Beyond vaccine hesitancy: It’s time for Africa to expand its vaccine manufacturing capacity amid growing COVID-19 vaccine nationalism

In The Lancet Microbe, Paul Adepoju provides a report
1
Africa is preparing for COVID-19 vaccines.

on Africa’s delay in the global race to roll out mass vaccination against COVID-19. This race is unprecedented and characterized by high-income countries adopting strategies such as pre-ordering millions of doses before COVID-19 vaccines complete clinical trials. Africa has now embarked on the largest vaccination campaign in history with the aim of achieving 60% coverage of the population with the COVID-19 vaccine by June 2022, via the COVAX center led by WHO. Other continents appear to be far ahead, with Asia securing the commitment of the United States, Australia, India and Japan to deliver up to a billion doses of COVID-19 vaccine across the world. continent by the end of 2022 and the Asian Development Bank to provide the United States with $ 9 billion to the Asia Pacific Vaccine Access Facility to provide COVID-19 vaccines. These trends have resulted in the world’s poorest countries receiving just 0.2% of the 700 million doses of COVID-19 vaccine by April 2021, while more than 87% of global vaccine stocks have gone. to high-income countries.

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WHO says more than 87% of the global supply of Covid vaccines has gone to higher income countries.

This inequality gap is bridged by strong multilateral cooperation involving the African Union African Vaccine Acquisition Task Force and the COVAX consortium with COVID-19 vaccines mainly produced in India.
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WHO
First doses of COVID-19 COVAX vaccine administered in Africa.

However, India’s recent export ban on COVID-19 vaccines in response to an increase in COVID-19 cases has resulted in the depletion of COVAX stocks in several African countries.

Adepoju also reports that additional doses of COVID-19 vaccines have been secured for Africa by the African Vaccine Acquisition Task Force from AstraZeneca, Pfizer and Johnson & Johnson.
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Africa is preparing for COVID-19 vaccines.

Morocco has adopted proactive vaccine procurement policies by accelerating the approval of AstraZeneca, Sinopharm and Sputnik V vaccines. A leading Egyptian pharmaceutical company has signed an agreement to manufacture more than 40 million doses of the Sputnik V vaccine by year in Cairo. Seychelles has also registered the Sputnik V vaccine under an emergency use authorization.

In addition to the complexity and interconnection of global supply chains, the effectiveness of vaccine deployment underway in Africa could be compromised by a familiar enemy: reluctance to vaccinate. Reluctance to immunize refers to a delay in accepting or outright refusal of vaccines. This has been reported in several African countries and is linked to three factors. First, public distrust of the government’s response to COVID-19; second, the lack of community involvement in decision-making on health issues; and third, minimal attempts to demystify misinformation about COVID-19 on social and traditional media.
4
Coping with vaccine hesitancy in Africa: the prospective context of the COVID-19 vaccine.

The problem of vaccine hesitation is not new in Africa. A striking example is the boycott of the polio vaccine in Nigeria in 2003-04, which, fueled by mistrust, quintupled the incidence of polio in Nigeria between 2002 and 2006, leading to polio epidemics on three continents.

5
  • Ghinaï I
  • Willott C
  • Dadari I
  • Larson HJ
Listening to the Rumors: What Northern Nigeria’s Polio Vaccine Boycott Can Tell Us Ten Years Later.

The vaccine reluctance is not limited to Africa, however, as rumors and reports of serious blood clotting problems following the administration of the AstraZeneca vaccine in European countries have interrupted the use of this vaccine in 16 of these countries.

6
Covid-19: European countries suspend use of Oxford-AstraZeneca vaccine after reports of blood clots.

Only 1% of vaccines administered in Africa are produced by manufacturers based in five countries: Egypt, Morocco, Senegal, South Africa and Tunisia.
7
How COVID prompted Africa to prepare for a vaccine revolution.

,

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Developing Country Vaccine Manufacturers Network
Vaccine manufacturing in Africa: briefing for DCVMN members.

On April 13, 2021, African leaders embarked on an ambitious plan to build factories and support research and development to increase the share of vaccines manufactured in Africa from 1% in 2021 to 60% by 2040. With the African Center for Disease Control planning to establish five new vaccine manufacturing centers in Africa and the African Development Bank pledging to fund at least two technology platforms worth $ 400 million Americans for vaccine production,

1
Africa is preparing for COVID-19 vaccines.

the continent appears to be moving towards creating an indigenous vaccine industry.

However, vaccine manufacturing in Africa will require significant long-term funding, government and stakeholder commitment to purchase manufactured vaccines, expanded research capacity, and strategic regulatory support and advice. Establishing supply networks is also essential to ensure uptake of vaccines manufactured on the continent. The African Continental Free Trade Area which was launched on January 1, 2021 to connect 1.2 billion people in 54 countries holds great promise in this regard.

Technological innovation, including whole genome sequencing
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Africa needs more genome sequencing to tackle new variants of SARS-CoV-2.

providing real-time information on the biology and evolution of infectious organisms – should be adopted to support the development and manufacture of vaccines in Africa to reduce production costs. New research in Africa indicates that the combination of genomic and epidemiological surveillance strengthens the response and containment of infectious disease outbreaks.

ten
Genomic and epidemiological surveillance could shed light on the future viral response.

This will be invaluable in identifying new variants of SARS-CoV-2, including the kappa (B.1.617.1) and delta (B.1.617.2) variants. The combination of these approaches could better position Africa to mitigate the next pandemic by producing vaccines for its citizens.

We do not declare any competing interests.

The references

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    Africa is preparing for COVID-19 vaccines.

    Lancet microbe. 2021; 2: e59

  2. 2.

    WHO says more than 87% of the global supply of Covid vaccines has gone to higher income countries.

  3. 3.

    First doses of COVID-19 COVAX vaccine administered in Africa.

  4. 4.

    Coping with vaccine hesitancy in Africa: the prospective context of the COVID-19 vaccine.

    Pan Afr Med J. 2021; 38: 3

  5. 5.
    • Ghinaï I
    • Willott C
    • Dadari I
    • Larson HJ

    Listening to the Rumors: What Northern Nigeria’s Polio Vaccine Boycott Can Tell Us Ten Years Later.

    Global public health. 2013; 8: 1138-1150

  6. 6.

    Covid-19: European countries suspend use of Oxford-AstraZeneca vaccine after reports of blood clots.

    BMJ. 2021; 372: n699

  7. 7.

    How COVID prompted Africa to prepare for a vaccine revolution.

  8. 8.
    • Developing Country Vaccine Manufacturers Network

    Vaccine manufacturing in Africa: briefing for DCVMN members.

  9. 9.

    Africa needs more genome sequencing to tackle new variants of SARS-CoV-2.

    Nat Med. 2021; 27: 744-745

  10. ten.

    Genomic and epidemiological surveillance could shed light on the future viral response.

    Nature Africa. 2021; ()


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