Due to her fragile health system, Africa has one of the highest death rates solely linked to diseases. Despite such a precarious position and a teeming population that makes up 14 per cent of the Global whole, the continent is yet to possess the capacity to manufacture its Covid-19 vaccines.

Since the first jab of the vaccine was administered in December 2020, the developed world has pumped millions of doses into Africa through the COVAX facility. Yet, at the last count, only 2.9 per cent of the eligible population have been fully vaccinated in Nigeria.

More so, the World Health Organisation has affirmed that less than 10 per cent of Africa’s 54 nations are projected to hit the year-end target of fully vaccinating 40 per cent of their people.

While there are religious and socio-cultural factors to blame, the elephant in the room remains that there are not enough vaccines to go around. And the only sustainable way to fill that gap is through local production.

As the deaths from Covid-triggered complications soar daily, some questions come to mind.

• What is impeding Africa’s move to produce locally?
• How can we grow self-sufficient and self-reliant as a continent aside the Pandemic?

Let’s get to the facts.

Why Vaccines?

Africa heavily depends on imported vaccines with much noise but little action for local production. More so, according to the Anadolu Agency in 2019, an estimated 19.8 million children did not receive the measles vaccine immunization coverage; a significant number of them are from Africa and Asia.

For decades, Africa has battled deadly ranks of diseases. HIV/AIDS, malaria and tuberculosis, though cornered, are still kicking. Others such as the Ebola virus, Lassa fever continue to reappear through the years.

The novel Coronavirus which broke out in China took the world by storm; killing millions in its wake. Though it seems the world has gotten over Covid-19, the virus still reigns supreme in countries such as Austria whose government imposed a fresh lockdown on Monday, November 23.

As the world gradually recovers from the devastating pandemic, Africa is still grappling for economic survival.

May 2021, saw the vaccination of some of the wealthiest countries; an estimated 1.16 billion Covid-19 doses. Within the same period, Africa could only account for the vaccination of a measly two per cent of its entire population.

It is common sense that the producing regions should prioritise their people before shipping out the excess. That reality already puts Africa at the bottom of the priority table.

Even when the vaccines arrive in Africa, most countries work based on a prioritization system that allows the most susceptible population such as health workers and the aged, to be vaccinated first.

This strategy though understandable has been largely abused; leading to an ineffective system that leaves a majority at the risk of the virus. 

There’s another angle to the circulation problem. The health workers equipped to handle the situation are abysmally inadequate.

According to a report by Tony Blair Institute, Africa has a low ratio of 1.3 workers per 1,000 which is a far cry from the Sustainable Development Goals target of 4.5 workers. The shortage of trained medical hands is directly connected to the massive exodus of health workers.

In Nigeria for instance, the Nursing and Midwifery Council of Nigeria revealed that between January and September of 2021, at least 7000 professional nurses have left the country for greener pastures.

The African Union’s goal of vaccinating 60 per cent by 2023 is a noble target. But like given the current realities, may not see the light of day soon.

Then there’s the shortage of vaccines occasioned by the absence of local production capacity and capabilities. For how long can we rely on GAVI and COVAX for vaccines?

In my opinion, not very long.

The Vice President of Nigeria, Professor Yemi Osinbajo, SAN, while representing President Muhammadu Buhari at the Commonwealth Parliamentary Association meeting a few weeks ago said, “Without vaccinating a huge number of its people, Africa remains at continued risk of socio-economic stagnation because continuing infections including new variants will prevent full recovery.”

Furthermore, the Nigerian President went on to solicit help as Africa takes the initiative to scale vaccine production.

He said, “To be sure, we need resources that will help increase the scale and pace of vaccination against Covid-19 in Africa. The high and upper-middle-income countries have achieved vaccination rates of over 80 per cent while very few African countries have reached a 5 per cent level of vaccination.”

Also, Africa bears the brunt of a centralized global production and distribution instability and imbalance hence total dependence results in vaccine nationalism and procurement constraint.

Here’s what we can do

With the right pieces of infrastructure, Africa can shift from external reliance to local manufacturing. This way, the continent will thrive independently irrespective of the torrents of disease outbreaks that will strike in future. To do this, we need investments. Huge investments.

Investment support for manufacturing vaccines locally is limited. The best we have come so far is Senegal’s Institute Pasteur de Dakar which manufactures only Yellow Fever Vaccines.

A 2018 study sponsored by WHO and UNIDO estimated the cost of building a vaccine manufacturing plant at $60 million to $130 million. That’s a huge pile to climb. But we can do it.

These three strategies will morph Africa from dependency to self-reliance in vaccine manufacturing.

1. Standards Regulation

I believe that Africa cannot get local vaccines production right without the right regulation. When we start to produce, we stand the risk of duplication by purveyors of fake commodities who would cash in on the moment at all cost.

Ideally, every country has a regulatory agency that ensures the safety and effectiveness of vaccines used by its citizens. A weak National Regulatory Authority will pose a serious setback for vaccine manufacturing.

These regulatory bodies must be captured in the implementation plan for establishing and maintaining vaccine infrastructure in Africa. These structures will smoothen licensing, ensure quality production, enable equitable distribution and simplify specialized activities for vaccine pre-market approval.

        2. Technological Know-How

Manufacturing Vaccines require in-depth practical and theoretical knowledge. Essentially in biopharma, regulatory competence and quality assurance. Such information is almost non-existent in Africa.

About 40 per cent of our pharmaceutical workforce focus solely on packaging and labelling while another 40 per cent on infill and finish. The continent is suffering severe brain drain as skilled workers escape the country due to unconducive work environments and policies. This places Africa at a disadvantage leading to a dependency on expertise from external manufacturers.

The way forward, I believe, is to implement health care reforms that make Nigeria an attractive hub for healthcare workers.

On September 6, 2021, President Buhari approved the setting up of a Health Sector Reform Committee to commence the development and implementation of a Health Sector Reform Programme for Nigeria in collaboration with the State Governments and the FCT administration.

This came on the heels of a Health Sector Diagnostic Review Report developed by a consultant, Vesta Healthcare Partners and the Federal Ministry of Health.

I believe this is a step in the right direction. However, the reform must capture the equipping of the medical community on tech knowledge which is an essential component to vaccine manufacturing in Africa.

     3. Partnership/Collaboration

Collaboration remains crucial considering that Africa is in its infancy stage in vaccine manufacturing. While Africa manufactures primarily for her population, she must also consider the market side of the deal.

With quality production capacity, I believe African-made vaccines will be patronized by other countries. Therefore, the continent must partner with the like of GAVI and Gates Foundation in a bid to grow its market.

We must produce knowing that we can export to other climes. For this to happen, we must, as a matter of urgency, incentivize research and development.

Overall, GAVI must lend support to human capital development. This is the only way out of Africa’s overdependency.

The partnership can also be on a local level amongst the African States. Responsibilities can be delegated among nations pooling their collective efforts to foster manufacturing, circulation and administration of vaccines.

Speaking about collaboration, Cameroonian virologist, Dr John Nkegasong, said, “We are building a hub and spoke model, where everybody doesn’t need to do everything from end to end.”

According to him, this is an effective way for Africans to move progressively in local manufacturing. Buttressing his point, Nkegasong said, “If we recognize that it takes so many components to build a vaccine, then we could say that country X focuses on glassware for vaccines, country Y focuses on lipids. I would mean that nobody can just say, first of all, we’re going to immunize 200 million people in this country before anyone else gets anything.”

The shortage and inaccessibility of vaccines portend a continued spread of the Coronavirus. Imported vaccines will continue to be of help. However, sustainability will demand local manufacture within Africa by Africans.