Building health systems for Africa’s vaccine sovereignty

At the 38th African Union Summit in February 2025, the continent’s Heads of State and Government issued a deliberate and consequential resolution. Health security, local manufacturing and system resilience were no longer to be treated as external dependencies to be managed, but as responsibilities to be owned. This reflected a shared recognition that Africa’s vulnerability to recurrent disease outbreaks and medical supply disruptions constitute a structural risk to development, political stability and economic resilience, with direct implications for productivity, fiscal sustainability and regional integration.

One year on, the rationale for that resolution remains compelling. Surveillance by the Africa Centres for Disease Control and Prevention shows one of the continent’s most severe cholera waves in decades, with more than 300,000 suspected cases and over 7,000 reported deaths across Eastern, Southern and Western Africa. Zambia has been at the epicentre. As President Hakainde Hichilema and WHO Director-General Tedros Adhanom Ghebreyesus wrote in The Guardian in October 2025, Africa’s dependence on external suppliers placed countries “at the back of the queue” when global demand surged.

Cholera is not an isolated case. Over the same period, Africa recorded tens of thousands of confirmed mpox cases, widespread measles outbreaks, with significant child mortality, expanding dengue transmission linked to climate variability and rapid urbanisation, and recurrent seasonal surges of Lassa fever in West Africa. Marburg virus disease outbreaks have also been formally noted by the African Union and WHO, with the outbreak in Ethiopia contained after less than three months by the Africa CDC. Taken together, these patterns confirm that preparedness should no longer be episodic; it is a standing obligation of governance, matched with financing and delivery.

From Global Dependence to System Readiness

This experience has clarified a lesson that was previously easier to overlook. Africa’s engagement with global vaccine supply over the past five years has shown that access to vaccines and biologics is shaped less by goodwill or financing alone; it has been defined by whether scientific capability, regulatory authority, manufacturing capacity, and market coordination are built as an integrated system. During COVID-19, despite unprecedented global spending on vaccines, including through COVAX, African countries remained constrained by external supply chains for finished products, underlying technologies, clinical data generation, and regulatory decision-making. That dependence delayed access, even when products were available globally and narrowed national response options.

In response, African leaders articulated a clear strategic ambition. The African Union set a continental target for Africa to produce 60 per cent of the vaccines it uses by 2040, under the Partnerships for African Vaccine Manufacturing (PAVM) framework. This ambition aligns with Agenda 2063 and is reinforced by the AU Roadmap to 2030, which places access to medicines, regulatory harmonisation, and local and regional manufacturing at the centre of Africa’s development pathway. It is further anchored in the New Public Health Order for Africa (NPHOA), which elevates health security, resilient institutions, and local production as pillars of continental self-reliance.

As implementation has started to advance, a second reality has become apparent. Manufacturing capacity alone will not deliver vaccine sovereignty, unless supported by upstream research and development, credible product pipelines, regulatory science, skilled human capital, and predictable demand. Africa’s vaccine challenge has therefore entered a decisive phase. The question is no longer whether facilities should be built, but whether investments are assembling the ecosystem required to sustain them, reduce exposure to supply shocks, and respond effectively to endemic and epidemic threats.

Financing Signals and Structural Gaps

Recent market-shaping instruments reflect this shift. The African Vaccine Manufacturing Accelerator, launched by Gavi in June 2024, makes up to US$1.2 billion available over ten years to offset early market risk and stabilise demand for African-manufactured vaccines. The Regionalised Vaccine Manufacturing Collaborative, convened by the World Economic Forum and partners, focuses on building regional manufacturing and supply-chain networks to strengthen vaccine equity and health security.

Several billion US dollars have also been committed to vaccine manufacturing and technology transfer. The European Commission has supported Africa’s mRNA technology-transfer hubs. The African Development Bank plans to mobilise US$3 billion through the African Pharmaceutical Technology Foundation to support upstream research and development. Afreximbank has financed fill-and-finish facilities and regional supply chains, while Africa CDC has outlined financing options for health-product manufacturing.

These investments have been essential but uneven. Financing has been largely concentrated on downstream manufacturing and fill-and-finish capacity, while comparatively little has flowed into product discovery, early development, clinical-trial ecosystems, core laboratories, biostatistics, and regulatory science. Africa’s gross expenditure on research and development remains around 0.5 per cent of GDP, compared with a global average of 2.2 per cent, constraining the emergence of regionally prioritised vaccine and biologics pipelines aligned with Africa’s disease burden. These gaps are explicitly diagnosed in the African Union’s Science, Technology and Innovation Strategy for Africa (STISA) 2025–2034.

Calls for increased investment in science and technology are longstanding. They date back to the Monrovia Declaration of 1979, were reinforced by the Abuja Declaration of 2001, and rehashed the Lusaka Agenda and Accra Reset and other AU Executive Council decisions, urging member states to allocate at least 1 per cent of GDP to research and development. The persistent challenge has not been diagnosis, but sustained execution at scale.

