SA vaccine tech hub a boost far beyond Covid and our borders

The World Health Organisation recently announced it would be establishing a technology transfer hub in SA – one that would give the whole continent the power to make its own mRNA vaccines.

President Cyril Ramaphosa said it placed the continent “on a path to self-determination” and that it was a historic move.

The hub is intended to enable vaccine manufacture while also scaling up other health-related commodities.

This comes in the midst of a global pandemic that has exposed the real fault lines of inequality.

According to senior executive for trade development at the Aspen Pharmacare Group Stavros Nicolaou, only about 40 million doses of the global 2.5 billion doses of Covid vaccines have been administered in Africa, despite carrying a population of 1.3 billion people.

He was speaking on a webinar organised by the Wits School of Governance, and said facilities such as Covax that sought to “support the least developed nations around the world have been met with only minimal, if any, success”.

He added: “We can talk about solidarity, but the reality is that the procurement is led by governments and I can’t blame governments for looking after their citizens first, and of course it becomes a scramble, but it comes at the expense of the global solidarity project”.

Less than 0.2% of Covid vaccines have gone to low income countries, and this is not the first time we’ve seen this.

Vaccine production happens in the three steps, and right now the first is missing on the continent.

They are: production of the active substance (the antigen that goes into the vaccine); “fill and finish” that involves putting the active substance in buffer solutions, putting it in a vial, heating and moulding it in a particular position and capping it to keep it sterile. 

The third is packaging and labelling ahead of distribution and, according to Nicolau, “security of vaccine supply only comes if you have all three”.

He said we needed technology and skills transfer to get us there, as well as “a full reorientation of the current global procurement dynamics” so that Covax and Gavi – both of which seek to redress vaccine inequity – did not end up buying vaccine for Africa from other continents.

If that happened, facilities in Africa could end up “white elephants” and that would not give the continent the security it needs.

That, according to Dr Martin Friede, who leads the vaccine research unit at the World Health Organisation, is precisely what the planned mRNA hub in SA can address.

He said that in April, the WHO decided it would be “important to increase the capacity of African countries to produce their own vaccines” and decided mRNA technology was the most appropriate, as it could be adapted each time to tackle different zoonotic diseases.

He added: “SA submitted the best proposal and also has the top academic know-how.”

He said technology skills transfer was important, but so were licences that went “beyond Covid so that the facility is sustainable and can also be used ultimately to produce what is needed to tackle malaria, HIV and TB in other African countries too”.

Vaccines for those diseases, using more traditional technology, had shown poor success rates, “but using new technology might enable SA to jump ahead of the game”.

He said no other countries would have “a combination of the technology, the clinical trial capacity and the disease burden all in one place”.

If the facility is only set up for pandemic situations, it sits idle between pandemics.

Like Nicolaou, he said the announcement of the mRNA tech hub came after witnessing what happens when vaccine nationalism abounds.

“Less than 0.2% of Covid vaccines have gone to low-income countries, and this is not the first time we’ve seen this,” he said.

Glaudina Loots, director of health innovation in the department of science and innovation, said: “One of the things we need to do is look at what we’re doing from the SA side and how we can use the crisis created by Covid to look ahead.”

She said “beyond mRNA”, the department was also looking at other vaccine technologies because in the long term, any sustainable capacity within SA and Africa on the vaccine front would be a boost.