Why SADC must up its game
Thabiso Scotch Mufambi
Harare – The global COVID-19 vaccine supply facility, COVAX, has so far shipped over 58 million doses to 122 participating countries, but only eight Southern African Development Community (SADC) member states have benefited since distribution started as supply challenges continue to dog the scheme.
The eight out of 16 SADC members – Angola, Botswana, the Comoros, the Democratic Republic of Congo, Eswatini, Malawi, Namibia and Zambia – have received a total 2.9 million doses, far short of the initial allocation and expectations.
The constricted supply to SADC countries has seen President Hage Geingob of Namibia decrying what he has termed “vaccine apartheid”.
As of May 10, according to statistics provided by one of the partners in COVAX, GAVI, the DRC has so far secured the highest number of doses from the facility – 1.7 million jabs of the AstraZeneca vaccine.
Angola took delivery of 624,000 doses on March 2 from a first round allocation of 2,172,000; Botswana received 24,000 jabs on March 28 from an allocation of 100,800; the Comoros 12,000 doses on April 12 from an allocation of 100,800 and Eswatini received its first doses on March 13, which amounted to 12,000 from a first round allocation of 108,000.
Malawi, Namibia and Zambia received 360 000 doses, 24,000 doses and 228,000 doses respectively, all far short of the published first round allocation.
The allocations constitute less than five percent of what was Southern African countries signed up for last year.
The vaccine supply challenges have resulted in amplified calls for the temporary waiver of intellectual property (IP) rights for COVID-19 vaccines.
The proposal for suspending IP rights for COVID-19 treatments and vaccines was first tabled by India and South Africa in a formal approach to the World Trade Organisation (WTO), and it has been backed by around 100 other countries.
According to the proponents, an IP waiver for vaccine patents could speed up vaccine access in poorer countries as it would allow any company with capacity – besides those who originated the processes – to manufacture the drugs.
But the proposal has been met with fierce resistance in some quarters.
The director-general of the International Federation of Pharmaceutical Manufacturers & Associations, Mr Thomas Cueni, said even with a waiver on patents, vaccine manufacturing remained a complicated process that would not be easily replicated.
“You could get the recipe from Mary Berry for the loveliest cake you can imagine. But if you try to replicate that cake, good luck,” he said recently.
Another critic, Sir Robin Jacob of the University College London in the United Kingdom, said there was no evidence that supplies would improve even if new manufacturers had IP access.
Citing the American company Johnson & Johnson which said it examined 100 potential partners but concluded only 10 were capable of making its shot, Sir Robin Jacob said: “There’s almost nobody you could license to. They couldn’t do it — you need a huge plant, huge skills, patent or not, it doesn’t matter.”
But the majority of the world contends these are attempts at stonewalling “vaccine democracy”, and they point to the proliferation of the first ever polio vaccine as an example of the good that can flow from opening up drug development processes.
In a 1955 interview with American broadcaster CBS, the maker of the polio vaccine, Dr Jonas Salk, was asked who owned the patent to the life-saving immunisation shot. He answered: “Well, the people, I would say. There is no patent. Could you patent the sun?”
The question being asked is if this could be done for polio, and with the world facing a global pandemic of epic proportions, is it not prudent and logical to waive IP rights for the COVID-19 vaccines?
World Health Organisation Director-General Dr Tedros Ghebreyesus certainly thinks so.
“Waving patents temporarily won’t mean innovators miss out. Like during the HIV crisis or in a war, companies will be paid royalties for the products they manufacture,” he said.
COVAX urgently needs 20 million doses during the second quarter of 2021 to cover interruptions in supply triggered by increased demands for vaccines in India, where COVAX’s main supplier of the AstraZeneca product is based.
To cover the supply gap, the WHO has been encouraging countries who have stockpiled vaccines to donate to other countries. On a good note, France, New Zealand and Sweden have already pledged to do as much.
Further, the lobby to waive IP rights received massive backing from the US government recently.
“This is a global health crisis and the extraordinary circumstances of the COVID-19 pandemic call for extra ordinary measures. The administration believes strongly in IP protections, but in service of ending the pandemic supports the waiver of those protections for CODI-19 vaccines,” the US government said.
Reacting to the news, WHO Regional Director for Africa Dr Matshidiso Moeti said: “A waiver of patents for COVID-19 vaccines and medicines could change the game for Africa unlocking millions more vaccine doses and saving countless lives.”
But a World Trade Organisation decision on the matter is only expected towards the end of the year.
While awaiting the fate of the IP waiver lobby, Africa has taken a step towards enhancing its internal vaccine production capacity to counter the current uneven global supply.
According to the Africa Centres for Disease Control and Prevention (Africa CDC), the continent requires about 1.3 billion doses of vaccines annually, representing 25 percent of global demand. Africa currently manufactures just one percent of its requirements, or 12 million doses, with unreliable imports being counted on to fill the gap.
In the SADC region, only South Africa has developed capacity to produce vaccines. Four other suppliers are concentrated in the North African countries of Algeria, Egypt, Morocco and Tunisia; while West Africa has one manufacturer in Senegal.
Africa CDC Director Dr John Nkengasong has repeatedly said the continent should end its over-reliance on the outside world for vaccines.
“People who do not have their own capacity for vaccine manufacturing, diagnostics and therapeutics cannot guarantee their own health security. I think we have learnt that over and over in the last couple of months,” he said.
Rwandan President Paul Kagame said he had recently initiated contact with COVID-19 vaccine manufacturers with a view to commence local production.
“In the past few weeks or maybe months I had the opportunity to initiate contact with different manufactures of vaccines specifically focusing on the Messenger RNA technique used say by Moderna and Pfizer. I have briefed a few colleagues on our continent but we want to take this forward by discussing it with others that there is a company that is capable of this technique just as Moderna and Pfizer have been doing that is ready and willing and we have been having these discussions I will brief those responsible very soon,” he said.
Earlier this year, SADC Chair President Filipe Nyusi of Mozambique made a clarion call on the need to enhance internal capacities to combat COVID-19.
“In this regard, we recommend the SADC Committee of Ministers of Health to establish a strong regional collaborative strategy which pools resources together to urgently acquire the vaccine for distribution to our citizens setting priorities in accordance with the level of risk.
“(We must) enhance vaccine research capabilities and develop regional manufacturing capacity for vaccines in the future,” President Nyusi said.
He added: “Following up surging of COVID-19 cases, we must intensify co-operation and collaboration between member states, through increased data sharing, policy harmonisation and standardisation, pooled procurement of essential medical and non-medical equipment to address the pandemic in a more effective way.”
And there is a legal foundation on which such collaboration can be anchored.
The SADC Protocol on Health, approved in 1999 and operationalised in 2004, reads in part: “Acknowledging that a healthy population is a prerequisite for sustainable human development and increased productivity, the Protocol on Health promotes co-operation among member states on key health issues.
“It recognises that this cooperation is essential for the control of communicable and non-communicable diseases and for addressing common health concerns, including emergency health services, disaster management, and bulk purchasing of essential drugs.”