Our viewpoint focuses on the paradox that Africa represents 25 % of total global vaccine usage, yet 99 % of these vaccines are manufactured overseas. In view of the iniquitous supply and distribution of COVID-19 vaccines to Africa during the pandemic, we emphasize the need for scaling up local vaccine manufacturing capacities across Africa. We review current vaccine manufacturing capacities within Africa, highlight priority vaccines needs, and describe opportunities and challenges of advancing local manufacturing capacities within Africa. Of 11 manufacturers in Africa, ten have operational formulation/fill/finish capacities. However, capacities to produce active vaccine components locally are very limited and leveraging of vaccine technology platforms such as live-attenuated virus, inactivated virus, and mRNA remain scanty. South Africa and Senegal are the only countries with end-to-end manufacturing capacities. Based on market demand, manufacturing complexity, target population, disease burden and vaccination regimen, the top 5 priority vaccines identified for local manufacturing in Africa were measles-rubella, yellow fever, cholera, rotavirus, and meningococcal vaccines. Enablers identified for Africa's vaccine manufacturing initiatives include: a preferential procurement of African-made vaccines for sustainable and reliable volumes through GAVI and UNICEF
deal preparation to target investments avoiding overproduction
technology transfers
regulatory systems strengthening
R&D capacities and infrastructure. Thus, African vaccine manufacturers and all stakeholders should focus taking forward the portfolio of activities required for continental vaccine manufacturing, including regulatory strengthening capacities, training and workforce development, rather than only focus on efforts that benefit a particular manufacturer or country. Optimism for advancing vaccine manufacturing in Africa comes from the announcement in December 2023 by GAVI for the establishment of the African Vaccine Manufacturing Accelerator, a financing mechanism of USD 1 billion aimed at creating a sustainable vaccine manufacturing industry in Africa. However, many challenges need to be overcome including that of having secure funding for sustaining what is developed.