Author: Africa Europe Foundation (AEF)
Site of publication: Africa Europe Foundation
Type of publication: Report
Date of publication: February 3rd, 2022
Context
The Africa-Europe Foundation (AEF) aims to build a real, inclusive, and transformative partnership between Africa and Europe. The 6th AU-EU Summit scheduled 17/18th February 2022 represents a significant milestone towards a shared future.
Dialogue on addressing the vaccine challenge
More than one year after the launch of the global vaccination campaign, the COVID-19 pandemic continues to heavily impact health systems, economies and the day to day lives of citizens in both Africa and Europe.
This debate addresses first the immediate challenge of ensuring Africa’s population’s effective vaccination against COVID-19, and then the best ways and means to develop local vaccine manufacturing capacity in Africa, in order to ensure the continent’s long-term health security and autonomy.
Extended report of the discussion
More than one year after the launch of the global vaccination campaign and just two weeks before the EU-African Union summit, the COVID-19 pandemic continues to heavily impact health systems, economies and the day to day lives of citizens in both Africa and Europe.
For Raji Tajudeen, Head Public Health Institutes & Research Division at Africa Centres for Disease Control and Prevention (Africa CDC), “there is no doubt that Africa felt let down by Europe because of vaccine nationalism and the collapse of some global architecture, including multilateral mechanisms
Matshidiso Moeti, WHO Regional Director for Africa, indicated that 11 million Africans had already been infected by COVID-19 and a quarter of a million had died, with significant regional disparities. She underlined that the indirect impact on health services as a result of the pandemic was a significant challenge, and that in the early phases of the pandemic access to services related to HIV, tuberculosis, and family planning, amongst others, declined. Countries are now trying to recover to ensure the number of deaths as a result of a lack of services are minimised.
Blaming game?
For Raji Tajudeen, Head Public Health Institutes & Research Division at Africa Centres for Disease Control and Prevention (Africa CDC), “there is no doubt that Africa felt let down by Europe because of vaccine nationalism and the collapse of some global architecture, including multilateral mechanisms”. “Even before the first vaccination was approved, we knew that Africa would be at the end of the queue and that it would trickle down after everyone has taken their share,” he said. Recalling that “no one is safe until everyone is”, Jutta Urpilainen, European Commissioner for International Partnerships, acknowledged that ”as long as the general vaccination in Africa remains below 10%, the whole international community has failed, because it means we won’t have done enough”. She indicated that the EU had provided €46 billion to help 130 countries, ten billion of which gone to Africa, and that Team Europe has committed to share 700 million doses by mid-2022. However, “Equity demands more than donations,” she cautioned, highlighting that “around half the vaccines have so far reached Africa, and it remains key to ensure that they reach people’s arms”.
Mo Ibrahim mentioned he was “disappointed at how Europe had moved to protect its pharmaceutical industry on the issue of intellectual property rights”. But he also recalled that “not all blame should be on Europe. Africans need to admit that they also made mistakes, the main one being only spending 1.9% of GDP on healthcare”.
Looking ahead: building Africa’s vaccine autonomy
Africa accounts for 25% of global vaccine demand but currently imports 99% of its routine vaccine needs.
Only ten local vaccine value chain players are currently operating in Africa (Nigeria, South Africa Algeria, Egypt, Ethiopia, Morocco, Senegal, and Tunisia. Research & Development (R&D) capacities are limited to South Africa and Nigeria.
There are multiple challenges to address on the road to Africa’s vaccine manufacturing autonomy: intellectual property rights and technology transfers, human expertise, governance and regulatory frameworks, health workforce, infrastructure environment, access to finance, and partnerships with private sector.
Stephen Karekezi, participant, Director at AFREPREN/FWD – Energy Environment and Development, Network also stressed that “the Covid-19 crisis has also stimulated interesting Innovations in for example, non-pharmaceutical interventions in Rwanda and low-cost testing options in Senegal which can be scaled up and replicated across the continent. How best to harness these demonstrated local innovative capabilities to boost local manufacture initiatives led by the EU in partnership with African countries”?
For Bjorg Palsdottir, participant, Co-founder and CEO at the Training for Health Equity Network, participant, “Scaling up manufacturing on the continent will require investment in health workforce, health workforce education institutions and local innovators as well as in infrastructure development such as sustainable energy. I hope there is sustained commitment in the private and public sectors as well as among development partners for this type of investment. It also requires supportive governance and regulatory system, as well as strong accountability mechanisms”.
