A hub for more vaccination equality

The World Health Organization (WHO) has decided to install an mRNA tech transfer hub in South Africa. That hub is independently working on a new generation of mRNA vaccines whose technology it will share with manufacturers from Africa and beyond. Belgium is backing the WHO initiative all the way. Development Cooperation Minister Meryame Kitir visited the hub along with WHO Director General Dr Tedros Ghebreyesus.

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Minister Kitir in Afrigen with laboratory technician and WHO boss Tedros Ghebreyesus

Minister Meryame Kitir (right) visiting Afrigen. On the left, WHO boss Tedros Ghebreyesus.

The coronavirus pandemic has been sweeping the world for over two years now. Fortunately, a number of pharmaceutical companies have been able to develop an effective vaccine fairly quickly.  Pfizer/BioNTech and Moderna used a new mRNA-based technique to do so. This is the messenger RNA, the intermediary that converts hereditary information (DNA) into proteins in the cell.

One advantage of an mRNA vaccine is that new vaccines can be developed fairly quickly and easily if a new virus variant emerges. Moreover, it is a promising technology that could potentially be used against tropical diseases.

Vaccine Disparity

In the early stages of the pandemic, wealthy countries in particular had the resources to purchase vaccines. They did so directly from the producers. Vaccine production centres are mainly located in the wealthy "North".

In addition, there were companies from India and elsewhere that produced 'generic' COVID-19 vaccines, a cheaper but perfectly equivalent alternative. These were supposed to provide Africa with COVID-19 vaccines through the COVAX programme.

However, the delta variant outbreak in India resulted in the country - alongside the US - imposing an export ban on COVID-19 vaccines, which led to a glaring 'vaccine disparity'. In rich countries, some 55% of the population is fully vaccinated, while Africa struggles to reach 6%.

This vaccination disparity is also affecting rich countries, though. Where people have had little vaccination, the virus can circulate and mutate freely. As a result, potentially more contagious and dangerous variants can emerge and spread throughout the world. This is why the pandemic can only really be contained if this is done everywhere in the world. Or as Development Cooperation Minister Kitir emphasises time and again, "No one is safe until everyone is safe.”

Local production of vaccines

That is why Belgium has already made huge efforts to address vaccine disparity. For example, in 2021, our country donated 9 million euros to the vaccine alliance Gavi for the operation of COVAX, which purchases vaccines and distributes them in poorer countries. In addition, Belgium donated 10 million doses of vaccines to COVAX last year, over 6 million of which were supplied to Africa. By 2022, our country anticipates more than 4 million additional doses.

But COVAX's efforts are not enough to adequately vaccinate the world's population. It is, at best, a short-term solution. What is needed is a long-term strategy with structural solutions for equitable access to quality vaccines, as well as therapies and medicines against COVID-19 and other diseases.

Belgium, therefore, fully supports the strategy of Team Europe (the European Commission, France, Belgium and Germany), which is committed to the local production of vaccines and medicines. To achieve this, there is a need for collaboration in research & development, building expertise, strengthening local and regional regulations and so on. In addition, access to know-how and technology is indispensable.

The WHO also wants all regions to develop sufficient vaccine production capacity so that they can be more independent of a handful of pharmaceutical production centres. Such a vision is in line with the African Union's goal of producing 60% of vaccines locally by 2040. Also within the WHO, members have adopted several resolutions calling for local production capacities for low- and middle-income countries.

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Minister Kitir in lab

Minister Meryame Kitir (right) visiting CERI (University of Stellenbosch).

An mRNA vaccine hub in South Africa

The establishment of an mRNA tech transfer hub in Cape Town, South Africa, is in perfect keeping with this vision. Through expertise from the WHO, universities and the South African biotech company Afrigen, the hub is set to develop knowledge and technology to produce its own mRNA-based COVID-19 vaccines. Other African countries will be free to adopt the formula and an open licence to produce vaccines. In this way, the entire continent - and subsequently the entire world - should have access to sufficient vaccines.

Cape Town was chosen because it already has a lot of know-how. Afrigen will be the core of the hub. It will operate as a centre of expertise and training, and develop its own COVID-19 vaccine. Biovac, a public-private pharmaceutical company, will be responsible for the commercial production of the vaccine.

In addition, academic institutions are also involved. For example, the Centre for Epidemic Response and Innovation (CERI) – affiliated with the University of Stellenbosch - boasts the largest and most advanced genome analysis lab in Africa. This is essential for detecting new variants and developing vaccines. CERI has discovered, among others, the beta and omicron variants of the COVID-19 virus.

The hub receives significant financial support from Team Europe. Our country is donating €3.9 million as part of an €8 million funding to the WHO on Access to Medicines. In February 2022, Minister Kitir visited Afrigen, Biovac as well as CERI. She had also invited the WHO's Director-General Tedros Ghebreyesus for this purpose.

Own research and development

Just recently, Afrigen announced that it could make its own mRNA vaccine under lab conditions based on the Moderna vaccine. Clinical trials are to follow shortly. Biovac is expected to produce the vaccine within two years.

Within five years, a number of low- and middle-income countries could adopt the technology and formula. The first 6 countries in Africa to benefit from this initiative are already known, namely Egypt, Kenya, Nigeria, Senegal, Tunisia and, of course, South Africa.

In addition to working on its own COVID-19 vaccine, the hub will also focus on its own research & development. For example, it will be tracking down local COVID-19 variants in Africa and working out COVID-19 vaccine formulations that are better adapted to African conditions. Fairly inexpensive vaccines that do not need to be kept in those extremely low temperatures spring to mind.

The hub will also explore whether the mRNA approach is useful for local and future epidemics, for example, tuberculosis, malaria or tropical diseases. Ultimately, it should grow into an advanced centre of expertise that provides the region with sustainable mRNA technology and its applications, independent of a handful of private players.

The idea is to work in close cooperation with the pharmaceutical sector for research & development and technology transfer, among other things. The WHO and Medicines Patent Pool, which manages the intellectual property and licenses for the hub, have been reaching out to the industry since its inception and are consulting intensely with Moderna and others to collaborate.

Strong momentum

The creation of an mRNA tech transfer hub is fully in line with Belgian policy. After all, for many years, our country has been campaigning for fair access to quality health products, in Africa and beyond, including through local production. The real solution lies in building solid health systems that can cope with current and future pandemics.

The momentum to make that possible has never been greater. This was evident from a high-level symposium organised by Minister Kitir on the sidelines of the EU-African Union summit to be held in February 2022. This summit, by the way, turned the spotlight on health care and the EU, too, wants Africa to be able to produce its own quality vaccines and medicines.

Incidentally, our country's efforts are not limited to South Africa. In total, Belgium spent €14.56 million on local vaccine production. Not only in South Africa, but also in Rwanda and Senegal, and through the WHO. We do this in close cooperation with our European partners and our partner countries from Africa.

In any case, with the creation of the mRNA tech transfer hub, an important step has been taken in promoting vaccination equality in the world.