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    Following full FDA approval, Pfizer and BioNTech must urgently share COVID-19 vaccine know-how to increase global production and supply

    A member of MSF’s mobile vaccination team prepares a dose of COVID-19 vaccine at a nursing home in Shayle, Lebanon. © Tracy Makhlouf/MSF

    A member of Doctors Without Borders’ mobile vaccination team prepares a dose of COVID-19 vaccine at a nursing home in Shayle, Lebanon. © Tracy Makhlouf/MSF 

    Following today’s full approval of the Pfizer-BioNTech mRNA COVID-19 vaccine by the US Food and Drug Administration (FDA), Doctors Without Borders / Médecins Sans Frontières (MSF) called again on Pfizer and BioNTech to immediately share the vaccine technology and knowledge with manufacturers on the African continent that could help boost global vaccine supply. They should do this via the World Health Organization’s (WHO) mRNA vaccine technology transfer hub hosted in South Africa. With only 1.7% of Africa’s population fully vaccinated against COVID-19, increasing and diversifying production and supply of mRNA vaccines through additional manufacturers, beginning with those based in countries on the African continent, offers an opportunity to urgently and sustainably address vaccine inequity during this pandemic, and in the future.

    "Setting up mRNA vaccine manufacturing capacity in Africa is absolutely possible. Our analysis shows that at least seven manufacturers in African countries currently meet the prerequisites to produce mRNA vaccines, if all necessary technology and training were openly shared,” said Lara Dovifat, Campaign Manager, MSF Access Campaign. “In fact, since July 2020, we’ve observed Pfizer-BioNTech and Moderna facilitate mRNA vaccine production with manufacturers in Switzerland, Spain and Germany, all within 8 months, so it is clearly feasible for other manufacturers to swiftly produce mRNA vaccines. The only reason these vaccines aren’t being produced more widely is because Pfizer-BioNTech and Moderna are refusing to share mRNA vaccine technology and information with manufacturers—including those in Egypt, Morocco, South Africa and Tunisia that could have the capacity to produce up to 100 million doses annually within a 10-month timeframe.”

    In an analysis by Imperial College of London commissioned by Doctors Without Borders, the estimated total cost needed for starting up mRNA vaccine manufacturing in an existing manufacturing site and producing 100 million doses is approximately US$127 million for BioNTech-Pfizer’s vaccine and $270 million for Moderna’s vaccine. Considering the estimated $2.5 billion of public money that has gone into the development of mRNA vaccines, and the forecasted 2021 sales revenues of $26 billion and $19 billion for Pfizer-BioNTech and Moderna, respectively, these companies have a public obligation to facilitate increasing vaccine production and supply wherever possible.

    Currently, only 1% of Pfizer-BioNTech vaccine doses have been delivered to low-income (0.1%), and low- and middle-income countries (0.9%).* Given that countries in Africa historically import 99% of the vaccines they administer, such vaccine dependence is clearly not sustainable for a continent of 1.2 billion people.

    “As we’re seeing in the places we work, being almost entirely dependent on erratic vaccine imports and donations has so far proven woefully insufficient for vaccine access on the African continent,” said Dr Khosi Mavuso, Medical Representative for Doctors Without Borders in South Africa. “As new variants emerge and people continue to die from COVID-19 at alarming rates across Africa, the vaccine shortages we’re seeing are incredibly concerning. This suffering could be alleviated if pharmaceutical companies shared the mRNA technology and know-how needed to produce more COVID-19 vaccines now, through the WHO technology transfer hub, so that local vaccine production can begin as soon as possible. It is a failure for global public health that governments and mRNA vaccine producers are not doing everything they can to scale up production of COVID-19 vaccines when there are potential manufacturers on the African continent.”

    mRNA vaccines are a revolutionary and lifesaving new medical tool that are an advantageous choice for use and manufacturing in low- and middle-income countries – they are relatively simpler, faster and cheaper to produce than traditional vaccines; relatively easy to scale up production; and highly adaptable to new variants. In addition, mRNA technology can be adapted to target other pathogens, meaning the same platform can be ‘switched’ to produce different vaccines or even therapeutics for other diseases of concern, including for preparedness for future pandemics.

    Supporting sustainable, independent vaccine manufacturing capacity in an African country would only require technology transfer from Pfizer-BioNTech and Moderna, but would be a gamechanger for equitable access to vaccines for people in low- and middle-income countries,” said Dr Carrie Teicher, Director of Programs, Doctors Without Borders-USA. “The US government must immediately urge Pfizer-BioNTech and Moderna to share the COVID-19 mRNA vaccine technology and know-how. It really is a no-brainer – sharing mRNA technologies will increase the global production and supply of COVID-19 vaccines, saving lives in this pandemic and in the future.”

    In addition to demanding Pfizer-BioNTech and Moderna share mRNA vaccine technology, Doctors Without Borders urges all governments to support the WHO COVID-19 mRNA Vaccine Technology Transfer Hub with financial and political support. Additionally, Doctors Without Borders calls on governments with sufficient COVID-19 vaccine doses to immediately redistribute excess doses to the COVAX Facility. Doctors Without Borders also urges governments to support the TRIPS Waiver proposal at the World Trade Organization (WTO) to waive intellectual-property monopolies on all COVID-19 vaccines, tests, treatments and other health tools during the pandemic; and to use all legal and policy tools to facilitate uninterrupted production and diversity in supply of COVID-19 medical tools.

    *Calculation based on data from AirFinity, 22 August 2021