African countries are at the back of the queue for lifesaving Covid-19 vaccines, a consequence of years of depending on foreign pharmaceutical suppliers. However, the current pandemic provides the chance to reset the clock and develop domestic pharmaceutical production.
Initially, Africa appeared to escape the worst of the first wave that wreaked havoc across many industrialised economies. Now, infections have passed 3 million, according to the WHO Africa desk, with an average of more than 25,000 daily infections so far this year.
“I hope vaccines get rolled out quickly,” says Professor Shabir Madhi, professor of Vaccinology at the University of the Witwatersrand in Johannesburg. “Covid-19 cases on the continent are rising rapidly, from Nigeria to South Africa...Malawi – where two cabinet ministers recently died – and even the Seychelles, which was more or less Covid-free before Christmas.”
South Africa has been especially hard hit. A mutant strain that local scientists said last week is 50 per cent more infectious, is ravaging the country. Hospitals are turning patients away, medical oxygen supply is stretched, and undertakers are struggling to cope with burials. More than 40,500 deaths related to Covid-19 have been reported so far.
The South African government has set a target to have two-thirds of its 60 million people inoculated, but it has yet to secure the 80 million doses scientists say would be needed to achieve this. The state has committed to purchasing 12 million doses through Covax, the global initiative to secure vaccines for poorer countries.
However, Prof Mahdi says that as a middle-income country, South Africa will pay $12-$13 per dose. Poorer countries will pay less, as will those who initially funded vaccine development, with a prevailing price of $3 per dose.
Dependence on an offshore logistics chain highlights the glaring lack of Africa-based pharmaceutical manufacturers. Previously, South Africa did have domestic drug making capabilities late into the 1990s, as did Nigeria and some other states on the continent. By the 2000s, all had closed and not a single country south of the Sahara produced vaccines locally.
“Vaccine manufacturing and continuous upkeep of good standard is a highly expensive exercise,” says Dr Morena Makhoana, the chief executive of Biovac, a vaccine development and manufacturing platform based in Cape Town. “All those facilities were state-owned and governments didn’t continue to invest in the upkeep. New technology also came up and governments were not able to keep up with the pace of an evolving industry.”
While the current pandemic is now at the centre of a pharmaceutical response, African countries require defences against a slew of nasty infections. Yellow fever, tuberculosis, malaria and HIV are among the most significant diseases that collectively take millions of lives each year.
Late last year Biovac, which is partly owned by the South African government, began manufacturing a six-in-one childhood vaccine that protects against diphtheria, tetanus, whooping cough and hepatitis B, among others. More will follow, pushing the country towards self-sufficiency and making it better able to respond to disease outbreaks.
“By developing and manufacturing vaccines on the African continent, we will be able to better meet the local demand and limit overreliance on fully imported vaccines, which we’ve previously experienced,” says Dr Makhoana.
Another South African firm, Aspen Pharmacare, has also recently spent $200 million on a vaccine processing plant. Aspen has a contract with US pharmaceutical company Johnson & Johnson to package its upcoming vaccine for the US market. Aspen said it could potentially manufacture the vaccine under license in the future.
For now, Africa remains at the mercy of the global supply chain. Pharmaceutical producers such as India, Europe, the US and China have pledged to help, but will clearly prioritise their own populations.
China, for instance, has begun talks with various African heads of state over supplying Sinopharm, currently being administered in the UAE.
“The president of China has made it clear that he will first vaccinate his own people,” says Simon Agwale, chairman of the Africa Covid-19 Vaccine Manufacturing Initiative, in Lagos, Nigeria. “We have to therefore look to internal resources.”
Mr Agwale says that the main constraint is not financial, but logistics. “The question is, where are we going to get the vaccine from? Most of the vaccines now under production are already committed to the countries that developed and paid for them. Even if we had the money and resources to pay for them, where is the supply for Africa?”
Africa’s vulnerability could soon become a global concern. A rapidly adapting virus that runs rampant will soon make its way to the rest of the world.
“It’s not really practical to expect a country that is vaccinating its population is going to be safe if the rest of the world is not in that position,” says Dr Salim Abdool Karim, an epidemiologist and senior adviser to the government.
“These variants will in the course of time spread throughout the world. The virus has to adapt for its own survival, so it’s important we tackle this pandemic as a global community.”
