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Move perpetuates inequity that characterised the response to the Covid–19 pandemic, say disappointed Africa CDC
ANALYSIS | RONALD MUSOKE | The African Centres for Disease Control and Prevention (Africa CDC), says it is “disappointed” with Moderna’s decision to halt its plan of building a vaccine manufacturing plant in Kenya.
Moderna’s announcement came as a surprise considering the Massachusetts-based pharmaceutical firm had one year ago reached an agreement with the Kenyan government to establish an mRNA vaccine manufacturing plant in Kenya.
According to the agreement which was unveiled on March 30 last year, Moderna was to set up a facility capable of producing up to 500 million doses of vaccines every year for Kenya and the African continent in the latter’s quest to provide health security for its 1.4 billion people. The state-of-the-art facility was expected to have “surge capacity” to enable it rapidly scale-up and respond to public health emergencies on the continent and around the world.
“The finalisation of our agreement with the government of Kenya is a key pillar of our global public health strategy, where we hope to bring mRNA innovation to the people of Africa in areas of high unmet need, such as acute respiratory infections, as well as persistent infectious diseases like HIV and outbreak threats such as Zika and Ebola,” said Stéphane Bancel, the Chief Executive Officer of Moderna. “This demonstrates our confidence in the investment climate in Kenya and the importance of utilizing mRNA technology to build resilience in healthcare security in Africa.”
Moderna excites Africa
Moderna noted at the time that it has spent more than a decade refining its mRNA platform to accelerate the pace and success of mRNA medicines. The speed, scale, and flexibility of Moderna’s mRNA platform is uniquely suited for rapid response to serious international epidemics, commonly referred to as Disease X, the American pharmaceutical firm noted.
The company noted that it is committed to advancing into clinical studies a portfolio of 15 vaccine programmes targeting emerging or neglected infectious diseases by 2025, advancing vaccines that address current diseases of significant impact to low- and middle-income countries, and those that prepare for Disease X (obscure disease).
Moderna added that it intended to prioritize development efforts against pathogens identified as persistent global health threats, including HIV, tuberculosis (TB) and malaria, neglected tropical diseases and the priority pathogens of the World Health Organization and the Coalition for Epidemic Preparedness Innovations.
At the time, Moderna’s announcement excited many players on the continent including the Africa CDC, an autonomous body that is mandated with strengthening the capacity of African countries to respond quickly and effectively to disease threat on the continent.
Even President William Ruto applauded the agreement referring to it as a milestone. “We are excited about this milestone that brings to bear our efforts as government to sustain our economic model of facilitating investments that serve not only Kenya but the African continent,” said Ruto.
“My government commits to supporting this investment as a critical signal to the investment community that Kenya is open for business.”
Moderna backtracks on commitment
But, on April 11, Moderna said in a statement that it has paused its efforts to build an mRNA manufacturing facility in Kenya while it determines future demand for mRNA vaccines on the African continent.
It pegged its decision on the decline in COVID-19 vaccines uptake which has declined since the pandemic subsided and, is therefore, insufficient to support the viability of the planned vaccine facility in Kenya.
Moderna noted that it has not received any vaccine orders for Africa since 2022 and it has faced the cancellation of previous orders, resulting in more than US$1bn in losses and write-downs.
Interestingly, the company noted that despite these challenges, it is still committed to ensuring equitable access and meeting emerging demands from African nations for its COVID-19 vaccine through its global manufacturing network.
“Moderna is actively working on the development of public health vaccines, including those for diseases that predominantly affect the African continent, such as HIV and malaria,” the firm noted in its statement issued on April 11.
“These initiatives are part of our broader commitment to help address global health challenges through our innovative mRNA technology. However, these investigational vaccines are at an early development stage.”
“Given this, and in alignment with our strategic planning, Moderna believes it is prudent to pause its efforts to build an mRNA manufacturing facility in Kenya. This approach will allow Moderna to better align its infrastructure investments with the evolving healthcare needs and vaccine demand in Africa.”
