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

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.