For the last two years, the terms ‘Africa’, ‘manufacturing’, and ‘medical commodities’, especially vaccines, have been discussed at length by different stakeholders. Most conversations have been around and/or about the disease burden, supply versus demand of medical commodities and the risks posed by the continent’s heavy reliance on importation. The common output has been an articulation of the need to accelerate the journey to self-reliance in the manufacturing of health products and technologies in Africa.
Several steps have been taken to achieve this ideal. In 2021, Partnerships for African Vaccine Manufacturing (PAVM) was established by the African Union (AU) and the Africa Centres for Disease Control and Prevention (Africa CDC). The main objective was to enable vaccine manufacturing by establishing five manufacturing hubs across Africa and supplying more than 10% of the required doses by 2025, more than 30% by 2030, and more than 60%by 2040 [1]. In the same year, the Coalition for Epidemic Preparedness Innovations (CEPI) and the AU agreed to work together through activities such as investing in research and development innovations for vaccines, capacity building and partnerships. In 2022, the World Health Organisation (WHO) announced that Egypt, Kenya, Nigeria, Senegal, South Africa, and Tunisia would be supported to produce messenger RNA vaccines. This is part of WHO’s larger efforts to empower lower- and middle-income countries to boost local production of health products and technologies (HPTs) for better response to health emergencies and for the attainment of universal health coverage[2]. To support the manufacturing of complex molecules such as mRNA vaccines, the Africa Medicines Regulatory Harmonization (AMRH) initiative has resulted in the Africa Medicines Agency (AMA) of which 15 countries have deposited their instruments of ratification.
How can we move beyond these goals to achieve our intended outcomes as a continent? Here below are some suggestions:
Look beyond COVID-19 and prioritize the agenda
Unless manufacturing in Africa is treated with the same urgency it demanded when the pandemic was at its worst, the goal will be far out of reach. COVID-19 cases have declined in the past few months. Some countries have achieved, while others are close to achieving their vaccination targets. This, however, should not be a reason for Africa to backtrack on venturing into manufacturing. The continent still has a high disease burden of both communicable and non-communicable diseases, and the threat of future pandemics is as real now as it was before COVID-19. African leaders should therefore continue prioritizing the health commodities manufacturing agenda.
Eliminate barriers that have hindered development
Mismanagement of resources due to weak accountability systems in Africa has caused a lag in achievement of development. Elimination of additional barriers such as, high illiteracy rates, poor infrastructure, brain drain, capital flight and political instability will result in a conducive environment for the development of Africa’s HPT manufacturing agenda.
Make conversations specific and prescriptive and assign responsibilities
Africa should progress from generalized and descriptive to specific and prescriptive conversations to prompt every nation to play its part. This includes but is not limited to:
- Which HPTs can, should, and will be manufactured in Africa?
- Where will they be manufactured?
- How can countries complement each other without duplication of efforts, thus contributing to a sustainable manufacturing sector?
- Which are the most effective accountability mechanisms?
- How can the responsibility of ensuring self-reliance be made both continental and country-specific?
Leverage on available resources
A local vaccine manufacturing mapping study by Clinton Health Access Initiative (CHAI) showed that globally, Africa has received the largest donor commitments and the second largest technology-transfers for the production of vaccines[3]. A journey of manufacturing vaccines requires the following: site selection, infrastructural development, staffing and capacity building, exploratory research, pre-clinical and clinical safety and efficacy testing on animals and humans, regulatory reviews, and licensing. These are all capital-intensive activities. For self-reliance, rather than waiting to have our proverbial ducks in a row, we can begin some of the activities required with the resources we have. We should also avoid duplicity of roles, and leverage on the strengths of each country to create a cohesive and sustainable ecosystem for churning out vaccines, therapeutics, and diagnostics for our most pressing health needs.
To conclude, the need for manufacturing of health products and technologies in Africa has been sufficiently justified, goals have been set, and some action has been taken. What is remaining for the continent to be self-reliant are bolder and more deliberate actions.
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