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Aborode A, Olofinsao O, Osmond E, Batubo A, Fayemiro O, Sherifdeen O, Muraina L, Obadawo B, Ahmad S, Essar M, Tsagkaris C. Africa preparedness to discover COVID-19 vaccine: current state and controversy. HPHR. 2021;30.
DOI:10.54111/0001/DD7
Given the global demand for a COVID-19 vaccine, it is likely that even after the vaccine approval; there will be a considerable delay before it will be available in Africa. The large-scale, high-volume vaccine manufacturing infrastructure is largely absent in Africa, low health care equipments, and the rapidly escalating COVID-19 pandemic highlights the urgent need for capital investment in the region to minimize dependency on developed countries. The sections discuss the controversies surrounding the COVID-19 virus among the African population, Africa response towards COVID-19, actions trigger towards controlling COVID-19 spread, as well as the current state of their (Africa) preparedness to discover the COVID-19 vaccine.
The World Health Organization (WHO) declared that the COVID-19 a global health emergency and later a pandemic due to its rapid expansion worldwide (Wadvalla, 2020). In principle, African countries have managed to keep the COVID-19 pandemic under control despite their weak health systems. Vaccine availability in Africa has been considered as a potential game changer, with a low vaccination rate leading to a spread of COVID-19 in the continent and potentially the emergence of novel SARS-CoV-2 strains (Wadvalla, 2020).
African countries have responded to the COVID-19 pandemic by means of public health interventions for individuals, communities, religious places. Screening of travelers in combination with hand washing, social distancing and lockdown have been instrumental in keeping the continent’s number of cases minimal. Unfortunately, due to the socioeconomic conditions in most African nations, the COVID-19 pandemic management restrictive measures cannot be sustained for a long time. Informal economy represents a big part of the population’s livelihood and lockdowns have drastically reduced the income of many individuals and families. On top of this, COVID-19 denial leads to disease-spreading behaviors (Senghore et al., 2020).
Simultaneously, lack of critical infrastructures is undermining basic hygiene and sanitation in most African communities. Overcrowding has led to the spread of hygiene – related diseases, while clean water scarcity makes frequent hand – washing impossible for many communities across the continent. The burden of hygiene – related diseases can critically reduce the capacity of African healthcare systems when it comes to treating patients with COVID-19 (Nkengasong and Mankoula, 2020).
African countries have engaged in various efforts to combat these adversities. Public and private health sector and industry have joined hands to produce inexpensive ventilators; Kenya has manufactured 3D printed medical equipment. South Africa has provided mobile testing units to prevent movement of potentially infected individuals; Zimbabwe has manufactured large amounts of medical supplies such as gloves, hand sanitizers, and facial masks; Benin has invested in e-learning platforms to reduce students’ exposure to the virus (Osseni, 2020).
Although each country developed its own response, the authors approach Africa as a whole because of the large number of similarities in terms of socioeconomic condition, healthcare systems strength and COVID-19 prevention measures among African countries. Moreover, a significant number of efforts are under the umbrella of the African Center for Disease Control (ACDC). This paper elaborates on the controversies surrounding the COVID-19 virus among the African populations. In this light, the authors discuss the preparedness of scientific institutions in the continent to discover a COVID-19 vaccine
Many African countries have insufficient capacity to implement widespread testing, surveillance, including the identification of asymptomatic and mild infections that are major drivers of the pandemic (Li, 2020). Lack of infrastructure restricts the production of tests and vaccines, so vaccines development in Africa can be questioned in terms of feasibility. African developers will need to outsource large-scale production in the near term to contribute to the global COVID-19 vaccine initiative.
The African Vaccine Manufacturing Initiative have set up a working group to mitigate the limitations that Africa faces in its efforts to develop vaccines. This was created to build local production potential in Africa that will actively involved with key stakeholders to address the local need for a vaccine and improve the inadequate healthcare infrastructure. With the goal of launching a clinical trial in Nigeria, Creative Biotech (Nigeria) has already collaborated with Medigen (USA) and Merck (Germany) to address SARS-CoV-2 (Li, 2020).
The WHO COVAX efforts aid to accelerate the development and equitable access to COVID-19 vaccines and this mark an outstanding shift towards bring African countries off the sidelines and back into the vaccination race, correcting inequalities that have been an unfortunate landmark to the global vaccine rollout (WHO, 2021).
Similarly, the Ethiopian Public Health Institute (EPHI) plans to develop the SARS-CoV-2 spike protein in a yeast-based fermentation method in collaboration with Software Innovation (India). Finally, Biovac (South Africa) has modern facilities on a modest scale and has launched a feasibility study for a massive facility with a minimum annual production capacity of 100 million doses of COVID-19 vaccines and possible pandemic vaccines, as well as routine immunization vaccines (Margolin et al., 2020).
Despite the absence of adequate facilities for current Good Manufacturing Practice (cGMP)-compliant vaccine or therapeutic manufacturing in most of Africa, substantial pre-clinical vaccine production knowledge is also available at academic institutes and, as was the case for the South African AIDS Vaccine Project, vaccines could be produced on contract for clinical trials (Gray, 2016).
