In a complex of white labs in Cape Town’s Pinelands suburb, biomedical engineers and big pharma executives are locked in a flurry of negotiations to clinch a deal for the manufacture of a vaccine to fight the global pandemic. Founded in 2003, the Biovac Institute is southern Africa’s first vaccine facility, and one of the few on the continent with the state-of-the-art heavy machinery, specialised equipment and bio-technical expertise needed to manufacture a Covid-19 vaccine.
Its Harvard Business School-educated CEO, Dr Morena Makhoana, who is also a graduate of the University of Cape Town’s medical school, says he is helping to build the institution as part of the government’s vision for a national renaissance in vaccine manufacturing.
Owned jointly by a private consortium with a minority South African government stake, the firm is responsible for the health ministry’s human vaccine procurement and sourcing, providing 25m vaccines annually as part of the government’s immunisation strategy against a range of diseases. It could come to play a crucial role in the battle against Covid-19.
Leading Africa’s race for a vaccine
South Africa is currently banking on Covax – a global collaboration of governments, businesses and global health and philanthropic organisations working to accelerate vaccine development, production, and equitable access – to get a first round of doses that will immunise up to 20% of the most vulnerable in its 58m population.
“The subsequent doses will line up with a procurement system that runs beyond Covax, and that’s where Biovac will likely play a role,” says Makhoana.
With the capacity for manufacturing, packaging, vial filling, formulation, and product development, Biovac can help the continent fight the pandemic in two ways, Makhoana says. The first is to sign a deal with a vaccine manufacturer that already contributes to Covax, so Biovac can manufacture vaccines in the short term which will be distributed by the scheme, whether that be inside or outside the country.
This is similar to the deal reached between Aspen and Johnson & Johnson (J&J), where Africa’s largest drug company will produce the vaccine, while J&J controls distribution.
The second way is to manufacture a vaccine for South Africa outside of the Covax scheme to supply inoculations for the country in the medium-term. This requires the government to be “clearer about what it requires from its procurement system, which it hasn’t yet developed,” Makhoana says.
The announcement of a cheap vaccine from AstraZeneca and Oxford University that could be stored at fridge temperature grabbed headlines due to its potential in emerging markets with less sophisticated cold storage chains. However, Biovac’s facility is designed to produce a different kind of vaccine.
Vaccine development is divided into four platforms, Makhoana explains. Pfizer and Moderna’s vaccines use the mRNA DNA platform, while AstraZeneca, J&J, and Merck use a second viral vector platform. A third platform being developed by the likes of French pharmaceutical company Sanofi and American firm Novavax, is protein-based. The fourth platform, an inactivated vaccine type, is being developed by companies including Chinese firm Sinovac.
“All those platforms are aiming towards the same thing, which is essentially generating antibodies that last forever. But when it comes to manufacturing, all of those are manufactured very differently,” he says. “The rest of the three (aside from the viral vector platform), from what we understand about those platforms, we can manufacture.”
Biovac is talking to a number of different companies, in a bid to find the right fit. “We want a sustainable deal that will take us into the medium-term. We’ll supply South Africa and if we have excess capacity we’ll certainly make it available to whoever wants it.”
But this involves diving into the details of what Biovac’s technical teams are capable of to avoid technical issues down the line. “Vaccine tech-transfers by their very nature have issues. I’d rather take my time,” he says.
Once Biovac reaches a deal with Covax or a global vaccine developer, it can start using its site to produce up to 30m vaccines a year for South Africa and the rest of the continent at the earliest by the end of 2021, Makhoana says.
Getting South Africa vaccinated will rely on securing funding in an economy wracked by the pandemic. Unlike the US, South Africa’s procurement system prohibits putting a down-payment on products before they have arrived in the country. Makhoana says that procurement will not be impossible but will require extra funding and jumping “through a lot of hoops”.
Despite making up 14% of the world’s population, the continent accounts for less than 0.1% of the world’s vaccine production, according to the WHO.
As Africa’s second-largest economy continues thrashing out the necessary government regulations to secure its order from Covax, Makhoana says the experience should be an important lesson for the continent to develop its manufacturing capacity in the coming decades.
“A lot of people think that capacity is built overnight and we just need fancy machines and bricks-and-mortar. We’ve been laying the foundation for many years. That’s the capacity that needs to be built, and it takes patience and funding. Africa is a donor-dependent continent and for people to develop capacity and build a plant on the continent you will need to have a buyer.
“We need to be less dependent and start buying our own vaccines in order for our vaccine capability to thrive, and unless we have existing plants we won’t be able to respond to the next pandemic.”