“Moderna appreciates the strong support received from the governments of the United States and Kenya on this journey. We look forward to a continuing dialogue about future options to support the Kenyan healthcare ecosystem, including as we advance other mRNA vaccines and therapeutics of importance to the African continent through our pipeline.”
Africa CDC reacts
However, the Africa CDC reacted with ‘disappointment’ at Moderna’s decision to halt plans of building the vaccine facility in Kenya. The agency said while it acknowledges that the need and demand for COVID-19 vaccines has indeed decreased significantly, both in Africa and globally, it is important that it reflect on the nuances of Moderna’s decision.
“The Africa CDC recalls the considerable efforts of Africa to timely access vaccines as member states of the AU considered vaccines as the most effective means in the pandemic response.”
“Its public evidence that Covid-19 vaccines were delivered late to Africa, long after vaccines were made available to the developed world. Such actions significantly contributed to lower the demand for vaccines once these eventually were made available for Africa.”
“We must also acknowledge that this late availability of vaccines to Africa, significantly affected the course of the pandemic, as well as the uptake and demand for vaccines.”
According to the Africa CDC, following the hardship of access to the vaccines, the AU mobilised funds and found a responsive solution by launching the African Vaccine Acquisition Trust (AVAT) with the African Export and Import Bank (Afrexim Bank).
The Trust would go on to acquire 400 million vaccines from manufacturers other than Moderna, simply because Moderna vaccines were not made available, despite attempts to buy. Indeed, less than 5% of the covid-19 vaccines administered in Africa, were from Moderna. Yet, despite these African efforts, Covid-19 vaccines were still delivered late to Africa, long after vaccines were made available to the developed world.
“Therefore, to blame Africa and Africa CDC for lack of demand for covid-19 vaccines and therefore the reason to put on hold plans to manufacture vaccines in Africa, only serves to perpetuate the inequity that characterized the response to the Covid–19 pandemic,” the Africa CDC noted.
“While other vaccine manufacturers are progressing with their plans and construction in Africa, Moderna is abandoning a commitment to build highly needed and relevant vaccine manufacturing capabilities in Africa, in truth, demonstrating that Moderna’s commitment is in fact not to vaccine equity and access to vaccines, through building manufacturing in Africa.”
Going forward, the Africa CDC said although it understands that building vaccine manufacturing infrastructure and capabilities, is complex, takes a long time, and requires significant investment, it will continue to advocate, and support the establishment of a strong local vaccine manufacturing ecosystem on the continent.
This continental infrastructure, the Africa CDC noted, shall support research and development, and local manufactures’ capacity to serve the African Union continental vision of producing 60% of vaccines, therapeutics, and other medical products by 2040.
“Through our Partnership for African Vaccine manufacturing (PAVM), now renamed PHAHM – Platform for Harmonized African Health Products Manufacturing, we will continue to work towards building and strengthening African manufacturing, with our member states, international finance institutions, regulators, and partners, including vaccine manufacturers.”
“This forms part of our comprehensive and African approach to pandemic preparedness and prevention, and we encourage Moderna, as an experienced vaccine manufacturer, to contribute to, and support, Africa’s ambitious goal of a secure and safe Africa on public health security for the betterment of African health security and beyond.”
But, Dr. Denis Kibira (PhD), the Coordinator of the Medicines Transparency Alliance (MeTA), a multi-stakeholder initiative that brings together governments, civil society and the private sector on the continent to improve access to pharmaceutical markets told The Independent on April 19 that he is not surprised by Moderna’s decision. “For me, this is not surprising because this is exactly what we witnessed during the distribution of COVID-19 vaccines.”
He says one of the challenges Africa has faced over the years is the reliance on foreign partners to help the continent meet its goals. He told The Independent that although this is not bad at all, it is important that the continent looks in-ward if it really wants to meet its health security targets.
“We cannot continue setting our objectives and then expect other partners to come and deliver on our behalf; Africa has this money and we just need to put this money where our mouths are,” Dr. Kibira said.
“But I also think the international community should step up and hold some of these partners to account because if you commit to do something and then you withdraw from that agreement, it does not bode well for future partnerships.”
