Goalkeepers report: Why Africa must emerge stronger

Bill & Melinda Gates Foundation CEO Mark Suzman and Africa Director Cheikh Oumar Seydi field questions from African journalists

In Summary

•The foundation co-chairs, Bill Gates and Melinda French Gates, also note that the Covid crisis has reinforced the belief that progress is possible but not inevitable. 

•"If we can expand upon the best of what we’ve seen these past 18 months, we can finally put the pandemic behind us and once again accelerate progress in addressing fundamental issues like health, hunger, and climate change."

A nurse administers a Covid-19 vaccine in Busia.
PROTECTION: A nurse administers a Covid-19 vaccine in Busia.
Image: EMOJONG OSERE

The Bill & Melinda Gates Foundation fifth Goalkeepers report shows that Covid-19 vaccine access has been strongly correlated with the locations where there is vaccine R&D and manufacturing capability.

The report, titled Innovation and Inequity, calls for the world to invest in R&D, infrastructure, and innovation in places closer to the people who stand to benefit.

The foundation co-chairs, Bill Gates and Melinda French Gates, also note that the Covid crisis has reinforced the belief that progress is possible but not inevitable.

The two call for optimism, and for the world to learn from the crises to build better systems to help the most vulnerable people.

"If we can expand upon the best of what we’ve seen these past 18 months, we can finally put the pandemic behind us and once again accelerate progress in addressing fundamental issues like health, hunger, and climate change."

On the sidelines of the report release, the foundation CEO MARK SUZMAN and Africa Director CHEIKH OUMAR SEYDI fielded questions from African journalists, on response to Covid-19 on the continent.

QUESTION: Only a small percentage of Africa is fully vaccinated at this point (Four per cent according to Africa CDC) because people do not have access to vaccines. How soon do you think can see more Africans being vaccinated?  What could you say to offer hope to people who are feeling hopeless at this point, because there's no access to vaccines?

South African-born Mark Suzman, CEO of the Bill and Melinda Gates Foundation
South African-born Mark Suzman, CEO of the Bill and Melinda Gates Foundation
Image: COURTESY

MARK SUZMAN: The main message would be that hope is on the way, that we are already seeing some of those numbers increase from the work of Covax. We are going to start seeing those volumes significantly increase coming into the countries in the next weeks and months ahead. We have, and are, working with partners like the African CDC, the WHO and others to put plans ahead to make sure that that distribution is equitable. It is true, there's no denying the challenges at this date. And the numbers speak for themselves. That is why it is so critical that we have this global focus now. I do mean a global focus on making sure that we're maximizing the access to those vaccines. I can't give you some concrete numbers at this stage, because those are being worked on in callbacks, but I do think this is a corner that we are turning.

CHEIKH OUMAR SEYDI: You know, I hesitate to put a time frame, because when you put a time frame, people will love you, but maybe they're better equipped to do it. There's another component to it: not only does it open the way, but this is the time to make sure that when those vaccine come in, we are ready to receive them and administer them the right way. Because it's one thing to deliver vaccine, and also one thing to make sure that it gets into the hands of those that we are hoping to vaccinate.

QUESTION: Covid-19 has set back a lot of development plans. A lot of African countries are weakened and not on track to meet Sustainable Development Goals. What are you seeing in terms of where the continent stands now?

MARK SUZMAN:  Unfortunately, across nearly every SDG, progress has been at best stagnant, and at the worst, it has been a setback. That being said, we remain at the Bill and Melinda Gates Foundation, impatient optimists. The kinds of innovation that we've seen both in terms of platforms like the African Medical Supplies platform, the work of the Africa CDC, the genomic sequencing and surveillance, these show the kind of investments that can be put in place and can be used as a springboard to accelerate so that we can start catching up towards those SDG goals in the years to come.

 What we have is a setback in terms of timelines, it has put the continent significantly off track to meet the SDGs, but we believe there are some important innovation platforms. That's why this [Goalkeepers] report has such an emphasis on innovation with equity, that we need to use those investments in things like vaccines to make sure that we're building back infrastructure that allows us to reach a much wider range of people more quickly with accelerated interventions.

Cheikh Oumar Seydi leads the Bill and Melinda Gates Foundation’s work in Africa.
Cheikh Oumar Seydi leads the Bill and Melinda Gates Foundation’s work in Africa.

CHEIKH OUMAR SEYDI: I guess that also relates back to the question about ‘hope is going away’. I would also add that because of those innovations, not all hope is actually lost. But yes, one of the reasons why we show this support is to make sure that people are aware of the fact that there's been a significant setback in other issues.

There has been this argument that waiving intellectual property rights for Covid vaccines is one way to get the vaccines to people faster. I'd like to hear your thoughts on this. Do you think this is something that actually helps, or as the former German Chancellor Angela Merkel said, it is just a waste of time, and this will not result getting vaccines much faster?

MARK SUZMAN: There's a short term and longer term there. In this particular case, that is an issue that South Africa, India, and a number of countries have brought to the World Trade Organization. As the Gates Foundation, we have said we are actually in support in this case of a limited waiver of IP to try and expand access simply because we believe that every possible tool should be used to address the crisis. And that is one available tool. That said, the complexity of vaccine manufacturing, the regulatory issues that lie behind it, only because these are about developing vaccines that have to be put into your otherwise healthy people, is very complex and time consuming. You can't just build or repurpose a factory to turn it into a vaccine factory overnight. And so, in the short term, meaning as of right now, it's about ramping up all the supply and the manufacturing capacity that we can through your existing institutions that have that capacity, like the Aspen Institute in South Africa, which is now making the J&J vaccines, and distributing them across the continent.

But the real long-term solution is actually about ensuring that we have the capacity on the continent and across the world to do the development, the manufacturing and the distribution in real time, both for Covid and any future crises.

In some countries, the distribution of vaccines has been restricted to only government and, sometimes, it takes a longer process than the private sector. What is being done by organisations like Gates Foundation to work with private pharmaceutical distributors, so that they are able to  distribute these vaccines to communities?

MARK SUZMAN: I think all governments are looking to distribute vaccines as effectively and efficiently as possible in a safe manner that is also equitable in terms of the population reach. And, we certainly would encourage governments to take a thoughtful approach to looking at all available public and private channels to do that, but the exact situation of context will vary significantly by country to country.

CHEIKH OUMAR SEYDI: Mark, let me also add that in this particular case, we are talking about COVAX or even AVATT. Their responsibility is to make sure that the supplies of vaccines are available and are delivered to the government. So, from there the government would actually make the rules in terms of how they actually organise distribution within the different countries. Because, in many of those cases, it's the government that actually purchased the vaccines coming into the country. So, it will be, I guess, very difficult for us to legislate about how those distributions happen. But I am sure from country to country there are specificities there that we may not be aware of or that they may look into.