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A nurse prepare to give a dose of Johnson & Johnson vaccine. Picture: MARK ANDREWS/DAILY DISPATCH
A nurse prepare to give a dose of Johnson & Johnson vaccine. Picture: MARK ANDREWS/DAILY DISPATCH

A contradiction lies at the heart of Africa’s response to Covid-19.

The continent consumes a quarter of the world’s vaccines across all diseases, so one would expect African nations to be well experienced at producing, procuring and delivering them to their people. Yet, more than a year and a half from the start of the pandemic, less than 2% of Africans have been vaccinated.

While life-saving Covid-19 vaccines roll out in other parts of the globe, African governments have been left ruing the injustice of vaccine nationalism. Rue they may, but with 99% of vaccines imported from outside the continent Africans have been left exposed to export restrictions and disrupted supply chains. Even with financing available, vaccine deliveries have remained unpredictable and could take years to provide sufficient immunisation.

Commitments from the EU to support vaccination hubs are a welcome step. However, these initiatives are the tip of the iceberg when it comes to preparing the continent for the next pandemic. That other policies such as patent waivers on Covid-19 vaccines remain tied up in international negotiations shows global solidarity only stretches so far. 

For Africa to avoid a repeat of the Covid-19 debacle it must learn to stand on its own. This by no means implies isolation but rather independence in areas critical to the wellbeing of its people and resilience of its economy. The key lesson from the pandemic is that African nations must rely less on others and more on fellow Africans.

Joint struggle has awakened the continent to its collective strength. Covid-19 responses have been most effective when African nations stood together. The African Medical Supplies Platform (AMSP), for example, has pooled procurement, enabling Africa to negotiate as a continent rather than 55 fragmented nations. This approach has delivered discounts, enhanced market power and facilitated equitable distribution across the continent.

The Africa Vaccine Acquisition Task Team (Avatt) — backed by $2bn from African Export–Import Bank (Afreximbank) and co-ordinated with the AU’s Africa Centres for Disease Control & Prevention, the UN Economic Commission for Africa and the AU special envoy on Covid-19, Strive Masiyiwa — has applied a similar approach to vaccine procurement.

By banding together African nations have negotiated directly with vaccine manufacturers rather than relying solely on foreign aid. The initiative has already secured 400-million doses of the Johnson & Johnson Covid-19 vaccine which will, importantly, be manufactured partly on African soil.

This will escalate efforts to tackle the pandemic call for leaders to double down on a whole-of-Africa approach. This will see the continent’s development finance institutions pooling resources to resolve common problems. Moreover, African nations should work together to ensure the $400bn of Africa’s foreign exchange reserves domiciled outside the continent work for Africa — especially heading into the post-pandemic recovery.

Co-ordination must not cease with the pandemic. Learnings from AMSP and Avatt are being channelled into an African Vaccine Acquisition Trust to continue pooled procurement of medical resources. This will offer long-term demand certainty and build a resilient system for the next pandemic.

Greater co-ordination will lead African nations to synchronise investments in medical infrastructure. The African Continental Free Trade Area (AfCFTA) agreement provides an unprecedented opportunity to expand the pharmaceutical industry by enabling developers and manufacturers to trade across a unified market. This opportunity is particularly compelling given McKinsey’s projections that the African vaccines market could rise from $1.3bn today to as much as $5.4bn by 2030.

To support this, procurement of vaccines and therapeutics managed by international agencies must be used to catalyse demand-driven expansion of pharma manufacturing on the continent. There is no reason these agencies cannot purchase products for Africa from Africa. That is the kind of “aid” that is sustainable.

African leaders must shift from national to regional thinking to leverage the AfCFTA opportunity. This means creating vaccine hubs with access to cross-border markets that ensure manufacturers enjoy economies of scale or co-ordinating policies so that different stages of vaccine development can be carried out efficiently across regions. A renewed effort to align regulations for medical supplies, with support directed to initiatives such as the African Vaccine Regulatory Forum and African Medicines Agency, should underpin these investments.

There is a strong chance Covid-19 will not be a once-in-a-lifetime event. Africa risks being sidelined again unless we learn to stand united. By co-ordinating efforts African nations can secure resilience for the future, protect the welfare of their citizens and retain the many skilled individuals who leave the continent to take medical and pharmaceutical jobs abroad.

As Dr Kwame Nkrumah put it, Africa must be “united in our common desire to move forward together in dealing with all the problems that can best be solved only on a continental basis”.

• Prof Oramah is president and chair of the African Export-Import Bank.

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