South Africa hails Covid milestone as vaccine factory set for fit-out

Inequity of global rollout of drugs to protect against Covid-19 fought by local production

The large empty factory on Cape Town's outskirts did not appear like a game-changer in Africa's bid to overcome the unequal distribution of Covid-19 vaccines globally when unveiled by president Cyril Ramaphosa last month.

Devoid of equipment and employees, the building located in the northern suburb of Brackenfell resembled a vacant warehouse rather than a state-of-the-art pharmaceutical production facility, which it will become by the end of 2022.

Yet South Africa’s president assured reporters its development was “a milestone” in Africa’s ambitious drive to improve vaccine equity for its 54 countries, as it aims to make – from start to finish – second-generation Covid-19 shots for distribution across the continent by the end of this year.

“We [African nations] share the colonial chains that have always bound us,” Ramaphosa said during the facility’s launch on January 19th, adding: “Today is a demonstration of how we are moving forward to becoming self-reliant as a continent. Bit by bit, those colonial chains are being broken.”

South Africa’s leader has been highly critical of the global rollout of Covid-19 vaccines to date, saying poorer nations are last in line while rich ones get preferential treatment from vaccine producers.

Official World Health Organisation (WHO) statistics show that only about 8 per cent of Africa’s 1.3 billion population had been vaccinated against Covid-19 by the end of 2021, while many developed nations have inoculated more than 60 per cent of theirs.

This has prompted many healthcare experts to warn that unless there is more equity in vaccination distribution, it could take years to inoculate enough Africans to bring the pandemic under control in a region where the current dominant Covid-19 variant – Omicron – was first identified.

A billion doses

Five African nations have full, albeit small, vaccine manufacturing capabilities, according to the WHO. Other vaccine facilities across the continent primarily carry out a “fill and finish” role – meaning they load and package vaccines developed and mixed elsewhere.

South Africa’s new vaccine production plant, which is being developed by the US-based biotech billionaire Patrick Soon-Shiong, aims to address this situation.

Born and raised in South Africa, Soon-Shiong has established the company NantSA to work with the newly-launched Africa's Access to Advanced Healthcare Coalition to produce a billion doses a year of his Covid-19 vaccine by 2025 in Brackenfell.

The doctor-turned-entrepreneur's new T-cell vaccine for Covid-19, which is being developed by his US-based company ImmunityBio Inc, is undergoing clinical trials in South Africa, Botswana, Australia and the US.

There are high hopes for it, Soon-Shiong said at the Brackenfell launch, as it is designed to not only target the virus’s spike protein, like mRNA vaccines do. It also activates “killer” T-cells, a type of white blood cell that is an essential part of the immune system, to attack a nucleocapsid protein at the virus core that is crucial to its structural integrity.

“An infected cell is the factory for Covid and killing these cells is the only way to get rid of this pandemic,” he said, adding: “We have developed this T-cell vaccine and we want to manufacture it in Africa, for Africa and export it to the world.”

Knowledge transfer

The goal is to use the ImmunityBio vaccine as a universal booster shot if it is approved by regulators in the US, EU and other countries, Soon-Shiong said.

Last May, Soon-Shiong also committed an initial three billion rand (€175 million) to help facilitate the knowledge-transfer process and local capacity building in South Africa around the T-cell vaccine for Covid.

Furthermore, ImmunityBio in collaboration with NantSA will provide the technology and expertise needed to manufacture this vaccine and others, as well as their ingredients. The production plant also aims to develop treatments for cancer, tuberculosis and HIV/Aids in the coming years.

Safura Abdool Karim, a South African public health lawyer, believes that once the Brackenfell plant is up and running, it holds great potential to develop Africa’s pharmaceutical sector.

“Building the capacity of local scientists is at this project’s core, so it bodes well for developing expertise here and facilitating vaccine equity for Africans. But the challenge is we are not privy to the nature of the technology and intellectual property transfer, so we will have to wait and see,” she said.

However, Abdool Karim maintained Africa still faces a massive challenge in the next six to 12 months to get sufficient Covid-19 vaccines for its people.

“Vaccine producers and developed countries need to provide more Covid-19 shots to Africa than they currently are. Vaccines are often shipped here close to their expiry dates even though they need to have at least a six-week shelf life.

“They are also sent to African countries on very short notice with little detail of their storage needs provided in advance. So, although rich countries are not monopolising Covid-19 vaccines as much anymore, their approach to sharing with Africa still has the same effect,” she said.