca (17%), China’s Sinopharm (15%) and Sinovac (7%). Currently, just more than 800 million doses of vaccines have been administered in Africa, or 80% of the total received.
Russia’s much-heralded vaccine diplomacy is neither vaccine diplomacy nor development assistance. Instead, it is a form of mercantilism, an effort by the state and its proxy to develop, market and sell Russian products abroad.
In February 2021, Russia offered the African Union 300 million doses of Sputnik V with financing packages for countries wanting to purchase them. Yet at $10 per dose for two doses of vaccine, Sputnik V was offered on terms making it significantly more expensive than the vaccine by AstraZeneca ($3 per dose), Pfizer ($6,75 per dose) and Johnson and Johnson ($10 for one dose-short vaccine).
Considering the cost implications, AU brokered with the French pharmacy brand Johnson and Johnson instead of Russian Sputnik V. Potential customers have also taken note of logistical challenges that plagued Russian officials’ vaccine efforts, combined with delivery delays, encouraged many desperate countries to look elsewhere during the crisis. Given these shortcomings, it is not all that surprising that Moscow’s strategic attempt to use vaccine diplomacy to showcase itself as a partner for Africa has not been very successful as envisioned.
At the Global Financing Summit held in Paris on 22-23 June 2023, South African President Cyril Ramaphosa emphasized the importance of vaccine manufacturing inside the continent; the further focus should be on developing actual vaccine R&D capacity, which must necessarily lead to health products. And this also requires substantial investment and a long-term commitment from external players and financial institutions. Notwithstanding those previous disappointments from external partners, at least African leaders have been rallying together to ensure that no effort is spared in facilitating and supporting the building of large-scale vaccine manufacturing capacity in the continent. The African Vaccine Manufacturing Summit held in April 2021 was an encouraging start, a collective effort to change the status quo.
Under the aegis of the African Union, the Africa CDC and the African Medicines Agency (AMA) are coordinating and cooperating to swiftly address health issues, including vaccine manufacturing and distribution in the continent. According to African Union’s report in mid-June 2023, the African Medicines Agency (AMA), a newly launched continental regulatory body for medical products, is concretely set to start its work, with its headquarters in Kigali, Rwanda. Rwanda was selected to host the agency during a 2022 AU Executive Council meeting in Lusaka, Zambia.
AMA is a specialized agency of the African Union (AU) intended to facilitate the harmonization of medical products regulation throughout the AU to improve access to quality, safe and productive medical products on the continent. Many AU member states, including Rwanda, ratified the treaty establishing the continental agency and deposited the legal instrument of ratification to the AU Commission. On June 10, for instance, Rwanda and the AU signed the host country agreement, an important step marking the start of the work by AMA.
The Health Minister Ruwanda Dr Sabin Nsanzimana emphasized the institution’s key role in building confidence in the quality of health products on the continent, promoting cooperation and mutual recognition in regulatory decisions and facilitating the movement of health products. The agency is tipped to enhance the capacity of state parties to regulate medical products and to improve Africa’s access to quality, safe, and productive medical products.
As we know, Rwanda’s government has already provided space for the agency’s operations. The following steps include getting leaders for the institution and establishing facilities like laboratories, et cetera. With much praise, AMA will contribute to medicine production on the continent and allow it to move across Africa.
In terms of bilateral relations, China and Africa will always be a community of a shared future. At least, its policies are strategically focused on addressing sustainable development. China has proved, over the years, in many aspects of dealing with Africa. Results are seen especially with all kinds of infrastructure built these years. And, of course, Chinese firms are actively engaging in joint vaccine production in Africa with local firms, helping countries, following their wishes, to realize localized vaccine production. According to reports, Chinese firms have started localized output in Egypt and signed cooperative agreements with Morocco and Algeria.
The headquarters building was completed after an agreement between the AU and China on the Africa CDC HQ’s building project in July 2020. it is now becoming one of the best-equipped centres for disease control in Africa, allowing the Africa CDC to play its role as the technical institution coordinating disease prevention, surveillance and power in the continent in partnership with the national public health institutes and ministries of Member States.
