4.3 PANDEMICS
“ Governments and regional bodies must treat local vaccine manufacturing as a long-term security investment, ensuring sustained financing and workforce development”
manufacturing practices requires vast capital, advanced technologies and reliable infrastructure that remain scarce across much of the continent. Access to patented platforms such as mRNA is costly and often restricted, and shortages of specialised personnel – from bio-process engineers to regulatory experts – slow progress. Financing is another obstacle, as high set-up costs and limited production volumes undermine commercial viability without sustained public support. Competition from subsidised global suppliers weakens Africa’s bargaining power. Intellectual property restrictions and limited technology transfer further reinforce dependence on external actors. In addition, governments often favour symbolic ‘national factories’ over regional efficiency. Overcoming these barriers demands bold, coordinated policy choices. Governments and regional bodies must treat local vaccine manufacturing as a long-term security investment, ensuring sustained financing and workforce development. Transparent, well-governed public-private partnerships can blend public guarantees with private efficiency, and strong African advocacy within global forums must push for equitable technology transfer, intellectual property reform and financing mechanisms that prioritise regional capacity. Furthermore, intellectual property sharing is critical, requiring AU-managed patent pools for essential components to ensure access to technology across specialized facilities. Strategic procurement policies should guarantee demand by allocating a growing share of vaccine purchases to African producers. ▪
health products through the ‘prequalification’ process. This helps regulatory review and uptake in low-resource settings. New WHO policies, including parallel processes for recommendation guidelines and assessment, address inequities in accessing essential health products. Interim guidelines, especially for innovative products, can accelerate timelines but require significant efforts to meet high data and evidence standards, produce complete dossiers, and engage with prequalification consultations. As of mid-2024, 915 human medicinal products were prequalified by the WHO, including 759 medicines (82.95%) and 156 vaccines (17.05%). The majority of these products originated from India (61.42%), followed by China (5.7%) and the United States (2.9%). Finally, the pursuit of vaccine sovereignty in Africa cannot be a fragmented every-country-for- itself effort. Attempting to replicate end-to-end manufacturing across each of the 55 AU members is economically unviable, technically unsustainable and strategically short-sighted. Instead, deliberate regional collaboration and specialisation, guided by the AU and regional economic communities, is essential to transform fragmentation into collective strength. This requires implementing structured, enforceable frameworks that leverage comparative advantages across the continent. Specialisation is non-negotiable because it underpins economies of scale, cost efficiency and supply chain resilience. Vaccine production demands massive capital investment and concentration on specific components – such as Ghana, Senegal and Kenya focusing on fill-and-finish, South Africa on mRNA antigen production, Egypt on glass vials and Rwanda on adjuvants – thereby avoiding duplicating costly infrastructure. Concentrating expertise and resources reduces per-unit costs and attracts private investment. Moreover, no single African country possesses all the elements for end-to-end production, from stable utilities and skilled labour to raw materials and logistics. Specialisation allows each country to contribute based on its existing capacities – for example, Nigeria’s gas reserves for bioreactor energy, Morocco’s production of pharmaceutical- grade glass, Tanzania’s cassava for vaccine stabilisers or Djibouti’s ports for logistics hubs. Cross-border value chains can be established by legislating the tariff-free movement of vaccine inputs. By distributing production roles, African countries can create a networked continental supply chain capable of withstanding shocks such as trade disruptions or pandemics, preventing systemic collapse. CHALLENGES, CONSTRAINTS AND THE WAY FORWARD The cost of inaction is clear. Political and structural barriers remain significant, despite strong political will. Establishing facilities that comply with good
NICAISE NDEMBI Nicaise Ndembi serves as the deputy director-general and regional director of the International Vaccine Institute’s Africa Regional Office. He is a faculty member of the Univer- sity of Maryland School of Medicine and the Kanazawa Uni- versity School of Medicine. He established the Partnerships for Africa Vaccine Manufacturing and developed, with John Nkengasong, the Framework for Action on Vaccine Manu- facturing in Africa. He was named to the 2025 TIME 100 Health list and the 100 Most Notable Peace Icons in Africa. X-TWITTER @IVIHeadquarters www.ivi.int
Health: A Political Choice – The Future of Health in a Fractured World 51
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