If you build it, it really depends on when and where. Moderna, Inc., announced yesterday that they plan on building a “state-of-the-art mRNA facility in Africa.” This sounds good given many countries in Africa urgently need many more Covid-19 vaccines to combat the Covid-19 pandemic. But will this Moderna plan really help fill this need?
In the announcement, Stephane Bancel, Moderna’s Chief Executive Officer described this factory plan as a way of extending “Moderna’s societal impact” and said “while we are still working to increase capacity in our current network to deliver vaccines for the ongoing pandemic in 2022, we believe it is important to invest in the future. We expect to manufacture our COVID-19 vaccine as well as additional products within our mRNA vaccine portfolio at this facility.”
Here’s a tweet of the announcement from Moderna:
Again, at first blush, the announcement seems positive. It certainly is better than an announcement saying “we will definitely not build a factory in Africa.” Africa is a big and diverse continent with around 17% of the World’s population, according to the United Nations. Yet, many countries in Africa haven’t had the same access to Covid-19 vaccines as the United States, United Kingdom, and other high income countries have had. As of the end of September, only 15 out of 54 countries in Africa have had least 10% of their population fully vaccinated, according the World Health Organization (WHO) Africa. In fact, half of the countries haven’t even vaccinated 2% of their populations. A WHO Africa press release on September 23 indicated that “Covid-19 vaccine shipments to Africa must rise by over seven times from around 20 million per month to 150 million each month on average if the continent is to fully vaccinate 70% of its people by September 2022.” And Moderna has been criticized for not supplying more Covid-19 vaccine doses 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 Covid-19 Advisory Board during the transition for Biden Administration into office:
Getting more Covid-19 vaccines to countries in Africa is an urgent need, not just because it is equitable thing to do. It is a key to stopping this pandemic for everyone. The rest of the highly interconnected world can’t neglect what’s happening in Africa, just like you shouldn’t leave one of your major body parts like your head at home when going to the market. As long as the Covid-19 coronavirus continues to spread in an uncontrolled manner somewhere in the world, new variants can readily emerge there and continue to spread to other countries. So will Moderna’s plans to build a factory in Africa help solve this problem?
Pictured here is a vial of the Moderna vaccine (COVID-19 mRNA, nucleoside modified) against the ... [+]
LightRocket via Getty Images
Upon a closer look, you’ll notice that the Moderna announcement was rather short on details. The announcement said that, “The Company expects to begin a process for country and site selection soon.” Isn’t that a bit like someone standing up and declaring, “attention, everyone, I have an announcement to make. I plan on making plans to find a way to get married to some human at some point in my life?” Remember, Africa is a continent and not a country, even though some Americans may say things like “do you plan on traveling to London, Paris, or Africa?” As they say in real estate, location, location, location. The impact of Moderna’s plans will depend heavily on which specific country in Africa eventually houses the factory, should it end up being built. A factory in South Africa, for example, could most benefit those in South Africa and adjoining countries but may not have as great an impact in countries that further away or don’t have good ties with South Africa.
The word “soon” in the announcement is rather vague as well. Does this mean over the next week or so, month, half-year, year, or longer. It would help to have more specifics. If you tell your friend, “I’ll be back from the bathroom soon” and return after a month, don’t expect your friend to be still waiting at the dinner table. Even if Moderna were to begin the process for country and site selection this month, it’s unlikely that the selection and construction were to be completed before the end of 2021.
It’s also not clear what the process may be. What criteria will be used? How much of a role will vaccine access by different countries play? What external experts and organizations will Moderna work with to make the determination?
The Covid-19 mRNA vaccine manufacturer did say that the facility will have “the goal of producing up to 500 million doses of vaccines each year at the 50 µg dose level.” Over the course of a year, this amount would cover some but not nearly all of the 1.3 billion people in Africa. Plus, whether the goal is producing a certain number of vaccines or trying to meet Harry Styles, there’s a difference between setting a goal and achieving it. There’s also a big difference between meeting a goal in a year versus a decade or beyond. Meeting Harry Styles in twenty years may not be the same as meeting him now.
According to the announcement, Moderna “anticipates investing up to $500 million in this new facility which is expected to include drug substance manufacturing with the opportunity for fill/finish and packaging capabilities at the site.” While $500 million is nothing to sneeze at, that’s still a fraction of the taxpayer money that has been 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 U.S. government. Other entities such as Gavi and the World Health Organization (WHO) via COVAX have paid Moderna for Covid-19 vaccines as well.
With so much of the general public’s money having gone to Moderna, many have been pressuring Moderna to do more to assist the fight against the pandemic. That means providing vaccines not just to those who can pay substantial sums for the vaccines but also to those who can’t afford to pay such large amounts, such as lower income countries in Africa. For example, Geoffrey York, Africa correspondent for The Globe and Mail tweeted out the following:
Critics have urged Moderna to take more action, ranging from donating vaccines or at least offering them at steep discounts to sharing the technology so that others can manufacture the Covid-19 vaccines too. For example, here is what Laurie Garrett tweeted:
Putting a vaccine factory in a country in Africa could help reduce the cost of the vaccine to various African countries. For example, it could reduce the shipping and distribution costs by decreasing the distances that the vaccines have to ultimately travel after being manufactured. However, unless that factory began operating soon (and in this case soon means within the next month or two rather than soon in geological time), it would be unlikely to help against the current pandemic. An alternative and more fast acting approach would be to have another manufacturer’s existing factory produce Moderna’s vaccine. But that would involve Moderna sharing its information.
So is Thursday’s announcement from Moderna a “don’t worry we’ll do something eventually” response to the criticism? Or will Moderna soon take additional steps to get more people across the African continent vaccinated against Covid-19? In this case, soon means within the next several weeks. When only two countries in Africa (Seychelles and Mauritius) have fully vaccinated over half their populations and only one other (Morocco) has fully vaccinated over 30% of its population, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still has far too many people to readily infect. This can result in many more hospitalizations and deaths in the coming months.
Even if you were totally selfish and didn’t care about people outside the U.S., it would be in your best interests to have more people in Africa fully vaccinated. As I have written before for Forbes, the virus reproducing is like a drunk person photocopying his or her butt. Each time new copies are made, mistakes can occur. Mistakes can lead to mutations and thus new variants of the virus. When such new variants are more transmissible and more able to evade vaccine protection than previous versions of the SARS-CoV-2, they can spread well beyond their point of origin. They can even spread across the world as the Delta variant has. So, anyplace where the virus is reproducing frequently in an uncontrolled manner can become a variant factory. And this is not the kind of factory that you want in Africa or any other continent for that matter.
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