The Drug Discovery and Development Centre (H3D) based at the University of Cape Town is the only fully integrated drug discovery center in Africa that has taken a drug into a phase II clinical trial. The center has very strong collaborations with the pharmaceutical industry and MMV, a leading product development partnership, as well as the infrastructure and expertise to find potential therapies against COVID-19 (Gray, 2016).
H3D has assembled chemical libraries for its malaria and tuberculosis projects that could be screened to identify possible drug leads against SARS-CoV-2; however, this will require additional resources and funding because the center is contractually focused on antimalarial and anti-tuberculosis drug development.
Accordingly, groups at the University of Cape Town (South Africa), the National Research Centre (Egypt) and the Kenya Aids Vaccine Initiative (KAVI) have all confirmed that early-stage research on SARS-CoV-2 vaccine development is underway although further details have not been disclosed (Roussi and Maxmen, 2020). Important considerations for these vaccines will be the cost, their safety in individuals who are immunocompromised and the availability of manufacturing partners who can produce the vaccines at the required scale.
The COVID-19 pandemic poses a – perhaps unparalleled – humanitarian and medical threat worldwide and particularly in Africa. While this has spurred excellent progress in many countries in the production of vaccines and therapeutics, the vulnerability of resource-limited countries in Africa has also been highlighted.
Not only do these countries have minimal research capacity, but also there is largely little infrastructure for the manufacturing of tests, vaccines and therapeutic drugs, and few clinical trials are underway to fight COVID-19 in the continent. In view of these facts, capacity improvement is desperately required and the resources available could concentrate on repurposing existing medications or using convalescent plasma that can be easily used to treat infection and could be prioritized for high-risk individuals.
In addition, effective vaccination can be put in place by educating the people ahead of the introduction of the vaccine to Africa. With the controversy that occurred with the hesitancy and misinformation about vaccine amidst Africans, most people now doubt the credibility of the vaccine on the African population. Instances like this have filled people’s minds already that make them fearful and reluctant to get the vaccine. Thus, educating the public is another preparation the African continent needs to consider.
Furthermore, in terms of preparation, consideration needs to be made on accessibility of the vaccine to people in rural areas of every African country. While those in urban communities might have the advantage of access to hospitals, rural areas might be at a disadvantage in this aspect. Hence, the need to ensure the rural areas have access to the vaccine either by posting doctors to those areas or taking the vaccine to their local health centers.
To manufacture vaccines that could be tested and approved on the continent, effective manufacturing alliances need to be formed to reduce dependency on global initiatives that could be overwhelmed by global demand for a vaccine. In reality, this could present an opportunity for governments to invest finally in much-needed production facilities for cGMP-compliant vaccines. While the situation is inarguably critical, Africa plays an important role in the global battle against COVID-19, and it is important not to underestimate the determination and ingenuity of the population. Through a global vaccination network, we encourage the global vaccine community to jointly mobilize the technological and financial resources required to effectively solve the COVID-19 pandemic and establish a solid foundation for addressing potential pandemics.
Abdullahi Tunde Aborode is with Oli Health Magazine Organization, Research and Development, Kigali, Rwanda and Healthy African Platform, Research and Development, Ibadan, Nigeria.
Oluwatosin Abiodun Olofinsao is a doctoral student majoring in environmental economics specifically economics of the ecosystem and water, in the Department of Economics, University of New Mexico, USA.
Osmond C. Ekwebelem holds a degree in Microbiology from the University of Nigeria Nsukka. His research interest is in the area of clinical microbiology with special focus on infectious diseases, public health, and antimicrobial resistance.
Abiokpoyanam Peace Batubo is a doctoral student in the Department of Economics at Northern Illinois University, USA, who thrives in a diverse, fast-paced environment and values group collaboration in a professional setting. She is passionate about development, and agricultural and financial economics.
Omowonuola Feyikemi Fayemiro, MPA, is a doctoral student of the Department of Public Administration, University of Illinois, Chicago, IL, USA. Her research interest primarily address the public and nonprofit inter-sectoral relationship, as well as cross-sector collaboration in sub-saharan African countries.
Onigbinde Sherifdeen is with Department of Biochemistry, Federal University of Agriculture, Abeokuta, Nigeria.
Luqman Opeyemi Muraina, MA, is enrolled as a Master’s student is the Department of Sociology at the University of Cape Town, South Africa. He is interested in issues around academia, education change-leadership, and agriculture, and works in the area of decolonization of higher education curriculum in South Africa.
Babatunde Obadawo is with Department of Chemistry, University of Toledo, Toledo, USA.
Shoaib Ahmad is with Department of Medicine and Surgery, Punjab Medical College, Faisalabad, Pakistan.
Mohammad Yasir Essar is with Medical Research Center, Kateb University, Kabul, Afghanistan.
Christos Tsagkaris is with University of Crete, Faculty of Medicine, Heraklion, Greece.
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