The African Union has signalled a demand for more Covid-19 vaccine doses from India, even as the Asian country recovers from low production following months of a deadly wave.

On Thursday, the Africa Centers for Disease Control and Prevention (CDC) said the African Union will send a delegation to India for negotiations on further supplies to Africa.

“We are very glad that India is embarking on vaccine exports. However, we are yet to know the number of doses Africa will receive,” said Dr John Nkengasong, who heads the Africa CDC, during a virtual press conference on Thursday.

India was a key vaccine exporter to Africa before it stopped the exportation to focus on fighting the local infections.

Now the African Union says India’s resumption of vaccine exports means the continent has to directly engage with the country on supplies.

“President Cyril Ramaphosa, the AU champion on Covid-19, is dispatching a delegation to India, which will include Mr Strive Masiyiwa, AU’s Special Envoy, to talk to the Indian leadership so that they release vaccines to us,” Dr Nkengasong said.

As per the official agreement from last year, the Serum Institute of India (SII), which is the largest vaccine maker in the world, was expected to supply a billion doses to the low and middle-income countries. The vaccine maker was required to provide 400 million vaccine doses in 2020 alone through Gavi, the international vaccine alliance of which the World Health Organisation (WHO) is a member.

This commitment did not materialise, following a surge in Covid cases in India, which prompted the Indian government to ban exportation of vaccine and prioritise her citizens.

 After exporting 66.3 million doses by April 16, this year, which were touted by the Indian government as Vaccine Maitri (vaccine friendship), meant to position India as a vaccine-manufacturing hub, the initiative has since been halted.

Earlier this year, WHO said that India's decision to ban Covid-19 vaccine exports had severely affected 91 nations that had been dependent on the SII for vaccines.

The global heath body further explained that with inadequate vaccine supply, many countries and especially in Africa remained extremely susceptible to new strains of Covid-19, including B.1.617.2, which was first discovered in India. 

“There are 91 countries that have been impacted by the shortage of supplies, particularly since the AstraZeneca parent company has not been able to compensate for the doses which have not come from Serum.

“If the this inequitable distribution of available vaccines persist, some countries will return to normal while others will be hit very hard by subsequent waves," Dr Soumya Swaminathan, WHO Chief Scientist explained.

Last week, Kenya’s Health Cabinet Secretary Mutahi Kagwe asked India, which also has a ‘fill and finish’ deal in place with Johnson and Johnson (J&J), to remember her obligations to prioritise meeting her Covax commitments and obligations despite their own challenges.

“We appeal to countries like India, with whom we had an agreement under the Covax facility, to deliver vaccines, to honour their promise and obligations towards us. We understand that they, too, have a challenge with the surge in infections. But they have to meet their obligations,” he said.  

However, the SII Chief Executive Officer (CEO) Adar Poonawalla said that it is crucial for nations depending on India for vaccines to remember that the country is also a low income country.  

“Our exports to Covax will recommence again in October. However, we will only manage to export in large quantities in January 2022 to Covax after local demand has been met,” Poonawalla said.

Dr Nkengasong further disclosed that the AU remains optimistic that Covaxin, India’s latest Covid-19 vaccine will be hitting the market soon. WHO experts are expected to decide whether to give the vaccine a WHO Emergency Use Authorisation approval after experts reviewed data and endorsed it for use earlier this week.

“WHO and an independent group of experts are scheduled to meet next week to carry out the risk/benefit assessment and come to a final decision on whether to grant Emergency Use Listing to Covaxin,” WHO tweeted after a meeting of its Strategic Advisory Group of Experts (SAGE) to discuss the Covaxin EUL application.

Covaxin manufacturer, Bharat Biotech, has been submitting data to WHO on a rolling basis and submitted additional information as requested by WHO on September 27.

WHO experts are currently reviewing this information, and if it addresses all questions raised, WHO assessment will be finalised next week.

“The Emergency Use Listing process, done by WHO and the Technical Advisory Group of independent experts, is centred on determining if a manufactured product such as a vaccine is quality-assured, safe and effective,” the global health regulator said in a series of  official tweets.

The Africa CDC boss also said that the AU is engaged in ongoing discussions with Western governments over intellectual property (IP) rights, so that Africa can manufacture her own vaccines.

“What we, however, need now are vaccines. Since we started the vaccination exercise, 200 million doses have been supplied to 55 AU member states with 115 million doses being used up, amounting to 76 per cent. However, those who are fully vaccinated or have received both the first and second jab are 4.5 per cent.

“The uptake in Morocco is at 53 per cent, Tunisia at 26 per cent, South Africa at 16 per cent, Algeria at 9 per cent and Egypt at 6 per cent, those are some of the best performing in the region,” he highlighted. ​