Building Africa’s vaccinology expertise and leadership
Expanding vaccine production in Africa, now a key objective for the continent, will require a highly skilled workforce with the necessary expertise. This is why BACKUP Health is supporting vaccine production-related further education and training through the University of the Witwatersrand in South Africa. The recent African Advanced Vaccinology course is one example.
In recent years vaccines have substantially reduced morbidity and mortality among children in Sub-Saharan Africa, but huge inequality and gaps in coverage and supply persist, particularly in times of disease outbreaks. One problem is that Africa currently only produces around 1% of the vaccines the continent needs, and there are very few African manufacturers who even fill and finish vaccines, let alone develop and manufacture them. This means that Africa is dependent on international producers for pretty much all the vaccines it uses. The COVID-19 pandemic vividly illustrated the dangers of this dependency, as countries struggled to secure enough vaccines.
Expanding vaccine production in Africa is now a key objective for the continent, and the African Union and Africa Centres for Disease Control and Prevention (Africa CDC) have set a hugely ambitious target of producing 60% of vaccines locally by 2040. In 2021, the AU initiated the Partnerships for African Vaccine Manufacturing (PAVM) to coordinate all initiatives and stakeholders towards achieving this goal.
This will involve not only massive investment in manufacturing facilities and infrastructure, but in the regulatory structures and safety standards needed for vaccine production. There is also an enormous shortage of trained, skilled staff that will be urgently needed if Africa is to build sustainable vaccine production and development.’Shingai Machingaidze, Senior Science Officer at the Africa CDC
Afro-ADVAC 2023: A course with participants from across the continent
Designed to develop African leadership in vaccinology expertise, the fourth African Advanced Vaccinology Course – or Afro-ADVAC 2023 – was held in Muldersdrift, South Africa, from 17th to 26th April. It brought together 50 participants from 16 African countries, as well as a further 50 participants online, and experts from all over the continent. The course targets mid- to senior-level professionals within the field of vaccinology, “including a broad spectrum of scientists, doctors, veterinarians, pharmacologists, pharmacists, public health scientists,’ says Clare Cutland, the course organiser and scientific coordinator for the Witwatersrand University African leadership in vaccinology expertise group, known as the Wits Alive consortium.
In order to attend, participants were required to undergo a rigorous online selection process to demonstrate why they should be selected and what difference the course would make to their current and future policy-making roles. The aim is to have in-person representatives from as wide a range of African countries as possible, with others joining the course online.
I think what is very special about this course that it brings together not only students from all over Africa but it also has very high profile lecturers So it’s really high standard – that is unique I believe.Dr Sabine Fleßenkämper, GIZ BACKUP Health
A skilled workforce is essential for local vaccine production
The course was funded by the German Federal Ministry for Economic Cooperation and Development (BMZ) through the BACKUP Health project, a global programme of the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH to improve the framework conditions for sustainable vaccine production in Africa. Enhancing education and training to provide a skilled workforce is a vital part of the project, along with harmonising and strengthening the regulatory framework and improving conditions for technology transfer.
‘The aim of the AU is very ambitious, and it will need a multi-sectoral approach to make this happen, says Dr Sabine Fleßenkämper, team leader at BACKUP Health. ’This means you need not only people from the health sector, but also regulation and quality control. You need not only people from the private sector on the manufacturing side but also from academia to train people. It needs coordination and cooperation between them all to make it happen’.
Enabling mid-career professionals to become vaccine leaders
‘I’m really happy to be here,’ says course participant Dr Olufunke Bolaji, a paediatrician neonatologist from Ekiti state in south-west Nigeria. ‘They are trying to produce leaders who can be decision-makers for vaccine on the continent. I think that I fit in quite well in that role, since my job involves making decisions on childhood vaccinations against preventable diseases and for the last couple of years, I’ve been involved in policy making decisions at national level.’ Such training is unavailable in Nigeria says Dr Bolaji: ‘There’s no way I could have afforded to attend the Afro-ADVAC course in South Africa if it wasn’t sponsored by German Development Cooperation.
It’s really important to have clinicians who are exposed to this kind of training and are able to take decisions about vaccinations that affect overall outcomes.Dr Olufunke Bolaji
A full time MSc course in vaccinology
While the Afro-ADVAC course is targeting mid- and senior- level professionals who are already engaged in that field, BACKUP Health also supports a two-year full time MSc course in vaccinology at Wits University. Since the course first started in 2019, 41 students from 15 African countries have enrolled, and 12 have graduated so far. Most of the MSc students have also been able to attend parts of the Afro-ADVAC courses, either online or in person.
