This is the story of how Africa is preparing for this future, and taking steps to safeguard the health of the youngest and fastest growing population in the world. 

The facts

• 23% of the global burden of disease was in Africa in 2021.
• 14% of the world’s vaccine doses were delivered to Africa in 2022.( 2 )
• 99% of Africa’s vaccine supply is imported.( 3 )
• 8 out of 54 countries in Africa currently have the capacity to produce vaccines — Algeria, Egypt, Ethiopia, Morocco, Nigeria, Senegal, South Africa, and Tunisia.
• 20.7 million vaccine doses were produced in Africa in 2022.( 4 )

Why it matters where vaccines are made

Africa received 14% of the world’s vaccines in 2022, including COVID-19 vaccines.

And, produced just 0.2% of the world’s vaccine supply.

In contrast, Asia produced 43%, North America 35%, and Europe 20%.

When a health crisis hits, Africa finds itself at the back of the queue. 

In 2009 during the swine flu pandemic, vaccine production was slow to scale up to meet demand, and lower-income countries were locked out of the market. At the time, South Africa’s health minister emphasised the need for regionally developed vaccines. 

In 2023 the global stockpile of cholera vaccines nearly dried up when the Indian manufacturer that produced about 15% of the world’s supply stopped making the vaccine — just as cholera outbreaks were surging in Africa.

But no example is as stark as the “vaccine apartheid” of COVID-19. Here’s how the story unfolded:

Since COVID-19, many countries are retreating further into nation-first approaches.

COVID-19 made it clear that Africa needs more options to ensure its population can receive timely vaccinations during pandemics. But there are other benefits to Africa building a sustainable, fit-for-purpose vaccine manufacturing industry. 

• Regional manufacturing will help make the world more resilient against the next pandemic. 
• Regional vaccine manufacturers are more likely than Western pharmaceutical companies to focus on neglected diseases.
• Regional manufacturing can drive down costs whilst creating jobs and driving economic growth. The AU’s strategy could add up to US$4 billion to the continent’s GDP and create 12,500 jobs by 2040.

The current state of vaccine production in Africa

By 2030, Africa will account for 37% of all global vaccine demand. 

This stratospheric growth potential is driven by a population set to nearly double by 2050.

Today, Africa’s routine vaccine market is worth US$1.3 billion annually. It could reach US$4.7 billion by 2030. 

But Africa sees very little of that money. Just 1.1% of Africa’s vaccine supply comes from Africa, with Asia providing over half and Europe over one-third of Africa’s vaccine supply.( 4 ) 

Meanwhile, Africa’s demand for vaccine sovereignty will only become more critical. Thirty-nine African countries are currently supported by Gavi, the Vaccine Alliance, which accelerates access to new and under-used vaccines and improves childhood immunisation coverage. Six of those countries — São Tomé and Príncipe, Nigeria, Kenya, Ghana, Djibouti, and Côte d’Ivoire — are projected to transition out of Gavi support by 2030. These countries represented 18% of vaccine doses fully supported by Gavi funding in 2023 and will be home to 11.9 million newborns by 2030. 

Thankfully, the Partnership for African Vaccine Manufacturing, as mandated by the African Union, has a 20-year plan to produce 60% of Africa’s vaccine needs locally by 2040. 

The plan prioritises vaccines for the region’s leading causes of illness, but has expanded to include the manufacturing of other medical products as well. 

Since the plan was launched, it has attracted over 30 public investment announcements. Information on all 30 announcements is hard to find, but our case studies suggest at least two are progressing and at least one has been cancelled, while others have stalled or lack further information.

A 6-point plan for accelerating vaccine sovereignty in Africa

Meeting the African Union’s target will require collective action. Here are six areas where focus and progress will be essential for success:

1. Focus on vaccine hubs: Not every country in Africa needs vaccine manufacturing capacity. Three to five geographically dispersed manufacturers would create a sustainable manufacturing ecosystem. That would include a handful of vaccine manufacturers, alongside initiatives focused on attracting and training talent, brokering technology transfers, spurring research and development, and strengthening regulations. These vaccine hubs should prioritise domestic and regional needs, but could also serve global markets.

2. Level the financial playing field: Capital expenditure for the construction of high-tech manufacturing facilities is 40-70% higher in Africa than in India. African manufacturers face higher production costs and market risk that impact manufacturers’ ability to stay competitive. Reducing the cost of capital, offering incentives to kickstart a vaccine manufacturing industry, and removing regulatory barriers could level the playing field and enable African players to compete. To that end, Gavi’s African Vaccine Manufacturing Accelerator (AVMA) offers US$1 billion to support the efforts of at least four African vaccine manufacturers to win Gavi/UNICEF tenders for the production of over 800 million vaccine doses over 10 years.

3. Diversify the portfolio: Many commitments made between 2021 and 2022 were linked to COVID-19 vaccine production, with unclear plans on expanding to other vaccines. What’s needed is a diversified portfolio of products and technologies that target priority diseases for African countries to ensure resilience against market shifts and better align with regional health needs. mRNA technology offers quicker and more robust production that can be repurposed during a pandemic at smaller scale and lower costs, whilst technologies that target specific outbreak diseases can make the African market more attractive to investors. Incentive payments, like those offered by Gavi’s AVMA, should support the development of priority vaccines that meet regional needs and use pandemic-ready technologies.

4. Transfer tech: African vaccine manufacturing capacity is concentrated on form/fill/finish, essentially putting together the final vaccine product from components produced elsewhere. Yet, 60% of this installed capacity lacks the needed technology transfer to bring a product to market. Funders and technical partners should respond to African manufacturers’ requests for technical support in navigating the technology transfer negotiations and process, and pharmaceutical companies should accelerate their engagement in technology transfers.

5. Reduce regulatory barriers: To sell to Gavi and UNICEF — the largest purchasers of vaccines for Africa — vaccine manufacturers must achieve WHO prequalification for their product. It’s a process that often requires additional time, financing, and regulatory requirements. Institut Pasteur de Dakar in Senegal is currently the only manufacturer in Africa producing a WHO-prequalified vaccine, and has been doing so for over 80 years. And, only Egypt and South Africa have national regulatory authorities operating at the level needed to produce vaccines for WHO prequalification. The African Medicines Agency (AMA) plans to harmonise the regulatory process across Africa once operationalized, but only 27 out of 54 African countries have ratified the AMA Treaty. In the meantime, national regulatory authorities need compliance and financial support.  

6. Shape the market: Any successful industry needs buyers. Pooled procurement mechanisms, market shaping initiatives, and commitments from governments to purchase African-manufactured vaccines can generate stable and predictable demand and lower prices. Commitments from Gavi and UNICEF to purchase African vaccines will also be essential in driving demand. So too will be swift implementation of a commitment from African leaders to create a pooled procurement mechanism.

Achieving vaccine sovereignty in Africa will require investments at many levels. 

But the potential dividends are significant: improved health amongst the world’s youngest and fastest growing population; strengthened capacity to respond to global pandemics; and new technological innovation, economic growth, and job creation in Africa.

Investments in this vision are needed today to deliver these steps toward health equity and safeguard the well-being of people worldwide.