Submission ID 129857
| Issue/Objective | A continent that imports 99% of its vaccines has no leverage when producing nations close their borders during crisis. This lesson cost Africa dearly; fewer than 2% of COVID-19 doses reached the continent by 2021 while billions went to high-income countries. Export restrictions exposed what pooled procurement and multilateral goodwill cannot fix, structural dependence failed precisely when vaccines matter most. What had long been termed logistics or financing gap was now a question of production power and hierarchies in the global supply chain. This study speaks directly to policymakers and continental institutions, explaining why manufacturing emerged as Africa's dominant vaccine security strategy between 2021 and 2024, and what drove that shift after decades of stalled ambition. |
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| Methodology/Approach | Set in Africa's continental policy arena, 2018-2024. This study applied process tracing and systematic discourse analysis to institutional documents, communiqués and financing instruments from the African Union, Africa CDC, Gavi, Afreximbank, and WHO. Drawing on multiple streams framework and institutional venue analysis, the approach reveals not just what changed, but precisely how and why the policy window opened, critical knowledge for those designing structural health reforms before the next crisis happens. |
| Results | Three findings emerge. First, COVID-19 delegitimised donor-mediated access models but crisis alone was insufficient, a prepared policy stream was equally necessary. Second, manufacturing gained decisive traction only when bundled with regulatory harmonisation through African Medicines Agency, demand guarantees through African Vaccine Manufacturing Accelerator, and Afreximbank's US$2 billion facility. Third and most distinctively, a measurable shift from logistics framing (~85% of institutional discourse pre-2020) to sovereignty and resilience framing (~90% by 2024), initiated by African institutions before multilateral adoption, served as the causally necessary mechanism coupling crisis, policy readiness, and political will. |
| Discussion/Conclusion | Africa's vaccine manufacturing turn is not a technical response, it is a structural reclaiming of health sovereignty in a fragmented global order. The mechanism identified sovereignty framing aligning crisis, policy readiness, and political will as transferable. LMIC regions facing similar structural dependencies can deploy it deliberately, before the next crisis. The lesson is clear: durable health equity and security require not only who can buy vaccines, but who can make them sustainably. |
| Presenters and Affiliations | Dr. Olakunle Ajayi Harvard T.H. Chan School of Public Health Olakunle Ajayi, Ph.D. Harvard T.H. Chan School of Public Health |
