Africa manufactures only 1% of the 1.3 billion vaccine doses it administers annually.

Let that sink in.

Africa has the highest incidence of mortality caused by infectious diseases, but yet lacks the capacity to manufacture requisite vaccines. Africa depends on other countries for its vaccine needs – 99 percent of the continent's vaccines are imported. This dependence on imports leaves its citizens vulnerable to shortages of vaccines, causing health security challenges. The vaccine shortage indeed triggered a continent-wide crisis during the pandemic.

Vx Demand-Supply Dynamics – A Highly Concentrated Market

Global vaccine market size in 2019 was estimated to be 5.5B doses, which equates to approximately $33B in value. Global demand for vaccines is driven by governments of industrialized and developing countries, pooled procurement agencies, and private sector, with regulatory and advisory bodies overseeing vaccine quality.

Vaccine manufacturing is concentrated among large manufacturers such as GSK, Pfizer, Merck, Sanofi managing nearly 90% of the global value market. Only five manufacturers produce 60% of the global volume.

Large vaccine market share with only a few global manufacturers poses hindrance in key vaccine supply to low- and middle-income countries (LMICs). This has been particularly evident during the COVID crisis. Many early developers of COVID-19 vaccines entered into advance purchase agreements with rich nations, selling most of their Vx supplies to United States and Europe. As a result, countries in Africa, South America, and Asia have had a much lower vaccine coverage thus far and this trend is expected to continue. According to the World Health Organization (WHO), just a little more than 1 percent of the African population has been fully vaccinated against the COVID-19. Compare it to the U.S., where more than 50% of the population is already fully vaccinated.

A Long Road Ahead to Build Vaccine Manufacturing Capabilities

Africa has a long way to catch-up, and the only way it can sustainably achieve vaccine security is by investing in building local vaccine manufacturing capabilities. Currently, there are only a few vaccine manufacturers in Africa, primarily executing downstream Vx manufacturing activities. As shown in the graphic below, most are more focused on fill and finish, while very few can manufacture vaccines from end-to-end.

Paving Way for a Bold Vision

By 2040, the African Union and the Africa Centers for Disease Control and Prevention aim to have 60 percent of routine vaccines consumed on the continent to be produced locally. Multiple initiatives are being undertaken towards this vision, including but not limited to:

1. Influx of Funds from Key Players – IFC, along with four other institutions, will provide up to $14 million in grant funding to IPD (Senegal) along with project development support, helping it kickstart a manufacturing hub for COVID-19 and other vaccines.
2. Support Offered by the Government – King Mohamed VI of Morocco officially announced the signature of 3 conventions with a) Sinopharm; b) Recipharm; and c) Sothema, for the construction of a new vaccine manufacturing facility in Morocco. The top priority will be given to the anti-COVID vaccine; however, future opportunities exist for building a smaller plant for other profitable vaccines.
3. Collaboration with Global Manufacturers – Biovac (SA) will manufacture COVID-19 vaccines for Africa in collaboration with Pfizer and BioNTech. Biovac will acquire drug substance from Pfizer/BioNTech in Europe and perform fill/finish in South Africa. This showcases the capabilities, and tech transfer comfort with Pfizer, that Biovac has been able to build while working on the PCV13 vaccines over the years, enabling it to participate in the global vaccine supply chain for multiple products over time.

IQVIA point of view

The vision is definitely achievable, but Africa needs a change of strategy. We observe that various countries in Africa are adopting a rather fragmented and siloed approach around vaccine manufacturing, instead of a common, unified continent-wide strategy. The continent needs a long-term pan-African strategy, and not country-specific initiatives. Africa CDC and the African Union would benefit a lot more by promoting regional vaccine manufacturing hubs on the continent through public-private partnerships to achieve economies of scale and have feasible business models.

1. Focus on the high-value, expanding NIP routine vaccines such as Rotavirus and PCV, as it will be difficult to compete with existing DCVMs for legacy routine vaccines.
2. Follow backward integration strategy, i.e., start with downstream vaccine manufacturing activities, build capabilities, and incrementally move upstream.



3. Build regulatory capabilities and work towards WHO pre-qualification to supply through UNICEF/GAVI channels.
4. Leverage urgent global action for anti-COVID vaccine manufacturing to develop public-private partnerships and capacity that can eventually extend to other vaccines.
5. Establish partnerships with global manufacturers, facilitated by multilaterals through tech transfer hubs and incentivized by government through demand guarantees.

IQVIA has a dedicated public-health focused practice actively engaged with governments, national/international donors, non-governmental organizations (NGOs) and private sector stakeholders to support evidence-based decision making. Our service offerings include Policy and Strategic Planning, Disease Burden Assessment, Research and Analytics including undertaking large community and institutional surveys, Monitoring and Evaluations of Large programs, Procurement and Supply Chain Assessments, Digital Health in Public Health, Public-Private-Partnerships, Support Private sector engagement and Program Implementation. The public health team serves more than 20 countries in the Middle East, South Asia and African region. For more information, please reach out to Rishabh Jhol at rishabh.jhol@iqvia.com or Deepak Batra at DBatra@in.imshealth.com