By Michael Gwarisa
The Africa Centres for Diseases Control (Africa CDC), has established a new system, the Platform for Harmonised Africa Health Products Manufacturing (PHAHP), that will see the continent coordinating the manufacturing of vaccines, therapeutics and diagnostics, a top Africa CDC official has said.
While the continent has already made inroads regarding local manufacturing of vaccines following the setting of the Partnership for African Vaccine Manufacturing of Vaccines (PAVM) in 2021, which sought to ensure Africa at least manufactures 60 percent of vaccines locall, the PHAHP platform seeks to ensure the continent is capacitated in not only vaccine manufacturing but also around therapeutics and diagnostics.
At the five-day International Conference on Public Health in Africa (CPHIA) in Lusaka Zambia, the need to expedite the local manufacturing of vaccines on the continent was repeated in numerous sessions, amidst indication that vaccine manufacturing on the continent is currently below 1 percent.
Giving opening remarks during a Track 2 session on Fostering African-led Innovation and Advancing Local Production in Vaccines, Diagnostics and Therapeutics, Africa CDC Director General, Dr Jean Kaseya told delegates that Africa needs to secure the health and well-being of its citizens and locally manufacturing vaccines was a first step toward meeting that goal.
African nations in aggregate, lack the infrastructure, production capacity and the know-how to create a robust ecosystem and other medical products that we need. Moving beyond vaccines, African nations have decided to set up the Platform for Harmonised Africa Health Products Manufacturing (PHAHM),” said Dr Kaseya.
The platform, according to Dr Kaseya, will fulfill African manufacturing ambitions of becoming a vaccine, therapeutics and diagnostics manufacturing powerhouse.
“Therefore, I have decided to create a directorate that will lead this agenda and in a few days, I hope most African people will have the opportunity to send applications for all of the positions we are creating starting with the position to lead the platform that we are talking about.”
Status of Diagnostics and Therapeutics Manufacturing In Africa:
Following the COVID-19 pandemic, the focus on the continent has been on developing vaccine manufacturing capacity as the continent works on preparing for the next pandemic. However, the CPHIA 2023 also echoed the need for a vibrant Therapeutics and Diagnostics manufacturing system to support the new vision for self-sufficiency around Africa’s healthcare.
Professor Abderrahmane Maaroufi Director, of the Institute Pasteur Maroc (National Public Health Institute), said it is easier and affordable to manufacture diagnostics and therapeutics locally, at the moment, the continent only manufactures less than 2 percent of Africa’s needs and demands.
“97 percent of diagnostics and therapeutics are imported from outside which could affect of capacity as a continent in terms of combating diseases. However, there is now progress that we can observe through the efforts by Africa CDC,” said Prof Maaroufi.
Before formation of the Africa CDC, Africa had no structure or mechanisms in place to enhance continental preparedness in terms of public health and emergency response.
Vaccine Manufacturing in Africa:
Turning to local vaccine manufacturing, he said the plan to manufacture vaccines on the continent came as the recognition of problems that existed including some that were exacerbated by the COVID-19 pandemic. He said without taking action, the health problem on the continent could get worse as in a few years, the population of Africa is likely to hit the 2 Billion mark.
The Africa CDC is also working on developing a pooled procurement mechanism of vaccines and other medical products for the continent and ensuring and encouraging the procurement of African-made vaccines by African states.
Manufacturing of vaccines, diagnostics and therapeutics on the content is also backed by a task force comprising Africa CDC, PEPFAR and Global Fund. UNICEF is also working with Africa CDC to see how best to support countries in the area of Supply Management.
Mobilising Resources to Kick-Start Vaccine Manufacturing on the African Continent:
Vaccine manufacturing on the continent is also set to be supported by development partners and foreign governments. Dr Kaseya said manufacturing vaccines won’t be possible without the buy-in of the European Union.
Meanwhile, Belgian Director General for Development Cooperation and Humanitarian Aid, Ms Heidy Rombouts said her government will champion the cause to have more European countries supporting the initiative to manufacture vaccines on the African continent.
“Belgium will host the European Union Presidency from January 1st 2024 onwards, for a period of six months. From the perspective of international cooperation, Belgium will put global health and our partnership, EU/Africa is high on the agenda of the Six-month Presidency,” said Rombouts.
“We all witnessed how the international community mobilised to address one of the global health crises and one of the pandemics. We witnessed the need to reshape the international health system. It is critical that as the international community, we all embrace this initiative by Africa to start manufacturing vaccines as a way to build a stronger health architecture.”
He however noted manufacturing capacity and infrastructure woes that continue to hinder the continent’s efforts to produce vaccines, therapeutics and diagnostics.
Steps Towards Manufacturing Oral Cholera Vaccine On The Continent:
Despite the challenges Africa is facing regarding ramping up local manufacturing of vaccines, the Africa CDC has developed a list of 22 diseases that require urgent vaccines on the continent. This will see records and capacity being channeled toward local manufacturing.
Amongst the priority vaccines on the list is the local manufacturing of Oral Cholera Vaccines on the continent in light of the recent surge in demand for OVC across the globe. This comes as a way to bridge the supply gap which has been greatly widened by low manufacturing capacity and supply chain-related challenges and production is currently confined to a few organisations.
In an interview with HealthTimes on the Side-lines of the CPHIA, Ms. Akhona Tshangela, the PAVM Programme Coordinator under Africa CDC said the Oral Cholera Vaccine had been included among the 22 priority vaccines to be locally produced.
“Over the past two years, we have been able to think through the roadmap in terms of what is needed for local manufacturing of vaccines to come to fruition for us to be able to reach 60 percent of vaccines being manufactured on the continent of for them to be used by its people,” said Ms. Tshangela.
“We have identified the priority diseases that need vaccines for contextualising them to the African continent. These are about 22 vaccines looking at our legacy vaccines but also looking at the epidemic-prone diseases. We see a lot of outbreaks on the content and we have over 18 countries battling Cholera outbreaks at the moment. I am glad to say the Cholera vaccine is definitely among the 22 priority vaccines to be produced on the African continent.”
Currently, there are three World Health Organization (WHO) pre-qualified oral cholera vaccines. These are Dukoral manufactured by Valneva Sweden AB, Shanchol manufactured by Shantha Biotechnics (an Indian subsidiary of Sanofi) and Euvichol-Plus manufactured by EuBiologics Co. Ltd. Shanchol and Euvichol-Plus are currently available through the Global OCV Stockpile.
In 2022, Shantha Biotechnics, which produces about 15 percent of the world’s supply of OCV, announced that it would end production and distribution of Shanchol by 2023.
“We have a few manufacturers who are already thinking of producing the Oral Cholera Vaccine. We have tech transfer to do so and Oral Cholera Vaccine is one of those key epidemic-prone diseases on the continent and we have to ensure that there is access to vaccination. What’s important to think about however is the demand for Oral Cholera vaccines. Member states should be able to say they want OCV and utilise it during an outbreak or before an outbreak occurs.”
A total of 18 countries including 10 African Countries, seven from Asia and one from America are currently battling Cholera outbreaks, pushing demand for Oral Cholera Vaccines (OVC) to unprecedented levels. At the same time, approximately 4,000 people have since died from Cholera since January 2022.
Countries experiencing Cholera outbreaks and in need of the OVC in Africa include Burudi, Cameroon, Congo, the Democratic Republic of Congo (DRC), Ethiopia, Kenya, Mozambique, Uganda, Zambia and Zimbabwe. Afghanistan, Syria, Iraq, the Philippines, Pakistan, India and Yemen are also experiencing outbreaks. In America, only Haiti is having a Cholera outbreak.
