African Union struggles to garner interest in its J&J vaccines

While the African Union has secured up to 400 million doses of Johnson & Johnson’s COVID-19 vaccine for countries to purchase, very few have finalized orders — and time is running out.

Only Botswana, Cameroon, Tunisia, Togo, and Mauritius have completed orders and submitted a 15% deposit as a down payment for the doses, said Benedict Oramah, president of the African Export-Import Bank, or Afreximbank, during an emergency summit of health ministers on Saturday.

Another 13 have signed commitment letters, but not given deposits, and another 17 have expressed interests in pre-orders but not taken further action. Twenty-one countries have not taken any action toward securing these doses.

The AU expects to close its order book in the coming weeks in order to move forward with finalizing the delivery, which will start in the third quarter of this year.

“We want to make an appeal to all of you, especially those who have not made the orders, to please make your orders,” he said.  

The contract with Johnson & Johnson was signed in March and includes an agreement for an initial 220 million doses. The AU also has the option to purchase another 180 million doses, but it needs to make this decision by September.

The AU is taking an “All of Africa” approach to securing doses, through a pooled procurement rather than countries negotiating independently with manufacturers, which helps countries to access lower prices, Oramah said.

Securing doses for African nations to purchase supplements the free doses provided by the COVAX Facility. The promised doses through COVAX, which have been delayed, will not provide the continent with enough doses to vaccinate at least 60% of its population, which is the estimate needed to achieve levels of herd immunity.

The Johnson & Johnson agreement would bring the continent to around half of its requirements for herd immunity, said Dr. John Nkengasong, director of the Africa Centres for Disease Control and Prevention.

The J&J vaccine is seen as an ideal option for the continent because it’s one shot, which reduces logistics and administration costs, Oramah said. The company also signed a contract with Aspen Pharmacare to have some of its vaccines manufactured in South Africa.

“Because we saw what was happening with vaccine nationalism ... we thought that it would be safer, entering a contract with an entity that has a contract manufacturing arrangement with an African entity,” he said.

Afreximbank has provided a non-refundable $330 million upfront to J&J as down payment for the doses. Countries can secure doses through the Africa Medical Supplies Platform and can participate in a payment plan of up to five years with the bank, with a subsidized interest rate between 3% and 5%, according to Oramah.

The African Vaccine Acquisition Trust is the entity entering into agreements with the manufacturers, with the bank providing the guarantees. The trust has also negotiated with the United Nations Children's Fund to provide logistics around the procurement.

The World Bank is expected to provide financing to countries, which would include grants and concessional loans, for the purchase of vaccines and the funding from Afreximbank serves as bridge financing in the interim before this funding is accessible, Oramah said.

“We've worked very hard to secure those as the African Vaccine Acquisition Task Team. It is up to countries now to show the leadership and what I call the 'fierce urgency of now,' to protect their people and protect their economies by securing those vaccines,” Nkengasong said.