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Why Gavi must commit to buying Africa-manufactured vaccines

Vaccine Solidarity
Why Gavi must commit to buying Africa-manufactured vaccines

By Dr Githinji Gitahi, Group Chief Executive, Amref Health Africa

African governments, with strong support from the African Union’s Africa Centres for Disease Control and Prevention and WHO have engaged in high gear in an agenda to start vaccine manufacturing on the continent. This has been driven by injustices meted on Africans by high-income countries who gobbled available COVID-19 doses as Africa watched and waited.

Vaccine manufacturing is a great step forward for a continent that currently imports 99% of all the vaccines it consumes. This is not unique to vaccines as the same malady, though to a much lower level, afflicts essential medicines and health commodities.

However, Africa’s Manufacturing Plan is threatened and may be nothing more than headlines of intellectual property transfer, media launches and manufacturing site ground-breaking events.

The vaccine manufacturers currently falling back to a stock market-driven, paternalistic approach to support African governments in their manufacturing agenda may be guilty of deliberately duping the world that they really care - while in actual fact, they may be doing these efforts to distract from calls of voluntary licensing of intellectual property to markets where they see a real profit threat!

I fear they know the Africa Manufacturing Plan has little chance of success and is no threat to their profits.

The Global Vaccine Alliance (Gavi) can change this.

Gavi was launched on 31st January 2000 with the aim of expanding and improving immunisation in the developing world. An innovative financing mechanism for the global public good. Eligibility for vaccine funding from this multi-lateral global agency, funded through contributions from high-income countries and foundations, is based on a country’s Gross National Income per capita. Poor countries qualify.

AMIU COVID-19 vaccination drive in Kibera
A COVID-19 vaccination drive run by Amref International University Students in Kibera, Nairobi, January 2022 (c) Maureen Cherongis

As of 2020, there were 57 Gavi-eligible countries globally, out of which, 40 are in Africa – 70% of all Gavi-eligible countries and close to 75% of all African countries.

Since its launch in 2000, Gavi has deployed over $13.3 billion to its eligible countries with $8.5 billion to Africa alone. This means that 64% of all Gavi funding finds its way to Africa to finance childhood vaccines needed to save lives from vaccine-preventable diseases. African governments finance only 6% of the budget.

So, Gavi vaccinates Africa!

Gavi’s vaccine business is Africa’s business and Africa’s vaccine business is Gavi’s business.

It has not been any different for COVID-19 vaccines.

Did you know?

Currently, Africa imports
The continent is home to some
Of the COVID-19 vaccines Africa has received, close to

Since the start of the COVID-19 vaccination programme in Africa, Gavi, through the COVID Vaccines Facility (COVAX), has sent 473 million doses to 52 African countries. That is 62% of all COVID vaccine doses received in the continent free of cost as they are multilaterally financed through Gavi.

It’s clear that Africa-manufactured vaccines have no market unless the Africa Union establishes a well-funded alternative to Gavi: but why should it?

Why not just support the existing and working mechanism to continue raising more money, expand its funding to building primary health systems that are the foundation of effective vaccination programmes, and, most importantly, demand and negotiate for Africa-manufactured vaccines to be purchased by Gavi for distribution, largely on the continent?

Without advance market commitments on vaccines manufactured in Africa by Gavi, the Manufacturing Plan is dead.

If you are looking for examples, consider that the South Africa Aspen Institute is manufacturing J&J vaccines but Gavi hasn’t offered to purchase yet and they have no place to sell beyond the South African (not a Gavi-eligible country) local consumption market. Once the local market is satisfied, will the Aspen Institute COVID-19 vaccine production line close?

And why would a Gavi eligible country like Kenya, Senegal, or Rwanda manufacture vaccines while all their local consumption is being delivered for free from Gavi unless there is a committed plan to sell to Gavi?

This is not Africa begging. It’s Africa rightfully demanding its role in the global supply chain paid for by global multilateral financing mechanisms.

The Africa Union through Africa CDC's Partnerships for African Vaccine Manufacturing must demand a purchasing plan through the Advance Market Commitment instrument from Gavi before all African manufacturing efforts collapse as is inevitable without such a plan.

This is not Africa begging. It’s Africa rightfully demanding its role in the global supply chain paid for by global multilateral financing mechanisms.

Gavi’s money is the world’s money, and the world must enable more resources to Gavi but also reform its governance for more representation of the African continent which forms 70% of its business.

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