As countries in the world scramble for access to the COVID19 vaccine, Africa once again faces the risk of being left behind. In the meantime, with more than 3 million cases and the alarming spike in the spread of the virus on the continent leading to the reintroduction of curfews, lockdowns and declaration of states of emergencies, the imperative for speedy access to the vaccine has become even more pressing.
Africa will need 1.5 billion doses of vaccine in order to vaccinate 60% of its population—the estimated minimum requirement for achieving ‘herd’ immunity. Yet, Africa’s path for access to the required level of vaccine is very narrow. A map of the world showing the status of the rolling out of COVID19 shows Africa as a part of the world where no vaccination has commenced, as a reflection of what Achelle Mbembe called ‘the global rule of health apartheid’.
In this context, African Union (AU) agency Africa Centre for Disease Prevention and Control (Africa CDC) head, John Nkengasong, warned that the world risks moral catastrophe if COVID19 vaccinations are delayed in Africa while wealthy countries are socking vaccines. WHO Director, Tedros Adhanom reiterated this stern warning in his latest address on 18 January. As an issue that concerns rights to health and life and global public good, of course much more than a ‘moral’ catastrophe is at stake.
While there are more than 150 vaccine candidates with 56 already at the stage of human trials, a number of vaccines have been approved for use in China, Europe, Russia and the US. Most recently, Pfizer’s COVID19 vaccine and Moderna’s COVID19 vaccines have been approved and being administered in the US. In Europe, the vaccine comirnaty, developed by BioNTech and Pfizer, has also been approved by the EU.
Much of the vaccine has been bought or ear marked for acquisition by economically well-off parts of the world. According a recent news report, none of those producing the vaccines approved in the US and Europe have plans to availing vaccines to Africa. Only, Pfizer Inc. and BionTech SE indicated to supply Africa with 50 million shots of the vaccine for health workers by the end of 2021.
The current supply of vaccines, notwithstanding the speed of approval & production, is very limited. This has mostly to do with the market-based approach to the production of the vaccine which vests enormous power in the pharma industry to determine the production and distribution of the vaccine. Needless to say this is not in accord with the consideration of vaccines for the global COVID19 pandemic as global public good. The most effective way of speedy production and distribution of the vaccine is through the creation of conditions for its generic production and distribution.
As a measure for averting the marginalization of African people from COVID19 vaccine, the continent’s premier human rights body, the African Commission on Human and Peoples’ Rights, in its Resolution 449 of its 66th Ordinary Session held in July/August 2020 called on the AU to develop a strategy for making arrangements for the production and distribution of COVID19 vaccine within the continent.
The AU through the Africa CDC has developed COVID19 vaccine development and access strategy. While this is good, the strategy covers only three areas 1) accelerate African involvement in the clinical development of the vaccine 2) access of sufficient share of the global vaccine supply and 3) remove barriers to widespread delivery and uptake of the vaccine. In November, President Cyril Ramaphosa of the Republic of South Africa, and Chairperson of the African Union, established the COVID-19 African Vaccine Acquisition Task Team (AVATT) to bolster the vaccine strategy endorsed by the AU Bureau of Heads of State and Government in August.
Within the framework of the foregoing, the AU Chairperson announced that the AU has successfully negotiated to have access to 270 million doses of COVID19 vaccine from three major suppliers: Pfizer, AstraZeneca (through the Serum Institute of India) and Johnson and Johnson with 50 million being available for the critical period of April to June 2021.
Notwithstanding the COVID-19 Vaccine Global Access (COVAX) Facility which promises 2 billion doses for all countries in the world and is considered by the AU ‘vital for Africa’s response’, it is rightly observed by the AU that the target of 600 million doses from COVAX will cover only about 300 million people across the African Continent, which is only about 20 % of the population. The additional 270 million does not expand the percentage of the population that will be covered significantly either.
As good a news as this is, it also highlights the limitations of the current approach. It depends on buying the vaccine doses from the pharma companies producing it. Such an approach shies away from including access to the technological knowhow of the vaccine and the intellectual property (IP) for the generic production and distribution of the vaccine on the African continent.
The World Health Organization (WHO) says transfer of technology is critical for manufacturing and distributing vaccines rapidly. Several barriers to scaling up the manufacture of Covid-19 vaccines could be addressed through collective actions of states, including conditions tied to vaccine funding that require technology transfer and the sharing of IP to allow mass and generic manufacturing of successful vaccine candidates.
In terms of transfer of technology, one notable initiative is the call to action that has been initiated by Costa Rica with The Who to create the Covid-19 Technology Access Pool (C-TAP)—a common shared pool of rights to technologies, data, and know-how that everyone around the world could use to manufacture any medical products needed to tackle Covid-19, including vaccines. Apparently, there are very few countries in Africa that have endorsed the C-TAP Solidarity Call to Action.
With respect to addressing the IP regulations, in October, India and South Africa put forward a proposal that the World Trade Organization (WTO) allows temporary waiver of the IP regulations, under the organization’s intellectual property agreement, “Trade-Related Aspects of Intellectual Property Rights,” or TRIPS. Now supported by nearly 100 countries, the proposal would allow for the more affordable production of generic treatments during the duration of the pandemic. Unfortunately, this call is facing stiff resistance from many developed countries and indeed from the major pharmaceutical companies themselves.
Yet, it is not clear what kind of more catastrophic health condition than COVID19 would justify the consideration of vaccine as global public good to which the rules on IP that apply for normal situaitons should be temporarily waived. Complementing the Africa CDC Strategy and as part of the human rights-based call of the African Commission on Human and Peoples’ Rights in its Resolution 449 for the AU to create the conditions for enabling the generic manufacturing and distribution of the COVID19 vaccine within the continent, it is of paramount interest for Africa that the AU expands its strategy on COVID19 vaccine to include access by and transfer of the know-how and technology to Africa for the production of the COIVID19 vaccine and the waiver of the IP restrictions for enabling its speedy access by the people of the continent by supporting the initiatives of South Africa and India and Costa Rica and the WHO.
This constitutes a critical addition to the current AU strategy to achieve, in the words of the AU Chairperson statement the containing of ‘the ever-changing toll of the pandemic in Africa’, hence the protection of people on the continent from the continuing threat of COVID19 to their rights to health and life.