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Bridging the vaccine divide

Nature Medicine volume 31, page 1737 (2025)Cite this article

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The African Union (AU) has prioritized local production of health countermeasures since its inception, with heightened focus following the COVID-19 pandemic and challenges such as cholera, Ebola, malaria, mpox, Marburg and other emerging diseases. One of its efforts was the development of the Pharmaceutical Manufacturing Plan for Africa in 20071. The plan aims to strengthen the continental capacity to produce affordable, high-quality essential medicines, improving health outcomes while fostering economic benefits. The AU’s Agenda 2063 further reinforces the development of resilient health systems and local pharmaceutical manufacturing to achieve health sovereignty2.

These goals confront a stark reality in Africa. In 2024 alone, the continent had to deal with over 160 disease outbreaks3. Yet as many as 70–90% of drugs consumed in sub-Saharan Africa are imported, and <1% of global vaccine production occurs on the continent4. This limited manufacturing capacity exacerbates delays in accessing life-saving vaccines during public health crises, as exemplified during the COVID-19 pandemic5 and the current mpox outbreak6. Moreover, over-reliance on imports — often coupled with inadequate cold-chain infrastructure — hinders the timely distribution of vaccines7. Diseases such as cholera and typhoid further emphasize the necessity of regional solutions and end-to-end vaccine production systems. The oral cholera vaccine (OCV) technology transfer from the International Vaccine Institute to the Biovac Institute in South Africa exemplifies how strengthening manufacturing capacity can address vaccine shortages amid recurring outbreaks.

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Authors and Affiliations

  1. International Vaccine Institute (IVI), Kigali, Rwanda

    Nicaise Ndembi

  2. Centre for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda

    Leon Mutesa

  3. Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda

    Claude Mambo Muvunyi

  4. International Vaccine Institute (IVI), College of Natural Sciences, Seoul Natural University, Seoul, Republic of Korea

    Jerome H. Kim

Authors
  1. Nicaise Ndembi
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  2. Leon Mutesa
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  3. Claude Mambo Muvunyi
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  4. Jerome H. Kim
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Correspondence to Nicaise Ndembi.

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The authors declare no competing interests.

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Ndembi, N., Mutesa, L., Muvunyi, C.M. et al. Bridging the vaccine divide. Nat Med 31, 1737 (2025). https://doi.org/10.1038/s41591-025-03728-1

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