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Dr Neema Kaseje, a public health specialist and a surgeon with Medecins Sans Frontieres, highlights what must be done at continental level to get vaccines for the population

Harriet James @harriet86jim

In your view, what are some of the challenges hindering Africa from manufacturing its own vaccines? 

Vaccine manufacturing is not simply a case of setting up a factory and churning out vials of vaccines the next day.

That doesn’t mean that this shouldn’t be a priority — it makes good economic and even environmental sense to have vaccines produced in Africa — but we need to nuance the conversation further.

For me there are four key barriers – or rather ingredients for success – to improving Africa’s vaccine capabilities. 

First off, we need to see institutions and governments work hard to develop the next generation of researchers and scientists who have the expertise and knowledge to design and manufacture vaccines.

We need more molecular biologists, microbiologists and virologists. We have great institutions here in Africa, but many of our brightest leave the continent as there are not as many opportunities in these areas here. 

Secondly, we need to ensure we have the right regulatory processes and environments.

The new African Medicines Agency will go a long way to help this, but we also need strong local regulators to ensure medicines are created in a way that’s safe for those involved in making it and that the final product is a high quality.

This will need investment in institutions that conform to the highest scientific standards.

To promote trust in these institutions and their products, we must include communities in the process. There needs to be more interaction between scientists and the public. 

Third is leveraging structures already in place, including the Africa  Centres for Disease Control and Prevention, to negotiate the best possible deals that will build local infrastructure and supply chains to strengthen pandemic preparedness and response.

Covid-19 will not be the last pandemic, so we must be well-equipped, working together to strengthen capacity.

And finally, is the work of governments and regional organisations such as the African Union to simplify and accelerate processes for vaccine transport and delivery across the continent.

Progress made with the African Continental Free Trade Agreement can be leveraged now to facilitate production and delivery of vaccines to serve our population of one billion. 

This will need a coordinated approach, and no one African country should do it alone. 

How can African countries build strategic partnerships to manufacture its own vaccines?

The global development landscape is changing rapidly, and African countries have seen a significant increase in trade, foreign direct investment and official development assistance from countries such as China and Japan.

We should, therefore leverage on these existing ties to offset some challenges.

Recently, the AU partnered with African CDC to launch the Partnerships for African Vaccine Manufacturing, which aims to leverage Pan-African and global partnerships to scale-up vaccine manufacturing on the continent. 

However, such partnerships can only come to fruition if African countries can set aside personal interests and come together to achieve a common goal.

Africa is at risk of being left behind when it comes to vaccine access. We need more solidarity and more collaboration within the continent.

Furthermore, we need to maximise effective interventions such as hand washing, mask-wearing, and physical distancing.

Vaccines should complement adherence to public health measures that are already in place.

Most experts say Africa is ready to have its own vaccines, especially after handling diseases such as Ebola. Have we really learnt from our experience?

Africa has the capacity: we have centres producing vaccines in Algeria, Egypt, Morocco, Senegal, South Africa, and Tunisia. Some  lessons we learnt from Ebola include the need to prioritise community leadership, and maintain community trust.

The Ebola crisis in West Africa ended when the community took the lead and that was before a vaccine was developed.

In Liberia, for example, whether there is a pandemic or not, there are handwashing stations everywhere, and community infection prevention and control measures have become part of their DNA.

When Covid-19 hit, they had a distinct advantage compared to other countries who had not dealt with Ebola. Second, we need to be comprehensive in our approach.

We cannot focus on Covid-19 alone, we need to address mental health, maternal and child health outcomes, the lack of access to surgical services, the teenage pregnancy crisis, HIV, Tubercosis and malaria.

One of the main factors affecting the continent is the lack of political will by our leaders to form partnerships with other countries, set aside funds for research, such things.

How will we be able to give our leaders the will to set aside funds to build this capacity or even be involved in the process of vaccine manufacturing? 

Leaders from Rwanda and Ghana are stepping up to the plate, but more leaders on the continent need to prioritise health and research investments as key components of health security. 

How can we convince our people to come out in numbers and be vaccinated by something that we have produced?

We need to provide more information and invest more in the public during the production and the release of vaccines.

Maintaining trust is critical during this process, and scientists will need to actively engage with the public, through traditional media platforms, social media, and radio shows. 

The public needs to understand what vaccines are available and their benefits. Communicating with transparency is key to maintaining public trust in vaccines.

Then, finally, the public should be provided with a streamlined process of receiving vaccines. 

For Africa to produce its own vaccines, we require changes to intellectual property laws, trade agreements.

We need to ramp up advocacy efforts to highlight disparities in vaccine access and to point out futility in hoarding vaccines and IP rights.

From a global perspective, without equity in vaccine access, no one is safe, and the pandemic will continue to rage on with devastating consequences in terms of lives lost and livelihoods.

We need to make sure that governments and pharmaceutical companies with IP rights waive them in the interest of saving lives. 

Is the vaccine passport the solution in easing travel and what are its pros and cons?

Before we get to international travel, there’s a lot more we need to do to protect people against Covid-19.

For example, we have had some success maximising mask wearing, hand washing, and distancing, using the community-based approach with community health workers, youth, and digitised household visits.

Our next step now is to roll out the intervention across Kenya and other countries in the region who use community-based health care as a strategy for delivering essential health services. 

Vaccine passports can come later and, yes, they would help to facilitate travel, once the pandemic is under control.

Examples from India, and Brazil show us that the pandemic is still not under control in parts of the world.