The rising concerns about global vaccine inequality have raised a critical question about the ability of many countries to protect their own in the case of an emergency. While Africa is not so prone to natural disasters, its man-made crisis, due to lack of planning and investment in human capital, despite huge natural resources, has left the continent continually dependent on the importation of its basic needs like food and drugs from other countries. With the COVID-19 pandemic, the need to look inwards and produce its own foods and drugs has become a wake-up call. FEMI ADEKOYA writes.
Beyond the disruption in the global supply chain due to the COVID-19 pandemic, the weakness in the production systems of Nigeria and other African countries became pronounced through their lack of access to active pharmaceutical ingredients and raw materials necessary for key food and medical items, as other nations hoard supplies in a bid to address the global emergency.
Rollouts of COVID-19 vaccines are well underway in some countries, especially those with large domestic manufacturing capacity. Many African countries have received their initial shipments from the COVAX facility and from bilateral deals, in some cases months earlier than in previous pandemics such as H1N1, but on the whole, Africa has struggled to secure timely access to adequate supplies.
Africa relies heavily on vaccine imports. The continent imports almost 99 percent of its routine vaccines today.
Although pharmaceutical products are currently manufactured in countries such as South Africa, Nigeria, Kenya, Morocco, and Egypt, as a whole, Africa currently imports more than 80 per cent of its pharmaceutical and medical consumables. It is unsustainable.
Available data show that only 1% of the 1.3 billion vaccines injected around the world have been administered in Africa – and that comparative percentage has been declining in recent weeks.
One issue is that 40 African countries, as the World Health Organization recently pointed out, had been relying on the Covax facility, the scheme designed to deliver cheap doses to promote vaccine equality. Supplies were supposed to come from the Serum Institute of India but have now been diverted for domestic use in India.
The WHO announced in May that Africa needed at least 20 million AstraZeneca doses in the next six weeks to give second shots to all those who had received the first dose. In addition, another 200 million doses of approved vaccines are needed to enable the continent to vaccinate 10% of its population by September.
Though the pandemic aggravated existing challenges, Nigeria’s local pharmaceutical production has remained undermined by poor access to raw materials, while heavily depending on west African neighbours for the supply of key ingredients.
With manufacturers and operators in the backward integration plan possessing capacities to produce mainly antibiotics and antimalarials, there are concerns about the value the government places on the well-being of the citizenry, healthcare, and the economy when it has to continue relying on external support to tackle local challenges.
Local drug manufacturers believe that any country incapable of determining how its medicines are made is a disaster waiting to happen, noting that the Ebola experience where Nigeria was denied supplies should make anyone who still considers dependence on other nations for critical issues such as access to medicines to come to terms with reality.
With roughly 30 per cent local production capacity alongside heavy dependence on the importation of critical raw materials, mainly active pharmaceutical ingredients (APIs) and machinery inputs as well as competition from a poorly regulated market, indices point to the nation’s inability to manage emergencies.
Indeed, at the onset of the pandemic, the Central Bank of Nigeria (CBN) identified some pharmaceutical firms to whom it would provide funding to facilitate the procurement of raw materials and equipment to boost local drug production in Nigeria.
According to the CBN Governor, Godwin Emefiele, “the Bankers’ Committee took the decision to support the pharmaceutical companies given the fact that the present pandemic was of grave public health concern, coupled with the fact that many drug-manufacturing countries planned or had already banned the export of drugs and medical supplies from their respective countries, thereby leaving Nigeria no choice but to produce the drugs locally.”
One year later, the apex bank noted that it has disbursed N83.9bn loans to pharmaceutical companies and healthcare practitioners to support 26 pharmaceutical and 56 medical projects across the country.
While the efforts remained commendable, the capacity to produce vaccines remains a concern for stakeholders.
Recently, the Director-General of the World Trade Organisation (WTO), Ngozi Okonjo-Iweala, expressed concern over the reliance of African countries on developed countries for COVID vaccine.
Okonjo-Iweala said the continent imports 90 percent of its vaccines and pharmaceuticals, noting that Nigerian can produce their own vaccines, more so that two Nigerians in the diaspora have developed vaccines.
