Professor Benedict Oramah wears many hats. He is the President of the Africa Export and Import Bank (Afreximbank), the Chairman of the Board of Trustees of the African Union COVID-19 Response Fund and a member of the African Vaccine Acquisition Task Team (AVAT), an initiative of the AU Commission and its partners to provide Africans access to COVID-19 vaccines. Against the backdrop of the start of distribution of 400 million vaccines to African countries, Africa Renewal’s Kingsley Ighobor interviewed Prof. Okey Oramah on Africa’s vaccination needs and procurement challenges; and actualizing the goal of manufacturing pharmaceutical products on the continent. These are excerpts:
As Africa battles the COVID-19 pandemic, what role will a successful vaccination programme play in recovery?
The panacea for economic recovery is vaccination. You cannot talk about recovery without vaccinating our people. No matter what policy or what facility you put in place, without dealing with this fundamental problem, it's going to go to waste because you may give a country a facility today, and tomorrow they lock down the economy. Already, our [Afreximbank] board approved a $2 billion facility that made it possible for the African Vaccine Acquisition Task Team [AVATT], through the African Vaccine Acquisition Trust, to acquire 400 million doses of Johnson & Johnson vaccines.
As you know, even today, you cannot talk to vaccine manufacturers without money behind you. What we did as Afreximbank was to make it possible for the AU members to procure the vaccines through AVATT. We believe those vaccines will be delivered starting this week.
Yes, successful vaccination will trigger a post-pandemic recovery in the coming months.
Regarding the 400 million vaccines you just mentioned, that’s with the support of the World Bank. Is that correct?
We [AVATT] put the structure in place that made it possible for others to come and support us. You see, the World Bank’s approach is to deal with individual countries. But you cannot tell a small country to negotiate with vaccine manufacturers, the manufacturers will not pay attention. It’s about money.
And so, the AVATT team created a structure for pooled procurements. We negotiated 400 million doses, but you cannot negotiate 400 million doses worth billions of dollars without money and the World Bank will not engage in a pooled procurement. So, we had to provide the support and make a down payment of $330 million. Based on that, the World Bank came in to do what we always wanted them to do and that is provide support to individual countries to pay for the vaccines.
Therefore, the World Bank financing, which is cheaper than ours, is used to pay for those vaccines.
The 400 million J&J vaccines, in addition to the less than 100 million doses administered in countries in Africa so far, will not cover even half of the African population. Do you plan to procure more vaccines?
Let me explain: the AU said, through the Africa CDC, that to achieve herd immunity we needed to vaccinate 60 per cent of our population [or 800 million people]. That was the goal. But of course, the Delta variant has changed that calculus.
Africa was initially expected to receive vaccines for 30 per cent of its population through the COVAX facility. We knew we had to look for money for another 30 per cent. As a result, we procured 400 million doses for 400 million Africans. If COVAX provides vaccines for another 400 million people, that would be 800 million Africans that could potentially be vaccinated.
Is COVAX coming through on its promise?
Most of the doses were supposed to come from India, but at a point the country imposed an export ban that hampered deliveries. So, there have been some disappointments and other issues. I'm not an expert in these, but there is now a realization that something must happen quickly so that COVAX can deliver on the promises made, otherwise, Africa will continue to lag behind on this.
Are you putting any pressure on COVAX for the 400 million doses promised?
There is a lot of pressure going on. To be fair, we are getting responses. The US government has made donations, some of which are being distributed. The French also announced some donations. We think that through these efforts, in addition to ours, we may get to the 60 per cent we are talking about. I must also thank the Mastercard Foundation that has donated, through AVATT, about 67 million doses worth $500 million.
Some countries have engaged in bilateral arrangements. Do you factor this into your distribution plan in terms of who gets what quantities?
No, we're not running a donation, so to say. It’s COVAX that is making donations. We deliver what African countries order through us. Before the orders, I assume they have already factored in what they have, the donations they’re getting, and all that.
Is Africa capable of manufacturing its own pharmaceutical products? Is Afreximbank supporting any initiative in this regard?
Why not? For example, for the Johnson & Johnson vaccines we are buying, the fill and finished is being done by South Africa's Aspen Pharmacare facility. Here in Egypt [Afreximbank is headquartered in Cairo] Vacsera, [the vaccine manufacturers,] is working to begin producing vaccines. Companies in Algeria, Nigeria, and Senegal hope to produce vaccines.
Regarding pharmaceuticals, there is a good opportunity for Africa. The problem we have is access to markets. One of the things we are trying to change is to get those agencies that make huge orders to rethink their strategy, to give Africa the opportunity to produce pharmaceuticals.
We have had very fruitful discussions with UNICEF in this regard, and Afreximbank is ready, and I know other banks are, too. We signed an MOU with the Africa Finance Corporation to collaborate and support vaccine manufacturing projects in Africa.
We need to create this capacity for manufacturing pharmaceutical products because there is a market for them. In fact, we are the market. These drugs are coming to us; the buyers buy the products from other markets and then ship them to us. So, we want to change that situation. We've seen the danger of over-concentration of production in a few places.
Will the effective implementation of the African Continental Free Trade Area (AfCFTA) help in this regard?
Of course, that's one of the rationales for the AfCFTA. An integrated market will create supply chains; the markets will begin to consolidate, and we will have that buying power that will make it possible to produce more within the continent.
If people can buy things from any part of Africa, you will see an aggregation of demand. Today, we are a fragmented market. We don't have information about what happens across the border.
The AfCFTA will help deal with this lack of market information. And when we deal with it and consolidate the market, we'll begin to change the narrative on the continent.
How does Africa acquire the requisite technology to manufacture its pharmaceuticals, given that companies in advanced countries tend to protect technology secrets?
Technology is an issue of intellectual property, isn't it? Knowledge is cumulative. Take your mind back to say 35 years ago, 40 years ago. Was China where it is today? Did they have the technology then that they have today?
We must find a way to foster technology transfer, especially for something that will provide health security.
At Afreximbank, we have a facility to make it easier for foreign companies to license their technologies to African manufacturers. We guarantee payment of the royalties or license fees, we guarantee that the license fees will be used according to the terms of the agreement, and we guarantee nothing will be expropriated. The alternative is what we don't want, where people steal the technology. We want a fair and transparent transfer of technology.
Also, we must begin to strengthen the capacities of our educational institutions so that Africans can contribute significantly to global knowledge and own intellectual property. That is the way we think things should evolve. So, we’re helping to pay for access to technology, helping to finance manufacturing—that is in the short term. But over time, we must support our people to create their technology.
The Director of Africa CDC, Dr. John Nkengasong, calls for co-creation. We can co-create because we have the local knowledge and the resources. If you look at our biodiversity, for example, what we have that has helped feed the pharmaceutical drug industry is amazing.