Several public and private stakeholders in our healthcare sector were shocked to learn of Moderna’s decision to pause plans to establish a vaccine production facility in Kenya recently, raising repeated concerns about vaccine accessibility and production capacity in Africa. The indignation and frustration that many felt at reading these headlines places us among the thousands who, like most Africans, view Moderna’s decision as confusing and, once again, part of the trend of relegating Africans’ health and wellbeing to the whims of corporate interests.
Balancing access to healthcare products with economic realities
Of course, morality and the world of business are difficult to reconcile (and no less so in the fields of pharmaceuticals, a hotbed for debates on the right to access treatment vs the economic incentive to produce said medication).
However, Moderna’s decision also touches on the political economy of inequality and entrenched disadvantages on our continent, thereby soliciting strong emotions from public and private stakeholders in Africa, who are (justifiably) sensitive to matters regarding the equitable access to medicine and vaccines in the region.
Prior to the COVID-19 pandemic, people living in Africa were aware that the continent was partly, and in some cases wholly reliant on external actors for its health and security. Amidst the pandemic, however, this awareness turned into panic and urgency as Africans fell (sadly predictably) to the bottom of the pile when it came to global efforts at vaccinating the public. Despite the rhetoric and overt gestures in support of Africa’s wellbeing by foreign governments, NGOs, and celebrity activists, a simple problem remains unaddressed: how can Africans rely on non-African entities who chase short-term gains over long-term success?
Making sense of Moderna’s decision
Make no mistake, no matter the good intentions behind a deal or announcement, much of the business world – the venerated engine of innovation and distribution – is wholly myopic and stuck behind short-term horizons. Take Moderna: The decision to halt plans for African-based vaccine production sites have been justified in response to the drop in demand for the COVID-19 vaccine. But we all intuitively knew that demand for the COVID vaccine after the pandemic was never likely to be significant. So how do we make sense of it all?
De-risking vaccine manufacturing in Africa
It is true that producing COVID vaccines today will unlikely generate profit over the short term. But that doesn’t mean that Africa cannot expedite the development of the vaccine manufacturing framework for the continent to prepare ourselves beyond the threat of COVID. If the pandemic has taught the world anything, it is that our modern society is not as invulnerable to outbreaks of diseases as we may have thought. Citizens living in countries across the African continent, in particular, cannot ignore this reality as the region remains rife with long-burning epidemics and populations highly susceptible to infections (both new and known).
It is at this point where that fiery indignation and frustration at Moderna’s decision needs to be tempered; trepidation surrounding demand for your product is natural, and without demand, the process is unsustainable (making everyone a loser). Treating Moderna’s decision to withdraw as an immoral act once again makes us victims of the hyperbolic media cycle, where no nuance exists and outrage dominates. We may not like Moderna’s decision, but they are far from the only actors involved in their decision to withdraw from the continent. The risks involved in setting up vaccine production on the continent are, realistically speaking, quite substantial. However, they are not insurmountable.
Trust & commitment between stakeholders is key
De-risking a business venture requires trust and commitment. In this case, lining up buyers ahead of operations is crucial. The Africa Centers for Disease Control and Prevention (Africa CDC) is already driving a pooled procurement initiative towards this end.
While the demand for COVID vaccines has cooled, the infrastructure required to meet the demand for vaccines and treatments will be needed to address Africa’s ongoing medical needs. The local government’s commitment to sound offtake agreements will be required to get such a venture to the critical mass it needs to become sustainable.
Policies by local lawmakers should also clear the way for companies such as Moderna from fighting an uphill battle. Regional governments and associations would be well-advised to lay strong foundations for health security by standardizing the applicable regulations across our borders (the African Medicines Agency, for one, is championing this cause as part of an initiative with the African Union).
An environment that does not promote the sustainability of ventures cannot hold any pretenses of outrage when such ventures fail to launch. Yes, Moderna’s withdrawal hurts all Africans, as the need for vaccines and medications extends beyond that of COVID 19. However, we need to be aware of the leading role that governments and agencies can play in creating a more enabling environment for the successful development of this sector in the long-term.
Without a solid foundation, that isn’t underpinned by short-term profits, we remain insecure and exposed. Without access to a sustainable supply of locally produced healthcare products, there can be no long-term security. We must learn to involve policy and decision-makers in kickstarting the development of industries affecting the equitable access to and distribution of healthcare products in Africa – failure to do so will only leave us with years of outrage as we continue to read of foreign companies’ unwillingness to enter a fraught and risk-filled environment.
