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Rwanda and Senegal are Hosting Africa’s First COVID-19 Vaccine Plants: What’s Known so Far



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By David Richard Walwyn

The lack of vaccine production capacity in African countries has been the subject of much concern and hand-wringing in the wake of the COVID-19 pandemic. It has become a particularly hot topic because of the gravely unequal access to COVID-19 vaccines between developed and developing countries.

Africa has limited capacity for vaccines production. Only Tunisia, Senegal, Egypt, Ethiopia, and South Africa have varying capabilities to produce and fill or finish vaccines. The largest and most integrated facility is the Biovac Institute in Cape Town.

Recently Pfizer signed a letter of intent with the institute for 100 million doses per annum. The deal covers the importation of the drug substance in bulk, the filling of vials, and the distribution of the product in Africa and elsewhere.

Africa’s shortage of manufacturing capability contrasts strongly with developing countries such as India, which has extensive pharmaceutical production capability, and Brazil.

That’s why the recent announcement by German biotechnology company BioNTech that it will be building a vaccine manufacturing facility in Rwanda, to be followed by a second in Senegal, is seen as a game changer.

The BioNTech plan involves the construction in Germany of a containerised manufacturing unit that will then be installed in Rwanda, shortening the construction period for a vaccine facility by at least a year and lowering the risk of delays. Initially, the facility will be managed and operated by BioNTech staff. But the ownership and expertise will be transferred over time to local operations. At present, such expertise does not exist in Rwanda and, based on the experience of Biovac in South Africa, could take a decade to develop.

To make a vaccine you need intellectual property as well as know how. The deal between BioNTech and the two countries includes technology transfer – this will happen in the second phase of the contract – and a license agreement that covers intellectual property rights which will remain with the company.

There are no further details about either facilities. It’s still not known, for example, when the locally-manufactured vaccine will be released and how the infrastructure will be financed.

Nevertheless, the deal with Rwanda is unique. That’s because, for the first time, the drug substance, or active ingredient for a COVID-19 vaccine – in this case mRNA – will be manufactured on the continent. mRNA for the COVID-19 vaccine is currently being manufactured only in the US and Europe.

Recent experiences with vaccine availability in developing countries show clearly that local manufacture increases the likelihood of vaccine coverage. This was true in both India and China, both of which have significant local capacity.

The shortfall

The level of COVID-19 vaccination in Africa is low. Only 60 million of the total population of 1.22 billion, equivalent to 5%, had been fully vaccinated by the end of September 2021.

There is a shortfall of many tens of millions of doses in the market. There is also no sign that this shortage will be overcome before mid-2022.

mRNA vaccines use tiny amounts of active substance. Less than 50kg of mRNA will be required to vaccinate everyone on the African continent.

However, local production of vaccine is not only about manufacturing technology. The operation will require the establishment of a regulatory system for drug approval and a quality assurance system that will be able to certify each production batch.

Clearly, the pressure on drug companies to extend COVID-19 vaccine coverage to Africa is partly the driver for this announcement. But the market could have more easily been supplied directly from BioNTech’s facilities in Germany and elsewhere. Undoubtedly part of the rationale for this deal is the pricing structure for African countries.

Drug companies are careful to protect their high-value markets, where drug prices are high and margins extremely attractive, from any product which may be distributed under ‘access pricing’. Access pricing is a mechanism whereby developing countries are able to purchase equivalent products at significantly reduced prices.

But problems arise when the product becomes available in lucrative markets as a consequence of parallel importation.

Parallel imports can be avoided by using geographically separate manufacturing sites, operating under different regulatory regimes. Product manufactured in Rwanda, and approved by a Rwandan regulatory authority, would not be accepted in Europe or other developed regions.

In this way, pharmaceutical companies can meet the criticisms of the global community in terms of health product access, while retaining their profit margins in the most lucrative segments.

The end game

The hope is that the deal will be beneficial for the development of vaccine manufacturing capability throughout the continent. One possibility is that the BioNTech deal exerts pressure on countries like South Africa to accelerate their manufacturing plans, leading to greater vaccine availability over a shorter time period.

