By Parminder Vir OBE

Latest figures put the supply of COVID-19 vaccines to Africa at 53.5 million doses. However, this represents only about 1.5% of global vaccinations and only 0.54% of Africans have been fully vaccinated. 

At the UBA Africa Conversations 2021 held recently to mark Africa Day, a number of global leaders – Rwandan president Paul Kagame, WTO DG Dr. Ngozi Okonjo-Iweala, IFC MD Makhtar Diop, and WHO DG Dr. Tedros Ghebreyesus – came together to discuss pertinent topics on Africa’s development. One important issue was COVID-19 vaccination efforts and the emergence of vaccine nationalism.

According to Dr. Ghebreyesus, while COVAX has supported 47 African countries to begin COVID-19 vaccinations, the volumes of vaccines available are “nowhere near enough” for Africa’s population.

Vaccine support in Africa

Gavi, the Vaccine Alliance is a public–private global health partnership that works with partners such as WHO, UNICEF, the World Bank, Bill & Melinda Gates Foundation, along with governments, advocacy groups, NGOs, and vaccine manufacturers to increase access to immunisation in eligible countries. Through its efforts sharing the implementing costs for vaccines, it has helped vaccinate more than 822 million children through more than 495 vaccine introductions and campaigns.

Gavi has worked in Africa since it was founded in 2000, supporting vaccine access in 40 partner countries. It has supported the introduction of 9 vaccines and reached 319 million children – 42% of all children in supported countries are immunised with Gavi support.

What is COVAX?

COVAX is one of the three pillars of the Access to COVID-19 Tools (ACT) Accelerator, co-led by Gavi, the Coalition for Epidemic Preparedness Innovations and WHO, and launched in April 2020. COVAX is focused on vaccine access, acting as a platform to support the research, development and manufacturing of a wide range of COVID-19 vaccine candidates, and negotiate their pricing. Within COVAX, the COVAX AMC (Advance Market Commitment) exists to support 92 low-and-middle-income countries, including 47 African countries to access almost 1 billion doses of COVID-19 vaccines at the same time as the self-financing countries under the COVID Facility. It is funded through Official Development Assistance (ODA) and philanthropic and private sector contributions. COVAX AMC will leverage the scale created by vaccine orders made by high-income economies to ensure that lower-income countries can still benefit from manufacturers being able to produce enough doses of various COVID-19 vaccines. For countries benefitting from COVAX AMC, they will need to establish national regulator pathways, logistics and cold chain, and social mobilisation to encourage confidence in the vaccines before they arrive.

Gavi recently hosted the “One World Protected” event in partnership with the US, to evaluate progress and improve on global access to COVID vaccines. It also launched the Investment Opportunity, a campaign to raise US$ 2 billion from donor agencies and raise US$ 1 billion through cost-sharing with the help of multilateral development banks. These funds will be directed to the COVAX AMC to help procure 1.8 billion doses of vaccines for the lower-income countries under the COVAX AMC. During the event, donor governments and philanthropic organisations announced new financial commitments towards equitable vaccine access, as well as dose donations to COVAX. Current pledges stand at around US$ 6.6 billion. The campaign will lead up to the Gavi AMC Summit which will be held as a virtual event on 2nd June 2021, hosted by Japan.

The threat of vaccine nationalism

Vaccine nationalism, where richer nations are buying up COVID-19 vaccine doses and even purchasing more doses than are needed, will put Africa at a disadvantage in the race to end the pandemic and have ripple global effects. 

Immediate, short-term solutions to ensure equitable vaccine access include dose sharing, funding and support for schemes like COVAX, and increased manufacturing of vaccines aided by voluntary licensing and IP waivers to allow production of vaccines in more countries. As the WHO DG pointed out in the conversation, “sharing is not charity. It is actually in the interest of the whole world, even in the interest of the developed countries who… are better protected when they share.” Dr. Okonjo-Iweala also noted that research shows that spending an additional $50bn in order to vaccinate 40% of the world by 2021 and 60% by 2022 will reverse vaccine inequity and result in global economic gains of up to $ 9 trillion by 2025.

The long-term, and ultimately more sustainable solution, is to increase Africa’s capacity for producing vaccines and other medical supplies because it cannot continue to rely solely on imports. Indeed, the surge of COVID-19 infections in India in May have drastically affected Africa’s vaccination efforts – the COVAX facility depends heavily on the AstraZeneca vaccines produced by the Serum Institute of India, but exports from India were halted due to the outbreak. The WHO is now advising countries experiencing shortages not to stockpile the doses they have, but instead give as many first doses as possible, inevitably delaying second doses of the vaccine for many people.

Africa has begun working with partners to build the continent’s vaccine manufacturing capacity, as the pandemic has provided the necessary push to ramp up vaccine manufacturing across the continent. The Africa CDC is involved with plans to establish five new vaccine-manufacturing centres to enable to Africa manufacture 60% of its required vaccines within 20 years.

In an agreement signed in March 2021, all African Union Member States, through the African Vaccine Acquisition Trust (AVAT) set up in November 2020, will have access to 220 million doses of the Johnson & Johnson vaccine, with the potential to order an additional 180 million doses. This arrangement is funded by a US$ 2 billion facility approved by the African Export-Import Bank, and the AVAT task team and COVAX are working together to achieve a minimum of 60% immunization of the African population, in order to eliminate COVID-19. In addition, most of the supplies will be produced at an Aspen Pharma-operated pharmaceutical manufacturing plant in South Africa, and will be made available through the African Medical Supplies Platform (AMSP).

These are encouraging efforts, seeing as Africa currently only produces 1% of the vaccines it administers, and that there are fewer than ten manufacturers engaged with vaccine production.

To address Africa’s vaccine shortages, it will also be important to harness the creativity and innovation of Africa’s many SMEs and young entrepreneurs to promote vaccine production, distribution and effective tracking. Coordinating organisations industry such as Gavi, AVAT and the AMSP must work to include them in the supply chain in order to support the existing vaccination delivery systems and ensure the success of future efforts.

The COVID-19 pandemic has been challenging, but I remain hopeful that solving the challenges it brings will continue to drive African governments, policymakers and businesses to reimagine Africa’s value and capacity.

About Parminder Vir OBE

Parminder Vir OBE has dedicated herself to positively impacting and transforming lives through a professional career spanning 40 years in philanthropy, entrepreneurship, film and television production, arts and culture, and investment funding. She is the co-founder of the Support4AfricaSMEs campaign and The African Farmers Stories, launched in 2020. She served as the CEO of the Tony Elumelu Foundation, based in Lagos, Nigeria from April 2014 to April 2019. Prior to joining the Foundation, Parminder has enjoyed a distinguished career as an awarding winning film and television producer and private equity investor in film and media.