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Why Africa needs indigenous COVID-19 vaccine

By Adetokunbo Abiola

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A study published in The New England Journal of Medicine reported that the AstraZeneca-Oxford vaccine was not effective against the South African COVID-19 variant.
The study evaluated 1,467 patients in South Africa, and found that among the people receiving the vaccine, 19, or 2.5%, developed mild-to-moderate COVID-19 at least 14 days after receiving the second dose compared to 23 (3.2%) of people who received a placebo.
Of the 42 patients who became infected, 39 were from the B.1.351 South African variant, which the study projected as 10.9% effectiveness against the variant.
The researchers wrote, “The lack of efficacy against the B.1.351 variant should be considered in the context of the 75% efficacy…in preventing mild-to-moderate COVID-19 with onset at least 14 days after even a single dose of [the AstraZeneca] vaccine that was observed before the B.1.351 variant emerged in South Africa.”
The lack of efficacy of AstraZeneca vaccine in some quarters isn’t the only reason why Africa should be thinking of manufacturing an indigenous COVID-19 vaccine.
Many countries in Africa are relying on the AstraZeneca vaccine as it is cheaper and easier to store.
Under the Covax initiative, around 14,5 million doses have been delivered to African countries.
However, reports abound that AstraZeneca reveals a connection between clotting and the vaccine. Though the vaccine’s makers say there is no data suggesting a link with blood clotting, European countries are not agreed on this.
Some African nations toed their line, hence the Democratic Republic of Congo, Mali and Cameroon had put the rollout of the AstraZeneca vaccine on hold.
The issue of future availability causes some concern on the African continent, bringing debates over the production of the vaccines on the continent.
Ghana had received 600,000 doses through Covax and has so far used more than 420,000 of them.
Rwanda got just under 400,000 doses – some via the Covax scheme and some donated by India. It has so far vaccinated more than 320,000 people.
“Countries are clocking [up] an impressive vaccination pace, but we must ensure this…doesn’t slow down to a crawl,” says Matshidiso Moeti, the WHO regional director for Africa.
As of 15 March, only 23.6 million doses of vaccine had been distributed on the continent, the Africa CDC says.
This is equivalent to around 1.7% of the population.
There’s also an African Union plan to pool supply arrangements on behalf of all 55 countries in the continent.
Africa’s leading mobile network provider, MTN, has made a donation of $25m (£17.8m) to this plan to secure about seven million doses of the Covid-19 vaccine for the continent’s health workers.
South Africa has sold the one million doses of the AstraZeneca vaccine it had purchased from the Indian supplier to 14 African countries through the African Union.
The deliveries will be completed this week, although the names of the benefitting countries hasn’t been disclosed.
But the country has admitted it is now struggling to secure other vaccine supplies.
“We are inoculating as we’re speaking, but not at the pace that we want. We have opened a lot of sites, but with very little vaccines in each and every site,” says Deputy President David Mabuza.
John Nkengasong, head of the Africa Centres for Disease Control and Prevention (CDC) echoes the same view.
He says the vaccines provided under the Covax scheme “will not get the pandemic out” of the continent without further assistance, as African countries will eventually need to vaccinate at least 60% of their populations, with his target for this year being 35%.
All these show that at a certain time in the coming months ,the vaccines won’t be available for use, raising the issue of COVID019 vaccines in Africa.
So how does Africa manufacture her vaccines, since the current COVID-19 pandemic presents a great opportunity to harness the various conversations and proposals into an action-oriented road map led by the African countries towards vaccine production to facilitate immunization of childhood diseases and control outbreaks of highly infectious pathogens?
According to the World Health Organization, what might work best is to establish what is called fill/finish capacity first otherwise referred to as drug product manufacture. This would allow for collaboration with multiple partners for multiple products using a single formulation/filling line.
Another way of vaccine manufacture could be through a process whereby African governments collaborate with her scientists towards the initiative.
Also, existing research institutes could be upgraded towards the effort, with African nations collaborating with each other.
But it won’t come cheap.
”At least $200m injection is required for Africa’s quest to attain full vaccine production status,” South Africa’s Biovac Institute CEO Morena Makhoana told The Africa Report, while cautioning funding is only one part of a complex equation.
“In global terms when you look at what does it take from a funding perspective, we are estimating anywhere between R3bn-R5bn ($201m-$336m) to come with a facility that would be fully fledged and which would have the required large capacity: over 1bn doses could be produced out of a facility like that,” says Makhoana.
But there are complications.
Experts say the initiative would be affected by demand-side considerations, as a large proportion of the vaccine supply that flows into the continent is funded through donor initiatives spearheaded by the World Health Organisation (WHO), the United Nations International Children’s Emergency Fund (UNICEF) and Gavi, the Vaccine Alliance. They might frown on an African initiative.
Besides, large African markets in terms of vaccine demand, such as Nigeria, Ethiopia and the DRC, depend on the global donor market supported by the WHO, UNICEF and the likes of Gavi, as well as others. They might not be willing to use their scarce foreign exchange to purchase a vaccine produced in Africa.
Makhoana says as much.
“Let’s dream a bit and say Biovac had its own Covid-19 vaccine and wanted to supply to Nigeria or any of these other markets. There is no market. The market is in Geneva or, even, Copenhagen, where all of these donors are sitting,” he says. “As an African manufacturer, that is something we have to look at.”
Still, the cry for a vaccine developed in Africa remains strong.
In a paper published on Globalization and Health earlier in the year, scholars said the COVID-19 pandemic should be a wake-up call for sub-Saharan Africa to build vaccines, therapeutics and diagnostics manufacturing capacity as one of the resources needed to address public-health crises.
Of course, access to vaccines, therapeutics, and diagnostics for COVID-19 will be a challenge for sub-Saharan Africans, they say. But they also say this challenge should be confronted through a collaboration between vaccine developers, pooled procurement of COVID-19 therapeutics and local development of testing and diagnostic materials.
To cut the long story short, Africa will begin to reduce her dependence on the West if she takes steps to start the development of her own vaccines against the COVID-19 pandemic.

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Why Africa needs indigenous  COVID-19 vaccine

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