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Africa must work harder to beef up supplies of Covid-19 vaccines

OPINION
By Josea Rono and Pauline Aluoch | August 11th 2021
A health worker vaccinates a man against coronavirus disease (COVID-19), in Harare, Zimbabwe, February 18, 2021. [Reuters, Philimon Bulawayo]

The Covid-19 pandemic is the worst global public health crisis in a century, causing significant mortality and giving rise to daunting health and socioeconomic challenges. To achieve herd immunity in Africa, 60 to 70 per cent of the continent's population needs to be vaccinated.

Whilst countries like the United Kingdom have fully vaccinated over half their population, only about one per cent of Africa's population has been fully vaccinated. Initiatives such as Covax, which aim to support equitable vaccine access, have been underfunded and pledges made at the G7 meeting in early June were inadequate to reach the amounts of doses required by the World Health Organisation.

Limited supplies of vaccines and uneven vaccination in countries complicate efforts to vaccinate people on the continent. As of July, only about 58 million vaccines had been received by African countries. Of that number, 37 per cent of doses had been administered in Morocco. Morocco alone accounts for over 21 million administered doses, whilst Seychelles has the highest vaccination rate on the continent, having fully vaccinated 60 per cent of its population.

600 million doses

The vaccination process in Africa has been highly unequitable with 68 per cent of the doses administered being concentrated in five countries: Morocco, South Africa, Egypt, Nigeria, and Algeria. Covax, backed by the WHO and other multilateral bodies, is the main programme used to supply vaccines in Africa.

Covax aims to supply 600 million doses to Africa, enough to vaccinate at least 20 per cent of the population. It aims to vaccinate 10 per cent of Africa's population by September this year. With the current challenges, the continent is expected to only reach herd immunity in 2023 at the earliest.

The inequity in access to vaccines has in part been caused by the geographic imbalance of vaccine development. Africa did not invest in Covid-19 vaccine development, with most medical scientists struggling to find funding. The current structure of research funding is dismal with the continent’s expenditure on research and development at 0.5 per cent of GDP, lagging the global average of 2.2 per cent.

Domestic manufacturing

Another major limiting factor in African vaccination has been its limited vaccine manufacturing capacity. There are fewer than 10 African vaccine manufacturers and all are based in Egypt, Morocco, Senegal, South Africa and Tunisia.

Most pharmaceutical companies in Africa engage in packaging and labelling and occasionally fill and finish steps. In domestic manufacturing, most active pharmaceutical ingredients are imported, leading to cost pressure in times of currency fluctuation.

Over the last decade, the African continent has faced multiple crises in relation to drug stockouts due to the overreliance on drug imports. As highlighted by Covid-19, limited manufacturing severely limits vaccine availability in disease emergency situations.

The uneven distribution of manufacturing and financing capabilities has also led to an unequal distribution of global access to Covid-19 vaccines, with African countries largely reliant on external suppliers. It is therefore important that African vaccine manufacturers establish supply networks to both sustain the local markets and export to others (in Africa and elsewhere). 

Access to sufficient vaccine itself is only one part of the puzzle that African governments must navigate. African countries also need to ensure they have access to enough personal protective equipment, including gloves, masks and suits and key products such as needles, syringes and dilution liquids which are crucial in enabling healthcare workers to carry out the vaccination process while ensuring that they are protected from infection themselves.

The rollout of vaccination across the world is urgent, so governments need to procure resources quickly, efficiently and at low costs.

The Covid-19 pandemic has necessitated the need for additional resources, with one of the most obvious demand being on investing in health research in the region to address the outbreak of pandemics. The development of Covid-19 vaccines in Africa would have secured more vaccines for the continent's population. It would also have encouraged increased investment in local innovations and products for other healthcare challenges in the continent.

Component supplies

The region needs increased investment on health infrastructure, especially in vaccine manufacturing. A robust and stable manufacturing process and consistent component supplies is important towards ensuring stable supply of vaccines.

In order to mitigate the impacts of the global supply chain disruptions, local institutions should bridge the demand gap through locally manufactured vaccines.

The critical aspects for establishment of vaccine production capacity include exploring investment consolidations to increase financing on vaccine manufacturing. Beyond financing, other areas within the ecosystem that need improvement include policy development and increased government responsiveness on vaccine research and manufacturing.

Dr Rono is a managing partner at E&K Consulting Firm. Ms Aluoch is an analyst at E&K Consulting Firm

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