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<p>This review presents a comprehensive systems-based assessment of Africa’s vaccine ecosystem. It highlights persistent inequities in vaccine access, manufacturing, and distribution, while proposing a strategic and evidence-informed roadmap toward achieving regional vaccine sovereignty and universal immunization coverage by 2040. Despite decades of implementation under the Expanded Programme on Immunization, Africa continues to depend on imports for over 99% of its vaccine supply while consuming approximately one-quarter of the global demand. The COVID-19 pandemic further magnified these systemic weaknesses, revealing gaps in supply chain efficiency, regulatory harmonization and sustainable domestic financing mechanisms. The analysis identifies four strategic pillars essential for transformation: strengthening local research and development (R&amp;D) and innovation ecosystems; expanding regional manufacturing hubs and fill-and-finish facilities; harmonizing regulatory and quality-assurance systems through the African Medicines Agency and regional authorities; and developing diversified, long-term financing models, including public–private partnerships and health investment funds. The proposed roadmap aligns with continental and global frameworks, notably the Africa CDC’s Partnership for African Vaccine Manufacturing, the African Union’s Agenda 2063, and the WHO’sImmunization Agenda 2030. It follows a 3-phased approach: foundation building by 2027, scaling regional production and supply systems by 2035, and achieving full health sovereignty by 2040<b>.</b> Lessons from COVID-19 underscore the importance of community engagement, equitable access strategies, transparent governance, and robust data and surveillance systems. This study contributes a novel framework grounded in expert-informed, policy-aligned scenarios rather than empirical modeling, clarifying that the proposed milestones represent aspirational yet achievable targets. This calls for enhanced South–South and North–South cooperation, multi-stakeholder partnerships, and evidence-driven monitoring mechanisms to build resilient and self-reliant vaccine ecosystems capable of responding swiftly to future public health emergencies. Ultimately, achieving an equitable and sustainable vaccine ecosystem will position Africa not only as a beneficiary but also as a global contributor to its health security.</p>

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Building equitable and sustainable vaccine ecosystems in Africa to achieve health sovereignty and universal immunization by 2040

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月24日

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  • Olalekan John Okesanya,
  • Mohamed Mustaf Ahmed,
  • Zhinya Kawa Othman,
  • Omar Abdulkarim Saeed Alhammadi,
  • Adamu Muhammad Ibrahim,
  • Olaniyi Abideen Adigun,
  • Shuaibu Saidu Musa,
  • Md. Faiazul Haque Lamem,
  • Edgar G. Cue,
  • Don Eliseo-Lucero Prisno III

摘要

This review presents a comprehensive systems-based assessment of Africa’s vaccine ecosystem. It highlights persistent inequities in vaccine access, manufacturing, and distribution, while proposing a strategic and evidence-informed roadmap toward achieving regional vaccine sovereignty and universal immunization coverage by 2040. Despite decades of implementation under the Expanded Programme on Immunization, Africa continues to depend on imports for over 99% of its vaccine supply while consuming approximately one-quarter of the global demand. The COVID-19 pandemic further magnified these systemic weaknesses, revealing gaps in supply chain efficiency, regulatory harmonization and sustainable domestic financing mechanisms. The analysis identifies four strategic pillars essential for transformation: strengthening local research and development (R&D) and innovation ecosystems; expanding regional manufacturing hubs and fill-and-finish facilities; harmonizing regulatory and quality-assurance systems through the African Medicines Agency and regional authorities; and developing diversified, long-term financing models, including public–private partnerships and health investment funds. The proposed roadmap aligns with continental and global frameworks, notably the Africa CDC’s Partnership for African Vaccine Manufacturing, the African Union’s Agenda 2063, and the WHO’sImmunization Agenda 2030. It follows a 3-phased approach: foundation building by 2027, scaling regional production and supply systems by 2035, and achieving full health sovereignty by 2040. Lessons from COVID-19 underscore the importance of community engagement, equitable access strategies, transparent governance, and robust data and surveillance systems. This study contributes a novel framework grounded in expert-informed, policy-aligned scenarios rather than empirical modeling, clarifying that the proposed milestones represent aspirational yet achievable targets. This calls for enhanced South–South and North–South cooperation, multi-stakeholder partnerships, and evidence-driven monitoring mechanisms to build resilient and self-reliant vaccine ecosystems capable of responding swiftly to future public health emergencies. Ultimately, achieving an equitable and sustainable vaccine ecosystem will position Africa not only as a beneficiary but also as a global contributor to its health security.