Over seven decades ago, Ethiopia had the capacity to produce six human vaccines through the “Institute Pasteur d’Ethiopie”, in partnership with the French government (History of EPHI – Ethiopian Public Health Institute). Each year, the Institute provided 3,000,000 doses of ‘Anti-variolica’ vaccine, 400,000 doses of Antityphus vaccine, 50,000 doses of Antirabies vaccine, 30,000 doses of BCG vaccine, 10,000 doses of ‘Antityphoid-paratyphoid’ vaccine, and 6,000 doses of Yellow fever vaccine free of charge through its dedicated departments. This capacity is now gone.

On the other hand, the National Veterinary Institute, which was similarly established with technical support of the French Government through the French Veterinary Mission in Ethiopia, is now the largest supplier of animal vaccines in ‘Tropical Africa’  (History of NVI – National Veterinary Institute). If I had the privilege of speaking with the Ethiopian leaders last week when the French President visited, I would have suggested a return to this historic engagement on vaccine technology. This is, in fact, what triggered me to write this note. The issue of local vaccine and medicinal products manufacturing capacity must be addressed as a top priority. COVID-19 has demonstrated why. 

When words fail me, I occasionally ask my friend, Naizgi, a professional painter, to translate my thoughts into a sketch. The painting below was by Naizgi at the beginning of COVID-19. 

Coordinating the knowledge synthesis and translation work at CDT-Africa (Vol. 60 No. Supplement -1 (2022) | Ethiopian Medical Journal), I had to be intimately engaged in what was going on internationally. COVID-19 was a terror globally. We prefer to forget, perhaps at our own peril.

In the early days of the pandemic, our vulnerability was stark. In my head, Africa was like a person trapped in a dark, rainy, and stormy night in the middle of a forest, surrounded by hyenas. The only hope of escape was a house in the distance. The weaker person is likely to be caught, while the younger, more energetic man might escape provided the residents in the distant house welcome him. However, escaping the first night is not enough. What he does the next day matters. He must either build a shelter or leave the place if that is an option.

Vaccines were introduced in Ethiopia (Ethiopia introduces COVID-19 vaccine in a national launching ceremony | WHO | Regional Office for Africa) within three months of the first person being vaccinated globally (The nurse who gave world's first COVID-19 vaccine | Bulletin | Royal College of Nursing), which was an amazing achievement. However, it took a year before a relatively sufficient flow of vaccines into Ethiopia was secured.

Now that COVID-19 is no longer a public health issue, the critical question is, what are we doing now? Are we still enjoying the morning, with the frightening night just behind us? What are we doing to prepare for the next inevitable crisis? There are encouraging national and continental initiatives, particularly the focus on ensuring access to essential medicines and vaccines through local manufacturing. However, the lack of urgency and clear commitment is concerning. 

I hope the lessons from the recent history of COVID-19 will spur us to stronger and urgent actions. Historic links and platforms may be easier to reignite to build local manufacturing capabilities.