Fiocruz reinforces commitment to South-South partnership

The Conference On Expanding Africa’s Vaccine, organized by the African Union and the Centers for Disease Control in Africa (CDC Africa), held on 12 and 13/4, had the Oswaldo Cruz Foundation (Fiocruz) president as one of the speakers on Tuesday. During Session 8, on the Partnership with Foundations for Vaccine Production, Nísia reaffirmed Fiocruz's commitment to a South-South agenda to support the needs of the African continent in strengthening its health system, preparing for disease emergencies, and providing the population with access to medical care.

The session, moderated by Winnie Byanyima, executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), featured Trevor Mundel, president of the Global Health Division of the Bill & Melinda Gates Foundation in the US; Reeta Roy, president and chief executive officer of the MasterCard Foundation in Canada; Gordon Dougan, head of the Wellcome Infection Health Challenge at Cambridge University, UK; Paul Pattinson, director of Oxford International Biomedical Ventures, UK; Etleva Kadilli, director of the Supply Division at the United Nations Children's Fund (UNICEF); and Padmashree Gehl Sampath, senior advisor to the Global Access in Action Program at the Berkman Klein Center at Harvard University, USA. The meeting goal was to create a dialogue leading to potential partnerships between African foundations and vaccine producers.

"We should not question whether it is possible for us to do it. It all starts with one simple step. India started somewhere. Twenty years ago, they were sitting [talking] as we are now", pointed out virologist John Nkengasong, director of CDC Africa, during a brief participation in the meeting, in a reference to the country that today is an important producer of inputs and generics.

"Vaccine Apartheid"

Compared to other regions, vaccine production in Africa is still in its infancy, Winnie Byanyima pointed out, and the continent is looking for support to advance in this field. The mediator recalled that the COVID-19 pandemic is not only testing health systems but also highlighted the difficulty in accessing vaccines. For her, there is a kind of "vaccine apartheid," noting that seven African countries have not received a single dose so far. "This is a strategic issue for the development and security of Africa," she said.

Nísia, in turn, highlighted Fiocruz's long history of cooperation on the continent, especially with Portuguese-speaking countries, which yielded initiatives such as the establishment of the Mozambican Medicine Society and the milk banks implementation. Fiocruz also has an office in Mozambique to articulate, monitor, and evaluate cooperation programs developed by its units in the continent.

According to the Fiocruz president, in the last decades the Foundation has developed an approach that sees health as a development factor, understood in the Health Economic-Industrial Complex concept. A set of public policies for partnerships between the state and private initiative was established, including the strengthening of state-of-the-art tests, drugs, and vaccines local production. "This conception shows that the bases of local production, science, technology, and innovation are essential to give economic sustainability to health systems, also favoring global cooperation based on the technologies solidary exchange”, she explained. "This link in the relationship between local technological training in less developed countries and global cooperation has been demonstrated by the experience of Brazil's cooperation with Africa in the vaccines and medicines area, including the technological and productive capacity transfer, and not only the products commercialization and supply.”

The Foundation is willing to discuss new partnerships and technology transfer agreements to increase Africa's vaccine production capacity. Nísia pointed out that it would also be interesting to use the initiatives taking place in the BRICS countries - a group composed of Brazil, Russia, India, China, and South Africa - so that Africa can participate in a production and innovation in health global effort, which goes beyond medicines and vaccines.

About COVID-19, she recalled the partnership with AstraZeneca and Oxford University for vaccine acquisition and technology transfer, highlighting that Fiocruz already produces approximately one million doses per day from Active Pharmaceutical Ingredient (API) received from the company. He also pointed out that the Foundation's units are undergoing adaptations to produce IFA in the second semester.
Nísia also highlighted two major challenges that she believes must be addressed for health future to contribute to a more equitable and just world guided by sustainable development: the science and technology strengthening, facing inequality in knowledge, innovation, and basic production; and a global effort to guide an economic, productive, and technological base coming from different countries with different levels of development.

"Without a more symmetrical distribution of production and innovation capacities, the health care increasing concentration and monopolization will make national and global responses based on universality and equity unviable," said the Fiocruz president.

Development and Inclusiveness

A participant in the meeting, Reeta Roy advocated the creation of conditions, uniting the academic and private sectors, for the talent and technologies development - something he said is also fundamental for the production of vaccines. "You have to think about inclusion. There are many talented young people, but they encounter many barriers. Gender inclusion also needs to be discussed," said the Mastercard Foundation president.

When referring to vaccine production, Paul Pattinson said that it is also necessary to think about the long-term issue, facing problems such as capacity to build facilities, specialized professionals such as engineers and chemists, and technicians. He advocated knowledge transfer and the excellence centers creation on the continent, also bringing in specialists from abroad. Like Roy, he stressed the need for women to have the same opportunities.

Trevor Mundel suggested maximizing efforts, using existing structures, bringing new technologies to Africa, and using company experiences to make progress. He cited initiatives of the Bill and Melinda Gates Foundation in Senegal and South Africa. Padmashree Gehl Sampath, meanwhile, stressed that it is critical to get funding so that testing and diagnostics can be done. "Promises need to materialize. Local production is key to success," he said.