The mpox pandemic has reminded the world of a critical truth: Africa needs to be able to produce its own vaccines or risk being relegated to the back of the queue in the event of an outbreak — a painful lesson from the Covid pandemic.
What is often overlooked when facing an emergency disease outbreak is that the capacity to produce emergency vaccines hinges on a country already possessing the technical and scientific capacity and manufacturing infrastructure to produce routine childhood vaccines.
The global standards expected for good manufacturing practice means it isn’t possible to create pop up-vaccine production facilities in response to a disease such as mpox; specialised technical skills need to be developed, along with specialised equipment and processes. Those critical skills also need to be retained.
Investors, organisations and governments have recognised this, leading to a range post Covid-19 pandemic announcements supporting vaccine manufacturing in Africa. In a move to develop and support such sustainable vaccine manufacturing the Africa Centres for Disease Control and Prevention (Africa CDC) and partners have compiled an initial list of eight routine childhood vaccines that will be manufactured on the continent and pre-qualified by the World Health Organisation for global procurement between 2025 and 2030.
Six of the eight planned vaccines will be produced in SA, thanks to the country’s advanced manufacturing capacity, the globally recognised strength of its regulatory environment and the partnerships entered into by its vaccine manufacturing companies with global vaccine manufacturers. Three of the planned eight are intended to be end-to-end manufacturing projects — meaning the vaccines will be manufactured from scratch.
One of these end-to-end vaccines is Biovac’s oral cholera dose, which is much needed as outbreaks still occur on the continent and there are shortages of the vaccine. Based in Cape Town, Biovac is the result of a public-private partnership between the SA government, represented by department of science & technology, and the private sector. The Institute Pasteur in Senegal, a long-established biomedical facility, will produce the other two vaccines.
The call for Africa’s vaccine sovereignty has resonated globally. In 2022 at the AU heads of state meeting leaders encouraged all agencies involved in bulk vaccine procurement, including African governments, vaccine alliance Gavi and Unicef, to prioritise sourcing vaccines for African countries from African producers rather than relying on manufacturing hubs outside the continent. The AU also committed to ensuring that 60% of Africa’s vaccines are produced on the continent by 2040, up from 1% now.
Helping hand
In response, the Gavi board approved the African Vaccine Manufacturing Accelerator (AVMA) in December 2023 to provide financial support for African manufacturers by reducing the medium-term high cost of manufacture. That makes it more feasible for new entrants to compete with established players. The funds will be available to African manufacturers for World Health Organisation pre-qualified, Gavi-approved, vaccines from 2024 to 2034. In June the AVMA was officially launched in Paris with $1.2bn raised from donors.
These efforts by global organisations to support African-made vaccines need to be reciprocated by local governments. It is critical that African member states make the decision to prioritise choosing locally manufactured vaccines above imported ones and that internal government procurement policies are aligned to support this.
Similarly, Unicef and other global buyers of vaccines for African countries need to ensure that routine vaccines are bought locally when available. The reality is SA and other African countries vaccines won’t immediately be competitive with major multinationals or their Indian counterparts purely on price, especially as we set up new facilities to compete with incumbents or invest in research. Still, it’s possible to be competitive provided there are volumes to support economies of scale; hence the urgent need to unlock continental demand for routine childhood vaccines.
SA is clearly leading the charge in vaccine manufacturing capability on the continent. It and other African countries therefore need to take a broader view of the value proposition of investing in domestic vaccine manufacturing, viewing vaccine capability as a national strategic asset that develops scientific skills, provides pandemic readiness and boosts the economy.
This drive for industrialisation will ultimately lead to health security and create a thriving competitive biotechnology hub in SA for the continent. Supporting local vaccine production is also in line with the AU’s commitment to produce 60% of the continent’s vaccines by 2040 and global calls from the G7 for such initiatives.
SA has the scientific capability, manufacturing capacity, skills, regulatory environment and technology transfer partnerships to meet Africa's charge towards vaccine self-sufficiency and pandemic preparedness. The country is poised to be the leader in Africa in creating a sustainable vaccine manufacturing ecosystem for other countries to follow and benefit from.
• Dr Makhoana is CEO of Biovac.
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