By Jessie Taylor

The dream of a free trade between African states could be key to creating a medical manufacturing economy on the continents – a focus that has become vital as African Union members pool resources to fight Covid-19.

While Africa has been one of the continents least affected by the spread of Coronavirus, the roll out of vaccines has been met with challenges which include: purchasing power, competing with wealthy developed nations in securing vaccine supplies, as well as certain shortcomings in the healthcare systems of some African countries.

Not only do most African countries face the challenge of providing healthcare to rural or inaccessible communities, they also are significantly reliant on the import of medical supplies and medications. 


Administration of vaccines

Less than 2% of the 690 million Covid-19 vaccine doses administered globally have been in Africa. Many countries on the continent received vaccines in early May. Of the 43 countries to have received the vaccine, 10 countries have administered 93% of the doses.

“Although progress is being made, many African countries have only just moved beyond the starting line. Limited stocks and supply bottlenecks are putting Covid-19 vaccines out of reach of many people in this region,” said Dr Matshidiso Moeti, the World Health Organization (WHO) Regional Director for Africa.

Moeti explained that vaccine roll out in some countries has been delayed by operational and financial hurdles or logistical difficulties such as reaching remote locations.

“Africa is already playing Covid-19 vaccination catch-up, and the gap is widening. While we acknowledge the immense burden placed by the global demand for vaccines, inequity can only worsen scarcity,” said Dr Moeti.

“More than a billion Africans remain on the margins of this historic march to overcome the pandemic.” Through the COVAX Facility, 16.6 million vaccine doses – mainly AstraZeneca – have been delivered to African countries.

The African Union has secured 400-million Covid-19 vaccines from Johnson & Johnson (J&J), which are expected to be delivered in the third quarter of 2021. The African Vaccine Acquisition Trust (Avat) could increase this order by an additional 180-million doses during 2022. There have been an estimated 4.3 million Covid-19 cases on the African continent, which have resulted in less than 120 000 deaths. Kenya is currently experiencing a third wave and the epidemic is showing an upward trend in 14 other African countries, including Ethiopia, Eritrea, Mali, Rwanda and Tunisia.

The African Union is aiming to vaccinate at least 750 million people, or 60% of the population, to reach population immunity in the face of the pandemic.


A move towards manufacturing

But one of the most significant challenges facing the continent is a lack of medicine’s manufacturing and a dependence on imported drugs.

The pandemic has highlighted weaknesses African nation’s pharmaceutical systems. Many countries do not have adequate manufacturing facilities, while weak regulatory systems and poor accessibility to health products are common.

Part of the challenge facing the continent is that African nations are heavily dependent on manufacturers, in countries such as India and China, to supply medication. 

Francis Aboagye-Nyame – programme director of the USAID-funded medicines, technologies, and pharmaceutical services project at the US-based health organisation, Management Sciences for Health – estimates that between 70% to 90% of medication is imported by African nations.

To improve the country’s independence, and increase access to much needed medications, the Africa Union has called for the continent to do more of its own manufacturing to help ensure a sustainable supply of medicines.

To this end, the organisation has developed the Pharmaceutical Manufacturing Plan for Africa, endorsed by heads of states in 2007, which looks to strengthen the continent’s capacity to produce high quality, affordable pharmaceuticals across all essential medicines. This will not only improve healthcare on the continent but will also bring with it economic benefits. But the part to a stronger medicine manufacturing industry lies in regionalism. 

If countries promote manufacturing based on regional needs rather than their individual country-by-country requirements, it will remove regulatory and trade bottlenecks, in turn making it easier for medicines to reach people — both within and across countries. This would require medical products to be listed as a priority sector for the African Continental Free Trade Area.

The African Union has been working towards a Continental Free Trade Area (CFTA) taking the decision to establish one in 2012 a single continental market for goods and services, with free movement of businesspeople and investments. This would ultimately lead to the establishment of the Customs Union.

The CFTA would bring together a combined gross domestic product of more than US $3.4 trillion, across 54 African countries, with a shared population of more than one billion people.

The agreement would enhance competitiveness at the industry and enterprise level through exploitation of opportunities for scale production, continental market access and better reallocation of resources.

“Regional collaboration could also leverage pooled procurement mechanisms, speeding up purchasing and distribution, and enabling smaller markets in Africa to have easier, cheaper access to more products,” explained Aboagye-Nyame.

This concept has recently been put into practice through the Africa Medical Supply Platform. The platform offers personal protective equipment, rapid test kits, ventilators, and other Covid-related medical products, some locally made.  It then aggregates demand and allows participants to negotiate prices.  


African Union – Partnerships for progress

The principle of sharing economic resources to boost the continent’s economic power is being put to the test in the fight against Covid-19. The continent has been forced to look to partnerships to increase the African Union’s ability to procure, and roll-out, vaccines.

One such partnership has been with mobile carrier Vodacom, which has joined forces with the African Union Development Agency (Auda-Nepad) to build digital infrastructure in managing vaccines. The mVacciNation Platform allows healthcare workers to track what vaccines and medical equipment are available nationally, patients to register and be assigned an appointment at a vaccination site, as well the management of resources to specific sites as needed. 

Dr Ibrahim Mayaki, CEO of Auda-Nepad, said: “The response to the Covid-19 crisis has significantly accelerated the adoption of frontier technologies. Africa’s booming digital sector offers great opportunities for public-private partnerships to help build resilience in the aftermath of the Covid-19 crisis and respond to critical continental priorities. As the development agency for the African Union, we act as a channel to connect innovators and governments to roll out and localise these solutions.”


The AU’s Africa Vaccine Strategy

In an effort to pool resources, the African Union has established the Covid-19 African Vaccine Acquisition Task Team (AVATT) under the AU’s Africa Vaccine Strategy. This allows African governments to pool financing for the acquisition of vaccines in an effort to be more competitive against wealthier developed nations.

In establishing AVATT, South African President and ex-Chairperson of the African Union, H.E. Cyril Ramaphosa noted that Africa needed to urgently implement its vaccine strategy, with a focus on acquisition and financing, in order to fully control the spread of the virus.

The Africa Union would need around $12-billion to fund the vaccination drive, with funding expected to come from the COVAX Donor Initiative, The World Bank, direct donors. The African Import Export Bank has committed to raise up to $5 billion to fund the vaccinations.

It is partnerships such as these, both between private companies and member states, that hold the potential to allow the African Union to not only roll out a response to Covid-19, but use the global pandemic as a springboard to improve healthcare provision across the continent.


*Check out the May 2021 edition of the Public Sector Leaders publication here.

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