Africa has huge potential to manufacture vaccines that cater to the needs of its growing population, says a top Kenyan policy maker.
“Africa is the fastest growing continent, and we need to have the know-how to be able to manufacture vaccines,” said Dr. Patrick Osewe, chief of the Health Sector Group at the Asian Development Bank (ADB).
Currently, just 1 percent of the vaccines used in Africa are manufactured on the continent.
“There is a great opportunity for African institutions to partner with western institutions to build the capacity for us to be able to do our own research on the continent,” he said.
Osewe, who guided ADB’s response to COVID-19, told a recent press briefing sponsored by the Africa Science Media Center that many partnerships are emerging to enable vaccine production on the continent.
He cited a report by the Clinton Health Access Initiative that found vaccine manufacturing is expanding in Africa, primarily in response to COVID-19.
“In 2021, 825 million doses were produced,” he said. “The target is to produce about 3.1 to 3.5 billion vaccines.”
In some instances, countries have partnered to take advantage of one another’s resources, such as Rwanda collaborating with Ghana.
Some of the vaccines planned for production between 2022 and 2023 are 150 million doses of Pfizer-BioNTech and 1 billion Corbevax vaccines in South Africa, as well as 250 million Afrigen mRNA doses.
Some 10 million mRNA doses from Biovaccines are planned in Nigeria, with 15 million Sputnik vaccines in Algeria and 300 million mRNA vaccines in Morocco. Egypt will be producing 65 million Sputnik vaccines and 20 million to 60 million Sinovac vaccines.
Another 50 million mRNA and 250 vaccinia virus (VV) vaccines are under development in Senegal.
“There’s also a lot of discussions ongoing with Moderna and others across many countries,” Osewe stated.
Still, it’s imprudent to focus only on COVID-19 at the expense of other illnesses that require vaccines, he said.
“If the focus is only on COVID, then there is a challenge because the disease is beginning to wane in many countries, although it is rising in a few countries as well,” he said. “But at some point, COVID will wane and possibly become an endemic disease. So, if you build all this capacity only for COVID then you have a challenge. However, if you build it for other vaccines, then that is quite promising.”
Vaccine manufacturing is tightly managed and controlled. Companies and governments are subject to stringent regulations set by the World Health Organization. Due in part to the rigor associated with vaccine manufacturing, it will take time before Africa achieves its full potential in vaccine manufacturing, Osewe said.
“As we talk about manufacturing and the plethora of interests in our continent, the solution will not be this year or next year,” he said. “That’s because it takes time. The first stage takes between 12 to 16 months. The second stage — contract manufacturing — is two to three years.”
Thus, a fully-fledged vaccine manufacturing process commencing from scratch in 2022 would churn out its first vaccines in 2026-27.
There are three phases in vaccine manufacturing, Osewe explained. The first phase, known as “fill and finish,” takes between 12 and 16 months and involves technology transfer and training.
The second phase, known as contract manufacturing, refers to the outsourcing of large-scale production of vaccines to contract manufacturing organizations (CMOs). The third phase is full scale bio-manufacturing.
He stressed the need for a strong regulator. Regulators are subjected to the WHO’s global benchmarking tool, which classes them in levels from maturity levels 1-4.
“Maturity level 4 is the ultimate goal where countries want to reach,” Osewe said. “At this level, you are a fully-fledged regulator, and you can regulate any condition. It’s not easy to get there. Level 3 is also quite good, but below this level you cannot export that vaccine. Now this is a big challenge to many countries, because if you want to manufacture you must have at least a level 3 regulator in place.”
Senegal has a level 3 regulator. Through the Institut Pasteur in Dakar, it has been producing yellow fever vaccine for almost 30 years, he said. “And so when COVID-19 came and companies were looking for partners in Africa to be able to produce vaccines, the natural partner was the Institut Pasteur.”
South Africa also has a particularly robust vaccine manufacturing industry, he noted.
“There’s so much going on in South Africa,” Osewe said. “There are a lot of initiatives in the country to produce vaccines.”
Though financial constraints hinder manufacturing initiatives in Africa, he said that lessons can be learned from the two vaccine manufacturing giants in Asia: India and China.
“Every sixth child in the world gets a vaccine manufactured in India,” he said. “India started its pharmaceutical industry while still a very poor country in 1970 and wound up as a huge manufacturer.”
He sees a promising market for vaccines on the continent beyond COVID-19 due to the significant number of children born every year in African countries. For example, over 3 million children are born every year in both Ethiopia and the Democratic Republic of Congo, while 2.2 million are born in Tanzania and over 1 million are born in both Kenya and Uganda.
Additionally, African countries that are experiencing economic growth might lose the support provided by GAVI, an international organization that provides vaccines for children in the poorest nations, Osewe noted.
“So, many of our countries that are becoming middle-income countries will not get the subsidized vaccines that they’re getting from GAVI right now. Many children are born in these countries every year, and every child needs about five or six vaccines. So, there’s a market for childhood vaccines in all these countries, but companies have to manufacture vaccines that are needed.”
Image: Workers in a bio-manufacturing facility. Photo: Shutterstock/Gorodenkoff