Conclusion
For Commissioner Urpilainen, “The EU-African Union summit is approaching, and I truly hope to break new ground. There is lots of work ahead of us, and only together can we find solutions that are longstanding for both of our continents.”
Chrysoula Zacharopoulou, MEP, co-chair of the COVAX Shareholders Council and co-chair of the Strategy Groups of the Africa-Europe Foundation, stressed that “The global response to the pandemic has not been perfect nor has it been perfect within European borders. We must recognise and correct what went wrong and move forward together. This shouldn’t divide us, on the contrary, let’s learn from it.”.
Under current vaccine rollout projections, it is estimated that most African countries will not achieve mass immunisation until 2023. In the continent’s poorest countries, it may not even be reached until 2024
She concluded: “If there is a positive takeaway, it’s that all citizens have been made aware of the importance of health and the need to invest in the health sector including in Africa. Let us take advantage of the summit to launch a comprehensive partnership on health.”
Africa and Europe – Facts and Figures on COVID-19 Vaccination
Vaccine inequity: Africa’s population vaccination rate is barely over 10%, compared to 72% in EU
According to WHO, 70% of population should be vaccinated by end of 2022 to reach immunity level
- Under current vaccine rollout projections, it is estimated that most African countries will not achieve mass immunisation until 2023. In the continent’s poorest countries, it may not even be reached until 2024.
As of 27/1/2022, COVID-19 vaccine doses administered in Africa account for less than half of the amount administered in the EU, for a population that is more than three times larger
The long-term challenge: Building Africa’s vaccine autonomy
An obvious case: Africa accounts for 25% of the global vaccine demand but currently imports 99% of its routine vaccine needs
- About 99% of Africa’s routine vaccines are imported, most of them supplied by a few developing-country vaccine manufacturers (DCVMs), with the support of Gavi, the Vaccine Alliance, and UNICEF. The majority of these DCVMs are Indian manufacturers, such as Bharat Biotech, BioMed and the Serum Institute of India.
In Africa, only 10 local vaccine value chain players are currently operating
- The ten local vaccine value chain players are located in Nigeria (2), South Africa (2), Algeria (1), Egypt (1), Ethiopia (1), Morocco (1), Senegal (1) and Tunisia (1).
- About 40% engage only in packaging and labelling, and 40% only in fill and finish.
- Only five engage in some degree of drug substance manufacturing, but mostly on a very small scale.
- Research & Development (R&D) capacities are limited to South Africa and Nigeria.
Multiple challenges to address on the road to Africa’s vaccine manufacturing autonomy
Intellectual Property Rights/technology transfers World Trade Organization’s (WTO) TRIPS framework (Trade-Related Aspects of Intellectual Property) regulates trade-related intellectual property matters, including patents. To increase access to COVID-19 vaccines, in October 2020 South Africa and India proposed a temporary waiver of TRIPS patent rights to allow wider production of COVID-19 vaccines and other medical products. Even if in May 2021 the US backed the proposal, several developed countries are still opposing the waiver under the allegation that most of the world’s developing countries do not have adequate manufacturing capacity for COVID-19 vaccines yet. WTO’s 12th Ministerial Meeting has been postponed from 30 November 2021 to March 2022 due to the Omicron variant emergency, and WTO’s Council for TRIPS remains engaged on the matter in various configurations
Ensuring the relevant market size
A sustainable approach to developing vaccine manufacturing capacities requires reliable demand for large volumes to support the production scale required to be cost-competitive. The Gavi and UNICEF Supply Division (SD) procurement mechanism has been envisaged as a pooling arrangement to meet this requirement, through sizable procurements with well-managed processes. Non-Gavi-supported countries often procure at higher prices, as they typically are unable to buy in the volumes that Gavi does or with the same reliable patterns. A solution would be for non-Gavi countries to pool their procurement to aggregate demand. Africa has been successful with this tactic, such as for COVID-19-related personal protective equipment and vaccines (e.g., 400 million doses of the Johnson & Johnson vaccine).
Governance/regulatory/quality control frameworks
While continental and regional regulatory reform related to COVID-19 vaccines is ongoing, continent-wide harmonisation under the African Medicines Agency (AMA) is not yet a reality and national regulators face capacity constraints. To ensure Africa’s vaccine manufacturing capabilities are scaled up, a pan-African regulatory framework will be necessary.
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