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There's something fascinating happening with African Covid vaccine procurement and this is probably a better thread for my niche global health alt account, but maybe it'll add something new to your timeline here
In layperson's terms, Africa has been facing a vaccine crisis. The South African govt calls it 'vaccine apartheid'; a term they do not use lightly. Virtually all the supply of current and potential vaccines have been bought by rich countries
LMICs (lower to middle income countries) not only don't have the money to purchase vaccines and can't access credit in the same way rich countries can, even if they had money, all the manufacturing capacity has been taken by rich country orders
Enter COVAX - the WHO/Gavi mechanism to pool financing for Covid vaccines, and make advance commitments to supply them to LMICs. COVAX needs about $7bn to supply all LMICs with 20% of their vaccine needs. This is peanuts money in context. It does not have this money
COVAX is probably the single biggest multilateral project since WWII. Maybe that's an exaggeration? But it is incredibly ambitious, complex and trying to do audacious things. Manufacture, purchase, and deliver billions of vaccines for billions of poor people, in a year
COVAX is struggling with 'resource mobilization' (fancy way of saying getting the cash to fund its work). Donor govts perceive themselves tapped out (Canada has been incredible though), negotiating with development banks and private finance is hard. Enter the African Union....
The AU was concerned COVAX has only secured vaccines for 20% of African citizens in Q1, so mainly health workers etc. It wanted more, but no country has the financial or political capital to secure supply on its own. It's not just the money, it's getting in the queue for supply
This week, the AU did its first vaccine deal. Details are...a bit unclear, but it's a complex Africa-wide advance purchase, using Afreximbank to front the payments, with repayments over 5 years. Supply is guaranteed through licensed manufacturing in India https://www.news24.com/news24/southafrica/news/african-union-secures-270-million-covid-19-vaccine-doses-for-africa-ramaphosa-20210114
OK now to fascinating. This for me is the AU staking more ground as a serious geopolitical player. The first trade under the Africa Continental Free Trade Area started 14 days ago, and they're doing major, complex financing deals on vaccines https://au.int/en/cfta
COVAX in some ways is a donor-driven vaccine mechanism. It fills a very real need, and its players are fully integrated into African health systems. It's not entirely a colonial mechanism. But it's not entirely....not. It's part of the aid-beneficiary dynamic
I read the AU as saying COVAX is great and all, but we're not content with whatever others can cobble together for us, plus rich countries' donated left-over vaccines. We're going to do our own big private sector deals for our own vaccines
TheAU deal potentially undermines COVAX, which is a problem cause the AU still needs COVAX. It's also risky for the AU. They've essentially borrowed $2bn for countries that definitely can't replay, albeit with strong backstops from the World Bank and African Dev Bank
Many of the factors supporting the AU deal were donor funded though - Gates funded the Serum Institute to produce the vaccines the AU will purchase. Health systems readiness to get vaccines into arms is largely donor-funded, UNICEF and Gavi
All this to say, the AU taking some ownership of the continent's Covid vaccine supply crisis, even in a way that may eventually cause problems down the road, is a fascinating development. Flexing its muscles in a way that challenges the traditional donor-beneficiary dynamic
And a new Africa-centred group is now tracking Africa's vaccine purchases, supply and actual vaccinations (once they start). Alongside @OurWorldInData, they seem to have the most updated figures https://twitter.com/DevReimagined/status/1347628749127208960
