Though under-reported by the media, a game-changing agenda has been taking shape. On 6 and 7 December, Rwanda’s President Kagame hosted the Partnership for Africa Vaccine Manufacturing meeting in Kigali and online.

African leaders, and Africa CDC, are taking an approach that will be key to ending Covid-19 in Africa and to beating all other pandemics. That approach has two key elements:

First, that Africa must strengthen self-reliance in the development and manufacturing of life-saving technologies, so that it will never again find itself dependent on what other countries and pharmaceutical companies may choose to provide.  

Second, that self-reliance for Africa in research, development and in manufacturing will only be achieved through pan-African collaboration. 

African leaders recognise that the institutions we must strengthen and the plants we must build need to be shared with all countries of Africa. That is the basis of this work and the importance of the meeting that has been held. We cannot achieve this if we operate only within our national boundaries. We will only rise together. 

African leaders came to this approach because, rightly, they will not accept being pushed to the back of the queue again.

Production is key. Procurement is not enough. 

Already, African leaders had developed, for the first time, a pooled purchasing mechanism — the Africa Vaccine Acquisition Task Team (Avatt)– which we at UNAIDS have been supporting and championing, that was to strengthen the negotiating hand and to enable economies of scale. It secured 23 million doses. 

However, Avatt continues to face the monopoly of pharmaceutical companies. The companies stalled on selling, they stalled on delivery — and Africa has continuously been put down the priority list.

The consequence of this inequality: less than 7.5% vaccinated while rich countries are more than 68% vaccinated. Those who led the resistance to apartheid have called it Vaccine apartheid, and they are right. 

This is a repeat of what happened with antiretrovirals for HIV, when 12 million lives — most of them on this continent — were needlessly lost while lifesaving medicines remained out of reach.

The contrast in profit and loss is stark and grim. 

Pfizer, Moderna and BioNTech alone are making a $1,000 profit every second, meaning that in that next sentence you read, another $1,000 dollars goes into their account as profit.

Meanwhile, the cost of the international delay in getting Covid-19 vaccines to Africans is not only that people have died from Covid-19 and continue to die, it is the millions who are suffering the destruction of their livelihoods. The IMF has noted that the gap between sub-Saharan Africa’s growth and that of the rest of the world is expected to widen further over the next five years. 

Jobs have been lost, children pushed out of school (some never to return), women have suffered from gender-based violence and more constraints imposed on their livelihoods. As the head of the UN’s work to end Aids, I have drawn attention to the interruptions this crisis has brought to vital prevention programmes. These are impacts we cannot afford to allow to drag on.

We are very proud of South Africa’s and Botswana’s scientific capacity and transparency on Omicron. And we are deeply disappointed that the payment for that sharing of that knowledge is the unjust travel bans, which will further hurt African economies. 

The delays and bad faith show that we cannot rely on the goodwill of pharma companies. 

It’s now clear to anyone who has been watching the Covid vaccine distribution scandal, that pan-African collaboration to strengthen self-reliance in life-saving technologies is essential for our health — for keeping us safe, and for our economies.

Africa is developing critical institutions that will pave the path to creating viably strong biomedical manufacturing. The Africa Medicines Agency, ratified this year, is a critical institution in this path. The production centres set up in several countries are also important steps forward on the journey of African production. But we need to ensure that production goes beyond the fill and finish of making a vaccine, and move fast to full manufacturing.

Now is the moment for determined support for the Africa CDC-led vaccine manufacturing and regulatory initiatives, for prioritising investment in universities and other research institutions to enhance our technical capacity to develop medical technologies, and for developing R&D hubs.  

African countries should invest even when the location is not in their country, because that investment is for every country — for our continent. 

Donors and investors follow when we take the lead as Africans and invest. We need to scale up production in the next year and we need, by 2040, to move from 1% to 60% production in Africa. It’s not just aspirational, it is achievable. 

The path that Africa is now on is the right one. As I urged African leaders when I addressed them: “Don’t wait. Don’t walk. Run. We will be the wind at your back.”

Strengthening Africa’s collective self-reliance in the production of life-saving technologies is not a vision for a far-off future, but an urgent task for today. 

This is not idealism — this is a matter of life and death. DM/MC

Winnie Byanyima is the Executive Director of UNAIDS and Under Secretary-General of the United Nations. 

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