Inside Kenya’s deal with global vaccine agency

Inside Kenya’s deal with global vaccine agency

President William Ruto last year announced Kenya’s intention to join, as a state party, the International Vaccine Institute (IVI).

This came after Covid-19 vaccine costs pushed many developing countries to the back of the vaccine queue. The government explained that Kenya’s bid to embark on manufacturing human vaccines, biotherapeutics and diagnostics began when it formally presented an official letter of intent to join IVI, which is based in Seoul, South Korea.

This informed the opening of the Kenya Biovax Institute to be used as a vehicle for working with other stakeholders and institutions such as the Kenya Medical Research Institute (Kemri).

In an exclusive interview with the Nation, IVI Director-General Dr Jerome Kim, who is currently on an official visit to the country, gives details of the deal between Kenya Biovax Institute and IVI and how the country stands to benefit.

Thank you so much for speaking to us. What is IVI all about?

IVI is an international organisation with a mission to discover, develop and deliver safe, effective and affordable vaccines for global health. Because of our mission, IVI works on diseases that the major vaccine companies do not want to work on.

We develop vaccine solutions and transfer these solutions to companies that will be the ultimate manufacturers, and help these companies to develop and test the vaccine, to secure approvals from local and international regulatory authorities and then work with Gavi and others to ensure that the vaccines are used and make an impact.

Is this your first time in Kenya and do you understand our challenges and needs in regards to vaccines?

This is not my first time in Kenya, I used to work for the United States Military HIV/AIDs research programme, which has an extensive collaboration with Kemri. Our programme, which involved testing and developing HIV vaccines, was being carried out in Kericho and Kisumu. I have now had an opportunity to return to Kenya which is remarkable.

Last year you had a meeting with President William Ruto when Kenya officially submitted her letter of intent to join IVI, what did you discuss?

In the Covid-19 and post Covid-19 era, President Ruto and Kenya have recognised the inequity that the world faced as we dealt with the coronavirus pandemic. We discussed inequities with President Ruto. We had inequities in distribution and availability of diagnostic kits. For instance, Kenya wasn’t fully aware of the extent of the disease in the country and if we are not aware of the extent of the disease we are not also aware of the extent of death or disability that is associated with the disease.

Another inequity was in the distribution of research and development funding. We know that Kenyan scientists have participated in other international groups in the development and testing of vaccines yet the distribution of funding favoured certain types of companies in different parts of the world. There wasn’t a focus on developing vaccine solutions that would be safe, effective and widely used in sub-Saharan Africa.

Did you and President Ruto come up with solutions to the major inequality, which is vaccine manufacturing?

In fact, this is the major concern that President Ruto wanted to discuss as Africa manufactures less than 1 per cent of her own vaccines. This means that in terms of vaccine security, Africa is vulnerable and dependent on the goodwill of international companies and donors.

As a result of what we have seen during the Covid-19 pandemic, there is increasing effort to build regional manufacturing capability. Could that capability be located in each African country?

We have to identify African country’s that are best positioned to support a sustainable vaccine manufacturing industry.

The other inequity we discussed with President Ruto is vaccination.

We have been faced with a situation continuing from 2022 to now where about 70 per cent of people living in low-income countries have not received even a single dose of a Covid-19 vaccine.

Why is this? The reasons are complex. For example, it has been difficult to convince companies that it is necessary to vaccinate an entire population or even a significant portion of the population.

It has also been difficult to overcome vaccine hesitancy, remember Africa was for two years subject to anti-vaccine rhetoric and misinformation from the Global North and within Africa itself.

African experts told us that Africa did not have a vaccine hesitancy problem. We saw G7 countries like Canada hoard vaccines meant for low-income countries before succumbing to pressure. What will IVI do different?

Remember, globally, we had 10 billion doses of the Covid-19 vaccine in 2021. At the same time, 80 per cent of low-income countries were unvaccinated. But by the end of the last quarter of 2021, many African countries were calling us to say that they had extra vaccines and want to get rid of them before they expire.

It wasn’t necessarily a supply issue, it was a mixture of things. For example, Africa should have received vaccines earlier to inoculate their vulnerable populations such as the elderly and front-line healthcare workers.

We saw Global North countries refuse to share technology or make raw materials available in time to countries like India, which helped Kenya and Africa when the HIV epidemic showed up with affordable antiretrovirals (ARVs) when the West had made these life-saving medication too expensive for low-income countries. What is your take?

Unfortunately, the way the billions of dollars that went to Covax, a facility created by the World Health Organization (WHO) to oversee procurement, allotment and distribution of Covid-19 vaccines to 92 countries, were not able to position it for early purchases. By the time the vaccines were shown to be safe and efficacious Covax was at the end of the line.

We know better now and hopefully in the next pandemic, we will give whatever global agency is created the ability to purchase vaccines in advance and make the kind of contracts that are necessary to ensure countries in low and middle income settings have faster access to critical vaccine technology because we have seen the same thing with the rotarivirus vaccine where it took 16 years after the US made it to reach low-income countries even after WHO approvals.

What does Kenya’s deal with IVI look like?

Kenya is in the final steps of joining IVI . Kenya has enormous assets such as Kemri and the University of Nairobi, there is a tremendous amount of research, development and expertise. At the same time, the government has created the Kenya Biovax Institute.

IVI is coming in to answer this question, how do we make the Kenya Biovax institute sustainable and successful? So that in the end it is not just a building that makes vaccines but a building that makes vaccines that are purchased by the Kenyan government and regional governments and used to prevent diseases in the region.

Kenya also has an opportunity to join the board of trustees through a new mechanism that was created this year that allows countries that don’t fund IVI to actively participate in the board. This is important because Kenya having a voice on the board trustees like Rwanda will give her an opportunity to work with other board members and make known the needs of middle and low-income countries.

What vaccines is Kenya going to be making?

We do not have a good answer for that at the moment, but funding the research for vaccine development is going to be an important part of a sustainable vaccine ecosystem.

Africa can solve some of the problems with infectious diseases that are here, these are not infectious diseases that the big companies are going to develop vaccines ... but there are Indian companies that cover 60 per cent of global health vaccines for one or two dollars a dose. Do you want a small African manufacturer to compete with big pharma and other manufacturing giants? This is why we have to be very careful when we are developing vaccine manufacturing in Kenya so that whatever is developed is sustainable so that we have what Kenya will develop used in Africa and elsewhere in the world.

How will the Kenya-IVI vaccine manufacturing partnership work?

The partnership is evolving. We have done a lot of technology transfer and it works as follows. IVI can develop a vaccine, say for cholera, and then transfer the ability to a company. This is a very important step because it teaches a company how to make a vaccine without a patent, without a licensing fee and makes the company responsible for the quality of the vaccine and passing the regulatory hurdles as well as being commercially successful with it. We have so far done it for five different vaccines and have done nine different technology transfers with the most recent being with a South Africa-based company called Biovac.

Why do you think President Ruto found IVI attractive for Kenya?

Our technology transfer, like I said we don’t do patents and any licensing fees. We want to work with Kenya and other partners from developing the manufacturing site to technology transfer. To work with Kenyan regulators to get the vaccine approved then to work with distributors in Africa and begin vaccination campaigns using the vaccine. That has been the model that IVI goes by and President Ruto and Kenya found it attractive, we are a partnership of countries and being able to work with new partners is critical.

IVI is currently working with WHO and the government of South Korea and has set up a global training hub for bio-manufacturing. So far, 400 students, including 12 from Kenya, have come to learn the basics of bio-manufacturing before going to the WHO hub in mRNA manufacturing in South Africa.