Politics and economics of vaccines in Africa

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CWA # 709

NIAS Fortnightly on Science, Technology & International Relations

Politics and economics of vaccines in Africa

STIR Team
29 March 2022

Vol 1, No. 18, 22 March 2022

Cover Story

The EU-AU Summit: The politics and economics of vaccines in Africa

By Joeana Cera Matthews

Africa has been facing a dearth of vaccines bothin terms of accessibility and availability. Vaccine disparity prevails both within Africa and globally. Efforts have been made to ensure that the African Union (AU) is as much a partner in vaccine technology as the European Union (EU). However, vaccination politics exceed general understandings of equity.

On 18 February, the World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus addressed the sixth EU-AU summit. Addressing the leaders, he said: “The development and approval of the first vaccine within 12 months of this new coronavirus being identified is a stunning scientific achievement. But this scientific triumph has been undermined by vast inequities in access to these life-saving tools.” Africa has been facing a dearth of vaccines, both in terms of accessibility and availability.

I
Vaccine disparity: Issues and challenges

Africa and the Vaccine Apartheid issue
The pandemic highlighted the double standards in place. The “vaccine apartheid” ensured limited inoculation rates; while new variants rose across the world, European countries prohibited travel only from Africa adversely affecting the latter’s economy. The WHO Chief Ghebreyesus also pointed out the stark difference in the inoculation rates of other countries in reference to Africa. The continent is yet to vaccinate 80 per cent of its population. As of 18 March, only 14.86 per cent of the people living in the African continent have been fully vaccinated with the two prescribed doses. Meanwhile, those in Europe have already received their third dose – the booster shot. It is noteworthy that Europe as a continent has thrown away more vaccines than it has donated to Africa. The norm of European “charity” is one of the foremost reasons for the lack of an equitable distribution of vaccines.

Vaccination rates: The disparity within Africa
As mentioned earlier, Africa as a continent has the lowest vaccination rate. Evidently, the “scientific triumph” that was the development and approval of the first vaccine within a year of the virus’ identification was dulled by the lack of equality in the distribution of this “achievement” of humanity.

This disparity is not peculiar to the world and Africa alone; it is an issue that is deeply rooted even within the continent of Africa. While the rest of Africa suffers from the lack of vaccines and the ability to inoculate themselves, countries such as Nigeria and South Africa have been doing quite well. South Africa and Nigeria maintain strong healthcare industries capable of manufacturing vaccines and providing for their citizens.

Nonetheless, the disparity raises the question of the reasons behind the vaccine divide. To date, the bloc has been largely addressing the effects of the issues that affect Africa. Instead of fighting the effects, it would serve the bloc well to address the cause of the problem which is poor governance and the lack of health infrastructure. The primary reason behind the lack of equitable vaccine distribution in the continent owes to its problem of poor governance. The Sahel region alone has witnessed four coups in 2021 indicating poor leadership, poverty and insecurity. The lack of health infrastructure directly leads to an inability to function well even if vaccine rollouts were regular and sufficient.

II
The Sixth EU-AU Summit: “A Joint Vision for 2030”

On 17 February, members of the African Union (AU) and the European Union (EU) met at Brussels in Belgium for the sixth EU-AU summit. The two-day conference was chaired by President of the European Council Charles Michel along with President of the Republic of Senegal and AU Chairperson Macky Sall. The conference, delayed by 16 months due to the pandemic, witnessed the heads of 27 EU member states and 55 AU states gathering. The conference was held with the backdrop of the agenda that pointed to “A Joint Vision for 2030”. Despite the set agenda, the conference attempted to forge a partnership of equals evolving from the donor-recipient trend of the colonial era.

First, the deal. The declaration chalked up hopes to combine the Global Gateway Strategy with the EUR 1 trillion-worth European Green Deal. In line with this endeavour, the conference concluded with the announcement of a EUR 150 billion Global Gateway Investment Package for Africa that would span the next seven years. The EU would, thus, invest in three sectors - infrastructure, digitalisation and telecommunications, and health.

