BLOG | On GAVI’s Landmark Decision that May Change Future of Healthcare in Africa

GAVI Board meeting

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Yavi Madurai writes about a recent landmark decision by the Global Vaccine Alliance’s (GAVI) board’s approval of the establishment of the US$1 billion African Vaccine Manufacturing Accelerator (AVMA), and what it means for Africa’s healthcare and pharmaceutical sectors vis a vis the Africa Continental Free Trade Area (AfCFTA).

It could mean that Africans no longer have to fear death for themselves or their loved ones as a result of diseases like Diabetes, Cancer, and Heart Disease, among others, which are on the rise at an alarming rate on the continent.

This is thanks to a landmark decision by the Global Vaccine Alliance’s (GAVI) board at the end of a 2-day meeting (December 6-7, 2023) which approved the establishment of the African Vaccine Manufacturing Accelerator (AVMA), a financing instrument that will make up to US$1 billion available to support sustainable vaccine manufacturing in Africa.

After hearing of the milestone decision, I had separate phone calls earlier today with H.E. Dr Jean Kaseya, who attended the GAVI board meeting in his capacity as the Director-General of the Africa Centres for Disease Control (Africa CDC); and Dr Stavros Nicolaou, Group Senior Executive responsible for Strategic Trade at Aspen Pharmacare, one of the largest pharmaceutical manufacturers on the continent.

Both were excited that the advocacy of the Africa CDC over the last few years have finally rendered this game-changing decision. They both said to me, “Now the [real] work starts!”. I responded by asking them what that work entailed and where does it start exactly.

So, UNICEF – the procurement entity for GAVI will have to place orders for vaccines and medication to activate and actualize the AVMA, which means Africans across the continent will receive vaccines and medicals which are manufactured IN Africa, BY African manufacturers.

In this vein, we should ask ourselves the question, “What does success mean?” It’s actually one fundamental thing that is required – the political will, support and advocacy of African Union Member States and most importantly, the Heads of State.

The Organisation of African Unity (OAU) and its successor, the African Union, were founded on the premise of African unity and integration. However, the most crucial catalyst for Africa’s integration is the African Continental Free Trade Area (AfCFTA), which has made the notion of a United Africa a reality in the future. Maybe it will be the future generations of Africans that will have an Africa THEY Want.

The Africa CDC has indeed brought us here to this historical moment, yet it will be the AfCFTA that determines its success and effectiveness because the decision on vaccine manufacturing is not where this African economic and healthcare optimizer will find its ultimate success. Its ultimate success will be rooted in Member States ordering vaccines and medical supplies from African manufacturers.

The products will hopefully be procured and paid for through Africa’s own payment system, the Pan-African Payment and Settlement System (PAPSS) and delivered seamlessly courtesy of the Single African Air Transport Market (SAATM), which aims to create an integrated air transport market across Africa, as well as through the Africa Integrated High Speed Railway Network (AIHSRN), which seeks to increase rail connectivity and reduce the transport costs for goods, services and people.

Some of these initiatives may sound idealistic but all are realistic yet will most likely only become a reality in the distant future. However, some will actually become a reality in the short to medium term. Although I am an afro-optimist, I am very much concerned about the fact that we unfortunately suffer from a disease of in-action and non-implementation in Africa. Yet, if we continuously put our resources where our mouth is, we will be able to address our crucial challenges and ultimately achieve our grand vision and goals.

I have always been a believer of the metaphor of “build the plane while flying it.”  As impractical as it seems, it explains my hope for this landmark GAVI decision on vaccine manufacturing in Africa. In summary, let’s do what we can immediately with what we have, lets continuously optimize and innovate as we move forward, keeping the end goal in mind. The GAVI decision presents to us one of the biggest opportunities to leapfrog the AfCFTA.

The AfCFTA’s Guided Trade Initiative (GTI), which is a kind of pilot initiative to implement the Agreement, has effectively created a cross-border intra-African trade initiative for specific products even though for a handful of countries. It was launched in 2022 with a shipment of AfCFTA-certified Kenya’s world-renowned tea along with cars and truck batteries to Ghana as well as other products to other GTI member countries, namely Cameroon, Egypt, Ghana, Kenya, Mauritius, Rwanda, Tanzania and Tunisia.

I believe that the AfCFTA Secretariat should now create sector-specific GTI’s and this can begin with the pharmaceutical sector, and particularly target the export of the AVMA vaccines to African countries. This way, we can learn about and begin to address practical sector-specific challenges for intra-African trade.

For example, logistics for healthcare and medical supplies require far more technologically and scientifically regulated service provision than say items of clothing or dry food products. This is because vaccines and other medical products have short-term expiry dates and require specialized refrigeration hence could best transported by air or high-speed trains.

This also calls for efficient and effective border management systems as well as investment in ICTs and transport infrastructures. We have all seen social media viral videos about the never-ending queues of trucks waiting for days and weeks at notorious border posts across the continent. The status quo would not work at all for vaccine distribution; hence AU Member States will have to develop a system to deal with it.