South Africa is grappling with the fourth wave of the coronavirus, driven by the omicron variant. The country is pushing for more vaccinations — and for its own mRNA vaccine.
South Africa working on vaccines
From the outside, the building in an industrial district of Cape Town looks like any other nondescript warehouse. In fact, it is a beacon of hope for the biotech industry and vaccine productionof the entire African continent.
Inside, preparations are ongoing for future mRNA vaccine production. The Covax initiative for the development of COVID-19 vaccines called on manufacturers to apply for the establishment of an mRNA hub for low- and middle-income countries — and Afrigen Biologics prevailed against about 60 competitors.
The European Union, the World Health Organization and several countries are funding the project.
"That's one of the positive legacies of COVID. We have seen this massive funding available now in South Africa, and also in Africa," Afrigen managing director Petro Terblanche said during a tour of the facilities. The research started five years ago with a focus on tuberculosis vaccines for Africa, now the focus has shifted to mRNA technology.
Replicate the Moderna vaccine
BioNTech-Pfizer and Moderna are the only companies that commercially established themselves in the mRNA field during the pandemic. Germany's BioNTech is set to begin bottling its COVID-19 vaccine in South Africa with a partner next year. Terblanche had hoped to find a partner in Moderna – but that didn't happen.
"So the team now has jumped in with our university partners and the knowledge base in South Africa to develop our own vaccine," she said.
Johannesburg-based Witwatersrand University is a key partner; its Antiviral Gene Therapy Research Unit has been researching mRNA therapies since 2015 — a unique project on the continent, according to director Patrick Arbuthnot. Since the coronavirus pandemic, the focus has been on COVID-19, and the scientists are sharing what they know with the Afrigen team.
"We have been able to take information available in the public domain, to work out how the Moderna mRNA is produced. We have the sequence and the context of the sequence, which we have been able to reproduce — the purpose of that is to use it as a reference rather than using it as a product, " Arbuthnot said. "We would like to develop our own ideas — and we are doing that already — and compare that to the Moderna vaccine."
The South African government commissioned the team to develop a vaccine that is also effective against the omicron variant, which is responsible for most of the new COVID-19 infections in the country.
People who have been vaccinated or have recovered from an infection can still contract the virus, just like South African President Cyril Ramaphosa, who was one of the first in the country to be vaccinated with Johnson & Johnson's vaccine. Stricter measures limiting public events or social gatherings are not in place so far, as authorities instead try to convince vaccine-hesitant people to get the jabs. Currently, only one in four South Africans is fully vaccinated.
Possible turning point for the pandemic
On Twitter, Shabir Madhi, a professor of vaccinology at the University of the Witwatersrand, called it inexcusable" that the government has "15 million vaccines in depot" but does not offer booster shots to everyone, even people who received the one-shot Johnson & Johnson vaccine.
But he also noted a turning point may be ahead if there is "no massive surge in hospitalization and death in the next 2-3 weeks."
In the mRNA lab at Witwatersrand University, Abdullah Ely analyzes sequences of omicron cases sent to him by other labs. He said he wants to have a DNA sequence to test in mice within "a few months."
"Once we have a candidate that works well, we will be able to take that to Afrigen," he said, adding that Afrigen would then "translate this into something that can be produced in a larger scale."
Part of a strategy
It is a lengthy process that requires clinical trials and could take years. According to Terblanche, it would be quicker if a company that had already developed an mRNA vaccine cooperated. South Africa has been urgently calling for a suspension of patent rights since the pandemic began. Moderna has said it would not sue for its COVID vaccine patents during the pandemic. But any company that goes through clinical trials with a Moderna-based vaccine and then wants to commercialize it could face lawsuits.
"We would like to have a voluntary license to be able to transfer this technology to other low- and middle-income countries, and use the platform for other vaccines: HIV, TB, Ebola, flu," said Terblanche. "This hub, and the capacity and capability we are building here, is beyond COVID. This in fact is part of a strategy from Africa to produce 60% of our vaccines by 2040 — this is part of building an industry."
With regard to vaccine distribution, one of the most important lessons of the pandemic is to become more independent, Terblanchesaid, adding that most vaccines used on the continent are imported. "Afrigen and its partners aim to bring the first home-grown products to market within three years."
They are not the only ones who have become active. The Pasteur Institute in Senegal produces a yellow fever vaccine, and Rwanda has expressed interest in producing vaccines and drugs. BioNTech signed cooperation deals with the Pasteur Institute and the government in Rwanda. Moderna's final decision is still pending.