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Rich countries offer funds for future vaccine production but do little this year to get the serum to developing economies

Credible plans are in train to establish production centres in Africa but the global inequities in distributions are stark and deadly

On 6 September, Britain's former Prime Minister Gordon Brown told the BBC that the Group of 7 economies would have a billion surplus doses of vaccine by the end of this year. On present trends – such as the lack of distribution to developing economies, i.e. much of the rest of the world – that surplus would grow to about 2 billion.

Although an average of between 60-70% of people have been vaccinated in North America and Western Europe, less than 4% have been in Africa. Changing that pattern requires political will in the G7, argued Brown.

But there have few signs of that. Neither the G7 nor any of the G20 countries have been prepared to back with the necessary finance the International Monetary Fund's $50 billion plan to vaccinate 70% of the world by mid-2022. The plan would prioritise all health staffers and public service workers and the most vulnerable.

Instead of committing to measurable actions and financial contributions, successive G7 and G20 summits have lamented the deadly inequities in vaccine distribution and made general statements of concern. On 6 September in Rome, G20 officials said 'the strongest countries … [were] committed to investing significant resources and sending vaccines to the most fragile…'

When asked for specifics, Italy's Health Minister Roberto Speranza said such 'pledges' risked being a 'straitjacket' but their priority was the 'political goal' of global vaccination. Speranza held out the prospect of some practical commitments being made at a meeting of G20 finance and health ministers in October.

Vaccine manufacture in Africa was on the agenda of the Compact with Africa summit, led by President Paul Kagame of Rwanda, President Macky Sall of Senegal, and European Commission President Ursula von der Leyen on 27 August.

German pharmaceutical giant BioNTech SE has agreed in principle to manufacture vaccines at two sites proposed by the Africa Centres for Disease Control & Prevention: the Rwanda Biomedical Centre and the Institut Pasteur de Dakar.

The European Union says that it will provide financial support under its clunkily named 'Team Europe' to fund three vaccine hubs in Africa. Eventually, wider vaccine and pharmaceutical production facilities could take place at the hubs.

The move comes shortly after a row over the export of Covid-19 vaccines bottled in South Africa to Europe and repeated accusations by African leaders of Western 'vaccine nationalism' (AC Dispatches 24/08/21, Health activists lambast plan to export South African-bottled vaccines to Europe).

The European Commission maintains that the South African contract was part of a wider EU plan to promote investment in vaccine hubs but the arrangement was condemned by World Health Organization director general Tedros Adhanom Ghebreyesus. The rejection by G20 countries of a proposal by India and South Africa at the World Trade Organization to partially waive the agreement on intellectual property rights on vaccines has also caused ill–feeling.

However, this is a long–term project. BioNTech's Chief Executive Uğur Şahin has been clear that the first priority at the two sites is to manufacture malaria and tuberculosis vaccines, rather than Covid shots. No date has yet been confirmed for when manufacturing will start.

The malaria and TB treatments would be based on the so-called messenger RNA technology, which is used by BioNTech in its Covid-19 vaccine.

In the meantime, the African CDC and AU want to move ahead with a proposed African Medicines Agency, an AU agency intended to facilitate the harmonisation of medical regulation across the continent.

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