Sun 30 January 2022:
Cape Town, South Africa – On January 19, at a cavernous warehouse on an industrial estate in Cape Town, South African-born billionaire Patrick Soon-Shiong launched a project he believes will be a considerable step in Africa’s struggle for vaccine equity.
Within a year it is hoped that the empty building will be a hive of industry with a workforce of up to 600 people intent on producing the first entirely African-made COVID-19 vaccine.
“We want to manufacture this in Africa, for Africa, and export it to the world,” Soon-Shiong told Al Jazeera in an interview.
He hopes the facility, which will be run by NantSA, a company he established last year, may be able to produce as many as a billion doses per year by 2025.
The project is the latest in a series of initiatives seeking to redress Africa’s reliance on the West for vaccines, a problem that has been laid bare during the COVID-19 pandemic.
At the opening of the plant, South Africa’s President Cyril Ramaphosa evoked the language of the independence movement as he spoke of the need to “shed those colonial chains” and become self-sufficient.
“Africa should no longer go cap in hand to the Western world begging and begging for vaccines” he announced. “Africa should no longer be last in line.”
The continent imports some 99 percent of the vaccines it consumes annually, according to the World Health Organization, making it vulnerable to global shortages.
Now, spurred by the pandemic, Africa’s small but growing biotechnology sector is racing to catch up.
Soon-Shiong’s company, ImmunityBio, is working on a “second generation” COVID-19 vaccine, currently undergoing trials. It is designed to not only target the virus’s spike protein but also to activate “killer” T-cells to attack the nucleocapsid protein in the core of the virus, which is less prone to mutation.
Soon-Shiong said trials have shown that the vaccine may remain effective for longer than the current generation of COVID-19 vaccines and be effective against multiple variants.
“Most excitingly, recently, we showed that these T-cells crossed all variants … [The vaccine] reacted to a Delta variant, Alpha variant, a Beta variant, and now we’re testing against the Omicron variant,” he said.
The United States-based doctor-turned-entrepreneur, who described the inequality in access to vaccines during the pandemic as “vaccine apartheid”, also said his family foundation would also be investing 100 million rands ($6.5m) in educating a new generation of African scientists.
“There was a need to say ‘enough’. And I thought that we had a moral obligation to actually create some self-reliance on that continent,” said Soon-Shiong, who was born in South Africa’s Eastern Cape province and graduated from the University of Witwatersrand in Johannesburg before emigrating and making his fortune in cancer therapies.
“It’s always been a long-held dream of mine, once I left the country, to come back and help, not just for COVID, but for TB and schistosomiasis and HIV,” he said.
Benjamin Kagina, a senior researcher for the Vaccines for Africa Initiative, based at the University of Cape Town, told Al Jazeera that the new facility is “a significant milestone that should be celebrated”.
“To have such an investment shows that investors appreciate our capabilities to make vaccines and the infrastructure that’s already in place,” Kagina said.
Vaccine inequity
Africa remains the world’s least vaccinated continent, with barely 10 percent of its 1.3 billion inhabitants fully inoculated against the disease.
Vaccine hesitancy has played a part, but Kagina says lack of access to vaccines is also a major factor.
Since the first COVID-19 vaccines were approved in December 2020 there has been glaring inequity in the way they have been distributed.
An October 2021 study by the science analytics company Airfinity found that 15 times more COVID-19 vaccination doses per capita had been delivered to G20 countries than to Sub-Saharan African ones.
And according to a December report by the People’s Vaccine Alliance, more vaccines were provided to the United Kingdom, the European Union and the US in the six weeks leading up to Christmas than to the entire African continent in the whole of 2021.
The COVAX scheme, which has attempted to facilitate the provision of vaccine doses to lower-income countries, has failed to sufficiently bridge the gap.
“There’s this window period of opportunity across the continent because of COVID-19 and we’re in a good position to make a success of that,” says Patrick Tippoo, executive director of the African Vaccine Manufacturing Initiative (AVMI), which campaigns for increased vaccine production on the continent.
