SA facing Covid-19 vaccine dilemma
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Cape Town - There are two companies capable of manufacturing Covid-19 vaccines in South Africa – but it will be a long and expensive road ahead until they are able to do so.
As multiple candidate vaccines being trialled around the world are showing promise, and looking likely to head into commercial production, wealthy countries have already called dibs on the bulk of the doses to keep their citizens safe.
For developing countries such as South Africa, this begs the question: how do we secure enough doses to immunise our citizens, once a safe and effective vaccine is available?
One solution to this would be to manufacture the vaccine locally, but this is an extremely costly and complex undertaking, according to the director of health innovation at the Department of Science and Technology, Glaudina Loots.
“It’s essential to keep in mind that the manufacturing of vaccines and biologics is not as easy as the manufacturing of other drugs,” Loots said. “Because you are dealing with a live product and sterile environments where you have to manufacture it or fill/finish it, it’s a far more complicated process.”
Loots shared her insights at a dialogue on Covid-19 vaccine policy hosted by the Human Sciences Research Council (HSRC).
“At the moment in South Africa, there are two companies that have the ability to do formulation and fill/finishing of vaccines: Aspen Pharmacare and Biovac.”
Aspen has signed a deal with Johnson & Johnson to receive a technology transfer of their candidate vaccine and is hoping to go into production within the first half of next year, according to senior executive Dr Stavros Nicolaou.
Loots said Biovac is in the process of expanding their facilities as well as entering agreements with other pharmaceutical companies for technology transfer of a Covid-19 vaccine.
“Unfortunately, that process will take up to five years to complete,” she said.
The complexity and cost of producing vaccines is why facilities on the African continent are so limited.
“We need to take into account that you need R2 billion just to establish a facility that can fill up to 500 million doses. And to put such a facility together will take approximately three years and that is just to do the fill/finishing component,” Loots said.
“The moment you want to look at the manufacturing of active pharmaceutical ingredients, that is an additional cost of approx R2 billion.”
Aspen’s Nicolaou said the need for a vaccine in SA goes beyond the obvious public health impact.
“Many countries far richer than ours have already secured supplies far in advance. Finding a solution to the Covid vaccine problem for our country is exceedingly important.
“A vaccine will make a fundamental difference to the President’s economic recovery plan. In fact, it’s pivotal. So when we have this discussion, it’s not just a public health conversation; it’s one that is pivotal to rescuing our economy.”
Nicolaou said that of the 250 plus clinical trials taking place around the world, his pick of the four most likely to succeed are the Pfizer vaccine, Johnson & Johnson, Moderna and Oxford-AstraZeneca.
“They’re all showing varying degrees of promise in phase three trials,” he said. “As a country, we will probably be procuring one or more of those vaccines.
“We don’t understand what this is going to cost, and the price tag we’ve seen is excessive. Some of that blow can be mitigated by private sector procuring and putting up some of that funding.
“You’re always best off if you can manufacture these things locally.”
Dr Morena Makhoana, chief executive of Biovac, said that the supply chain of vaccines to African countries needs to fundamentally shift if we are to be better equipped to respond to pandemics in future.
“Vaccine manufacturing is happening everywhere else except Africa. Africa is not producing for itself,” he said. “We can’t expect vaccine manufacturing to pop up only when there is a pandemic. We need to have routine vaccine manufacturing happening on the continent in order for a ramp up to happen when there is a pandemic.”
Luckily, in the past 10 years, biotechnologies and companies have advanced to the point where we are able to respond.
“The good news is that 10 years later, there is at least capability that exists, globally and on the African continent,” Makhoana said. “On the continent, we have Biovac and Aspen which have declared that they will enter into a response to the pandemic. Ten years ago, neither company would have done so.”