Prioritizing local vaccine manufacturing, distribution, and rollout is crucial for addressing the challenges faced by Africa's health systems. Ensuring vulnerable communities have access to life-saving health innovations will not only help millions live longer but also yield economic benefits for developing economies.
The African health landscape is riddled with complex challenges stemming from colonialism that persist today. Malnutrition, social inequality, uncoordinated regulatory bodies, poor health infrastructure, and declining government healthcare funding are some of the challenges call for urgent action.
While progress has been made in addressing these challenges through frameworks like the Framework of Actions (FAS) for Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) for Africa, the COVID-19 pandemic exposed vulnerabilities in many health systems on the continent.
In addition to existing challenges, the climate change emergency has led to an increase in emerging infectious diseases spreading beyond their endemic locations. Africa has faced outbreaks of diseases like Ebola, measles, yellow fever, Zika virus, chikungunya virus, rift valley fever, and coronavirus, adding to the burden of diseases like malaria, tuberculosis (TB), and HIV.
According to the World Health Organisation (WHO) high burden diseases like malaria is responsible for an estimated 608 000 deaths in 2022 with 95 percent of cases in Africa, TB was responsible for an estimated 424 000 deaths in 2022 and an estimated 25.6 million people on the continent are living with HIV with up to 380 000 deaths caused by AIDS-related illnesses. These three diseases and other infections are responsible for the loss of economic productivity amounting to more $800 billion annually.
Non-communicable diseases (NCDs) like cardiovascular disease, diabetes, hypertension and obesity have also reached catastrophic levels with devastating outcomes resulting in more than 41 million deaths annually with 77 percent of premature deaths caused by NCDs occurring in low-middle-income countries. For the human papilloma virus (HPV) which has the potential of causing cervical cancer in women, the HPV vaccine remains crucial in preventing 90 percent of cervical cancer-related deaths.
Furthermore, prioritising vaccine manufacturing in Africa would curb maternal mortality ratio (MMR) by at least 20.3 percent to achieve the SDG target by 2030. Africa currently accounts for 69 percent of the global maternal deaths. Child mortality on the other hand accounts for up to 50 percent of deaths of children under five who die from pneumonia, malaria, measles, diarrhoea, HIV and tuberculosis.
The state of Africa's vaccine industry which makes up less than one percent of the global demand and the growing threat of infectious diseases like Mpox, cholera and meningitis calls for swift action to grow the industry. Mpox has become the latest public health emergency with more than 74 000 reported cases and 193 deaths globally.
Africa has since 2022 reported over 6800 cases and 173 deaths. The resurgence of these diseases is currently a public health emergency that requires the urgent strengthening of local vaccine manufacturing capabilities that will foster sustainable equitable access to life-saving products that will restore the continent's health. On the other hand, the hepatitis B vaccine can prevent the over 1.1 million deaths caused by cirrhosis and hepatocellular carcinoma (primary liver cancer) in 2022.
Strides have been made to turn Africa into a self-reliant region that is capable of having a thriving vaccine manufacturing industry. This has been demonstrated through the 13 operational companies in South Africa, Egypt, Morocco Senegal, Ethiopia and Ghana - that either have fill and finish capabilities or are manufacturing drug substances. Nigeria, Ethiopia, Algeria, Rwanda and Uganda are also making efforts to establish their own manufacturing capabilities.
These strides are encouraging but more needs to be done to boost the research and development capabilities that are crucial to countries succeeding in their efforts to manufacture vaccines locally. Enabling framework like the Priority Vaccine Manufacturing (PAVM) Framework outlines the continent's strategic direction to address the 22 legacy diseases, expanding diseases and outbreak diseases. The framework seeks to scale up local vaccine manufacturing to address the reliance on global suppliers.
Some of the notable milestones that align with the PAVM include the RTS, S/AS01 malaria vaccine for children in areas with moderate-to-high malaria transmission and the WHO recommended R21/Matrix-M malaria vaccine. While there is currently no vaccine for HIV, the development of the longstanding, twice a year injectable Pre-Exposure Prophylaxis (PreP) Lenacapavir, changes the landscape in the prevention of HIV transmission amongst key populations in Africa. The third priority disease for Africa, TB currently has 11 vaccine candidates that are undergoing clinical trials that are critical to reducing the global burden of TB.
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The African Medicines Agency (AMA), African Continental Free Trade Area (AfCFTA) and the Pharmaceutical Manufacturing Plan for Africa (PMPA) are some of the mechanisms that will play a crucial role in improving access to locally manufactured vaccines by addressing the challenges of poor access to market, financial mechanisms to support vaccine manufacturing, streamlined regulatory processes to fast-track the approval of vaccines, training and equipping the local workforce with practical experience and global collaboration, and developing partnerships with multinational companies to create an enabling environment that will support local manufacturing.
BY SAKHILE KHAWEKA ( Policy and Advocacy Project Manager at the South African Health Technologies Advocacy Coalition (SAHTAC))
THE ETHIOPIAN HERALD TUESDAY 12 NOVEMBER 2024