Building Upstream Capability and Continental Coordination

This systems gap has, nevertheless, informed upstream and midstream responses. Accelerating Health Innovation, Equity, and Development of Vaccines and Biologics in Africa (ACHIEVE 2.0 Africa) is an African-led framework designed to strengthen the foundations of supply and manufacturing with credible products, evidence, and regulatory readiness. Anchored through the International Vaccine Institute, ACHIEVE 2.0 aligns discovery, pre-clinical research, clinical trials, data generation, regulatory collaboration, and human-capital development around African-prioritised health needs.

The framework has attracted substantial African commitments, with initial funding pledged by governments, including Nigeria, Rwanda, South Africa, and Zambia, alongside engagement from scientific and philanthropic partners. ACHIEVE Africa 2.0 is structured to reduce utilisation and evidence risk by ensuring facilities are supplied with products, data, regulatory pathways, and skilled personnel, improving capital efficiency and long-term viability.

National Execution, Workforce Capacity, and Sustained Delivery

These efforts sit alongside broader continental financing prospects. At the AU level, leaders have highlighted the mobilisation of approximately US$3.2 billion to support Africa CDC’s agenda for local manufacturing of vaccines, medicines, diagnostics, and other health commodities. In parallel, AU planning under the Partnerships for African Vaccine Manufacturing recognises the upstream gap, with plans to mobilise US$3.0 billion over the next decade through the African Pharmaceutical Technology Foundation to support research and development in novel therapeutics and vaccines. Together, these commitments signal that healthcare sovereignty is being treated as an investible continental programme.

National reforms illustrate how this systems-logic translates into execution without displacing the continental framework. In Nigeria, health-sector renewal efforts have positioned health as economic infrastructure and national security, supported by a whole-of-government delivery platform linking policy, regulation, financing, and private investment. The Presidential Health Sector Renewal Investment Compact, launched in late 2023, achieved approximately 84 per cent of its targets by late 2025, expanding coverage, strengthening primary-care delivery, unlocking value chains, and deploying digital monitoring systems. Rwanda’s US$150 million BioNTech modular mRNA facility in Kigali, South Africa’s vaccine-manufacturing agreements through Aspen Pharmacare, and Zambia’s leadership on a continental cholera response illustrate complementary national pathways aligned with continental objectives.

Human capital remains an abiding constraint. Africa’s shortage of experienced product developers, regulatory scientists, quality specialists, and biostatisticians continues to limit both manufacturing sustainability and immunisation impact. Addressing this gap requires coordinated investment in applied training and product-development pathways that allow skills to accumulate through practice. Nigeria’s commitment to training 10,000 pharmaceutical and biotechnology professionals under the World Bank-supported Health Works programme links workforce development directly to domestic manufacturing, regulatory strengthening, and regional market integration. ACHIEVE 2.0 Africa deepens these efforts at a continental scale by linking laboratories, trials, and data centres into a shared talent ecosystem.

The implementation record on immunisation reinforces the case for sustained systems investment. A WHO African Region review of IA2030 progress found that vaccination in 2023 averted an estimated 1.8 million deaths; all 47 countries sustained the wild-polio-free status; and 43 achieved maternal and neonatal tetanus elimination. Coverage nevertheless remained below targets, with DTP3 at 74 per cent and MCV2 at 49 per cent, while zero-dose children declined from 7.3 million in 2022 to 6.7 million in 2023, still above the 2019 baseline. These trends underline that manufacturing scale, routine immunisation performance, surveillance, and regulatory capability must advance together.

The global context reinforces the urgency of this approach. International health financing has become more constrained and unpredictable, as aid budgets tighten and geopolitical priorities shift. Reliance on external funding flows, therefore, carries increasing strategic risk. African leaders’ decision to invest in domestic and regional capability reflects an understanding that health security underpins economic resilience, political credibility, and the capacity to act collectively in moments of crisis. Continental instruments such as the African Epidemics Fund signal a move toward sustainable, coordinated financing for public-health emergencies. Taken together, the conclusions of the 38th African Union Summit, the AU Roadmap to 2030, STISA 2025–2034, and frameworks such as ACHIEVE 2.0 Africa point in the same direction. Africa’s health security will not be secured through emergency response or manufacturing capacity alone. It will depend on sustained investment in the systems that generate vaccines, validate evidence, regulate quality, and deliver immunisation reliably across borders. Vaccine sovereignty in Africa is no longer an abstract ambition. It is a process underway, grounded in Ubuntu and African political decisions, institutional reforms, and emerging delivery platforms. Getting it right is not only a health imperative, but an economic and political necessity. The measure of success now is sustained delivery.

Chinedu Moghalu is a lawyer, strategic communications expert, and public policy adviser with over two decades of leadership across government, international organisations, and development institutions. Currently, he is a senior special adviser to Nigeria’s Coordinating Minister of Health and Social Welfare.

Nicaise Ndembi is the Deputy Director General, Regional Director of the International Vaccine Institute (IVI)’s Africa Regional Office, overseeing IVI’s operational, scientific, and partnership activities in the Africa region, including the Africa Regional Office in Kigali, Rwanda and a Country Office in Nairobi, Kenya. He is based in Kigali.

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