Vaccine pricing and production capacity in Africa: can Africa move beyond pooled procurement in the face of a future pandemic?

Christian Kwaku Osei , Edward Nketiah-Amponsah , Ama Pokuaa Fenny , Frank Otchere
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Abstract

We examine Africa’s vaccine manufacturing potential, spurred by the coronavirus disease 2019 (COVID-19) pandemic, while critically analyzing vaccine price inequities and procurement strategies during the pandemic, with anticipation of future outbreaks. Although Africa consumes approximately 25% of the global vaccine supply, over 99% of these vaccines are produced outside the continent, primarily due to insufficient local investment. Vaccine procurement strategies have relied heavily on pooled procurement mechanisms and tiered-pricing models, predominantly controlled by external organizations. Significant disparities in vaccine pricing have resulted in vaccine price inequities, with evidence suggesting price discrimination, where different prices are charged for the same vaccine across countries and regions. While vaccine prices are only one component of vaccination campaign costs, the inequitable pricing of vaccines poses serious challenges to fair access, especially in low-income countries. Given the inevitability of future pandemics and other outbreaks, the central question remains: Does Africa possess the capacity to strengthen its vaccine production infrastructure and reduce dependency on external suppliers? Our review reveals that, with robust political commitment, enhanced investment in Research and Development, and leveraging the heterogeneous nature of the regional bloc, Africa has made strides toward establishing vaccine manufacturing hubs with the potential for substantial capacity expansion. Furthermore, we argue for a regional campaign based on the principles of the fair priority model as an ethical framework for vaccine procurement, which prioritizes need and ensures equitable distribution, thereby complementing existing pooled procurement arrangements in times of future pandemics. This paper concludes with two key recommendations based on lessons learned from the COVID-19 crisis and future preparedness. First, Africa must push for a transparent and equitable tiered-pricing structure to ensure affordability for all. Second, intentional and sustained investment in R&D is critical to addressing systemic inequities in vaccine supply, not only for COVID-19 but for future outbreaks and routine immunization programs.
非洲的疫苗定价和生产能力:面对未来的大流行,非洲能否超越集中采购?
在2019年冠状病毒病(COVID-19)大流行的刺激下,我们研究了非洲的疫苗制造潜力,同时批判性地分析了大流行期间的疫苗价格不公平和采购战略,并预测了未来的疫情。虽然非洲消费了全球约25%的疫苗供应,但99%以上的疫苗是在非洲大陆以外生产的,主要原因是当地投资不足。疫苗采购战略严重依赖集中采购机制和分层定价模式,主要由外部组织控制。疫苗定价的巨大差异导致疫苗价格不公平,有证据表明存在价格歧视,同一种疫苗在不同国家和地区收取不同的价格。虽然疫苗价格只是疫苗接种运动成本的一个组成部分,但疫苗定价不公平对公平获取构成严重挑战,特别是在低收入国家。鉴于未来大流行病和其他疫情的不可避免性,核心问题仍然是:非洲是否有能力加强其疫苗生产基础设施并减少对外部供应商的依赖?我们的审查表明,凭借强有力的政治承诺、加大对研发的投资以及利用区域集团的异质性,非洲在建立疫苗制造中心方面取得了长足进展,并有可能大幅扩大产能。此外,我们主张开展一项基于公平优先模式原则的区域运动,作为疫苗采购的道德框架,优先考虑需求并确保公平分配,从而在未来发生大流行病时补充现有的集中采购安排。根据从2019冠状病毒病危机和未来准备中吸取的教训,本文最后提出了两项关键建议。首先,非洲必须推动透明和公平的分级定价结构,以确保所有人都负担得起。第二,有意和持续的研发投资对于解决疫苗供应中的系统性不公平问题至关重要,这不仅适用于COVID-19,也适用于未来的疫情和常规免疫规划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Global health journal (Amsterdam, Netherlands)
Global health journal (Amsterdam, Netherlands) Public Health and Health Policy
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5.00
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