“Disappointed” is how the Africa Centres for Disease Control and Prevention phrased its response to pharmaceutical company Moderna “pausing” its Kenyan mRNA vaccine manufacturing facility. 

Moderna’s decision is yet another example of how complex it is to kickstart vaccine manufacturing on the continent – an essential component to safeguard Africans against future pandemics on the continent that was simply unable to procure COVID-19 vaccines until way after developed nations.

“The demand in Africa for COVID-19 vaccines has declined since the pandemic and is insufficient to support the viability of the factory planned in Kenya,” Moderna announced in a statement last Thursday.

Back in March 2022, Moderna and then Kenyan president Uhuru Kenyatta signed a memorandum of understanding, with the company aspiring to produce up to 500 million vaccine doses a year with a focus on drug substance manufacturing.

But Moderna disclosed last week that it “has not received any vaccine orders for Africa since 2022 and has faced the cancellation of previous orders, resulting in more than $1 billion in losses and write-downs”.

Moderna’s experience mirrors that of South African generic drug company Aspen, which spent millions of dollars expanding its production facilities to make Johnson and Johnson vaccines – yet it never sold a single vial, as reported previously by Health Policy Watch.

“Unless there is security around domestic or regional procurement, you’re going to be very guarded about getting into this business ever again,” Stavros Nicolaou, Aspen’s head of strategic trade, said at the time.

However, Moderna is estimated to have made $18.4 billion in profits from COVID-19 vaccines in 2022 alone in other markets.

Moderna was a latecomer to African COVID-19 market

In its response, Africa CDC reminded Moderna that it entered the African COVID-19 vaccine market late – some time after various calls by African leaders and the African Union (AU) for “equitable and timely access to, and receipt of, vaccines”, which  “in many instances went unanswered by the international community and industry”.

The @AfricaCDC's Statement on @moderna_tx Plan to reassess commitment to African vaccine manufacturing. This is in response to Moderna's decision to put its plans on hold for establishing vaccine manufacturing in Kenya. Read more: https://t.co/0BRuUbSW9r

— Jean Kaseya (@JeanKaseya2) April 15, 2024

When the AU’s African Vaccine Acquisition Trust (AVAT) eventually managed to acquire 400 million COVID-19 vaccines from manufacturers for the continent, none were from Moderna “simply because Moderna vaccines were not made available, despite attempts to buy [them],” said the Africa CDC, adding that less than 5% of the COVID-19 vaccines administered in Africa were from Moderna.

“Therefore, to blame Africa and Africa CDC for lack of demand for COVID-19 vaccines and therefore the reason to put on hold plans to manufacture vaccines in Africa, only serves to perpetuate the inequity that characterised the response to the COVID–19 pandemic,” said Africa CDC. 

“While other vaccine manufacturers are progressing with their plans and construction in Africa, Moderna is abandoning a commitment to build highly needed and relevant vaccine manufacturing capabilities in Africa, in truth, demonstrating that Moderna’s commitment is in fact not to vaccine equity and access to vaccine, through building manufacturing in Africa.”

While pulling back from COVID-19 vaccines, Moderna stated that it is” actively working on the development of public health vaccines, including those for diseases that predominantly affect the African continent, such as HIV and malaria”, using mRNA technology. 

“However, these investigational vaccines are at an early development stage. Given this, and in alignment with our strategic planning, Moderna believes it is prudent to pause its efforts to build an mRNA manufacturing facility in Kenya. This approach will allow Moderna to better align its infrastructure investments with the evolving healthcare needs and vaccine demand in Africa,” said the company.

Gavi’s ‘Accelerator’ is a game-changer

Africa CDC said that it would continue to advocate, and support the establishment of a strong local vaccine manufacturing ecosystem as part of its “continental vision of producing 60% of vaccines, therapeutics, and other medical products by 2040”. 

But it acknowledged that “building vaccine manufacturing infrastructure and capabilities is complex, takes a long time, and requires significant investment”.

Vaccine platform Gavi’s decision to establish a new innovative financial mechanism, the African Vaccines Manufacturing Accelerator (AVMA),  is such an investment.

Through the AVMA, Gavi plans to make up to $1 billion available over the next 10 years to “support the sustainable growth of Africa’s manufacturing base”.

Making the announcement last December, Gavi put the current value of Africa’s annual vaccine demand at over $1 billion. 

“Africa already accounts for around 20% of the world’s population, yet the continent’s vaccine industry provides only around 0.2% of global supply,” said Gavi.

“A sustainable expansion of Africa’s vaccine manufacturing capacity would have a double payoff for the continent, contributing to the growth of a high-value biotechnology sector on the continent at the same time as supporting pandemic and outbreak prevention and response.”

The AMVA will be launched on 20 June at a high-level event in Paris co-hosted by the French government, AU and Gavi, with support from Team Europe partners.

AVMA will offer two types of incentive payments to offset some of the initial high costs of production. The first type of payment, known as a ‘milestone payment’, will be available to manufacturers that produce one of the vaccines included in the Gavi priority vaccine market group when they succeed in obtaining WHO pre-qualification (PQ).

“PQ is a form of regulatory approval that must be obtained before a manufacturer can win a Gavi-UNICEF tender . This payment is targeted to support manufacturers to offset some of the financial burden of meeting the standards for PQ, and helps to bridge the period between this pre-qualification and production,” according to Gavi.

Top-up payments per dose

The second type of payment, termed an ‘accelerator payment’, will be paid as a per-dose top-up, in addition to the market price that manufacturers receive for doses on winning Gavi-UNICEF tenders. These payments will be highest for the “end-to-end manufacture of priority market vaccines , and vaccines produced using ‘pandemic ready’ technology platforms”, while lower tiered incentives will be paid for lower-cost ‘fill and finish’ manufacturing.

“The need to ensure regional diversification of vaccine manufacturing was a key learning from the COVID-19 pandemic, when a lack of local manufacturing capacity in Africa and other parts of the world meant these countries had to wait longer for vaccines to become available,” according to a recent media release from Gavi.

 “Our determination to promote equitable access to global health and the health sovereignty of our African partners is growing further,” said Chrysoula Zacharopoulou, French Minister of State for Development and International Partnerships.

Gavi will also use the event to make the case for donors to invest in a “new era of immunisation for enhanced equitable access to health care” as well as pitching its 2026-2030 funding needs to the government leaders, partner organisations, civil society and business who are invited to the event.

Image Credits: Gavi , Moderna.