As I was reading an electronic copy of the News Diggers newspaper published on November 28, 2023, I stumbled upon a story that covered the speeches delivered at the 3rd International Conference on Public Health in Africa. To summarize a few points that Hakainde Hichilema, the Zambian president, made, as covered by the News Diggers, he started by lamenting the low levels of productivity on the African continent occasioned by poor health. Hichilema, then, went on and indicated that there was no need to blame wealthy nations for holding on to COVID-19 vaccine doses at a time the pandemic was ravaging the world. What impressed me is that Hichilema acknowledged that Africa was taught a lesson on how inequalities can arise in a pandemic situation such as that created by COVID-19. But what was disappointing was what the president appeared to think was the ultimate solution to addressing such health inequalities – proposing and lobbying for the establishment of manufacturing centers for vaccines.

It’s either Hichilema was genuinely ignorant about the dynamics surrounding vaccine marketing and manufacture, in which case, he can be forgiven, or he purposely decided to ignore to point out the real solution. Championing the establishment of manufacturing centers for vaccines should not be Hichilema’s preoccupation. I give the reasons why in this article along with an alternative solution which, in my opinion, is more viable.

To bring awareness to everyone, here are the key processes involved in developing a vaccine along with its manufacturing and marketing dynamics. Upon discovery of a vaccine, the owner, who may be a pharmaceutical company, an academic institution or a partnership of these entities, will invest financial resources to carry out a variety of experiments in the laboratory which are followed by investigations in animals to ensure the vaccine is safe and effective. The vaccine is then taken into clinical trials in humans which may involve hundreds or even thousands of healthy volunteers to demonstrate its effectiveness and safety. These investigations consume huge sums of money – approximately over USD1 billion for a single vaccine. Once a vaccine is finally approved for clinical use, its sponsors would have already secured patent rights to be the only ones to manufacture and market it. This protection for exclusive marketing by the developers of a vaccine may last for about 20 years. Therefore, even though one may have infrastructural capacity to manufacture vaccines, they may not be able to do so due to restrictions on manufacture and marketing imposed by patent laws.

I was hoping that, by now, Africa should have learnt lessons from the devastating impact of HIV/AIDS in the 1980s – 2000s. During this period, HIV/AIDS became a leading cause of death in Africa. Around the same period, in wealthy countries such as the United States of America, AIDS-related deaths had been reduced by more than 70%. Why, on earth, did we have this imbalance in the impact of the HIV/AIDS pandemic? Well, pharmaceutical companies, who developed different treatments for HIV/AIDS, had the exclusive right to manufacture and sell anti-retroviral drugs at a price that poor countries could not afford. Meanwhile, wealthy countries could afford these treatments, which is why the impact of the HIV/AIDS pandemic in these countries was less severe. HIV/AIDS continued claiming thousands of lives across Africa until around the late 2000s when treatment became widely available. The widespread availability of anti-HIV/AIDS drugs in the late 2000s was, in part, due to the expiry of patent protections on these drugs. This meant that, in the absence of patent protection, other pharmaceutical companies could manufacture much cheaper generic versions of the same drugs. In the absence of vaccines, drugs and proper health systems, the COVID-19 pandemic was equally expected to overwhelm Africa with a disproportionately high number of deaths. Fortunately, this was not the case, partly due to Africa’s young population which did not succumb to this pandemic as much as others in developed countries did. The manufacture of COVID-19 vaccines is still very much restricted by patent laws which could explain poor vaccination rates in most resource-poor countries.

It is clear that patent laws have historically negatively affected access to life-saving treatments and this is a pattern African leaders need to be conscious about. Considering how patent laws are applied, it should also be clear that setting up vaccine manufacturing centers will not solve Africa’s access-to-vaccine problems. Instead, Hichilema and his fellow African leaders should increase funding to research and development (R&D) in their respective countries. What this means is that we should research and develop vaccines on the African soil. Eventually, such strategic investments will result in innovations with patent ownership by Africans. African leaders should be resolute in making sure that the next pandemic should find this continent prepared to develop its own drugs and vaccines. It’s unacceptable that HIV/AIDS appears not to have taught us enough lessons about where to invest our resources in order to ensure access to health care solutions by African citizens. Our preoccupation should not be the setting up of vaccine manufacturing centers, but rather R&D centers because the former will emerge naturally from the latter. Africa needs to take control of its natural resources to realize income which will fund R&D across the continent. We need to reject the idea that we cannot develop our own vaccines. We can, and investing in R&D is the first step towards achieving this goal.

I acknowledge that vaccine development can be an expensive endeavor, just like drug discovery and development. It is characterized by failures along the way – some vaccine candidates may not make it to clinical testing while others may fail during these clinical investigations. But this is no reason to avoid investing in this critical aspect of healthcare innovation. Ultimately, avoiding investing in R&D of drugs, vaccines and diagnostics has a much higher human and economic cost to Africa. Drugs, vaccines and diagnostic tools developed in wealthy countries may not be immediately available in Africa due to patent protection laws. This results in a huge human cost that has a negative impact on the economic progress of the continent. Obviously, being a net importer of these health care innovations is also detrimental to the African economy. Investing in R&D will create more jobs, reversing the brain drain that Africa has been experiencing for decades. It is such investments that will create the foundation for the rise of the African continent to an economic superpower. Until African governments start pumping resources into R&D, democratizing access to medication and vaccines will remain elusive.

About the author:

Peter Mubanga Cheuka is a medicinal chemist and drug discovery expert. He is also a lecturer at University of Zambia where he teaches general chemistry, organic chemistry and medicinal chemistry.
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