Why Africa is facing an uphill battle to make its own vaccines

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Verity Bowman, The Telegraph photo: Simon Townsley

IIt was a shocking symbol of the West’s failure to honour its promises.

As governments vaccinated their people against Covid-19, the world was divided into rich and protected, and the poor and vulnerable. Africa, dependent on vaccines produced abroad, was left behind – despite the West’s pledge of equitable vaccine distribution.

But one positive seemed to come from the chaos: Africa and the West came to the realisation that something had to change, and it had to be fast. The continent was in dire need of its own production capabilities.

As the pandemic raged, in March 2022, Moderna, the biotech spearheading a revolution in mRNA vaccine technology, announced it would build a $500 million manufacturing plant in Kenya. It would produce half a billion doses of its Covid-19 vaccine annually, it said.

‘This is major,’ said Kenyan President William Ruto at the time.

But earlier this month Moderna revealed it had paused its plans, throwing its commitment to Africa into doubt.

‘Moderna is abandoning a commitment to build highly needed and relevant vaccine manufacturing capabilities in Africa,’ said the Africa Centres for Disease Control and Prevention.

The decision is symbolic of the uphill struggle vaccine producers and international players face in breaking ground in the continent, which currently imports 99 per cent of all vaccines it uses.

‘With epidemics and pandemics, there is a cycle of enthusiasm, and less enthusiasm or neglect,’ said Dr Charlie Weller, Head of Prevention, Infectious Disease at Wellcome. ‘But how do we enable the long term sustainability of these manufacturing organisations?’

Moderna said earlier this month that not one African country had ordered its Covid-19 vaccine since 2022, leaving the company with $1 billion in losses and write-offs.

It simply wasn’t affordable for the plans for a new plant to go ahead –something experts have described as a reality check for others.

The African Union (AU) has meanwhile set a target for the African vaccine manufacturing industry to supply over 60 per cent of the total vaccine doses required on the continent by 2040.

But with many vaccines already produced cheaply and on a mass scale in countries like India, the ‘pharmacy to the world’, it is difficult for local African manufacturers to establish themselves in the market.

Earlier this month the South African government ordered vaccinations from India, despite hosting its own mRNA hub, highlighting the tensions between price pressures and local production.

South African officials said that the decision to give a three-year contract to Indian generic company Cipla instead of approaching Cape Town’s Biovac would save the health department so much money that it could introduce two new childhood vaccines.

Cipla has its vaccinations made by the Serum Institute of India – a well-oiled vaccine conglomerate famed for producing low cost doses for the global south.

A vaccine queue ‘come the next pandemic’

Professor Petro Terblanche, the Managing Director of Cape Townbased Afrigen Biologics, where the WHO’s mRNA Hub is based, told the Telegraph that the move highlights the need to ‘support and nurture’ local production.

‘South Africa has a point scoring system and does make provision for local procurement. But the latter is not the only criteria – affordability is also important in tight budget situations.’

Professor Robin Shattock, the Head of Mucosal Infection and Immunity within the Department of Medicine at Imperial College London, said that affordability is the ‘main hurdle’.

‘It makes no sense to build capacity if there is no need or return on investment … African made vaccines will only grow if African countries are prepared to pay some sort of premium for an African made product.’

Professor Shattock believes that there is a moral duty to ensure that vaccines are affordable, rather than where they are made. However, he adds, the reality is that Africa will remain vulnerable until this issue is solved.

‘We are left with key tensions. Ensuring the lowest costs for life-saving vaccines doesn’t equate to making them in Africa – [but] if ‘African made’ vaccines are to be ensured, increased costs will need to be supported. However, without African capacity, then countries may again find themselves in a queue come the next pandemic.’

Scientific brain drain

The mRNA vaccine technology transfer hub in South Africa has trained scientists from 15 countries, including six in Africa, to produce mRNA vaccines themselves.

Afrigen developed an mRNA Covid-19 vaccination within a year of the hub’s launch, but with the market for Covid vaccinations stalling it has been forced to look elsewhere.

The company is now working to develop mRNA vaccines for tuberculosis and HIV, but researchers say it could take decades for such new vaccines to come to market – making the economics of the hub uncertain.

‘We can’t forget they are businesses, and they need to look at economic viability,’ said Dr Weller.

Some say the odds are stacked against Africa when it comes to mRNA production.

‘Africa and multiple countries from around the world and the global South suffer from a big brain drain,’ said Dr de Oliveira.

‘The more that we train, the more people leave … Those individuals then become commodities, where they can essentially work anywhere. in the world.’ Dr. Tulio de Oliveira.