Africa must continue to pursue, and drive the recent momentum in, the establishment of vaccine production capabilities and capacity on the continent to combat diseases and ensure healthy societies.

South Africa experienced about 107 000 deaths from pneumococcal diseases prior to the introduction of the locally made 13-valent pneumococcal conjugate vaccine (PCV) in 2011. The number of deaths has since decreased substantially, University of KwaZulu-Natal Paediatric Intensive Care and Pulmonology Department head Professor Jeena Prakash said on September 7.

Similarly, pneumococcal bacteria are related to cases of pneumonia and meningitis, which sees 175-million cases a year worldwide and is a highly mobile disease. South Africa's incidents of meningitis dropped by more than 50% following the introduction of the 13-valent PCV, he pointed out during a media briefing on the importance of local vaccine production hosted by Pfizer and Biovac.

The polysaccharide vaccine available prior to the introduction of the first PCV in South Africa in 2009 did not induce immunity in young children under the age of two years, which is where the main burden of the disease and bulk of morbidity occurred, as well as in the elderly, Prakash said.

Immunisation of such young children with PCV prevents three-million deaths a year and prevents 624 000 deaths a year specifically from pneumococcal diseases, he illustrated.

Vaccine development relies on high-level technical skills, as pneumococcal bacteria, for example, have 92 serotypes – specific variants on the bacteria, some of which present greater risks than others.

Immunologists and vaccine developers typically purify a sample to isolate a certain serotype to develop into a vaccine.

The pharmaceutical industry identifies the common ones for initial vaccine development, and pneumococcal vaccine development started with seven-valent, moved onto ten-valent vaccines, and the current one is 13-valent PCV. The 20-valent PCV will be introduced, which will further reduce mortality and morbidity, said Prakash.

Multinational biopharmaceuticals manufacturer Pfizer sub-Saharan Africa cluster lead and South Africa country manager Kevin Francis said the company announced positive, top-line results and data that demonstrate that a four-dose series of 20-valent PCV candidate, if approved, would provide the broadest serotype coverage of any pneumococcal conjugate vaccine in infants.

"Pfizer partnered with local vaccine production company The Biovac Institute (Biovac) in 2015 underpinned by a seven-year biotechnology transfer process for the manufacturing of the advanced 13-valent PCV, and can bring the 20-valent PCV into South Africa," he said.

Meanwhile, the Covid-19 pandemic highlighted Africa's vulnerability in terms of vaccine supply.

Further, according to some estimates, Africa produces less than 1% of the vaccine doses it requires each year, including for preventable diseases, such as pneumococcus, said Biovac head of science and innovation and Africa Vaccine Manufacturing Initiative executive director Dr Patrick Tippoo.

"About 99% of the vaccines used in Africa are imported. There are some key challenges and risks attached with importation, but Africa needs to look at vaccine development and manufacturing to establish the full capabilities to provide for its own needs.

"Establishing full capabilities can be supported through the establishment of partnerships, such as that between Biovac and Pfizer, as it is one of the speediest ways to build much-needed capabilities on the continent," he said.

Local vaccine manufacturing increases health security and, especially in terms of vaccine doses, ensures the smooth, adequate and consistent supply of essential products for patients in South Africa and beyond, agreed Francis.

"Local vaccine manufacturing stimulates the economy by increasing gross domestic product and providing job opportunities, as well as boosting local technology expertise. Local manufacturing of vaccines also reduces a country's dependency on imports, and makes vaccines more affordable to patients in South and Southern Africa," he added.

Further, skills is a critical success factor in establishing vaccine production. However, fortunately, many universities produce well-qualified graduates in many disciplines, and training for the biopharmaceutical industry is focused on hands-on skills development, said Tippoo.

"Training is typically on-the-job skills development that can be done in-house and with local partners and service providers, and internationally through technology transfer partners, such as Pfizer, which have a wealth of experience and walk with partners to build local workforces," he said.

Further, Pfizer, in March, committed to invest R255-million to build local capacity and capability for the production of the Pfizer Covid-19 comirnaty vaccine in South Africa. The biotechnology transfer work is well on track from a vaccine development and resource perspective to enable the production of commercial batches that will also be exported to other African Union (AU) member States.

"This commitment is also in line with the AU mission to produce 30% of vaccine demand on the continent, and is in line with Pfizer's objective of developing medicines and vaccines to provide the best protection and prevention for Africa's healthcare," noted Francis.

"Vaccination is the most cost-effective medical intervention humankind has ever developed, and has been the only intervention that has directly contributed to eradicating several diseases, as it is preventative as opposed to curative," emphasised Prakash.