The MSc course is very wide-ranging says Clare Cutland, the scientific coordinator at Wits University. It involves modules not only on immunology, epidemiology, and vaccinology, but also on safety, regulation, and distribution of vaccines. In addition, the course now links classroom studies with exposure to local vaccine manufacturing, e.g. at Biovac.
Mitchell Muchichwa is currently in the second year of the MSc. Originally from Zimbabwe, she grew up in South Africa, and has a background in public health. After graduating, she worked at a hospital gathering data about COVID-19. ‘During that time, we saw a lot of deaths. People were just so resistant to vaccinations and did not trust them. I felt there was a huge gap in knowledge about vaccines in general and wanted to do something about it. It’s not nice seeing people die when they can be helped.’
Without a funded place, says Mitchell, it would have been impossible for her to afford to do the MSc course. ‘I feel like these past couple of years have been so fulfilling because I’ve learned so much.’
Taking the courses to French-speaking Africa
Due to the success of the Afro-ADVAC course held in English in South Africa, there are now plans to hold similar courses in francophone Africa. GIZ is supporting the preparatory process for 2024. A Steering Committee is exploring the possibilities and some of the participants from francophone Africa, such as Leonard Numfor from Cameroon, have been trained as trainers and facilitated some of the events at the South Africa course – all part of the capacity development process.
Leonard says he’s very grateful to German Development Cooperation for the opportunity to attend the Afro-ADVAC course and plans to pass the knowledge he has gained to others as soon as he gets home, especially to the nursing school where he teaches in Cameroon: ‘As you teach one student, you know you have taught at least two as it spreads to the next level, so it’s going to have a ripple effect.’
Sharing the information with policy-makers
Dr Njoh Andreas Ateke, also from Cameroon, is Deputy Country Manager for the Expanded Programme on Immunisation and says he will also play his part to share the information from the course with the Ministry of Health and other policy makers and impress upon them the need for Africa to become more self-sufficient in vaccines. ‘If Africa joins in the vaccine production process, it will be able to contribute more to the bigger picture of global vaccine production to fight diseases, particularly vaccine-preventable diseases,’ says Andreas. ‘We know that Africa will soon have the second largest population worldwide, so if we are able to contribute to vaccine production it will help to relieve the pressure on global demand. It will also help to bring vaccines closer to us.’
If the African population is protected, then everyone will be protected. It needs to be a collective global effort.Dr Njoh Andreas Ateke, Deputy Country Manager for Cameroon’s Expanded Programme on Immunisation
Africa wants to contribute to global vaccine production
The time has come for Africa to be more proactive in vaccine production and develop the talents for this new role, argues Patrick Tippoo, Chief Science and Innovation officer at Biovac, Executive Director of the African vaccine manufacturing initiative (AVMI), and one of the speakers on the current Afro-ADVAC course. ‘We can’t go on operating the way we did 20 years ago. We want to make our contribution, not only to manufacturing in Africa for Africa but for the global vaccine supply chain.’ Dr Immaculate Ampaire, a senior medical officer in Uganda’s Ministry of Health’s vaccines and immunisation division, thinks it should be possible for countries like Uganda to invest in manufacturing and developing vaccines: ‘It’s a challenge but it’s a dream. One thing I’ve learned in this course is to never to say never.’
Course graduates are ready to step up
As the participants say farewell after the final session, conference organiser Clare Cutland and her team are tired but delighted about the way the 2023 Afro-ADVAC course has gone.
There are some brilliant minds in Africa. With the right sort of investment and training, Africa can become a centre of vaccine excellence and a continent of vaccine technology.Clare Cutland, scientific coordinator for Wits Alive
‘We’d like to acknowledge the hard work that the team has put in to produce this brilliant course,’ says CDC’s Shinhai Machingaidze. ‘It’s courses such as Afro-ADVAC that will help us to build this robust workforce that we require to feed into the vaccine manufacturing eco-system and find the leaders of the future.’
Asipherhona Ngema and Melissa Moselane, two young Wits University MSc students in their early twenties, aspire to be amongst those future leaders making Africa a centre of vaccine excellence. ‘I learned a lot over the last one and a half weeks,’ says Melissa. ‘I’m really keen to start to use all that new knowledge,’ adds Asipherhona. ‘I want to use my skills here in Africa and help solve some of the problems that burden our continent.’