Johnson & Johnson’s Covid-19 vaccine was to be one of Africa’s most important weapons in the fight against the coronavirus.
The American company has pledged to sell enough doses of its low-cost single-dose vaccine to ultimately immunize a third of the continent’s population. And it would be produced in part by a South African manufacturer, giving hope that the doses would soon be intended for Africans.
This is not what is happening.
South Africa is still waiting to receive the vast majority of the 31 million doses it has ordered. Only around 2 million doses of the Johnson & Johnson vaccine have been applied in the country so far. This is a crucial reason why less than 7% of South Africans are fully vaccinated – and why the country has been ravaged by the delta strain of the virus.
At the same time, Johnson & Johnson exports millions of bottled and packaged doses to South Africa for distribution in Europe. The information comes from the company itself and the South African manufacturer, Aspen Pharmacare, as well as local government documents to which the New York Times has had access.
Glenda Gray, a South African scientist who helped run J&J’s clinical trial in the country, said companies should prioritize sending doses to poorer countries involved in production.
“It’s as if a country produces food for the world and sees its production sent to resource-rich destinations, while its own citizens go hungry,” he explains.
Many Western countries have kept the doses manufactured on their territory to themselves. This was not possible in South Africa due to an unusual clause included in the contract signed by the government this year with Johnson & Johnson. The confidential document, to which the NYT had access, called on South Africa to waive its right to impose restrictions on the export of vaccine doses.
Popo Maja, spokesman for the South African Department of Health, said the government was not happy with the demands but did not have the leverage to evade them.
“The government had no choice,” he said in a statement. “Either I signed the contract or there would be no vaccine.
Johnson & Johnson had always planned to release some of the vaccines produced by Aspen from Africa, but never disclosed how many doses it was actually exporting. Records show the company shipped 32 million doses in the past few months, but that doesn’t capture the full number.
A spokesman for the German health ministry said that in April the country received doses of the vaccine produced by Aspen. In June and July, Spain received more than 800,000 doses.
Critics say South Africa’s vaccine deficit partly reflects an imbalance of power between a giant corporation and a desperate country.
“The disproportionate power wielded by Johnson & Johnson is really worrying,” says Fatima Hassan, a human rights lawyer in South Africa. “It hinders our efforts to get vaccines into the system in the short term. “
The picture is grim across the continent. While several African countries received small initial shipments of J&J vaccine last week, they represent only a fraction of the 400 million doses ordered by the African Union. About 2% of Africans have been fully immunized so far.
Johnson & Johnson Scientific Director Paul Stoffels said the Aspen plant is part of a production network in which vaccines are routinely transported between different countries for manufacturing, quality inspection and delivery.
“We have done everything possible to prioritize South Africa,” he said. He points out that at the start of this year, J&J made around 500,000 doses available to immunize South African healthcare professionals and that at a later date, the Aspen plant will provide doses exclusively to African countries. .
Aspen is responsible for the final stage of vaccine production, a process known as “filling and finishing”.
According to company executives, certain doses of Aspen have never been used, for fear of possible contamination at the Baltimore plant (USA), responsible for the first stage of production. Problems at this plant, operated by Emergent BioSolutions, have wreaked havoc on J&J inventories, forcing the company to delay orders around the world.
Stephen Saad, chief executive of Aspen, says the company does not control where its doses are shipped. “I would like to see everyone go to Africa.”
Aspen is currently finalizing the doses produced at a factory in the Netherlands; 40% will go to Europe and the remaining 60% to Africa by the end of September. The plan called for only 10% to go to Africa, but the European Union agreed to change the distribution due to the South African crisis.
The vaccination campaign in South Africa has been in full swing in recent weeks, thanks in large part to government-ordered Pfizer doses and US donations. But only about 4 million of the country’s 60 million people are fully immunized.
This left the population vulnerable when a third wave of cases gained traction in the country. “In terms of the increase in deaths, the third wave was the most tragic because it is the most preventable,” said Jeremy Nel, director of a hospital in Johannesburg. “We see people dying by the dozen. Everyone would be entitled to the vaccine and would be among the first to receive it. “
Critics say Pretoria shares responsibility for the low vaccination rate. Initially, the government had a UN-subsidized vaccination center, which delayed deliveries. The country took a long time to enter into negotiations with the manufacturers. In January, a group of immunization experts warned that “recklessness” would cause “the greatest human failure to protect the population since the AIDS pandemic.”
Johnson & Johnson’s deal with Aspen was announced in November. The Gqeberha factory was the first place in Africa to produce vaccines against Covid-19.
The J&J vaccine gained prominence in February, when a clinical trial suggested AstraZeneca’s vaccine offered little protection against mild or moderate infections caused by the beta variant circulating in South Africa.
Weeks later, Johnson & Johnson and the government signed a contract to produce 11 million doses. In April, South Africa ordered 20 million more doses.
The contract prevented the government from banning exports of the vaccine, citing the need for doses “to be shipped freely between countries.”
Sam Halabi, a health law expert at Georgetown University who reviewed parts of the South African contract at the New York Times’ request, said the terms of the deal appeared to be more favorable to the company pharmaceutical than the other agreements he had seen. South African officials said Pfizer had also called for strong legal protections.
The contract called for Johnson & Johnson to deliver 2.8 million doses to South Africa by the end of June, 4.1 million additional doses by the end of September and 4.1 million additional doses by the end December. (Maja said the government expects the additional 20 million doses to be delivered by the end of the year.)
The company is far from achieving these goals so far. By the end of June, South Africa had received only about 1.5 million of the doses planned in its order. The small number of doses delivered to the European Union arrived on time.