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| A nurse prepares vaccines |
The ongoing mpox outbreak in Africa, especially in the Democratic Republic of the Congo (DRC), has highlighted the continent's struggle to access or produce vaccines necessary for tackling the crisis. African countries produce less than 2 percent of the vaccines they need, leaving them reliant on donations and imports. This situation mirrors previous crises like the COVID-19 pandemic, where vaccine nationalism left poorer nations vulnerable. This report delves into the challenges African nations face in vaccine production, explores the global dynamics at play, and evaluates efforts to overcome these barriers.
The Current Situation
After months of logistical delays, the DRC has finally begun receiving mpox vaccines from Western countries. With more than 20,000 reported cases and over 500 deaths in 2024 alone, the Central African nation remains at the epicenter of the outbreak. Other African countries, as well as regions in Europe and Asia, have also reported cases, though the virus's impact is most severe in Africa. Despite the urgency, neither the DRC nor other African countries have domestic vaccine production capabilities to address this crisis. Instead, they depend on international donations.
Japan and Denmark are currently the only countries with manufacturers producing mpox vaccines, but even these have faced delays. In August 2024, Japan’s promised donation to the DRC fell through due to administrative issues. Meanwhile, the European Union donated 99,000 doses, and the United States, through USAID, sent an additional 50,000 doses. These vaccines were supplied by Bavarian Nordic, a Danish pharmaceutical company.
While the doses are being rolled out in the hardest-hit regions of South Kivu and Equateur in the DRC, the crisis exposes a deeper, systemic problem: Africa’s lack of vaccine production capacity.
Africa's Vaccine Production Capacity
Africa produces less than 2 percent of the vaccines required to meet its public health needs, according to the World Health Organization (WHO). By 2021, fewer than 10 African manufacturers were producing vaccines, with operations spread across Senegal, Egypt, Morocco, South Africa, and Tunisia. These manufacturers, however, produce fewer than 100 million doses annually, which is insufficient during health emergencies. This lack of capacity severely limits Africa’s ability to respond promptly to disease outbreaks, as noted by William Ampofo, CEO of the African Vaccine Manufacturing Initiative.
African Countries Producing Vaccines
Some African nations have taken steps to develop limited vaccine production capabilities:
South Africa: Afrigen produces COVID-19 vaccines and is partnering with the WHO on the mRNA Technology Transfer Programme. Biovac also develops vaccines and collaborates with companies like Sanofi and Pfizer. AspenPharma, another South African manufacturer, produces COVID-19 vaccines and is exploring mpox vaccine development.
Senegal: Institut Pasteur Dakar has been producing Yellow Fever vaccines for over 80 years.
Morocco: Marbio, developed in collaboration with Swedish pharmaceutical Recipharm, was set up to produce COVID-19 vaccines, though it has yet to start production.
Egypt: VACSERA produces a range of vaccines, including Hepatitis B, Tetanus, and cholera vaccines.
Tunisia: Institut Pasteur Tunis produces COVID-19 and flu vaccines.
Despite these efforts, African manufacturers are largely focused on their domestic markets, limiting their ability to export vaccines to neighboring countries.
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| A health worker shows a cervical cancer vaccine HPV Gardasil, during a vaccination campaign on the street in Ibadan, Nigeria |
Challenges to Vaccine Production
Vaccine production in Africa faces significant financial and technical hurdles. Analysts point to the need for substantial investments and government commitment to scaling up production. Mogha Kamal-Yanni, policy lead at the People’s Medicine Alliance (PMA), emphasizes the importance of local investment in vaccine manufacturing. She notes that large-scale production is crucial for reducing costs, as seen in India, where investments in vaccine manufacturing have led to high efficiency and low costs.
However, African manufacturers are constrained by a lack of financial resources, technical expertise, and market readiness. AspenPharma, for example, has raised concerns about the lack of commitment to vaccine volumes, which creates uncertainty for companies looking to produce vaccines for broader distribution.
Additionally, technical issues such as procuring specialized equipment, building production facilities, and hiring qualified staff further compound the problem. For instance, South African manufacturer Afrigen has been supported by the European Union (EU) to become a transfer hub for sharing vaccine production techniques with other African nations, but this kind of support is rare.
Moreover, regulatory challenges also hinder progress. Many African countries lack regulatory and quality assurance processes that meet international standards, limiting their ability to produce vaccines that can be globally distributed. Patent laws further complicate matters. During the COVID-19 pandemic, it took two years for developing nations to secure a waiver for vaccine patent restrictions, allowing manufacturers to produce vaccines without authorization from patent holders.
Access to Vaccines
In the absence of domestic production, African countries rely heavily on international organizations like the WHO, UNICEF, and GAVI for vaccines during emergencies. COVAX, an initiative designed to provide vaccines to low-income countries, played a critical role during the COVID-19 pandemic. However, the program was plagued by delays and inefficiencies, with vaccines arriving more than a year late in some cases. Many countries were forced to make separate deals with pharmaceutical companies, paying twice for vaccines.
The root cause of these delays was the limited supply of vaccines, as richer countries outcompeted poorer nations in purchasing vaccines from manufacturers. Analysts have long criticized the global vaccine market for its inequities, which often leave African countries scrambling for access.
The Way Forward: Efforts to Increase Vaccine Production
To address these issues, the African Union (AU) has set ambitious goals, aiming for the continent to produce 60 percent of its vaccines by 2040. However, achieving this target remains uncertain, given the existing challenges.
Countries like Kenya have attempted to scale up vaccine production. Kenya signed an agreement with Moderna to build an mRNA vaccine facility in 2021, but the project was paused in March 2024 due to reduced demand for COVID-19 vaccines.
In the short term, experts like William Ampofo suggest that African manufacturers should focus on honing their "fill/finish" capabilities. This involves filling vaccine vials, labeling, and packaging vaccines produced elsewhere. There are currently around 80 African companies capable of carrying out fill-finish operations.
Investing in local research, development, and production capacity will be crucial in the long term. As Kamal-Yanni points out, while Africa is unlikely to produce its own vaccines tomorrow, these steps can lay the groundwork for future production capacity.
Conclusion
The mpox crisis underscores Africa’s ongoing struggles with vaccine access and production. While some countries are making progress, significant challenges remain. Addressing these issues will require sustained financial commitment, technological investment, and international cooperation. Only by building up domestic vaccine production capabilities can African nations hope to mitigate future health crises and reduce their reliance on foreign donations. The road ahead is long, but with the right support, Africa can move closer to self-sufficiency in vaccine production, ensuring quicker responses to public health emergencies in the future.
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