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The World Trade Organization (WTO) and International Finance Corporation (IFC) have called for the manufacturing of Covid-19 vaccines across Africa as well as a boost to jab imports and the associated financing in order to tackle vaccine inequity.

“The fact that we have vaccinated so little of our population is not acceptable,” said Ngozi Okonjo-Iweala, director general at the WTO and Nigeria’s former finance minister, during a virtual panel hosted in late May by UBA, a pan-African bank.

Without access to more doses, the continent will struggle to recover sustainably from the pandemic, she stated.

“We have to fight for it, whether it’s getting more vaccines in from outside production, [or] whether it’s manufacturing our own, and the WTO stands ready to do its bit to keep supply chains open for this manufacture.”

She added that in a separate meeting with Makhtar Diop, managing director at the IFC, also a speaker on the UBA panel, the two had discussed how to finance any additional vaccine production in Africa.

Increasing financing for the trade of vaccines and pharmaceuticals in Africa will be crucial to securing more doses, said Diop during the session.

Fewer than 2% of people across Africa have been vaccinated, a far smaller proportion when compared with other continents. In North America, 37% of people have received at least one inoculation, while in Europe the figure is over 30%.

There are schemes being rolled out that aim to boost local vaccine production. On May 28, the IFC, French development financier Proparco, the German Development Finance Institution (DEG) and the US International Development Finance Corporation announced a partnership to support the manufacturing of Covid-19 and other vaccines in Africa.

The agreement will explore potential collaboration with vaccine producers on the continent, including South Africa-based Aspen Pharmacare. It follows the EU last month promising €1bn to build vaccination manufacturing hubs in Africa.

However, enhancing domestic production will be a challenge as vaccine manufacturing is a small industry in Africa. According to the African unit of the World Health Organization (WHO), there are fewer than 10 African manufacturers with vaccine production. They are based in just five countries: Egypt, Morocco, Senegal, South Africa and Tunisia.

It states that most African countries are supplied with vaccines by UNICEF, supported by Gavi, the Global Vaccine Alliance, with fewer than 10 countries being self-sufficient in terms of vaccine procurement.

Gavi co-leads Covax, the vaccines pillar of the Access to Covid-19 Tools Accelerator by the WHO, which aims to speed up the development, production and equitable access to coronavirus tests, treatments and vaccines around the world.

“With the support of Covax, as you know, 47 countries in the African continent have started vaccinating. However, the volumes of vaccines are nowhere near enough,” said Tedros Adhanom Ghebreyesus, director general at the WHO, during the panel discussion.

“It’s clear that Africa cannot rely solely on imports of vaccines from the rest of the world, we must build that capacity not only for Covid-19 vaccines, but for other vaccines and medical products. The co-operation of the private and public sectors will be essential in this effort.”

In the short to medium-term, licensing vaccine technology, which may include intellectual property waivers, will be important in increasing supply, he added.

Last month, the US administration voiced support for a waiver on Covid-19 vaccine rights, stating that it will work with the WTO to “make that happen”. However, EU leaders and manufacturers of doses such as Pfizer have largely opposed the measure. Analysts have also said that a waiver would likely have little impact on supply.

In terms of the economic recovery from the pandemic, Okonjo-Iweala says that further debt restructures to give African countries fiscal space to “breathe so that they can invest not only on the health side, but on the economic side” is “how we are going to recover”.

She adds that developed countries are recovering very fast because they’ve been able to implement “massive” amounts of fiscal stimulus.

The International Monetary Fund has warned that “economic recoveries are diverging dangerously”, and that disparities will widen further between wealthy countries that have widespread access to vaccines and poorer countries which are struggling to vaccinate frontline health workers.

The gap in recoveries is also becoming apparent in trade, with developed countries’ exports bouncing back while those of developing nations struggle to recover.

In the first quarter of the year, the value of exports was below pre-crisis levels for countries in the Middle East, South Asia and Africa. Developed countries’ exports were above pre-pandemic levels in Q1 2021.