Second, health beyond the pandemic. The summit arrived at the conclusion that the health sector’s infrastructural development was necessary to prepare for events in advance. Looking beyond the pandemic, long-term measures were opted in place of the short-term ones. Measures such as the provision of COVID-19 vaccines and their associated technology were adopted. Building on “the capacity of Africa,” President of the European Commission Ursula Von der Leyen expressed that the continent had a long way to go but was infinitely backed by the EU in this effort. However, Von der Leyen expressed the need for the EU's “investments in health” to extend beyond the “immediate urgency and take a strategic perspective that looks beyond the pandemic”. She added: “It is about the capacity of Africa, indeed, to produce their own vaccines, to develop mRNA manufacturing capacity across Africa.”

Third, the mRNA technology. The mRNA vaccines and their significance would be well understood if one recognizes that the technology is also helpful in creating other vaccines. As Von der Leyen stated: “... the fascinating part is that this is not only about COVID-19 vaccines, but this mRNA technology is phenomenal in engineering vaccines for other diseases that are the real killer, like, for example, malaria or tuberculosis. So there is a lot of progress in it.”

Fourth, the promises. The EU aims to provide Africa with at least 450 million vaccine doses by June 2022. This is expected to be done via the Africa Vaccine Acquisition Task Team (AVATT) platform. Simultaneously, the Team Europe Package Against COVID-19 is reported to have provided USD 3 billion, an equivalent to 400 million vaccine doses, to the COVAX facility that provides for the vaccine distribution in Africa, among other low-income countries. Meanwhile, Team Europe also aims to generate EUR 425 million to increase the momentum of inoculation rates. In association with Africa Centres for Disease Control and Prevention (CDC), Team Europe is also expected to aid in the efficient distribution of doses along with the medical training of teams. In accordance with the Rome Declaration adopted at the Global Health Summit, the EU-AU summit declaration also stated that the health sector would be reconfigured with initiatives on pandemic preparedness, health security and equitable access to quality essential health services.

Fifth, the question of execution. The summit witnessed the bloc committing to numerous promises while the ability of the EU to execute these plans remained in question. Even if the bloc were to implement the suggested measures, the extent of such an implementation was brought to discussion. Von der Leyen announced that 2022 would witness “two state-of-the-art factories” being installed in Rwanda and Senegal. Additionally, the Dakar’s Pasteur Institute would be a new vaccine production site. The European Commission President also expressed the support extended towards the WHO in its efforts to establish a “technology transfer hub for mRNA vaccine production in South Africa”.

Sixth, the TRIPS waiver. The “supportive” nature of the EU was questioned with the debate on the request to waive the Trade-Related Aspects of Intellectual Property Rights (TRIPS) on the COVID-19 vaccines’ technology. Although the EU leaders foresaw the demand, key players required to forge a deal such as the European Commission and Germany were quick to resist. Instead, a discussion was tabled for the future with the presence of the WTO Director-General Ngozi Okonjo-Iweala. Countries in Africa such as South Africa along with other developing countries such as India had called on the World Trade Organisation (WTO) to temporarily waive the patents placed over vaccines. This would enable these countries to boost vaccine production allowing them to manage the disparities in vaccine distribution. However, the summit’s long-drawn negotiation concluded with the EU stalling a decision on the waiver, stating that they were committed to continuing discussions on “intellectual property-related aspects”. Even the final declaration of the summit failed to mention the waiver apart from a commitment to deliberate on the said issue.

III
The politics and economics of vaccination

The Politics of Vaccinations
The EU’s fear of losing ground and not being Africa’s “chosen one” has led the bloc to become increasingly wary of foreign investors and actors in the region. European Commission President Ursula Von der Leyen was quite direct when stating the reasons behind the symbolism of the deal. Placing itself to be Africa’s “number one partner in the fight against COVID-19,” Von der Leyen said: “The European Union is the first trading partner and the first investor in Africa. And therefore, it is no coincidence that the first regional plan under our big investment strategy, Global Gateway, is the Africa-Europe plan, with more than EUR 150 billion of investment.” An official of the European Centre for Development Policy Management (ECDPM), Lidet Tadesse, commented on the same, as she stated: “The EU is a relevant partner but it’s no longer the main or the most important partner, while at the same time Europe’s attachment to Africa is significant… The African side is increasingly trying to assert itself.”

Given that it was the bloc’s first package under the Global Gateway Strategy, the investment was considered quite symbolic. The EU was seen as making an effort to let the AU recognize how important relations with Africa were and that they were foremost when considering bilateral ties. In an attempt to let the AU realise the significance EU leaders placed with reference to them, the previously-delayed summit was held, despite the Russian invasion of Ukraine.

