A nurse prepares to administer a vaccine dose in Ghana, 2021. Image by World Health Organization, CC BY-SA 3.0 IGO, via Wikimedia Commons.

Africa consumes nearly 25 percent of all globally produced vaccines. Annually, more than 100 major disease outbreaks take place on the continent, which is largely attributed to low vaccination coverage coupled with weak health and surveillance systems.

Despite being home to more than 1.4 billion people, which makes up about 18.83 percent of the global population, Africa imports 99 percent of its vaccines and 90 percent of its medical supplies. This dependency proved catastrophic during the COVID-19 pandemic, as countries hoarded doses and tightened export controls, leaving Africa at the back of the queue, even as its most vulnerable communities bore the brunt of the virus and its socioeconomic aftershocks.

Vaccine manufacturing in Africa

Decades ago, vaccine manufacturing was not a foreign concept in Africa. Nigeria, for example, once had one of the continent’s most vibrant production hubs. This laboratory contributed tremendously to the elimination of smallpox from West Africa, which today, remains the only human infectious disease to have been eradicated globally. However, the production facility was shut down in 1991 by the Nigerian government, and has yet to commence vaccine production three decades later.

In other parts of the continent, like Senegal, yellow fever vaccine production began as early as 1937 at the Institut Pasteur de Dakar (IPD), which remains one of only four WHO pre-qualified manufacturers globally. South Africa’s vaccine production also dates back to the early 1900s through the South African Institute for Medical Research.

These historic efforts were proof that African countries once actively contributed to global vaccine supply chains, until dependency on foreign aid, underinvestment in research and development, poor knowledge transfer, and emigration of highly trained professionals eroded much of that capacity. The annual loss to the African health sector from the brain drain of medical professionals is estimated at USD 2 billion.

Today, the imbalance is stark. As of 2022, Asia produced 43 percent of the world’s vaccines, including COVID-19 vaccines, while North America and Europe accounted for 35 percent and 20 percent, respectively. In contrast, Africa meets just  0.2 percent of its own vaccine needs through domestic manufacturing.

Recognizing this urgent gap, African heads of state in 2021 agreed to the Saving Lives and Livelihoods (SLL) initiative, an ambitious USD 1.5 billion strategy to vaccinate at least 70 percent of the continent’s population and spark a homegrown revolution in health security. 

Led by the Africa Centres for Disease Control and Prevention (Africa CDC) and funded by the Mastercard Foundation, SLL’s first phase helped deliver approximately 35 million COVID-19 vaccine doses, supplied 6 million units of personal protective equipment (PPE) to 12 countries, and facilitated the expansion of genomic sequencing labs from just two before the pandemic to 40 across the continent.

Beyond pandemic response, SLL also aims to lay the foundation for a sustainable vaccine manufacturing ecosystem through the Partnership for African Vaccine Manufacturing (PAVM). As part of this vision, African leaders have committed to achieving vaccine sovereignty by producing 60 percent of the continent’s vaccines by 2040, in Africa.

Clinical trials of vaccines in Africa

Even as Africa bears 25 percent of the global disease burden, including malaria, yellow fever, and cholera, it remains a marginal player in vaccine science. Less than three percent of global clinical trials take place on the continent. As a result, most medicines are developed through clinical trials conducted outside Africa without considering the implications of their use in African patients or within African health systems.

Addressing a common misconception during a journalist workshop organized by the Africa CDC in June 2025, Dr. Alemayehu Duga, a pharmacovigilance specialist with the Africa CDC, said:

Clinical trials are not about using Africa as a testing ground. They are about generating the evidence needed to protect African lives effectively. It helps us develop vaccines for African bodies.

A core pillar in the Saving Lives and Livelihoods (SLL) initiative, pharmacovigilance strengthens safety surveillance networks and enhances real-time reporting on adverse events following immunization (AEFI) and adverse events of special interest (AESI), using real-time and improved tools.

The first phase of SLL operated in 29 countries across East, West, and Southern Africa, training health workers, improving cold chain logistics, and delivering vaccines. By the end of the phase, 53 percent of the target population in participating countries had been fully vaccinated.

The situation room at the Africa Centres for Disease Control and Prevention, Africa CDC headquarters in Addis Ababa. Photo by Adesewa Olofinko. Used with permission.

The cost of under-investing in health

Aspiration 1 of the African Union Agenda 2063 envisions a healthy, well-nourished, and empowered population. In alignment with this vision, the African Health Strategy (2016–2030) urges member states to prioritize and invest in health through better inter-sectoral collaboration. Yet despite these blueprints, many African governments continue to fall short in public health funding.

Under the Abuja Declaration, adopted in 2021, African Union (AU) member states pledged to allocate at least 15 percent of their annual national budgets to health. More than two decades later, that commitment remains largely unmet. Only three countries — Rwanda, Botswana, and Cape Verde have consistently met or exceeded this target. In contrast, over 30 AU member states remain well below the 10 percent benchmark, with countries like Nigeria, Chad, and the Central African Republic allocating as little as five to seven percent of their national budgets to health. 

Despite these persistent funding gaps, countries like Rwanda and Morocco have made significant progress in pandemic preparedness and local pharmaceutical production. Morocco now ranks second in pharmaceutical production volume on the continent, trailing only South Africa, whose pharmaceutical market is projected to generate USD 13.63 billion by 2025.

Rwanda, in particular, stands out as a global health success story, with over 90 percent immunization coverage among children aged 12 to 23 months as recommended by the World Health Organization (WHO).

Across Africa, at least 25 vaccine manufacturing projects are in various stages of development, including initiatives in Nigeria, South Africa, Senegal, Egypt, and Kenya. To ensure regulation and access, the African Medicines Agency aims to harmonize regulatory frameworks, while the Africa CDC is working toward supporting the WHO prequalification of eight locally made vaccines by 2030.

If the COVID-19 pandemic taught Africa anything, it is that when the next global health crisis hits, no one is coming to save her. Despite the continent’s vulnerability, Africa currently accounts for just 2 percent of global research output and only 1.3 percent of worldwide research spending.

In June 2024, Gavi launched the African Vaccine Manufacturing Accelerator (AVMA), pledging up to USD 1.2 billion over ten years to support the sustainable growth of Africa’s vaccine manufacturing capacity. Around the same time, Afreximbank announced a USD 2 billion commitment through the Africa Health Security Investment Plan to scale health products manufacturing across the continent.

Meanwhile, the second phase of the Saving Lives and Livelihoods (SLL) initiative, backed by a USD 638 million investment from Africa CDC and the Mastercard Foundation, is set to run from August 2024 to December 2025.