‘Africa needs to become more self-sufficient’: Dr Sall, Institut Pasteur

Early on in the pandemic, the Institut Pasteur in Dakar shone out as a beacon of medical competency in a sea of government and civilian panic. It pioneered early diagnosis of Covid-19, and has for years led the continent in the fight against diseases like Ebola and yellow fever.

The Institute’s head, Dr. Amadou Alpha Sall, says Africa must invest in its health systems before the next shock.

How has the Covid-19 pandemic highlighted the shortcomings of the pharmaceutical industry in Africa?

Amadou Alpha Sall: The pandemic amplified a pre-existing situation and highlighted the importance of health security from an economic and social point of view. We were faced with a global dynamic. Everyone had to react quickly.

On the positive side, we became aware of the need to become autonomous in our pharmaceutical industry. That was a big change. One of the things that came out of that was a major initiative led by the Africa Centres for Disease Control and Prevention (Africa CDC): a partnership around vaccines, backed by heads of state. And several projects have emerged around vaccine production.

What three things would Africa need in order to gain pharmaceutical sovereignty?

I would say human resources, funding and strong political will. The funding already exists, but it is directed towards other sectors such as infrastructure or energy. It’s important that more money goes to the pharmaceutical industry. It’s a question of focus. I would add that we need technical expertise. We have been producing vaccines for more than 80 years. And, in the case of medicines, several institutions in Africa are producing generics. The expertise exists, but now it needs to be expanded.

We need to mobilise more on neglected cases that do not necessarily present a promising market for large pharmaceutical companies. The vaccine against Rift Valley fever, for example, is not widely distributed. It is the same with Ebola. It is important to keep this in mind.

The World Health Organisation (WHO) announced in February 2022 that six African countries – Senegal, South Africa, Egypt, Kenya, Tunisia and Nigeria – will benefit from a messenger RNA (mRNA) vaccine manufacturing programme. What might this technology transfer change?

Using mRNA technology – as we have seen with Covid-19 – allows vaccines to be produced in a very short time. It is a flexible technology. The idea is that tomorrow, in the event of another global emergency, we will be able to develop a vaccine very quickly, so that Africa does not find itself again in the situation where vaccines are manufactured in countries to which the continent does not have access. It’s about Africa becoming more self-sufficient in its ability to develop vaccines and then deploy them. Today, each country sets its own roadmap in this area.

The Institut Pasteur is currently finalising the construction of a vaccine manufacturing plant in Diamniadio, Senegal, in association with Germany’s BioNTech. How did this come about?

The African Union and Senegal wanted to become more autonomous in vaccine production. The process was accelerated by Covid-19. The objective is to ensure the local production of 60% of the routine vaccines administered in Africa by 2040.

The Institut Pasteur in Dakar was chosen because it has already been producing a yellow fever vaccine for more than 80 years. This is the only vaccine produced in Africa that is recognised by the WHO at the global level. The factory, which will have an annual capacity of 300m doses, is expected to start operations in 2022.

What will this plant produce?

We are working on three scenarios: the first, focused on the production of Covid-19 vaccines; the second, producing Covid-19 and other vaccines; and the third, where all the 300m doses would be assigned to other vaccines, such as measles, polio, or purely viral vaccines, for Ebola epidemics, for example. The objective is purely African. Depending on what we produce, the doses will be sent beyond Senegal and West Africa.

Are you also planning to conduct research into vaccines, for example against malaria or tuberculosis?

Our platform has a partnership with BioNTech, which is working on several vaccines against malaria, tuberculosis and HIV.

We intend to work together on researching these vaccines, which are very important for our continent.

In South Africa, a year after it opened, Aspen Pharmacare is already worried that it will have to close its Covid-19 vaccine production line because of insufficient demand. What can we learn from this?

Market demand needs to be much better understood. If Aspen is not selling today, it is because there are donations, and, in addition, orders had already been placed abroad. In a global market, if we want to support production in Africa, there must be incentives, support and backing for these producers to emerge. When we talk about vaccine production, it’s not a question of quantity, but rather of timing. You have to produce at the right time. If the 140m doses of Aspen had been available at a time when everyone needed vaccines, the stock would have run out.

The Institut Pasteur in Dakar has been producing yellow fever vaccines for a long time. Has Africa achieved self-sufficiency in the production of this vaccine?

No, Africa is not self-sufficient, the world is not self-sufficient. For several years, this vaccine has been in very limited supply, which is why there is a programme led by the WHO and various partners to increase it. In general, to my knowledge, there is no vaccine or medicine for which the African continent is self-sufficient.