This fear of losing their monopoly in Africa made the bloc realise that they were no longer the only players in the field that is Africa. Multiple countries have been investing in the continent they once monopolised. Although the US investments were welcomed, the EU remains wary of the increasing Chinese investments. Nonetheless, the continent continues to be dependent on the EU funds; the goal of an equal partnership will be realised only when this dependency is removed. Meanwhile, the EU lost a golden opportunity to strengthen ties with Africa by refusing the TRIPS waiver. Given that the bloc was looking beyond the pandemic and attempting to back Africa’s goal of being better prepared for the next pandemic, the TRIPS waiver was the first substantial step they could have undertaken. Provided that it was also requested by countries from the continent and elsewhere, it is to be noted that the bloc’s refusal shone light upon the extent to which the “equal partnership” and “cooperation” of the EU went.

The Economics of Vaccinations
According to an Oxfam report (16 November 2021), billionaire pharma owners of the companies behind the two most successful COVID-19 vaccines —Pfizer, BioNTech and Moderna— made combined profits of USD 65,000 every minute. These companies have sold the majority of vaccine doses to rich countries, leaving low-income countries out in the cold. The same Oxfam report claimed that Pfizer and BioNTech had delivered less than one per cent of their total vaccine supplies to low-income countries, while Moderna delivered just 0.2 per cent. Meanwhile, 98 per cent of people in low-income countries have not been fully vaccinated.

As Oxfam’s Pan Africa Programme Director Peter Kamalingin expressed: “EU leaders continue to make a song and dance about the importance of their relationship with the African continent. Yet they once again put the interests of their profit-hungry pharmaceutical corporations first… Instead of siding with Big Pharma who are making billions out of vaccines, the EU and European countries must stop kicking the can down the road and support the full waiver and insist the vaccine technology is shared. This is the only way to ensure we can supply and distribute vaccines, tests and treatments â€•to everyone, everywhere and bring an end to this pandemic.” Big pharma has learnt the art of strategically using the monopoly they have created in the market. The vaccine vacuum that continues to exist in a few countries is beneficial to these companies.

Nonetheless, criticism against these elitist vaccine-makers has risen from all corners. The harshest of these were witnessed when in conversation about Africa. The call for sharing vaccine recipes was outrightly denied by the Pfizer CEO Albert Bourla terming the request a “dangerous nonsense”. Oxfam’s Health Policy Manager Anna Marriott responded: “Contrary to what Pfizer’s CEO says, the real nonsense is claiming the experience and expertise to develop and manufacture life-saving medicines and vaccines does not exist in developing countries. This is just a false excuse that pharmaceutical companies are hiding behind to protect their astronomical profits.” Maaza Seyoum of the African Alliance and People’s Vaccine Alliance Africa added: “It is obscene that just a few companies are making millions of dollars in profit every single hour, while just two percent of people in low-income countries have been fully vaccinated against coronavirus.”

Permitting companies to maintain a monopoly over the vaccine market has turned out to be the real danger in the ability to provide vaccines. This is to be considered a direct failure of the government since artificial control of supply undertaken by these companies causes an increase in the demand leading to higher profits.

IV
The way forward

Ahead of the summit, the Aids Healthcare Foundation (AHF) addressed a letter to President Muhammadu Buhari, calling on EU and AU member states to take decisive action on the issue that was vaccine rollout and accessibility along with the availability. The letter notes: “This is not real cooperation. The pandemic has made it abundantly clear – a global public health crisis cannot be solved piecemeal; it requires genuine partnership and cooperation. We will only find a way out of the pandemic if the two continents work together as equals.” The letter was quite expressive when it claimed the global inability to cater to the needs of those in pain due to the pandemic directly implied a failed “international framework of public health governance”.

The high-income countries need to put an end to vaccine hoarding. The tendency to ship over nearly expired doses to Africa also needs to stop. These measures, if ignored, would only result in the cycle of deadly waves and variants prolonging. Regarding the TRIPS waiver, as Ghebreyesus stated: “The flexibilities in the TRIPS agreement are there to be used in emergencies. If not now, then when?” The EU’s attitude of providing Africa with its “perfunctory charity” needs to be altered if any substantial change is to be witnessed.

