If you build it, it really depends on when and where. Moderna, Inc., yesterday announced plans to build a “state-of-the-art mRNA facility in Africa”. This seems good given that many countries in Africa urgently need many more Covid-19 vaccines to fight the Covid-19 pandemic. But will this Moderna plan really help meet that need?
In the announcement, Stéphane Bancel, CEO of Moderna, described this factory plan as a way to extend “Moderna’s societal impact” and said “as we are still working to increase the capacity of our current network to provide vaccines for the ongoing pandemic in 2022, we believe it is important to invest in the future. We plan to manufacture our COVID-19 vaccine as well as additional products within our mRNA vaccine portfolio in this facility. ”
Here’s a tweet from Moderna’s announcement:
Again, at first glance, the announcement looks positive. It is certainly better than an ad saying “we certainly will not build a factory in Africa”. Africa is a large and diverse continent with around 17% of the world’s population, according to the United Nations. Yet many countries in Africa have not had the same access to Covid-19 vaccines as the US, UK and other high-income countries. At the end of September, only 15 of 54 African countries had at least 10% of their population fully immunized, according to the World Health Organization (WHO) Africa. In fact, half of the countries have not even vaccinated 2% of their population. A WHO Africa press release on September 23 said that “Covid-19 vaccine shipments to Africa are expected to increase more than sevenfold from around 20 million per month to 150 million each month on average. if the continent wants to fully immunize 70% of its population by September 2022. And Moderna has been criticized for not providing more doses of the Covid-19 vaccine to low- and middle-income countries in general.
For example, here is a tweet from Celine Gounder, MD, ScM, an infectious disease who served on the Covid-19 advisory board during the Biden administration’s transition to power:
Getting more Covid-19 vaccines to African countries is an urgent need, not just because it’s a fair thing to do. It is a key to stopping this pandemic for everyone. The highly interconnected rest of the world cannot overlook what is happening in Africa, just as you shouldn’t leave any of your major body parts like your head at home when you go to the market. As long as the Covid-19 coronavirus continues to spread uncontrollably somewhere in the world, new variants can easily emerge there and continue to spread to other countries. So will Moderna’s plans to build a factory in Africa help solve this problem?
Upon closer inspection, you’ll notice that Moderna’s announcement was rather short on the details. The announcement stated that “the company plans to launch a country and site selection process soon.” Isn’t it a bit like someone standing up and saying, “Watch out, everyone, I have an announcement to make. Am I planning on making plans to find a way to marry a human at some point in my life? Remember that Africa is a continent and not a country, although some Americans may say things like “Are you planning to travel to London, Paris or Africa?” As they say in real estate, location, location, location. The impact of Moderna’s plans will depend heavily on the specific African country that ultimately houses the factory, if it were to be built. A plant in South Africa, for example, could mostly benefit those in South Africa and neighboring countries, but may not have as great an impact in countries more distant or not having good ties to the South Africa.
The word “soon” in the ad is also quite vague. Does that mean in the next week, month, semester, year or more. It would be helpful to have more details. If you tell your friend, “I’ll be back from the bathroom soon” and come back after a month, don’t expect your friend to always be waiting at the table. Even if Moderna were to begin the country and site selection process this month, selection and construction are unlikely to be completed before the end of 2021.
We also do not know what the process may be. What criteria will be used? What role will access to the vaccine play by the different countries? What experts and external organizations will Moderna work with to make this decision?
The Covid-19 mRNA vaccine maker said the facility would “aim to produce up to 500 million doses of vaccine each year at the dose level of 50 µg.” Over a year, this amount would cover some but not nearly all of the 1.3 billion people in Africa. Also, whether the goal is to produce a certain number of vaccines or to try to meet Harry Styles, there is a difference between setting a goal and achieving it. There is also a big difference between hitting a goal in a year versus a decade or more. Meeting Harry Styles in twenty years may not be the same as meeting him now.
According to the announcement, Moderna “plans to invest up to $ 500 million in this new facility which is expected to include the manufacture of drug substances with the ability to fill / finish and package capacities on site.” While $ 500 million is not insignificant, it is still a fraction of the taxpayer money that was given to Moderna. Jonathan Saltzman reported for the Boston Globe in April 2021 that Moderna had at the time already received around $ 6 billion from the US government. Other entities such as Gavi and the World Health Organization (WHO) via COVAX have also paid Moderna for the Covid-19 vaccines.
With so much money from the general public going to Moderna, many have pressured Moderna to do more to help fight the pandemic. This means providing vaccines not only to those who can pay substantial sums for vaccines, but also to those who cannot afford to pay such large sums, such as low-income countries in Africa. For example, Geoffrey York, Africa correspondent of The Globe and Mail tweeted the following:
Critics have urged Moderna to take more action, from donating vaccines or at least giving them big discounts to sharing technology so others can make the Covid-19 vaccines as well. For example, here’s what Laurie Garrett tweeted:
Setting up a vaccine factory in an African country could help reduce the cost of the vaccine for various African countries. For example, it could reduce shipping and distribution costs by decreasing the distances that vaccines ultimately have to travel after being manufactured. However, unless this plant starts operating soon (and in this case, that means soon in a month or two rather than soon in geological time), it would be unlikely to help combat the current pandemic. An alternative and faster approach would be to have another manufacturer’s existing plant produce Moderna’s vaccine. But that would imply Moderna would share its information.
So is Moderna’s Thursday announcement a “don’t worry, we’ll do something eventually” response to critics? Or will Moderna soon take additional steps to vaccinate more people across the African continent against Covid-19? In this case, soon means in the coming weeks. While only two African countries (Seychelles and Mauritius) have fully vaccinated more than half of their population and only one other (Morocco) has fully vaccinated over 30% of its population, acute respiratory syndrome coronavirus 2 severe (SARS-CoV-2) is still too many people to easily infect. This can lead to many more hospitalizations and deaths in the months to come.
Even if you were totally selfish and didn’t care about people outside of the United States, it would be in your best interest to get more people vaccinated in Africa. As I wrote for Forbes before, reproducing the virus is like a drunken person photocopying their butt. Whenever new copies are made, errors can occur. Errors can lead to mutations and therefore new variants of the virus. When these newer variants are more transmissible and more able to evade vaccine protection than previous versions of SARS-CoV-2, they can spread far beyond their point of origin. They can even spread across the world like the Delta variant did. Thus, any place where the virus frequently reproduces in an uncontrolled manner can become a variant factory. And that’s not the kind of factory you want in Africa or any other continent for that matter.