Aside from his role at AVMI, Tippoo also heads up the science and innovation department of the Biovac Institute, a Cape Town firm that struck a deal with Pfizer in 2021 to produce up to 100 million doses of the Pfizer-BioNTech vaccine per year at its Cape Town plant.
The deal is what is known as a fill and finish partnership, under the terms of which Pfizer will provide Biovac with the necessary drug substance and Biovac will complete the process and distribute the end product.
Another South African company, Aspen Pharmacare, has a similar arrangement with Johnson & Johnson.
Such agreements are important in building up local capacity and getting vaccines into production quickly, Tippoo says.
“But the important thing is that you should not stop there. The ultimate addressing of the cycle of dependency comes with developing the product from scratch.”
Continental hub
It is not only South Africa that has used the impetus of the pandemic to develop its vaccine production capability.
Rwanda and Senegal have announced plans to construct COVID-19 vaccine manufacturing plants in partnership with BioNTech; Nigeria and Ghana have announced plans to develop their own vaccine production facilities; and Morocco, Egypt and Algeria have all signed agreements with COVID-19 vaccine producers.
Meanwhile, the African Union-sponsored Partnership for African Vaccine Manufacturing has brought together key stakeholders from across the continent to help streamline efforts.
But Cape Town has emerged as something of a continental hub of COVID vaccine production.
Just a few kilometres away from the NantSA site, in the Montague Gardens neighbourhood of the city, a team of local scientists working for Afrigen Biologics and Vaccines has adopted a different approach to creating a vaccine.
The company, which forms part of the WHO’s South Africa-based mRNA tech transfer hub, is attempting to reverse engineer the vaccine made by Moderna, which has repeatedly declined to share its process but has said it will not enforce infringements of its COVID-19 vaccine patents during the pandemic.
“I never thought for a second that I was taking on Big Pharma,” Petro Terblanche, Afrigen’s managing director, told Al Jazeera.
“My objective was to build capacity for lower-income countries … Unfortunately, Big Pharma has ended up on the other side. We’re still wishing that they’ll collaborate with us but it doesn’t look like that’s going to happen.”
Throughout the pandemic, pharmaceutical companies have come under intense pressure from governments, charities and the United Nations to share their vaccine technology, with the Biden administration joining calls for a waiver of intellectual property restrictions for COVID vaccines in May 2021.
Tom Frieden, the former director of the Centers for Disease Control and Prevention (CDC), went as far as to accuse the big COVID vaccine producers of “holding the world hostage”.
Yet the patent holders have proved largely resistant.
Had Moderna agreed to share its technology, says Terblanche, Afrigen may have been able to produce a vaccine ready for phase one clinical trials by the end of 2021.
Without that cooperation, the company is on track to reach that stage by the end of 2023. If it succeeds, it intends to distribute the technology to other lower-income countries.
“What’s important is that we build capacity and the capability to make vaccines, not only for COVID but for all the future needs of the continent,” Terblanche said.
“The goal is by 2040 for Africa to be producing 60 percent of the vaccines it requires.”
However, experts say that considerable obstacles remain. Problems with power and water supply have hampered Cape Town’s biotech industry in the past. Across much of the continent regulatory mechanisms are sorely inadequate.
Funding also remains a challenge, as does the lack of a unified, continent-wide African market. And a lack of skilled personnel has also posed problems.
“The big challenge that we’ve had is manpower,” Terblanche said.
“[NantSA] are talking about 400 to 600 highly specialised jobs, but they’ve got to find those people. And I would advise them, do not underestimate the logistical challenges around construction and electricity supply and regulatory challenges that come with a project like this.”
Nevertheless, she welcomed the new development.
“It brings direct foreign investment but also it brings cutting edge technology transfer for production of very advanced medicines on the continent,” she said. “And of course, we’ll collaborate with them, because it’s important for the continent that these initiatives succeed.”
“It’s chicken and egg,” says Soon-Shiong, about securing a skilled workforce.
“If not given the opportunity to actually have the know-how, [if you don’t] actually train the workforce, you will then have a self-fulfilling prophecy of not having the people. So that’s the cycle we intend to break.”
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