References

Edouard Mathieu, “COVID-19 Data Explorer - Our World in Data,” Our World in Data, 18 March 2022.

“EU leaders' refusal to consider AU calls for a waiver on COVID-19 vaccines and technology “an insult to the millions of people in poorer countries who have needlessly lost loved ones,” Oxfam International, 18 February 2022.

“16th European Union - African Union Summit: A Joint Vision for 2030 We, the Heads of State and Government of the Member States,” European Council, 18 February 2022.

Ashleigh Furlong and Barbara Moens, “Vaccine bad blood troubles EU's Africa reset,” POLITICO, 18 February 2022.

“Statement by the President following the EU-AU Summit,” European Commission, 18 February 2022.

“WHO Director-General's remarks at thematic roundtable: health systems and vaccine production EU-AU Summit,” World Health Organization, 18 February 2022.

Tope Templer Olaiya, “End COVID-19 vaccine inequalities, AHF tells EU-AU summit,” The Guardian, 18 February 2022.

“Opening speech by the President: 6th EU-AU Summit,” European Commission, 17 February 2022.

“What to expect at the 6th EU-AU Summit,” Al Jazeera, 17 February 2022.

“Pfizer, BioNTech and Moderna making $1,000 profit every second while world's poorest countries remain largely unvaccinated,” Oxfam International, 16 November 2021.

About the author

Joeana Cera Matthews is a postgraduate scholar from the Department of International Relations at the University of Mysore. She is currently a Visiting Research Scholar at the National Institute of Advanced Studies.

In Brief
By Harini Madhusudan and Akriti Sharma

Russia- Ukraine War: The challenges and fallouts from Outer Space
On 18 March, Reuters reported that Britain and the US warned the organisations of the risks associated with using satellite communications following a cyberattack on satellite internet modems due to the war. It was reported that there was a possible hacking by Russia of US satellite communications provider Viasat on the day it invaded Ukraine. While there has not been any public accusation, it is largely believed to have been a very significant cyber attack that wiped devices on 24 February. If proven, the cyber attack on the satellite could be a dangerous trend in armed conflict.

The attack is said to have affected military and government communications. The attack is one of the many instances of the war having an impact on the activities in outer space. The war in Ukraine has managed to bring to light two scientific strengths that Russia holds over the rest of the world. These included the hypersonic and outer space capabilities.

The major domains of outer space during the war, pose questions on the sustained future of outer space. First, Elon Musk offered internet access to Ukraine through his Starlink project. Though the offer was timely, it would be an alarming precedent when a US based private company offers critical technology access during conflict/war. This is because the Outer Space Treaty ascribes all roles of private entities in outer space to that of the state it belongs to. The usage of these satellites during the war would qualify the Starlink technology as military objects.

Second, on 24 February, following the series of sanctions placed on Russia, the Director General of Roscosmos announced with a series of tweets on the International Space Station (ISS). He threatened to shut off the ISS’ Russian-controlled propulsion systems, which could possibly damage the space station with the effect of possibly falling to Earth. Russia has previously used this tactic as a threat in 2014 and 2021. Though, it is lawfully and practically both dangerous to do, the possibility of such actions weigh heavy during the conflict. Additionally, the legal document signed by the parties involved with the ISS, the Intergovernmental Agreement, imposes duties against such threatened actions. However, the Russian Soyuz announced that they would bring back to earth the American cosmonaut along with the Russian citizens, regardless of the ongoing war.

Third, the impact of the economic sanctions on Russia. The western allies have imposed wide-ranging sanctions including the banks and the military technology sectors. Though there aren’t any clear indications of the sanctions targeting the space industries, Biden announced that the sanctions would halve the high-tech imports of Russia thereby aiming to degrade the aerospace industry and the space program. Both the sectors depend on high-tech imports, semiconductors specifically, which play a crucial role in almost all satellites and space technologies. As a counter, Russia has suspended all Soyuz launch cooperation with Europe. Russia was demanded a contract launch to guarantee the satellites would not be used for military purposes. Russia is also known to have cut off its supply of rocket engines for Northrop Grumman and United Launch Alliance.

