Making Vaccines in Africa

Episode Narrative

In the heart of the African continent, a profound transformation began to unfold in 2021. At a time when the world was grappling with the ferocity of the COVID-19 pandemic, the African Union took a monumental step by establishing the African Medicines Agency, also known as the AMA. This initiative aimed to harmonize regulatory standards across the continent, allowing for accelerated access to safe and effective medicines. In an era when healthcare sovereignty was desperately needed, the AMA emerged as a beacon of hope, symbolizing a commitment to regional integration under the African Continental Free Trade Area. This was not merely about medicine; it was about charting a new course for health equity, dignity, and self-sufficiency within a system that has often relegated the continent to the margins.

Fast forward to the year 2025, and three striking mRNA vaccine technology hubs sprang to life in Dakar, Senegal; Gqeberha, South Africa; and Kigali, Rwanda. Supported by the World Health Organization and a host of international partners, these hubs were not just facilities; they were the foundation of a vision. A vision to produce vaccines locally, to dismantle the chains of dependency that had historically bound African nations to foreign suppliers. As the pandemic continued to reveal stark vulnerabilities within African health systems, these hubs became vital cogs in the machinery of resilience.

The experiences of 2021 painted a harrowing picture. While the rest of the world raced to secure vaccines against the deadly virus, Africa remained at the back of the line. By the end of that year, the continent was among the last to receive life-saving vaccines against SARS-CoV-2. This disparity wasn’t limited to COVID-19; the routine childhood immunization rates plummeted to the lowest levels recorded by UNICEF in Eastern, Southern, West, and Central Africa, hovering between 69% and 74%. These figures were not merely statistics; they represented the millions of children left vulnerable in a world that had all but turned its back on them.

In response to this troubling landscape, the African Union introduced the Partnership for African Vaccine Manufacturing, or PAVM, in 2022. The ambitious goal was clear: to produce 60% of Africa’s routine vaccine needs by the year 2040. With initial investments focusing on mRNA and viral vector platforms, this initiative sought to ensure that no child, no family, and no nation would suffer the pangs of vaccine scarcity ever again. But as lofty as these goals were, the challenges loomed large. Between 2000 and 2021, public funding had been the backbone of health financing in Africa, yet it was evident that this funding failed to capture the complete picture. Critical gaps remained in understanding investments in vaccine manufacturing and research, leaving many questions unanswered.

Further complicating the landscape of health equity, reports in 2025 highlighted severe disparities in healthcare access and outcomes not only within Africa but also across the globe. The American Cancer Society reported that Black people in the United States faced the lowest survival rates for cancer compared to any other racial or ethnic group. The stark reality underscored a global inequity in access to advanced therapies and vaccines. In the same year, the repercussions of funding cuts were felt acutely, particularly within the realm of HIV/AIDS care. PEPFAR’s funding suspension jeopardized the wellbeing of over 20 million individuals in Sub-Saharan Africa, including 550,000 children. This threatened to unleash a resurgence of AIDS-related mortality, echoing the fragile nature of donor-dependent health programs and the urgent need for sustainable local solutions.

The struggle for health equity extended beyond just vaccination. In 2023, research from Rivers State, Nigeria, starkly illustrated the urgent need for rapid diagnostics and local vaccine development in the face of emerging diseases like Lassa fever. A retrospective cohort study revealed that 25% of suspected cases were confirmed, bearing a chilling mortality rate of 20.5%. These findings underscored a harrowing truth: spontaneous and rapid intervention was necessary. As emerging infections posed threats, the ability to quickly develop effective vaccines became paramount.

Yet, the shift towards robust health systems went deeper than the urgent need for vaccines alone. By 2025, evaluations of digital health interventions in Sub-Saharan Africa surfaced promising avenues for medication management and healthcare delivery. Telemedicine and mobile health programs began to forge connections where physical spaces remained limited. These innovations hinted at a future where technology could bridge the gaps in vaccine distribution and monitoring, carving pathways toward more resilient health infrastructures.

As these advancements unfolded, they simultaneously illuminated the stark realities tied to systemic inefficiencies. A pooled efficiency score of 0.77 for African health systems suggested an inefficiency of around 23%. This inefficiency was palpable within vaccine procurement and distribution, where improvements were critical and urgent. Contrast this with the World Health Organization's findings: Africa only accounted for 3% of the global health workforce while shouldering over 24% of the global disease burden. As the disparity became patently clear, so too did the pressing challenges in healthcare delivery.

Amidst these challenges, the finances guiding African health systems beckoned for scrutiny. A systematic review revealed that tax-based systems and National Health Insurance Authority schemes outperformed out-of-pocket payments in providing financial protection and enhancing service accessibility. Yet, as out-of-pocket expenses consumed over a third of total health expenditure, it raised alarm about the sustainability of health initiatives and the looming threat of catastrophic health spending, especially for families striving to access basic childhood immunization services.

The African Global Health initiative took up the mantle by 2025, calling for sovereign health systems capable of addressing the continent’s unique challenges. It emphasized the imperative need for local vaccine production and research capacities, illuminating a path toward self-reliance and resilience in the face of future health crises. The African Union’s health strategy for 2016 to 2030 became a guiding document, advocating for an African regulatory mechanism for medicines and medical products. Here, global health diplomacy was not just a strategic term; it became a lifeline, aiding the negotiations necessary for infrastructural and regulatory support for the AMA.

However, the successful realization of these aspirations hinged upon the health workforce supporting them. In 2025, reviews of the WHO African Region's healthcare landscape revealed both growth and gaps. Progress had been made in mitigating critical workforce shortages, yet significant work remained to ensure universal health coverage and security. Challenges in vaccine manufacturing persisted, especially in an environment overly reliant on external partners.

As projections highlighted the looming shortage in the health workforce, it became clear that planning and fiscal space needed urgent attention. The persistence of high out-of-pocket health spending raised profound concerns about the continent's capacity to meet Sustainable Development Goals and attain universal health coverage.

Reflecting upon the state of health systems in Africa by 2025 painted a picture of complexities intertwined with historical neglect and chronic underfunding. The systemic challenges across various sectors, particularly in vaccine manufacturing and research, call for radical solutions and innovative thought.

Yet, there was hope on the horizon. The African Union’s efforts to unify markets under the African Continental Free Trade Area brought forth an innovative framework that could reshape the landscape of health procurement. By promoting pooled procurement of vaccines and medicines, the African Union aimed to shatter the chains of dependency on imports while weathering the tumultuous cycles of market demands.

As this episode draws to a close, we are left with a powerful question: what legacy will these efforts leave for future generations? It is not merely about responding to a pandemic or a series of health crises; it's about building a future where Africa stands at the forefront of its health sovereignty. The journey towards local vaccine production and self-sufficiency symbolizes not just a goal, but a profound commitment to nurturing health equity in a world often characterized by disparities. It is a quest to ensure that every individual — every child, mother, and father — has access to the healthcare they deserve, anchored in the very soil of their homeland. The dawn of this new era is not just a promise; it is a necessity for a more equitable health landscape across Africa and beyond.