As Egypt somewhat moves on from covid — largely on account of our progress on vaccination — the rest of the continent isn’t keeping up. Africa is severely lagging behind when it comes to covid-19 vaccinations, falling short of targets set by the World Health Organization (WHO) when it comes to inoculating the continent’s populations. The WHO had anticipated that 10% of people in Africa would be fully vaccinated by last September, rising to 40% by the end of 2021 and 70% by mid-2022, writes the Financial Times.

As it currently stands, only 13% of Africa’s residents have been vaccinated, with around 20 of the continent’s 54 countries not even managing to reach the 10% September target. Meanwhile, the continent’s average vaccination rate needs to increase sixfold if we are to meet the 70% target set for the middle of this year, according to WHO. Currently, 6 mn people are vaccinated on average every week in Africa, meaning the figure needs to increase to 36 mn people.

Egypt is ahead of Africa’s average, but also didn’t meet the 2021 targets: Around 29% of Egypt’s population is fully vaccinated, while 11% are partially vaccinated, according to Our World in Data.

Why are we lagging behind so much? The answer is simple: Access to vaccines: As of last month, over 587 mn vaccine doses were sent to Africa since the onset of the pandemic. The majority of these (58%) were delivered through the Gavi / Covax program, while 36% came from bilateral agreements and 6% through the African Union’s Africa Vaccines Acquisition Trust. However, the total number of doses delivered throughout the continent are not sufficient to cover its population of around 1.4 bn.

And the continent’s logistics don’t help: Another hurdle slowing down the availability of vaccines is Africa’s poor trade and logistics quality, reports The Conversation. The World Bank’s Logistics Performance Index puts Africa at 2.45 on average. From disruptions in distribution channels to delays at customs, the country’s logistics are another factor that could lessen vaccine availability as doses often have a short shelf life or require special conditions such as cold-chain refrigeration.

African nations spent a long period dependent on the West to send vaccines: The West for a long time had a monopoly on vaccine production and prioritized rich countries to receive the jabs while Africa was left last in line. Rich countries received 16x more vaccines per person than poorer nations that rely on the Covax initiative, an analysis from last year found. Western countries have also often thrown away more vaccines than they donated to Africa, with the EU binning 55 mn vaccine doses last month compared to the 30 mn doses they sent our way in 2022. Foreign vaccine makers, such as Moderna, were also opposed to sharing vaccine intellectual property rights and training other countries to manufacture their vaccines.

Which has led Africa to take matters into their own hands: Local vaccine manufacturing has taken off since 2020 as countries realized the importance of having the technology in-house. At the onset of the pandemic, only Egypt, South Africa, Senegal, and Tunisia had vaccine manufacturing operations in Africa. Fast forward two years later and now 15 countries on the continent are rolling out projects to start producing jabs, Nicaise Ndembi, the chief science adviser at the Africa Centres for Disease Control and Prevention (ACDCP), told the FT. Egypt has been manufacturing China’s Sinovac jab at home and has begun to send them to neighboring countries in efforts to become a vaccine export hub.

WHO is also helping accelerate the move, setting up a program that will see six African countries receive the technology needed to produce mRNA vaccines. Egypt, Kenya, Nigeria, Senegal, South Africa and Tunisia will be the first African countries to join the WHO’s mRNA vaccine hub initiative which aims to “support manufacturers in low- and middle-income countries to produce their own vaccines.” This won’t materialize anytime soon, with WHO estimating that the first vaccines could roll off the production lines in 2024.

And some organizations have even bigger ambitions… ACDCP is aiming for 60% of all vaccines administered in the continent to be manufactured in Africa by 2040 — up from a mere 1% now.

We need to find a way to make all of this commercially viable: Even harder than setting up vaccine production facilities is being able to sustain their operations, Ndembi believes. “You need a system that allows for the production of routine vaccines and is therefore commercially viable,” he adds. The investment in people, skills, infrastructure, technology, and equipment needs to have more purpose than hedging against future pandemics. Therefore, ACDCP is hoping African nations will expand their production to encompass a wide array of vaccines for more than 20 diseases — including routine jabs for human papillomavirus and measles, and even HIV or malaria shots if they make it through clinical trials.

And control the value chain: While foreign pharma companies setting up manufacturing plants here would be helpful, it can also not work in Africa’s favor at times. Last summer, Johnson & Johnson came under fire for shipping mns of doses manufactured in South Africa to Europe instead of distributing them across the continent. African ownership of vaccine manufacturing is essential, believes Charles Gore, the executive director of the Medicines Patent Pool. “If the control remains in Europe, the fact that the manufacturing is in Africa is irrelevant,” he added.