The military and intelligence sections of Russia and Ukraine have heavily used the satellites in orbit for helping with surveillance, communications, and GPS. The role of private players have increased in the conflict, and this would continue to provide legal challenges in the case of adverse circumstances. (“Britain, U.S. warn of satellite communications risks after Ukraine hack” Reuters, 18 March 2022; Timothy Goines, Jeffery Biller, and Jeremy Grunert, “The Russia Ukraine war and the Space Domain,” WestpointEdu, 14 March 2022)

Climate change: Heatwaves in the polar regions
On 18 March, Antarctica recorded 70 degrees Celsius warmer than average temperature and the Arctic recorded 40 degrees Celsius warmer than average temperature. Such high temperatures are unusual in the polar regions. On 18 March, according to the satellite images, the Antarctica ice shrank to 772,000 square miles from 815,000 square miles in 2017. According to The Guardian, scientists warned that the events were “historic”, “unprecedented” and “dramatic”.This is the first time that Antarctica has less than 2 billion square miles of snow cover. The ice in Antarctica usually undergoes melt and freeze cycles but in the last two years the cycle has been unusual. The low ice cover in the region has adversely impacted the biodiversity of the region. According to the AP News, scientists said that if the temperatures increase repeatedly for the coming years then it would be attributed to climate change.

Normally, during this time the Antarctic is supposed to be in the autumn season, emerging from its summers and the Arctic is supposed to be in spring, emerging from winters. Simultaneous heatwaves at both the poles is witnessed for the first time. Unprecedented rise in the temperatures is a sign of disruptions in the climate pattern of the earth. Polar regions are the most vulnerable regions with fragile ecosystems and any change or disruptions in the polar climate can have serious irreversible implications.

According to the Intergovernmental Panel on Climate Change sixth assessment report, glaciers in the polar regions have lost mass since the 2000 and will continue to lose mass even if the global temperature rise is below the target of 1.5 or 2 degrees Celsius. Extreme heat events have increased in the Arctic since the 1980s along with an increase in the minimum temperatures. Permafrost warming and thawing have been widespread in the Arctic and it is likely to increase the carbon emissions. In Antarctica, warming levels between 2°C and 3°C have sustained and the West Antarctic Ice Sheet will be lost almost completely in the coming years. Climate change has unfolded two types of risks, the unprecedented heatwaves in the world's coldest regions and accelerated melting of the snow which would increase the sea levels.(Fiona Harvey, “Heatwaves at both of Earth’s poles alarm climate scientists,” The Guardian, 20 March 2022; Henry Fountain, “Sea Ice Around Antarctica Reaches a Record Low,” The New York Times, 23 February 2022; Seth Borenstein, “Hot poles: Antarctica, Arctic 70 and 50 degrees above normal,” AP News, 19 March 2022; “Heatwaves at Earth's poles: Record temperatures 30-40 degrees Celsius above normal worrying,” CNBC TV18, 22 March 2022)

S&T Nuggets
By Akriti Sharma and Harini Madhusudan

CLIMATE AND ENVIRONMENT

Australia: Coral reef bleaching
On 18 March, according to a report by the Great Barrier Reef Marine Authority, the coral reefs in the Great Barrier Reef were witnessing massive coral bleaching. It said: “Weather patterns over the next few weeks will be critical in determining the overall extent and severity of coral bleaching across the Marine Park,” The report came three days before the visit of the UN delegation which was supposed to assess whether the reefs should be downgraded from the World Heritage listing due to the damage done by climate change. The reefs have been undergoing bleaching due to the unprecedented warming up of the oceans since 2016. The bleaching has damaged two thirds of the reefs. Greenpeace accused the Australian government of its failure to protect coral reefs from the impact of climate change. Coral reefs are vital to the marine ecosystems and bleaching of the coral reefs due to the changing climate can adversely affect ocean health. (Rod McGuirk, “Great Barrier Reef suffers widespread coral bleaching,” The AP, 18 March 2022)

The US: Droughts likely to persist
On 17 March, the National Oceanic and Atmospheric Administration said that the droughts will persist throughout the month of June over half of the continental US, increasing the risk of wildfires. Around 60 per cent of the US is witnessing droughts and shortage of water which will become worse in the coming months. Reservoirs on the Colorado River faced the lowest levels of water since it was built. The extremely dry conditions and low levels of precipitation could lead to wildfires which have become more frequent throughout the US in the past years. (Maggie Aster, “Drought in U.S. Is Expected to Persist, and Spread, Through the Spring,” The New York Times, 17 March 2022)

