The Imperative of Diversifying Vaccine Procurement in Africa

In recent years, a profound problem has been highlighted about Africa and its procurement of vaccines. 

The continent relies overwhelmingly on imports, with them accounting for  99% of their vaccine use.

This means that Africa contributes less than 1% to global vaccine production, despite making up 20% of the world's population. 

This dependency poses significant risks during global health crises, as seen during COVID-19. 

The onset of the pandemic saw a substantial boost in global vaccine production, hitting 1.5 billion doses each month.

Despite this, Africa faced severe shortages, receiving only 540 million doses by 2022, a mere 6% of global COVID-19 vaccine distribution.

The deficiency in local production capabilities not only delayed vaccination across African nations but also heightened the spread of the virus and increased preventable deaths.

To stop this situation happening again in the future African countries must diversify their vaccine procurement. 

Diversifying vaccine procurement will reduce the continent's reliance on a few suppliers, minimising the risks of supply chain disruptions during crises.

Core to diversifying this procurement is developing a self-sustaining vaccine manufacturing sector. 

Gavi and the CDC are currently undertaking initiatives to make this a reality.

Tackling the problem: CDC and Gavi

The African Union (AU) aims to have 60% of Africa's vaccine needs produced locally by 2040. To achieve this, the Africa CDC has worked with AU Member States to prioritise actions supporting local vaccine manufacturers.

Central to this effort is the Partnerships for African Vaccine Manufacturing (PAVM), launched by Africa CDC in 2021 to advance vaccine production and healthcare infrastructure.

Together, they created a Framework for Action (FFA) to assess Africa’s current vaccine manufacturing capacity and outline eight bold programmes to scale production over the next 20 years.

Africa CDC has also partnered with Gavi, a major global vaccine buyer since 2001.

Gavi has increased the number of vaccine suppliers in Africa from five to nineteen and developed a ten-point plan to diversify and secure vaccine supply.

A key element of this plan is the African Vaccine Manufacturing Accelerator (AVMA), a US$1bn funding mechanism to drive sustainable vaccine production, improve healthcare infrastructure and integrate Africa into the global vaccine market.

The AVMA aims to provide economic incentives and scale vaccine manufacturing, positioning the continent for long-term growth.

This is vital as diversifying vaccine procurement in Africa has global implications, working to protect lives and increase the stability of global procurement. 

However Gavi and the CDC still have a long way to go to help build independent vaccine manufacturing across Africa.

Both organisations are up against a range of challenges, challenges which have long impeded independent vaccine manufacturing on the continent.

They include economic roadblocks, brain drain and a lack of robust healthcare infrastructure. 

Economic and commercial roadblocks

In March 2022, an agreement was struck for leading biotechnology firm Moderna to establish a US$500m mRNA vaccine manufacturing plant in Kenya.

However, Moderna later withdrew from this deal citing considerable losses after failing to secure orders from African nations. This incident exemplifies the economic challenges and uncertainties facing new entrants in African vaccine production.

A significant factor behind these challenges is the existing dependency on imported vaccines, especially from countries like India, often referred to as the "pharmacy of the world" due to its massive vaccine production capacity. For instance, despite having local production possibilities, South Africa opted for Indian-made vaccines to cut costs, demonstrating the tight balance between fostering local industries and managing fiscal pressures.

Local production and commercial inefficiencies prevent robust development in the sector.

While there are financial and infrastructural capacities to establish manufacturing facilities, the commercial viability and strategic market positioning lag behind, making investment in local production less appealing compared to imports.

Moreover, the timeframe required to develop and market new vaccines adds to the reluctance. For example, despite Afrigen in South Africa swiftly developing an mRNA COVID-19 vaccine through a technology transfer hub, by the time it was market-ready, demand had dwindled, forcing them to pivot towards other diseases like HIV and tuberculosis.

The impact of brain drain

The phenomenon of 'brain drain' — the emigration of highly skilled and qualified professionals to more developed countries — intensifies the struggles within Africa’s healthcare sector, especially in fields requiring high expertise such as vaccine production.

Countries like the UK, USA, Canada and France attract a significant number of African professionals, driven by better job prospects and living conditions.

Data shows that countries like Nigeria, Zimbabwe and Ghana are among the top nations whose citizens are granted work visas in the UK, filling crucial roles in sectors like healthcare.

This migration trend significantly depletes the essential human resources needed to advance local vaccine manufacturing initiatives in Africa.

Lack of skilled professionals within the continent directly impacts the capabilities to not only manufacture but also innovate in the vaccine production sector, further crippling efforts to achieve medical self-sufficiency.

Infrastructure deficits in vaccine manufacturing

African nations embarking on vaccine production face enormous challenges pertaining to infrastructure and technological access.

In many African countries, the healthcare and pharmaceutical sectors are underdeveloped and lack the necessary technology and training facilities to support extensive vaccine production.

This leads to them overwhelmingly procuring vaccines from abroad. 

The reliance on foreign technology transfer for crucial stages like form/fill/finish — the final steps in vaccine packaging — highlights the dependence on external support, which is often not sufficiently reliable or scalable.

This technological and infrastructural gap not only hinders current manufacturing initiatives but also poses risks to the feasibility of future projects, potentially leading to unviable operations that fail to compete on the global stage.

Addressing these multifaceted challenges requires a concerted effort from both African leaders and international partners to invest in local capabilities, infrastructure and the human resources necessary to nurture a thriving vaccine production landscape in Africa.

Why this matters for global vaccine procurement

Africa relying on imports for 99% of its vaccines has significant implications for global vaccine procurement.

This heavy dependence creates vulnerability to supply chain disruptions, as global crises—such as pandemics—can prioritise vaccine distribution to wealthier nations, leaving African countries with limited access.

It exacerbates inequities in vaccine availability, delaying responses to outbreaks and heightening the risk of diseases spreading across borders. Furthermore, it pressures international suppliers, constraining their ability to meet demand globally.

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