By Paul Kagame, President, Rwanda; Emmanuel Macron, President, France; Cyril Ramaphosa, President, South Africa; McKee Sall, President; Olaf Scholz, Chancellor, Germany; and Dr Tedros Adhanom Ghebreyesus, Director-General, WHO.
Asymmetry has plagued the response to harmful pathogens. Take COVID-19: an unprecedented 11.9 billion vaccine doses have been administered worldwide, helping many countries turn the tide on the pandemic. Although more than 80% of people in Africa have not received a dose, about 18 months after the first person was vaccinated. As long as this gap remains, we cannot protect the world from new virus variants and end the acute phase of this pandemic.
Thanks to groundbreaking innovation, effective vaccines were developed in record time to protect against COVID-19. However, at the beginning of the vaccination campaign, the concentration of vaccine and other health technology production was seen mostly in rich countries. Poor nations ended up at the back of the line. The situation has changed, with global supply exceeding global demand. The international community, led through the ACT-Accelerator and its COVAX facility, has played an important role to this end, affirming that responses to disasters such as COVID-19 require adequate preparedness and new ways of working to protect public health.
Now, the central challenges are how to ensure vaccines remain effective, increase the capacity of national public health systems to administer doses and increase vaccine uptake, and curb the pervasive air of misinformation that drives vaccine hesitancy.
A clear lesson from this pandemic is that we must expand local and regional production of vaccines and other essential health products in low- and middle-income countries. This will allow direct access to vaccines as well as the development of a local ecosystem of vaccine production. This will make supply more reliable and equitable in the event of another crisis, unless global supply chains are disrupted.
The World Health Organization (WHO), the African Union, the European Union, the governments of South Africa, Rwanda, Senegal, Germany and France, and partners, are working to help industry and partners scale up local vaccine production and help global and regional improvements. Helping prevent and respond to future pandemics. Collectively investing in all regions of the world to ensure state-of-the-art manufacturing infrastructure, trained personnel, and institutional and regulatory arrangements is a valuable asset for our common health security.
WHO is supporting multilateral efforts to create and disseminate mRNA technology in developing countries.
A year ago, WHO, South Africa and the Medicines Patent Pool established a technology transfer hub for mRNA vaccines in Cape Town., supported by the EU, France, Germany and other local and international partners. The goal of the hub is to disseminate this technology to developing countries to train and license manufacturers to produce their own vaccines for national and regional use.
With donor support, the Hub is already producing results. Scientists have designed a new mRNA vaccine based on publicly available information. Local manufacturers in Africa, Latin America, Asia and Europe have been selected to receive the technology. Partners in Medicine Patent Pool stand ready to help license technologies. A new initiative by the African Development Bank, the African Pharmaceutical Technology Foundation (APTF), can also contribute.
Some parts of the private sector are also moving forward. The recent groundbreaking ceremony in Rwanda of Africa’s first mRNA production facility, built by the German company BioNtech, is another example of African countries trying to work with partners to become more resilient in the face of the pandemic. Similar facilities are planned in Senegal, with fill-and-finish services in collaboration with Ghana.
mRNA technology is not just for fighting Covid-19. It can be adapted to fight other diseases such as HIV, tuberculosis, malaria and leishmaniasis, putting countries in the driver’s seat to produce the tools they need to meet their health needs. At a recent summit in Kigali, BioNTech committed to completing its malaria vaccine program and manufacturing any licensed product in Africa. The WHO mRNA Hub Program in South Africa already has its eyes on developing a broad suite of vaccines and other products to address the disease threat, such as insulin to treat diabetes, cancer drugs and, potentially, vaccines for other priority diseases such as malaria, tuberculosis. and HIV.
Building vaccine production facilities is difficult, but ensuring their sustainability is even more difficult.
First, there is a need to strengthen the capacity of the workforce by providing dedicated training to the staff working in these facilities. WHO is addressing this gap through the Biological Products Training Center in the Republic of Korea, under the framework of the WHO Academy in Lyon, France, to help developing countries produce not only vaccines but also insulin, monoclonal antibodies, and cancer therapies. . Rwanda recently launched the African Biomanufacturing Institute (ABI), an innovative structure that brings together industry training providers and universities to train the local workforce.
Second, manufacturing health products requires strong regulatory capabilities to ensure quality standards and approve final products. WHO and partners are investing in strengthening regulatory bodies in Africa and beyond. The Africa Center for Disease Control and Prevention (CDC) and the African Union Development Agency are working with regulators on the continent and in high-income countries to increase their capacity. And the African Medicines Agency (AMA), to be headquartered in Rwanda, has entered into force, and will become Africa’s continental drug regulator.
Stronger regulatory agencies in developing countries will increase confidence in locally produced products and the availability of misinformed and unsafe counterfeit drugs.
Third, new product facilities will depend heavily on a sustainable, and competitive, market environment where suppliers of vaccines and other new drug products will be prepared to purchase these life-saving devices. We recognize the need for current and future African vaccine producing countries to access vaccine procurement platforms, such as GAVI, among others. Market-shaping strategies at the regional and continental level, outlined by the Partnership for African Vaccine Development, can ensure the sustainability of ongoing efforts, leading market-shaping agencies and partners such as Unitaid, stand ready to support. G7 leaders have also raised the issue and urged relevant international actors to work on a joint market-sizing strategy.
At the recent World Health Assembly, it was agreed that building strong and sustainable manufacturing capacity in developing countries is essential for a safer world.
WHO member states also discussed the need for a new pandemic agreement, as an interconnected world requires globally agreed standards and mechanisms to ensure strong coordination during severe health crises.
And critically, the government acknowledged that additional funding is urgently needed to make the necessary investments in pandemic preparedness and response capabilities across countries, regions and globally. In this context, we welcome the newly established Financial Intermediary Fund for Pandemic Prevention, Preparedness and Response, which is housed at the World Bank, and plays a central technical lead role for WHO.
We know the next disaster is a question of when, not if. Time is of the essence to intensify collaboration and promote local production and build trust in locally made products, so that we are better prepared next time.