Environment: Lost ship Endurance found in the Antarctic
On 9 March, the scientist found Sir Ernest Shakelton’s lost ship, Endurance from the seabed of the Weddell Sea in the Antarctic after 107 years, making it the one of the greatest ever undiscovered shipwrecks. In 1915 the ship sank after getting crushed by the ice.The project to find the ship was executed by Falklands Maritime Heritage Trust using a South African icebreaker, Agulhas II. The mission's head, Dr John Shears said: "The discovery of the wreck is an incredible achievement," The ship was found at the depth of 3008 metres. It has sustained diverse marine life including sea squirts, anemones, sponges of various forms, brittlestars, and crinoids on its surface. The ship is significant for two reasons, first, it was part of the first land crossing of Antarctica and second, the challenging Weddell sea which is covered by thick ice. However, in the last month the soaring temperatures on the polar region resulted in melting of the sea ice like never before, making it favourable for the geographers to find the ship. (Jonathon Amos, “Endurance: Shackleton's lost ship is found in Antarctic,” BBC, 9 March 2022)

HEALTH
COVID-19: New Deltacron variant
On 11 March, the New York Times reported that some scientists have found a hybrid variant consisting of the Delta and Omicron variants of COVID-19, Deltacron. In February 2022, it was first found by an American scientist in Washington while inspecting the database of genomes of coronavirus. On 10 March, the new variant was found in 33 samples in France, Denmark, Germany and the Netherlands. The recombination of the viruses could have happened through people who were infected by the Delta and Omicron variants of the virus simultaneously. As of now, the scientists are not classifying it as a cause of concern. In Deltacron, the gene that encodes the virus protein has come from Omicron and the rest of the genome from Delta which would prevent people who have recovered from Omicron from contracting the virus. (Carl Zimmer, “New ‘Deltacron’ Variant Is Rare and Similar to Omicron, Experts Say,” The New York Times, 11 March 2022)

SPACE
Space: Giant Moonrocket reached launchpad
On 18 March, NASA’s giant moonrocket reached the launchpad for the first time. However, it is not certain when it will finally leave the Earth. The Artemis 1 moon rocket is NASA's first Space Launch System booster. The rocket, NASA's Space Launch System, is the most powerful rocket ever built. NASA Administrator Bill Nelson said: "At these launch pads, remarkable individuals achieve unthinkable things," He added, "NASA's Artemis program will pave the way for humanity's giant leap — future missions to Mars. "There's no doubt that we are in a golden era of human space exploration, discovery and ingenuity in space. And it all begins with Artemis 1” he said.(“NASA's new moon rocket, its most powerful ever, rolls out for 1st time,” Space.com 18 March 2022.

SpaceX: New records for reuse and payload mass
On 19 March, SpaceX set new records for the use of the Falcon9 booster and the mass placed by the rocket into orbit, in its latest launch of Starlink Satellites. The Falcon9 placed 53 Starlink satellites into an orbit at an altitude of approximately 320 kilometres with the payload at 16.25 metric tonnes. Following this mission, SpaceX has launched 2,335 satellites under the Starlink series. The company also set a record with the reuse of its booster. Designated B1051, this marked the 12th use of the booster; two other SpaceX boosters have flown 11 flights. (Jeff Foust, “SpaceX sets reuse and payload mass records in Starlink Launch,” SpaceNews, 19 March 2022)

TECHNOLOGY
India: BSNL to deploy indigenous 4G, 5G technologies
On 11 March, a TCS-led consortium with C-DoT announced the completion of their trials for 4G networks as a partner to BSNL. At a Convergence India Event, Centre for Development of Telematics executive director said that the consortium has developed technology at a cost of USD 30 million. The Committee on Communications and Information Technology also recommended that the BSNL should be allocated the spectrum to roll out 5G to ensure BSNL is on par with the private telecom operators in the country. The Indian government has made a provision of INR 45,000 crore for BSNL to roll out 4G. (“BSNL to launch 4G with 5G NSA network by August," Economic Times Telecom, 11 March 2022.)

About the authors

Harini Madhusudan and Akriti Sharma are PhD Scholars at the School of Conflict and Security Studies, NIAS.

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