African nations have agreed a plan to increase locally produced vaccines. This is how it will work

African leaders have agreed a deal aimed at providing greater health security for people across the continent.

The initiative, led by Africa Centres for Disease Control and Prevention (Africa CDC), establishes a pooled procurement mechanism for vaccines and other healthcare products.

“The decision means creating a robust market for manufacturers and ensuring the health security of all Africans,” the Director General of Africa CDC, Dr Jean Kaseya, said after the agreement was made at an African Union Summit. “This will be the second independence of Africa.”

The latest agreement throws a new focus on vaccine production in Africa. The African market for vaccines and medicines is valued at $50 billion annually, but the continent imports most of the healthcare products required.

According to Africa CDC’s press release, under 1% of vaccines required are currently manufactured on the continent. African leaders have committed to raising this to 60% by 2040.

The COVID-19 pandemic highlighted Africa’s vulnerability when it comes to access to vaccines. As the virus swept around the world, wealthy nations bought and stockpiled billions of vaccine doses, leaving entire populations in developing nations with little or no access to lifesaving treatments.

In December 2020, just as the first vaccines were being delivered, the EU and the United States bought up 2.6 billion doses, more than a third of globally available supply. Many low-income countries, including nations across Africa, had to rely on NGOs operating under the COVAX initiative, which managed to secure 700 million doses.

“One of the key challenges exposed by COVID-19 was the urgent need to establish vaccine manufacturing in all regions of the world, particularly in Africa,” says Shyam Bishen, Head of the Centre for Health and Healthcare at the World Economic Forum.

“The Forum’s Regionalized Vaccine Manufacturing Collaborative was created to support vaccine manufacturing that meets regional health needs. The development of African capacity will protect locals from future health emergencies and bolster global pandemic preparedness,” Bishen added.

Raising the level of local vaccine production in Africa is a strategic priority for Gavi, the Vaccine Alliance. Writing in a 2022 article for the World Economic Forum, the CEO of Gavi Seth Berkley highlighted the opportunity and the challenges Africa faces in building a vaccine manufacturing sector.

Berkley argued that building capacity in Africa will protect local people in a future pandemic as well as helping to bolster global readiness when the next health emergency strikes. In normal times, local vaccine production would increase supplies to protect against a wide range of preventable diseases.

Some of the challenges Berkley highlighted included the high capital costs of building manufacturing facilities, the need for an appropriately-skilled workforce and the requirement for production at high volumes to keep down the cost of the final product.

The agreement to create a pooled procurement system for African nations addresses one of the key challenges – the need for high-volume production. Under the system, multiple countries would place a single order for vaccine supplies.

Africa CDC says pooled procurement “creates predictable demand so manufacturers can plan for the long term to create a viable vaccine manufacturing ecosystem”.

As African nations struggled to secure vaccines during the pandemic, emergency manufacturing processes were put in place to try to increase supplies.

Vaccine maker BioNTech built a modular system that housed production facilities in re-versioned shipping containers.

To move from emergency cover to consistent supply, Africa needs to increase current capacity on a massive scale – a project that will require funding on an equally large scale.

In December 2023, Gavi announced the creation of the African Vaccine Manufacturing Accelerator (AVMA). The board of Gavi described the AVMA as, “a financing instrument that will make up to $1 billion available to support sustainable vaccine manufacturing in Africa”.

The AVMA will prioritize funding for organizations making vaccines from drugs manufactured on the African continent. This helps to establish an end-to-end vaccine ecosystem. It will also consider funding for so-called “fill and finish only” operations in which vaccines are manufactured using imported drugs.

Chair of the Gavi board, José Manuel Barroso, described the establishment of the AVMA as a “historic” moment for African healthcare and public/private cooperation, saying: “Gavi has worked closely with the countries, the African Union, Africa CDC, G7, G20, and other donors, WHO, UNICEF, civil society, industry, and experts to put into place innovative mechanisms that have the power to reshape our approach to regional manufacturing and pandemic response.”