South Africa has so far dominated vaccine deals. Apart from the Pfizer contract it has also announced a mRNA vaccine hub. This will be used to develop and license mRNA technologies from major pharmaceutical companies.

The prize, however, is local manufacture from end-to-end with full technology transfer and fewer restrictions on market access. This will be crucial in removing global inequities in the provision of essential health products.

Another factor might also come into play: a shift in the pharmaceutical manufacturing landscape. The deal that BioNTech has struck is the first its done independent of its partnership with Pfizer. This is a signal to the market that BioNTech is intent on developing its own customer base outside of its license agreement with Pfizer. This matters because Pfizer has made it clear that it’s not interested in releasing the core expertise about how to make the active ingredient for COVID-19 vaccines.

David Richard Walwyn is a Professor of Technology Management, University of Pretoria

Courtesy: Conversation

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Islamic Finance Shaping the Future: A Reflection on the International Summit on Financing Primary Healthcare Infrastructure in Nigeria




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On November 30th, 2023, the International Summit on Financing Primary Healthcare Infrastructure in Nigeria took center stage in Abuja, bringing together global leaders, financial experts, and healthcare professionals to deliberate on a critical theme: “Islamic Finance: Exploring New Sources of Financing for Primary Healthcare Transformation in Nigeria.” This landmark event, which was organized by DUKE Consult Limited in strategic collaboration with the Africa Islamic Economic Foundation, Ghana and Glocal Healthcare Systems Ltd, India, marked a significant step towards addressing the healthcare infrastructure challenges in Nigeria through innovative and sustainable financing mechanisms.

The Urgency of Healthcare Infrastructure Transformation

Nigeria, like many other developing nations, faces substantial challenges in its healthcare infrastructure. The need for adequate facilities, skilled healthcare professionals, and sustainable funding mechanisms has become increasingly urgent, especially in the wake of global health crises. The summit recognized that achieving robust primary healthcare infrastructure is pivotal to ensuring the well-being of the population and addressing health disparities.

Islamic Finance as a Catalyst for Change

The choice of Islamic finance as the central theme reflects a strategic move towards diversifying sources of funding for healthcare infrastructure. Islamic finance principles, rooted in ethical and equitable financial practices, provide an alternative framework for generating funds. By exploring these principles, Nigeria aims to tap into new avenues that align with its cultural values while fostering inclusive economic development.

Key Discussions and Agreements

The summit facilitated in-depth discussions on the potential of Islamic finance to transform Nigeria’s primary healthcare infrastructure. Attendees deliberated on the principles of Islamic finance, such as risk-sharing, profit and loss sharing, and ethical investment, as tools for shaping a more sustainable healthcare future.

One of the primary outcomes was the establishment of collaborative initiatives between the public and private sectors, leveraging Islamic finance instruments to fund healthcare projects. The summit also saw the formation of partnerships with international organizations and financial institutions, showcasing a commitment to shared responsibility in addressing Nigeria’s healthcare challenges.

Emphasizing Inclusivity and Cultural Sensitivity

An essential aspect of the summit was the emphasis on inclusivity and cultural sensitivity in healthcare financing. Recognizing that Islamic finance aligns with Nigeria’s cultural and religious values, the summit underscored the importance of tailoring financial mechanisms to the specific needs and beliefs of the population. This approach ensures that healthcare development is not only economically sustainable but also culturally resonant, promoting widespread acceptance and participation.

Looking Forward          

The International Summit on Financing Primary Healthcare Infrastructure in Nigeria has set a precedent for innovative and inclusive approaches to addressing healthcare challenges. As Nigeria strives to achieve its healthcare transformation goals, the incorporation of Islamic finance principles serves as a beacon for other nations facing similar challenges.

In conclusion, the summit marked a pivotal moment in Nigeria’s journey towards sustainable healthcare development. By exploring new sources of financing rooted in ethical principles, the country is forging a path towards a healthier, more resilient future. As the initiatives launched at the summit unfold, they have the potential not only to transform healthcare infrastructure but also to serve as a model for other nations seeking innovative financing solutions in the pursuit of universal health coverage.

