Local Manufacturing Can Save Lives and Boost Economies

Science responded incredibly to the onset of a new pandemic and it’s a historic achievement that a series of game-changing safe and effective COVID-19 vaccines were developed in less than a year. However, vaccine manufacturing concentrated in a small handful of high- and middle-income countries that produce vaccines to lock-up supply until most of their populations were fully vaccinated, which took the majority of 2021. Ultimately the unequal rollout meant the majority of older people and health workers – those most at-risk of dying from COVID-19 – in low-income countries were not protected, which led to unnecessary loss of lives and livelihoods.

There will be new variants of COVID-19 and there will be future pandemics. In the last 20 years, outbreaks of SARS, H1N1, MERS, Ebola, COVID-19 and now Monkeypox reinforce that it’s a question of when not if. And a warming world where humans and animals are pushed even closer together for increasingly scarce resources only exacerbates that risk.?

Based on the learnings of what happened during COVID-19 with the supply of vaccines, the inevitability of the next pandemic; WHO has been working with leaders particularly from government and the private sector around the world to build up manufacturing in low- and middle-income countries.

First, access to know-how and transferring technology is key to building up manufacturing capacity. Prior to the pandemic, of the hundreds of millions of vaccines used in Africa, 99% of them are made outside the continent. WHO is committed to righting this wrong and helping develop vaccines that are cheaper to produce and easier to store, which would help make them easier to distribute to hard-to-reach areas where very few have been vaccinated so far. To accelerate this effort, throughout the pandemic I have consistently supported a TRIPS waiver on vaccines, treatments and diagnostics.

Simultaneously, WHO set up an mRNA technology transfer hub in South Africa, a collaboration between the government, local manufacturers, health agencies and academic institutions and the good news is that it’s working. Already the hub has developed its own mRNA COVID-19 vaccine prototype and is working with 15 other countries around the world – ‘spokes’ – to share the know-how and technology as one package so countries can jump-start their own manufacturing. While the focus is currently on COVID-19, going forward it is hoped that the hub can be used to develop and manufacture at-scale vaccines to tackle other killer diseases like malaria, HIV and tuberculosis.

And the WHO’s COVID-19 technology access pool (C-TAP), which was launched in 2020 as the brainchild of then President of Costa Rica and backed by 44 Member States so that companies and governments could pool technology, licenses and resources for diagnostics, treatments and vaccines. In the last three months, C-TAP in partnership with the Medicines Patent Pool announced a new partnerships with the USA National Institute of Health to share several innovative therapeutics, vaccines and diagnostic methods,?and South African pharmaceutical company Biotech Africa announced the production of a COVID-19 serological antibody technology based on the shared license from Spain’s National Research Council.

This week at the Commonwealth Heads of Government Meeting in Kigali, Rwanda, I joined President Paul Kagame to witness the opening of a new BioNTech backed mRNA vaccine factory that will initially help produce mRNA vaccines and is part of a wider network of manufacturing, spanning Senegal and South Africa.

Second, strengthening workforce capacity and experience developing biological products. Acquiring know-how does not help if the workforce is unable to implement the know-how.

WHO has developed a biomanufacturing training hub in the Republic of Korea to help countries produce not just vaccines, but also insulin, monoclonal antibodies and cancer treatments. Thousands of professionals from Africa, the Middle East, Asia and other regions will be trained.

Third, strengthening regulatory systems is critical. There’s no point in making products if there is no strong regulatory oversight for quality assurance and if the population does not trust the products. Therefore, WHO is working actively to strengthen national regulatory authorities across Africa, in particular in countries receiving mRNA technology transfer.

WHO welcomes the establishment of the African Medicines Agency and will continue to provide technical and financial support. Like the equivalent in Europe, the European Medical Agency, it is really important to have a body that certifies quality standards and approves products for the region. WHO is working with partners in the African continent to increase capacity and support in enhancing confidence in locally produced products.

In the region of the Americas and the Caribbean, PAHO is working to strengthen regional regulatory processes, address challenges and identify the opportunities for increasing local production capacity through a regional based plan.

Fourth, commercial sustainability through long-term investment. Building facilities is easy but building sustainable facilities is more of a problem. With green shoots of hope sprouting across low- and middle-income countries, governments and international agencies that purchase health products - like UNICEF, the Global Fund and Gavi - have a key role to play in procuring supply from new regional manufacturing units and helping to provide a strong foundation for sustainable business. Boosting manufacturing is a job creator, and good for the overall economy. In the long-term the more producers there are, the easier it is to mass produce lifesaving health tools that are affordable, which in a future pandemic could be the difference between stopping an epidemic or at least minimising the damage of a pandemic.?

The COVID-19 pandemic and the economic and societal fallout has spurred the world into action. The pandemic cost the global economy more than US $24 trillion according to the World Bank, and it demonstrated that the current model of manufacturing isn’t fit for purpose as it’s based more on charity than self-reliance, which ultimately undermines equity. Boosting manufacturing takes time and there is an initial down-payment but in terms of investments there are few as astute for improving health, creating jobs and strengthening the economy. This strategy is nothing short of what any high- or middle- income country follows for its own economic prosperity and health security.??