By combating Covid-19, China and Africa withstand severe challenges, helping each other and fighting side by side to defeat the pandemic through solidarity and cooperation. In essence, China is participating in the African Vaccine Manufacturing Partnership (AVMP) launched by the African Union in April 2021. This Continental Vaccine Manufacturing Vision is “to ensure that Africa has timely access to vaccines to protect public health security by establishing a sustainable vaccine development and manufacturing ecosystem in Africa.”
It is also a splendid testimony of China’s steadfast support for Africa. “Together, we have written a splendid chapter of mutual assistance amidst complex changes and set a shining example for building a new type of international relations,” Chinese President Xi Jinping said in one of his speeches, emphasizing the principles of China’s Africa policy as pursuing the greater good and shared interests.
While discussing this vital question, it is critical to strengthen the capacity and to prepare for future pandemics based on the sentiments, and latest first-hand experiences during the Covid-19 period. The fear and the uncertainties engulfed human lives, the overall impact on the economic performance across Africa. Worth to note here that African leaders have passionately called on G7 leaders to increase investments in research and innovation for vaccines, new drugs and diagnostics to help reach the goals the World Health Organization set.
More interesting – apparently, recent arguments among health experts have offered enough grounds for finding at least modest but sustainable health solutions. We can now praise the Africa CDC and AU for their joint support; that alone is one giant leap for establishing vaccine development and manufacturing inside Africa.
The key focus of this new agreement is forging new and strengthened partnerships to reach the millions who still lack access to vaccines and other essential health services. We have already acknowledged that the global Covid-19 pandemic and climate change have, to some degree, jeopardized the health, security and livelihoods of people across Africa.
Patrick Tippoo, Executive Director at the Africa Vaccine Manufacturing Initiative, argues that vaccine manufacturing is a complex, time-consuming exercise requiring considerable commitment and financial and technical resources. He further underscores that the capital investment required is significant and equally essential in a long-term future view for Africa’s health system and population. Therefore, African leaders need to rally together to ensure that no effort is spared in facilitating and supporting the building of large-scale vaccine manufacturing capacity on the continent.
The African Union could contribute in the following ways: (i) the mobilization of resources and creating enabling environments for help to be unlocked and discharged, as vaccine production is capital intensive and requires access to innovative funding streams over 10-20 years.
(ii) Accelerate efforts to create streamlined regulatory processes for speedier accreditation of vaccine manufacturing facilities and licensing products to ensure that vaccines can be available in the fastest time possible.
(iii) Increase access and accelerate the uptake of life-saving vaccines across the continent, including immunization, providing technical and learning assistance.
(iv) Invest in skills development programs specifically geared to creating a workforce skilled in vaccine development and manufacturing know-how.
In a similar argument, Tom Page wrote in his report, published in CNN news and newsletter, that Africa might need its own central medicines agency. The main reason is that when Africa needs medicines, the continent often looks abroad. That report, sourcing the World Economic Forum, said African nations consume about 25% of vaccines produced globally but import nearly 99% of their supply, according to the African Union Development Agency. For packaged medicines, only 36% of demand is produced locally, and just 3% is supplied by regional trade, according to the World Economic Forum.
The world acknowledges that there are people who can pay and there are people that can’t pay. It is not a sustainable model to deny people who can’t pay because they need money. Therefore, the biggest challenge is making supplies more affordable to the population. The essence of localizing production inside the continent is affordability, but there are still enormous challenges. Partly the reason why African governments should adopt a system approach and outline how to tackle health issues as fast as possible.
Today, Africa comprises 54 sovereign countries, most of which have borders that were drawn during the era of European colonialism. In the 21st century, improved stability and economic reforms have attracted a considerable great increase in foreign investment in many African nations. We hope that the Africa Continental Free Trade Area (AfCFTA) will make cross-border trade in the pharmaceutical space easier. And there is also a lot more on the policy front from the World Trade Organization.
If vaccine manufacturing takes off with the expected speed, distribution without cut-throat customs tariffs (taxes) and through borderless countries to reach different destinations, it will ultimately ensure better healthcare delivery. At long last, the vehicle for Africa’s economic transformation has visibly arrived in the single continental market – AfCFTA and it will be a tremendous premise for achieving the health aspects of the African Union’s Agenda 2063.
By Professor Maurice Okoli is a fellow at the Institute for African Studies and the Institute of World Economy and International Relations, Russian Academy of Sciences. He is also a fellow at the North-Eastern Federal University of Russia.