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Highlights of the One Day International Summit on Financing Primary Healthcare Infrastructure in Nigeria




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By our special correspondent

A one-day international Summit on Financing Primary Healthcare Infrastructure in Nigeria under the theme: Islamic Finance: Exploring New Sources Of Financing For Primary Healthcare Transformation in Nigeria was held in Abuja, the Capital of the Federal Republic of Nigeria on the 30th of November, 2023, at the NICON Luxury Hotel, under the distinguished Chairmanship of His Excellency, Senator Ibrahim Shekarau, former Executive Governor of Kano State.

The groundbreaking event, which was organized by DUKE Logistics & Consult (Nigeria) Limited, Abuja, in strategic collaboration with the Africa Islamic Economic Foundation, Ghana and Glocal Healthcare Services Limited, India, was held to explore innovative healthcare financing models that leverage Islamic finance instruments such as sukuk (Islamic bonds), waqf (endowments), and takaful (Islamic insurance), etc. in providing sustainable and long-term financing for primary healthcare transformation in Nigeria; and to foster collaboration between the various states of the federation to share best practices and experiences in leveraging Islamic finance for healthcare projects.

The summit featured keynote speeches and discussions on various topics related to Islamic finance, healthcare infrastructure development and digital health solutions: The role of Islamic Finance in healthcare Infrastructure Development in Nigeria, by Prof. Ahmad bello Dogarawa of the Ahmadu Bello University, Zaria; Digital Health Solutions Innovation: The Glocal Story, by Mr Shailesh Kumar, of the Glocal Healthcare Systems Limited, India; Digital Health Transformation: Opportunities & Challenges, by Hon Dr Abdel Majeed Haroun, former Minister of Agriculture, Republic of Ghana; Africa Healthcare Infrastructure Program (AHIDEP), by Hajiya Aishatu Usman Muhammad of the Gombe State University, Gombe, The foregoing presentations were supported with expert and insightful discussions by Dr Aisha Ahmed, an Islamic Finance expert and consultant, Abuja and Mr. Muhammad Lawal Shu’aibu, CEO, LCM Consult Limited Abuja.

One of the key discussions revolved around the role of Islamic Finance in healthcare infrastructure development in Nigeria. Participants delved into the potential of Islamic Finance to provide sustainable funding for the construction and maintenance of healthcare facilities. This topic explored innovative financing models that align with the principles of Islamic Finance, such as waqf (endowment) and sukuk (Islamic bonds).

Another captivating topic discussed at the summit was “Digital Health Solutions Innovation: The Glocal Story.” The term “Glocal” refers to the combination of global and local perspectives. The Summit focused on the Glocal Story, which highlighted its cutting-edge digital health solutions that bridge the gap between global advancements and local healthcare needs. Experts shared success stories, case studies, and best practices, showcasing how technology can revolutionize healthcare delivery in Nigeria by improving access, affordability, and quality of care.

Furthermore, the summit covered the topic of “Digital Health Transformation: Opportunities and Challenges.” This presentation highlighted the importance of adapting digital health solutions to the specific needs and contexts of Nigeria. It addressed how these innovations can improve healthcare accessibility, efficiency, and quality, particularly in underserved areas. Participants explored the potential benefits and challenges associated with digital health transformation in Nigeria. They examined how technological advancements, such as telemedicine, electronic health records, and artificial intelligence, can revolutionize healthcare delivery and management in the country.

The presentation of the Africa Healthcare Infrastructure Development Program, the flagship initiative of the Africa Islamic Economic Foundation, offered participants a glimpse of the functions of the Program. The presentation shows that AHIDEP is a great platform to connect with international organizations and investors who are interested in supporting healthcare initiatives in Nigeria. However, to showcase the importance and potential of a healthcare project to potential investors, potential beneficiaries would have to prepare a comprehensive proposal outlining their healthcare infrastructure development goals, strategies, and the potential impact.

