The coronavirus pandemic has highlighted Africa’s overdependence on imports of vaccines for its population.1 Nearly all vaccines used for routine immunization are imported: Only a small fraction is produced on the continent.2,3 The delay in securing access to COVID-19 vaccines led to preventable deaths and delayed economic recovery.4 Within this context, African leaders launched the Partnership for African Vaccine Manufacturing in April 2021.5 This builds on the efforts of the African Vaccine Manufacturing Initiative and aligns with the Pharmaceutical Manufacturing Plan for Africa.2

The goal is to increase the production of vaccines on the continent from 1% today to 60% by 2040. The Africa Centres for Disease Control and Prevention has developed a framework to drive progress towards achieving the goal through structural reforms and mobilization of key players, resources and program implementation with measurable milestones.6 There is growing interest and support for the actualization of the goal from governments, multilateral and regional institutions, philanthropies, development finance institutions and capital providers, based on a compelling business case.7–9

There are multiple initiatives to boost manufacturing capacity on the continent. The World Health Organization launched the mRNA technology transfer hub in South Africa: the Afrigen-led Hub has growing engagement with multiple institutions worldwide.10 In addition, BioNTech is opening an mRNA vaccine production facility at the Kigali Special Economic Zone in Rwanda; the country will host the African Pharmaceutical Technology Foundation and the African Medicines Agency.11,12 In Senegal, the Institut Pasteur de Dakar is expanding its research and manufacturing capacities to address prevalent and emerging infectious diseases – with the support of development partners. These efforts complement initiatives in Egypt, Morocco, Nigeria, Ghana, Kenya, Ethiopia, Botswana and Uganda to build a viable manufacturing ecosystem for vaccines and other health products.

Sustainable production of vaccines, generic medicines, diagnostics and other health products requires strong regulatory systems, consistent market access and apt procurement mechanisms. It also requires investment in workforce development, quality control systems and a flexible business model. This piece explores how various institutions can shape progressive market access at national, regional and global levels.

National Market Commitments

The development of manufacturing capacity on the continent is necessary but insufficient to guarantee health security, given the burden of communicable and non-communicable diseases. African leaders should increase investments in research and development despite prevalent fiscal challenges and commit to buying safe and effective vaccines and other products produced by African manufacturers.

Although countries are at different income levels, there is an opportunity for African states to adopt viable market and procurement commitments to guarantee demand within a specified timeframe. Developed countries across Europe, North America and Asia used advanced market commitments to secure timely access to COVID-19 vaccines: It was used for procuring routine vaccines, particularly pneumococcal vaccines and is likely to be deployed to tackle future epidemics and pandemics.13 National market commitments align with the vision to build a productive health industry with an adequate workforce, vital technologies and finance.

Continental Purchasing Platform

The African Medical Supplies Platform is one of the innovative approaches deployed to address access to medical products in the continental response to the pandemic. The platform connects manufacturers with institutional purchasers. Alongside the African Vaccine Acquisition Trust, these tools show the creative capabilities of African experts and leaders to develop and implement relevant solutions to address African and global challenges. There is an opportunity to harness these initiatives to create a widely-used aggregator for African manufacturers and institutions focused on strategic purchasing.14,15 This reduces fragmentation and limits market uncertainties. It can also be linked to a new initiative to efficiently support African enterprises to scale their capacity to distribute health products within evolving health markets.16

The African Union Commission, African Union Development Agency (AUDA-NEPAD) and Africa CDC are working on implementing the continental manufacturing plan within the context of Agenda 2063 and Global Goals. The African Development Bank launched the African Pharmaceutical Technology Foundation to drive research investments, intellectual property and related measures for viable health industry.17 Afreximbank can leverage its experience from the African Medical Supplies Platform and the African Vaccine Acquisition Task Force to shape trade finance and integrated procurement tools for health products. A combination of traditional and innovative financing tools should be deployed for the continental, pooled procurement mechanism beyond COVID-19.

Global Procurement Mechanisms

Governments, private sector players and development partners can work together towards securing capital for sustainable vaccine manufacturing and market access.18 Global institutions, particularly GAVI the Vaccine Alliance, Global Fund, United Nations procuring institutions, aid agencies and implementing partners, should procure health products from African manufacturers. In May, African leaders called on the international community, particularly advanced economies, philanthropies and global health agencies, to buy vaccines from African manufacturers.19 GAVI, the Vaccine Alliance, subsequently published a white paper in June, highlighting the opportunities for African vaccine manufacturers.20

A convening platform is necessary to manage stakeholder engagement for African producers to gain access to international procurement systems. The United Nations Economic Commission for Africa is implementing a Pharma Initiative to mobilize key players towards sustainable local production and harmonized procurement. Besides, the United Nations Development Programme co-published a report on value chain development with the African Continental Free Trade Area Agreement Secretariat – highlighting opportunities in the health and pharmaceutical sector.21 A specific program focused on facilitating market access for African manufacturers of health products should be developed within the broader implementation framework to achieve measurable results as investments in regulatory system strengthening rise.22,23

Conclusion

There is momentum to develop a viable vaccine manufacturing ecosystem in Africa despite prevailing constraints.24 Although COVID-19 has spurred renewed interest, investments in manufacturing sites should not be limited to producing COVID-19 vaccines. Emerging technologies should be harnessed to tackle other prevalent infectious diseases (like HIV, TB and malaria) and non-communicable diseases. Advanced market commitments, pooled procurement tools, innovative finance mechanisms and consistent access to international procurement systems can contribute to the emergence of an integrated health industry that ensures equitable access to safe and effective health products.

Funding

None.

Authors contributions

AA is the sole author.

Competing interest

The author completed the Unified Competing Interest form (available upon request from the corresponding author) and declares no conflicts of interest.

Correspondence

Abiodun Awosusi, Health Systems and Development Enterprise, Abuja, Nigeria; abiodun.awosusi@gmail.com