1. Background and Context The Nelson Mandela School of Public Governance at the University of Cape Town, in partnership with the Centre for Competition, Regulation and Economic Development (CCRED) at the University of Johannesburg, launched the AfCFTA and Transformative Industrialisation series in 2020. The main objective of this series was to explore the potential of building regional value chains in pharmaceuticals, agriculture, textiles and clothing, to strengthen policy implementation of the AfCFTA. In 2022, the Nelson Mandela School and its partners sought to make key policy and other actionable recommendations to develop regional value chains in the healthcare and pharmaceutical sector across Africa through leveraging opportunities presented by the implementation of the African Continental Free Trade Agreement (AfCFTA). To this end, a roundtable series on pharmaceutical manufacturing was curated for delivery in 2022. Many organisations have raised the issues of vaccine equity and the lack of access to vaccines in Africa since the start of the pandemic. Ways to address this inequity, both to meet the needs of the continent during the current pandemic and to create a state of self-sufficiency and competitiveness through local manufacturing, have been debated. Varying solutions have been proposed, some of which will keep the African continent in a perpetual state of external dependency. National and international responses to the Covid-19 pandemic have further exposed the global asymmetries in installed manufacturing capabilities and industrialization1. This inadequacy, as further revealed by the pandemic has renewed concerns and the genuine commitment to change the narrative of Africa’s lag in industrialization when compared with its peers2.
Pharmaceuticals are ranked the 4th highest category in terms of the value of imports to sub-Saharan Africa in 2018 (World Integrated Trade Solution), amounting to 70% - 90% of the total market in this region. In sharp contrast, the value of exports of pharmaceuticals in the same year was less than 10% of the value of imports3. An assessment of the vaccine manufacturing landscape in Africa reveals that the situation is dire in comparison to pharmaceuticals. Vaccine production in Africa is currently estimated at around one percent of the domestic need of the continent for routine immunization – this does not include needs for pandemic and outbreak control. There is limited accurate and up-to-date information on the status of existing vaccine manufacturing facilities in terms of their manufacturing capacity, sustainability in terms of business viability, compliance with required regulatory standards and their ability to ensure the security of supply. In response to this critical and urgent need for vaccines, Heads of State from across the continent met to make a collective commitment of manufacturing at least 60% of Africa’s consumption of vaccines for routine immunization on the continent by 20404. This important task was delegated to the Africa Centres for Disease Control and Prevention (Africa CDC) who facilitated the inauguration of the Partnerships for Africa’s Vaccine Manufacturing (PAVM) in April 2021, together with the establishment of several technical task teams with experts from Africa. Africa CDC’s PAVM initiative has motivated at least 9 countries on the continent to start (or plan) multiple initiatives towards expanding domestic manufacturing capacity on the continent, starting with Covid-19 vaccines through
1 Kumar A, Singh R, Kaur J, et al. (2021, November). Wuhan to World: The COVID-19 Pandemic. Front Cell Infect Microbiol. doi:10.3389/FCIMB.2021.596201/FULL 2 The African Continental Free Trade Area. Accessed March 10, 2022. https://www.worldbank.org/en/topic/trade/ publication/the-african-continental-free-trade-area 3 Banga et al., 2020; Conway et al. 2019; UNCTAD. 4 Africa-CDC. (2021). African Union and Africa CDC launches Partnerships for African Vaccine Manufacturing (PAVM), framework to achieve it and signs 2 MoUs. 12th and 13th April 2021. Africa Union-Africa CDC; Africa-CDC. 2021. Partnerships for African Vaccine Manufacturing in Africa (PAVM) –workshop with mRNA vaccine manufacturers and key players: Concept Note. Addis Ababa: Africa Union-Africa CDC.
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