“The vaccine volume is actually increasing. In June, they had 1.1 billion doses more vaccines produced in the world, 45 per cent more than the amount in May. That’s the good news. The bad news is that most of those doses ended up in the developed countries and the vaccine inequity continues and that is why we are trying to work with them (vaccine producers) to change the story.
“We cannot as a continent continue to import 99 percent of our vaccines and 90 percent of our pharmaceuticals. What we are now pushing is for them to develop that industry in Africa.
“And the AU ACDC is working very hard and in our country the minister of health, the CDC have been working very hard to also see that we can attract some of these companies. We can even develop our own vaccines, two Nigerians in the diaspora I hear have developed vaccines which they are experimenting now. So that is the right direction.”
What would it take for Africa to manufacture its own vaccines?
Expanding vaccine manufacturing in Africa, according to Mckinsey, is a complex undertaking, requiring several factors to align.
Critically, the nascent industry needs wide-scale collaboration among a broad range of stakeholders, including pan-African leadership organizations, regional economic governments, national governments, private-sector players, and global-health actors.
Mckinsey noted that for a healthy domestic-vaccines industry of sufficient scale to take root, a regional, if not continental, approach supporting a few regional players could be more sustainable.
“As a starting point, African leaders can accelerate the necessary actions required to make progress toward the common aspirations to which they have already agreed. The global COVID-19 pandemic presents a unique moment for leaders across the public, private, and social sectors to align on the importance and potential for developing this sector.
“The dynamics of supply and demand are subject to myriad influences, as are production costs. But there is another set of factors that is entirely within Africa’s power to fix.
“Our review of the literature and interviews with leaders in the field suggest that five barriers constrain the industry’s growth today: lack of a clear agenda or coordination across efforts, restricted access to finance, weak regulatory environments, challenging demand dynamics, and limited local talent.
“The case for homegrown vaccine manufacturing is by no means obvious, but with the right level of commitment and support, it is not out of reach for some countries.
“It is possible to build an industry, but it won’t be easy. Among other challenges, in most countries, vaccines will require a significant step-up in technical ability from small-molecule manufacturing, which is maturing in only a few countries in Africa. In our view, none of the challenges is insurmountable. Getting them all right will require considerable effort, but with the right level of commitment, it can be done”, Mckinsey added.
With a decline of 6.5 per cent in raw materials import in the first quarter of 2021, manufacturers’ concerns about access to foreign exchange for critical materials needed for local production remain a lingering issue needed to address capacity utilisation.
In Q1 2021, Nigeria imported antibiotics from the Netherlands and India worth N329.2billion and N43.3billion
Local manufacturers had explained that while the economy is beginning to recover from the shocks of the COVID-19 pandemic, operating challenges in the economy remain.
The Director-General of the Manufacturers Association of Nigeria (MAN), Segun Ajayi-Kadir, had told The Guardian that the negative impact of the depreciation in Naira value and acute shortage of forex were huge challenges in the first quarter of 2021, adding that the situation calls for more intentional actions from the government with a focus on supporting productive activities to drive better performance in the remaining quarters of the year.
He however reiterated the need for the government to intensify its intervention initiatives and follow through on the cost reduction aspect of ease of doing business, as there is an urgent need to create a friendlier operating environment and deliberately support the productive sector in a strategic manner.
A former chairman of the Nigerian Economic Summit Group (NESG), Sam Ohuabunwa, had in a chat with The Guardian, blamed the government’s bureaucracy and tardiness in getting progammes and policies implemented for the challenge.
He added that he was not unaware of the government’s plan to partner the private sector on the matter but for the red-tapism among officials.
He urged the government to not only support manufacturers with investment in infrastructure to enhance production, but also prioritise procurement of local products to stimulate more investments from the private sector.
Similarly, local operators urge the Federal Government to increase local production of essential drugs from the present 40 to 45 per cent to at least 75 per cent to ensure drug security.
They called on the Federal Government to approve a N300 billion pharmaceutical manufacturers expansion fund that will ensure that stakeholders have enough funds to improve their facilities to meet the World Health Organisation’s (WHO) pre-qualification and standard.
With the African Continental Free Trade Area agreement (AfCFTA) becoming operational, stakeholders believe an integrated market is key as countries need to strengthen and harmonize their regulatory systems to assure the quality of medical products and ensure that local manufacturers adhere to international standards.