Would we have Omicron if Africa could make its own vaccines?

At the end of November, I wrapped up the last of my work commitments in Johannesburg and prepared to head to the airport, ready to return to my new home in Dubai. I’d been presenting an awards ceremony for journalists in South Africa, lamenting the fact that it was being held virtually. I had become used to the freedom many of us have begun to enjoy as restrictions ease. Just a week earlier, I had been at the Intra-Africa Trade Fair in Durban, attended by around 15,000 people with renewed optimism. It felt like a reunion. Executives and policymakers were all bright-eyed about Africa’s resilience and ready for a more integrated, powerful continent. All the talk there was about how the world is finally emerging from the shadow of Covid, and perhaps we could finally look forward, rather than back. As I packed my bags in Johannesburg those words were ringing in my ears when I heard the news that, due to the Omicron variant, I wouldn’t be going anywhere. The cascade of travel bans that ensued after announcement of the variant's discovery in South Africa was swift and aggressive. Starting with the UK, a series of countries quickly placed South Africa and its regional neighbours on their red lists. South Africa has been praised for its efforts in genomic sequencing, an area in which it truly excels, as well as its transparency in alerting the world to the presence of this new variant; but many have argued that it has also been punished for both. As we know from the discovery of a number of past variants, just because one has been discovered somewhere, does not mean that it originated there. And as we have since learnt, Omicron already exists in many other countries, including the UK, and was present in the Netherlands even before its formal discovery in South Africa. Travel restrictions might appear to be a logical step in containing these new variants, but it is unsurprising that many in South Africa see them as unfair. As CNN’s senior medical analyst, Dr Jonathan Reiner, has said, travel bans may only offer “an illusion of protection”. The WHO has called for borders to remain open. Occurring in tandem with all of this is the ongoing conversation about vaccine inequality, which the Global South has been pressing wealthier nations on for many months now. With less than 25 per cent of its population fully vaccinated, South Africa lags well behind much of the world. How to get vaccines into the arms of South Africans remains extraordinarily challenging. We know, because we have been warned time and time again, that the greatest threat to the global recovery from Covid-19 is a large unvaccinated population. It is within this population that mutations are most likely to occur. So why do so many African countries lag so far behind the world when it comes to vaccinations, and what can be done to change that? One possible opportunity is local manufacture. There has, to date, been considerable resistance from many governments to sharing vaccine patents. On Monday, nursing unions in 28 countries around the world called for the temporary waiver of patents for Covid-19 vaccines. In a letter to the UN, they called the distribution of vaccines unjust and blamed it for “staggering numbers of deaths”. US President Joe Biden also joined a call to the WTO to waive the Trade-Related Aspects of Intellectual Property Rights (Trips) agreement in regard to vaccines last month. Placing manufacturing in the hands of local companies at least removes a significant step from an already complex supply chain. Janssen Pharmaceuticals, part of Johnson & Johnson, this week announced a deal with South Africa’s Aspen Pharma, which will enable Aspen to sell the J&J vaccine to African countries under its own brand. This feels like an important moment, and a start. The idea of waiving patents for life-saving drugs takes me back to the HIV/AIDS epidemic, when people in sub-Saharan African were dying at an alarming rate, while pharmaceutical companies held tightly onto IP rights of antiretroviral (ARV) drugs. As treatment cost thousands of dollars, poorer nations simply couldn’t afford to save their people. After much negotiation, companies relented and allowed generic drug makers to reverse engineer ARVs for the African market. It was a game-changing moment. There remain major logistical and psychological challenges beyond local manufacture and patent sharing, of course. Vaccine hesitancy is a persistent and difficult obstacle to overcome in South Africa, and transport and refrigeration are major issues in many African countries. The pandemic was supposed to be an opportunity for the world to come together, united against a common foe. It has produced extraordinary tales of bravery, ingenuity and resilience, as well as profound loss and tragedy; but it has also exacerbated divisions and turned many nations inward. The UN has lamented this, reminding the world that more African countries will be plunged into poverty not only as a result of the pandemic, but also the global response to it. Last week, South Africa reported an unemployment rate of 35 per cent – more than a third of the population without work, and the hardest hit sectors are hospitality and tourism. The economic damage of the present situation will be enormous and cannot be given a quick fix. For many Africans, their harsh experience of the pandemic has been a reminder of how old prejudices and inequalities run deep. They question how this pandemic can end if the world does not change the way it fights it. And at a time when they are suffering so acutely, it will be difficult for them to forget the feeling of being forgotten.