BERLIN – German mRNA vaccine maker BioNTech’s partnerships with vaccine manufacturing facilities in Rwanda, Senegal and South Africa will support the African Union’s ambition to produce 60% of the continent’s vaccine needs by 2040, the company told the World Health Summit.

But Ayaode Alakija, former Chief Humanitarian Coordinator for Nigeria and World Health Summit Ambassador, cautioned that Africa needs “end-to-end manufacturing” not a “cut-and-paste model”.

“It’s really about partnerships. Nobody can do this alone,” stressed BioNTech’s Sierk Potting. “What we are trying to establish right now, with the partners at the table and in Rwanda in Africa, is a first step into real manufacturing in Africa.”

Despite pandemic lockdown constraints, BioNTech took little over a year from conceptualizing a modular facility for the production of mRNA vaccines in Rwanda in March 2020 to breaking ground in that country in June 2021, Potting told a session hosted by the Partnership for African Vaccine Manufacturing (PAVM).

PAVM was launched in April 2021 and is a key component of the AU’s ambition to expand local production of vaccines. Currently, less than 1% of vaccines administered in the continent are locally manufactured, which contributed to the continent being last in line to receive COVID-19 vaccines during the pandemic.

“We have to start building this because otherwise we will be in the next pandemic and during the next pandemic, nothing would be happening,” said Potting, adding that local manufacturing in Africa is both necessary and feasible through partnerships with organizations like the AU and the African Centre for Disease Control and Prevention (Africa CDC). 

Emile Bienvenu, Director-General of Rwanda’s Food and Drug Administration, highlighted his country’s strategic approach towards achieving this goal as part of PAVM. 

“Building a vaccine industry in Africa relies on developing a conducive environment and the two main targets for Rwanda were attracting investors and becoming a regional hub for vaccine production,” he said. 

Bienvenu said that Rwanda’s collaboration with BioNTech has been successful thanks to five key factors: research and development, regulatory framework, supply chain, manufacturing, and human capital. 

He also emphasized the significance of the African Medicines Agency, which is in the process of being set up in Rwanda, in boosting pharmaceutical manufacturing across the continent.

Not tech transfer

But Alakija, who also served as the World Health Organization’s (WHO) Special Envoy for the Access to COVID-19 Tools Accelerator (ACT-Accelerator) during the pandemic, cautioned against tokenism.

“What we need in Africa is end-to-end manufacturing,” she said. “We don’t need a cut-and-paste model to give a sort of appeasement to keep Africa acquiescent,” referring to BioNTech’s self-contained modular approach, which it has shipped to the African countries to launch a production facility, and promoted as an efficient way to jump-start manufacturing in the region. 

“This is not how tech-transfer works,” Alakija told Health Policy Watch, in an interview after the panel. “Let us not sugarcoat: the discussion should not be infantalizing Africa, rather about decolonizing it.”

Historically the continent had been manufacturing vaccines, but inefficiency, corruption and under-investment had made the continent dependent on the global north for disease surveillance and response tools, critiqued Alakija during the panel.

“We in Africa have had governance problems and we need to first discuss these within home before publicizing bold plans as were shared in the panel today,” she told the session.

Stop gaslighting Africa 

Alakija also challenged the illusion of a seamless path to vaccine equity in Africa, pointing to the glaring realities of vaccine procurement challenges seen during the COVID pandemic, which have not yet been systematically addressed.

“Africa had pooled procurement, but BioNTech and Pfizer wouldn’t sell to us,” she pointed out, recalling the failed African Vaccine Acquisition Trust efforts to buy COVID vaccines in bulk shortly after they were put on the market in developed countries. 

“I’m sitting here (in this panel) mildly frustrated because some of what I’m hearing almost feels like gaslighting.”

“Money is power and would the global north, with vaccine hoarding history during COVID, really be ready to lose their contentious stronghold in the $5 billion vaccine market?” Alakija asked. 

“This is why I say we must all learn geopolitics, because until we have the right governance, poor governance in Africa will benefit high-income countries of the world.”

Alakija also challenged the emphasis on manufacturing vaccines, suggesting that focusing on health infrastructure may be a more important priority: “It is a money sink when we should be investing in our health systems.”

Long-term commitment 

Reflecting on PAVM and Rwanda’s example, Marie-Ange Saraka-Yao of the global vaccine platform, Gavi, stressed the importance of a sustained, long-term effort to bolster vaccine manufacturing in Africa. 

Saraka-Yao also underlined the necessity of matching supply with actual needs, pointing to the slump in demand for COVID vaccines. 

“We need to find an equilibrium in both product quality and pricing,” she added, referring to the recent controversy in South Africa when the government opted to procure its pneumococcal vaccine from the Indian manufacturer Serum Institute of India, rather than locally, because tendering to India was more affordable. 

She also introduced the new financial instrument that Gavi is in the process of designing – the African Vaccine Manufacturing Accelerator (AVMA), which aims to provide support for sustainable procurement and long-term vaccine manufacturing on the continent, in recognition of the larger initial costs faced by new African vaccine manufacturers.

“It’s really about supporting manufacturers to come into this market, to be able to produce at least 700 million doses a year over time,” she said. 

Image Credits: Kerry Cullinan.