SWITZERLAND — Gavi, the Vaccine Alliance has unveiled a plan outlining key priority areas to achieve the African Union (AU) vision of sustainably expanding vaccine manufacturing capacity across Africa by 2040.

The plan is a response to the AU call to action for Gavi and other stakeholders to concretely support supply security on the continent.

The plan has been developed in consultation with the AU and Africa Centres for Disease Control and Prevention (Africa CDC), as well as a wide range of supporting stakeholders.

The 10-point plan allocates responsibilities to other key players – G7 Development Ministers, African countries, international partners including development financial institutions, and the private sector – to support sustainable African manufacturing capacity.

However, Gavi will drive and coordinate the plan, given its enormous clout as the world’s biggest buyer of vaccines.

“For 22 years, as the largest buyer of vaccines in the world, Gavi has worked closely with African countries and manufacturers to favorably shape the market for essential routine and outbreak vaccines,” said Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance.

“Gavi is committed to contribute to the AU’s vision. The plan published today provides a pathway to ensuring vaccine supply security for Africa during pandemics and expanding access to other life-saving vaccines at sustainable, affordable prices.”

The COVID-19 pandemic exposed Africa’s vulnerability when the entire continent was unable to obtain vaccines for months due to wealthy countries buying up all of the doses manufactured by Pfizer and Moderna, and India halting the export of generic vaccines manufactured by the Serum Institute of India destined for the continent.

“In the last 18 months alone, more than 30 new African manufacturing projects have been announced and estimates indicate that the African vaccine market across all existing and projected novel products could range between US$ 2.8 billion and US$ 5.6 billion by 2040, demonstrating the potential for a thriving regional industry to emerge,” according to Gavi.

Following the COVID-19 experience, the AU has set a goal of producing and supplying more than 60% of its vaccine doses on the continent by 2040, up from 1% currently.

Most African countries receive vaccines from UNICEF, which is supported by Gavi, with only about ten countries being self-sufficient in terms of vaccine procurement.

Although Africa consumes vaccines worth more than US$1 billion each year, Gavi, UNICEF, and donors bear a large portion of the cost.

This has resulted in a very specific shaping of vaccine markets in Africa, where UNICEF supplies more than 1.5 billion doses.

As a result, establishing sustainable vaccine industries in Africa, which would ideally require advance purchasing support from African governments, presents enormous challenges.

For their part, African countries are tasked with accelerating investment in the enabling environment, including “strong regulatory authorities, robust supply chains, skilled human capital, reduced trade barriers and empowered regional coordination.”

In the current situation, this is simply not possible because most countries do not purchase their own vaccines and thus cannot commit to purchasing locally manufactured vaccines.

Gavi currently selects vaccine suppliers based on price and “does not systematically permit the accommodation of higher prices in the name of geographical diversity and supply security,” according to the organization.

The vaccine alliance acknowledges that the new accommodations in the way it assesses products against supply security as a new market health objective could have a substantial impact.

The risk of supporting more expensive African-made vaccines could be mitigated by countries committing upfront to vaccines which would enable predictable pooled procurement volumes.

African countries themselves also need to “send clear demand signals to the market on willingness to select and procure from African suppliers.”

However, the report admits that disorderly expansion risks unhealthy competition, potentially undermining the impact of market-shaping initiatives.

It proposes a “business model” that “actively shapes markets in support of the AU’s vision: meeting the mutually reinforcing goals of continued global market health and a sustainable regional manufacturing sector.”

To address the high cost for new entrants, the plan proposes a time-limited financial instrument that can help mitigate the high cost of vaccine production at market entry.

It also advocates that this financial instrument supports African manufacturers to make the most commercially viable antigen-based vaccines – starting with cholera and Ebola.

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