The discussions also touched upon the importance of involving stakeholders and ensuring efficient management of healthcare infrastructure projects. Furthermore, the discussions elucidated in detail how Islamic finance can support the innovation and implementation of digital health solutions tailored to the Nigerian context. The conversation revolved around leveraging technologies like telemedicine, mobile health applications, and electronic health records to enhance access to healthcare services, especially in remote areas. The importance of collaborations between local and international stakeholders for effective digital health transformation was also emphasized.

Overall, this one-day event, the international summit on financing primary healthcare infrastructure in Nigeria provided a platform for experts, policymakers, and stakeholders to discuss strategies and explore new sources of financing for primary healthcare transformation in Nigeria. It showcased the potential of Islamic Finance as a viable option and emphasized the importance of digital health solutions in shaping the future of healthcare in the country.

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Investments in Digital Can Accelerate Improvements in Health Care




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Digital technology can strengthen health systems, improve health financing and public health, and increase reach to underserved populations, according to a new World Bank report launched today. The report also finds that digital technology and data are especially helpful to prevent and manage chronic diseases, care for both young and aging populations, and prepare for future health emergencies and health risks triggered by climate change.

The report, Digital-in-Health: Unlocking the Value for Everyone, was launched today during the G20 Health Ministers Meeting in Gandhinagar, India. It presents a new way of thinking from simple digitization of health data to fully integrating digital technology in health systems: Digital-in-health. This means, for example, infusing digital technologies in health financing, service delivery, diagnostics, medical education, pandemic preparedness, climate and health efforts, nutrition, and aging.

The report also underscores that the successful use of digital technologies must be inclusive of all population groups, and ensure access to digital infrastructure, modern technologies, and skills, especially for vulnerable people.

Designed with people at the center, digital technology can make health services more personal, prevent healthcare costs from increasing, reduce differences in care, and make the job easier for those who provide health services,” said Mamta Murthi, Vice President for Human Development, World Bank. “We hope that this report will give governments confidence and practical guidance, regardless of the country’s stage of digital maturity or fiscal challenges.

Improving health is getting harder, not easier. Health systems face serious and growing challenges and policy decisions are too often not based on reliable data.  It is estimated that some countries use less than 5% of health data to improve health which means that decisions are not based on data or data is not used effectively to make improvements. Within challenging fiscal environments, people-centered and evidence-based digital investments can help governments save up to 15% of health costs. The report presents pragmatic, low-cost actions to improve digital-in-health, no matter the maturity of a country’s systems or digital infrastructure. For example, better health data governance and standards to ensure systems can readily connect and exchange information are not costly but will be game changing in reducing siloed digital solutions and fragmentation.

In India, we have shown that digital innovations such as tele-consultations have reached more than 140 million people and provided accessible, affordable and efficient healthcare for everyone,” said Mansukh L Mandaviya, Minister for Health and Family Welfare, India. “We believe a digital-in-health approach can unlock the value of digital technologies and data and has the potential to prevent disease and lower healthcare costs while helping patients monitor and manage chronic conditions.” 

To help countries embrace a digital-in-health approach, the report proposes three essential areas to guide investments:

  1. Prioritize evidence-based digital investments that tackle the biggest problems and focus on the needs of patients and providers.
  2. Connect the regulatory, governance, information, and infrastructure dots so that patients know that data is safe and health workers can use digital solutions transparently.
  3. Scale digital health for the long run based on trust with sustainable financing, and improved capacity and skills for digital solutions.

It will take global, regional, and country leadership to make digital-in-health a reality. The report recommends strong country leadership involving all relevant sectors and stakeholders, including civil society. Digital technology and data improvements will involve investments beyond the health sector and new partnerships with the private sector. A digital-in-health mindset needs to be a routine aspect of annual health system planning, budgeting, and implementation.

The World Bank is committed to helping low-and middle-income countries to make digital-in-health a reality to improve health for everyone. Over the past decade, the World Bank has invested almost $4 billion in digital health including in health information systems, digital governance, identification systems, and infrastructure.

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