When can we expect the COVID-19 vaccine in Africa?

From an email sent to my grandfather in February 2021.

You may remember that I wrote you last April about the possible path of COVID-19 in Africa. A lot of the predictions in my previous letter played out over the course of 2020. Now with vaccine production ramping up around the world, we are hopefully turning a corner on the fight against the virus. So today I’m turning to the next question.

When can we expect the vaccine in Africa?

An article from Nature estimates we will need about 1.5 billion doses of vaccine to cover 60%, their estimated requirement for herd immunity. Between the African Union and the COVAX initiative, there are some 1.2 billion doses reserved for the continent.

The shots are a mix between the AstraZeneca produced by the Serum Institute of India and the Sinopharm vaccine from China. It is likely the Johnson & Johnson company Janssen’s vaccine, which doesn’t require as intensive cold storage supply chains, will likely be introduced once trials are complete.

Some countries have already sourced and started administering the vaccine. South Africa has started their campaign. Similarly, Morocco started in the last week, having agreed last year to buy stock from India’s Serum Institute.

While I am hopeful, I am not sure how likely it is that these promised numbers will arrive quickly. The roll out is, in the words of a Moroccan health official, “dependent on a steady flow of supply.”

As it stands, even with the huge ramp in production there is not really enough to go around. It may take up to $10 billion to supply the whole continent with enough vaccines. Already we have seen countries hoarding supplies and guarding them jealously.

One main problem is the absence of local production. Currently only South Africa has solid plans around producing the vaccine on the continent. Their largest pharmaceutical company Aspen will be producing the Johnson & Johnson vaccine.

Meanwhile 3 billion of the Oxford/AstraZeneca vaccine are set to be produced in factories everywhere except Africa. It is not just a question of the developed versus the undeveloped world either. India’s Serum Institute will be producing a majority of this vaccine, and most of the supply likely to be consumed in the global south.

We are at a heavy disadvantage in this regard as with neither monetary nor production capacity leverage, the continent is largely left to charity from outside organizations to provide us with the vaccine.

This raised the interesting question of how to start local production? Nature outlined some ideas to start local vaccine production, but only identified eight organizations that they expect could be reasonably retooled to manufacture COVID-19 vaccines.

Ahead of future pandemics, and for the numerous other infectious diseases that are already prevalent on the continent, I think it is necessary to consider further what it would take to establish local production capabilities. One academic paper estimates that with only $70 million, one could establish a regional production facility. Some of this investment could be done alongside scaling pharmaceutical manufacturing, which is also lacking on the continent. Estimates are sketchy here, but the global vaccine market is almost $30 billion. Africa’s share of that is somewhere between one and two billion dollars, and expected to grow with strong demographic tailwinds.

It’s rare that you find a compelling business opportunity with the chance to do such lasting good. Though it might be too late to mitigate the delays for this iteration of the vaccine, it may be necessary for the next.