By Paul Kagame, President of the Republic of Rwanda; Emmanuel Macron, President of the French Republic; Cyril Ramaphosa, President of the Republic of South Africa; Macky Sall, President of the Republic of Senegal; Olaf Scholz, Chancellor of the Federal Republic of Germany; and the Dr Tedros Adhanom Ghebreyesus, WHO Director General
Inequalities have weighed on the response to harmful pathogens. Take COVID-19 for example: a record 11.9 billion doses of vaccines have been administered worldwide, helping many countries turn the tide of the pandemic. Yet more than 80% of people in Africa have not received a single dose, approximately 18 months after the first vaccination. As long as these inequalities exist, we can neither protect populations against new variants of the virus nor end the acute phase of this pandemic.
Thanks to groundbreaking innovations, effective vaccines against COVID-19 have been developed in record time. However, at the start of the vaccination campaign, the production of vaccines and other health technologies was confined to a few, mostly wealthy countries. Poor countries found themselves at the back of the pack. Since then, the situation has changed and supply exceeds demand on a global scale. The international community, under the aegis of the ACT Accelerator and the COVAX Facility, has played a crucial role in this regard, confirming that the response to scourges like COVID-19 requires good preparation and new ways of working in order to to protect public health.
The main issues today are how to ensure that vaccines remain effective, build the capacity of national public health systems to deliver doses, increase vaccine uptake, and counter the pervasive misinformation that fuels reluctance to vaccination.
An obvious lesson to be learned from this pandemic is that we need to increase local and regional production of vaccines and other essential health products in low- and middle-income countries. This will allow both direct access to vaccines and the establishment of conditions conducive to local production. So in the next crisis, supply will be more reliable and equitable, provided global supply chains are not interrupted.
The World Health Organization (WHO), the African Union, the European Union, the Governments of South Africa, Rwanda, Senegal, Germany and France and their partners are working increase local production of vaccines and improve global and regional collaboration to prevent and respond to future pandemics. Investing collectively so that all regions of the world are equipped with state-of-the-art production infrastructures, trained personnel and institutional and regulatory arrangements is a valuable asset for our common health security.
WHO is supporting a multilateral effort to establish and disseminate mRNA technology in developing countries.
A year ago, WHO, South Africa and the Medicines Patent Pool established a technology transfer center for mRNA vaccines in Cape Town(1), with support from Germany, France , the European Union and other local and international partners. This center aims to disseminate this technology to developing countries by training manufacturers and licensing them to produce their own vaccines for national and regional use.
Thanks to donor support, the center is already achieving results. Scientists have designed a new mRNA vaccine based on publicly available information. Local manufacturers from Africa, Latin America, Asia and Europe have been selected to benefit from this technology. Medicines Patent Pool partners are ready to help license technologies. The African Pharmaceutical Technology Foundation, a new initiative of the African Development Bank, could also help.
Some private sector actors are also stepping up their efforts. The inauguration ceremony last month in Rwanda of Africa’s first mRNA vaccine production unit, built by the German company BioNTech, is an example of efforts by African countries to join forces with partners to to become more resilient in the face of pandemics. There are plans to open similar units in Senegal, in collaboration with Ghana, for filling and finishing services.
mRNA technology isn’t just for fighting COVID-19. It can be adapted to fight other diseases, such as HIV infection, tuberculosis, malaria and leishmaniasis, as countries are called upon to manufacture the tools necessary to meet their health needs. At a recent summit in Kigali, BioNTech pledged to complete its malaria vaccine program and manufacture any licensed product in Africa. The WHO mRNA Vaccine Center program in South Africa already plans to develop a wide range of vaccines and other products to fight diseases that pose a threat, such as insulin to treat diabetes, cancer drugs and, potentially, vaccines against other priority diseases such as malaria, tuberculosis and HIV infection.
It is difficult to build a vaccine production unit, but it is even more difficult to ensure its sustainability.
First, there is a need to build the capacity of staff working in these units by offering them training. WHO is responding to this need through a biomanufacturing training center in the Republic of Korea, which operates within the framework of the WHO Academy in Lyon, intended to help developing countries produce not only vaccines, but also insulin, monoclonal antibodies and cancer treatments. Rwanda recently opened the African Biomanufacturing Institute, an innovative structure bringing together trainers from industry and universities to train local personnel.
Second, healthcare product manufacturing requires strong regulatory capabilities to ensure quality standards and approve end products. WHO and partners are investing in strengthening regulatory bodies in Africa and elsewhere. The Africa Centers for Disease Control and Prevention (CDC) and the African Union Development Agency have worked with regulators on the continent and in high-income countries to build capacity. And the treaty establishing the African Medicines Agency, to be headquartered in Rwanda, has entered into force, and the Agency will become the pharmaceutical regulatory body on the African continent.
Strengthening regulatory bodies in developing countries will also increase trust in locally produced products and help combat misinformation and the circulation of dangerous counterfeit medicines.
Third, new production units will be highly dependent on a sustainable and competitive market from which suppliers of vaccines and other new pharmaceuticals will be willing to purchase these vital tools. We recognize the need for current and future vaccine-producing African countries to access vaccine supply platforms, including GAVI. Market orientation strategies at regional and continental levels, as defined by the Partnership for Vaccine Manufacturing in Africa, can ensure the sustainability of ongoing efforts, with leading agencies and partners ready to lend their support. to guide markets, such as Unitaid. The G7 leaders also addressed this issue and asked relevant international players to work on a common market orientation strategy.
At the last World Health Assembly, there was consensus that building strong and sustainable productive capacities in developing countries was essential to move towards a safer world.
WHO Member States also discussed the need for a new pandemic treaty, as an interconnected world requires globally agreed standards and mechanisms to ensure strong coordination in times of acute health crisis.
And, crucially, governments have recognized that additional funding is urgently needed to make critical investments in pandemic preparedness and response capacities at national, regional and global levels. In this regard, we welcome the recent establishment of the new Financial Intermediation Fund for Pandemic Prevention, Preparedness and Response, housed at the World Bank, with WHO playing the central lead role. technical.
We are certain that there will be a new epidemic, the only question is when. It is high time to intensify collaboration, foster local manufacturing and build trust in locally produced products, to better prepare for the next outbreak.