African Union publishes COVID-19 vaccine strategy

Considerations
Preliminary acknowledgements
Vaccine strategy: a two-pronged approach
Comment

The African Union (AU) recently published a COVID-19 vaccine strategy. The strategy was announced in a communique issued by the AU ministers of health and heads of delegation following a virtual conference on 24 and 25 June 2020.

Considerations

The ministers considered the following factors, among others, when devising the strategy:

• Africa has a fragile health infrastructure, is experiencing rapid population growth and already suffers from endemic diseases such as HIV, tuberculosis and malaria.
• In January 2017 the Africa Centres for Disease Control and Prevention (Africa CDC) was created following an Ebola virus outbreak.
• COVID-19 is spreading quickly throughout Africa, having infected more than 350,000 people and resulting in over 9,000 fatalities.
• The pandemic poses serious social, economic and security threats to both Africa and Agenda 2063 – the AU's strategic framework for Africa's socioeconomic transformation over the next 50 years.

Preliminary acknowledgements

Before setting out the strategy, the ministers made the following preliminary acknowledgments:

• An effective COVID-19 vaccine must be identified and scaled up to slow the spread of the disease, protect vulnerable populations and ultimately return African societies and economies to normal while safeguarding Africa's broader global development agenda.
• In the past, intellectual property – including patents, trade secrets and other technological know-how – created barriers to the timely introduction of affordable vaccines in developing countries.
• There is an urgent need for countries to make full use of legal and policy measures, including flexibilities enshrined in the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the Doha Declaration, to ensure that monopolies do not stand in the way of access to COVID-19 vaccines.

Vaccine strategy: a two-pronged approach

Securing sufficient vaccine supplies
This aspect entails the following:

• Advocating for Africa to receive a sufficient global allocation of any future vaccine. This includes a partnership with the COVAX facility as part of the Access to COVID-19 Tools (ACT) Accelerator initiative and additional support from partner and regional bodies.
• Calling for an equitable and timely distribution of a vaccine in Africa, both across and within countries and seeking to ensure equity of distribution regarding gender and socioeconomic status.
• Calling on the AU Commission, donors and partners to provide the necessary financial resources to support Africa's efforts to secure the necessary vaccine supply.
• Calling on AU member states to raise domestic resources to support the efforts to secure vaccine supplies for the continent.
• Calling on all countries to remove obstacles, including the use of flexibilities provided in the TRIPS Agreement, in line with the recommendations of the 73rd World Health Assembly resolution on the COVID-19 response. This is to ensure that all relevant technologies, IP data and know-how are immediately made available and rapidly scaled up.

Removing barriers to vaccine roll-out
This aspect is also multi-faceted and involves:

• developing a continent-wide clinical trial network to better connect organisations that are supporting efforts to test potential vaccine candidates. This network should be responsible for sharing information resources and knowledge, with a view to increasing the data on vaccine efficiency and safety for the African population;
• enabling an effective regulatory control structure, including implementing indemnification for vaccine manufacturers, fast-tracked regulatory approvals at a country level and a robust infrastructure for ongoing monitoring of vaccine efficacy and safety;
• ensuring that the vaccine can be effectively delivered to target populations by strengthening distribution and supply chain networks in African countries and deploying innovative delivery models to reach the people in need;
• driving a set of community efforts across the continent to better inform key opinion leaders and the general public on the need for and benefit of the vaccine. This is intended, among other things, to minimise the dissemination of inaccurate public health information;
• partnering and collaborating with relevant global stakeholders to enable technology transfer to ramp up domestic vaccine production capacity, thereby allowing Africa to better control its supply of the vaccine over time; and
• requesting the AU Commission and Africa CDC to follow up the implementation of vaccine development and access. They must, in turn report to the AU heads of state and government regularly and seek collaboration with UN agencies and other partners.

Comment

Africa is facing a crisis that calls for a continent-wide response. It is encouraging that a consolidated approach is being followed, including utilising the IP exemptions allowed under the TRIPS Agreement.

Access to medicine in Africa is a recurring concern and it may be an opportune moment to use the response to the COVID-19 pandemic as a blueprint to secure future access to pharmaceuticals – including vaccines – for Africans.

For further information on this topic please contact André Maré at ENSafrica by telephone (+27 21 410 2500) or email (amare@ensafrica.com). The ENSafrica website can be accessed at www.ensafrica.com.