Published on Investing in Health

Pandemic failures show path to a stronger healthcare system

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Conducting research in Togo. Photo Credit: Erick Kaglan/World Bank
Conducting research in Togo. Photo Credit: Erick Kaglan/World Bank

The pandemic continues to expose major weaknesses with the existing global health care system, in particular equitable access to vaccines. The situation is most severe in Africa, a continent that imports 99 percent of the vaccines it consumes, and where only a small fraction of the population has been able to get the vaccine so far. The solution is not only to make sure more vaccines are available for Africa, but to start making them there.  

Building local manufacturing capacity

Building manufacturing capacity locally is vital, and it’s a priority for the International Finance Corporation (IFC), which supports private sector development in emerging markets as part of the World Bank Group’s overall mission. Meeting today’s needs matters, but we also need to be prepared for future health crises, and this is driving our efforts on the African continent , both in looking to develop more localized vaccine production and in strengthening health care systems overall.  

Recently, we mobilized $713 million in joint funding—together with German, French and U.S. development agencies—for Aspen Pharmacare, a South Africa-based manufacturer that is making the Johnson & Johnson COVID-19 vaccine. That’s an important step, but Africa needs more. Manufacturers and leaders in Africa want to be able to not only produce under fill-and-finish contracts, but also manufacture vaccine substances. We’ve embarked on some innovative initiatives to help.

Together with other international funders, we’re collaborating with the Institut Pasteur de Dakar (IPD), a vaccine maker and nonprofit health care foundation mandated to support public health improvements in Africa, to help it start a manufacturing hub for COVID-19 and other vaccines. In September we signed a memorandum of understanding with the Center for Epidemic Preparedness Innovations (CEPI) to boost vaccine production in low- and middle-income countries, among other initiatives.

Collaborations, like the one with CEPI,  require upfront work to identify opportunities and analyze what is needed for a project to launch and be funded, whether by us or another investor. In Rwanda, for example, we’re analyzing current capabilities to inform us what to do. Last month, we signed a collaboration agreement with the Rwanda Development Board to develop vaccine manufacturing capacity in Rwanda and contribute to expanding vaccine production in Africa.

Success requires close cooperation

Ensuring adequate provision of medical supplies and pharmaceuticals, including vaccines, is necessary to protect people from the pandemic, but it is hardly sufficient. It is obvious that countries need trained health care professionals, the right diagnostics, and well-functioning health care systems to properly battle the pandemic.  The World Bank Group, through its health operations, is helping countries across the globe to strengthen their health care systems. In many countries, public-private sector cooperation is an important element. For instance, to quickly fill gaps in the provision of certain health care services, such as diagnostic tests for COVID-19, governments can contract with the private sector. IFC is facilitating this in Africa where it teamed up with several of its international counterparts to fund Cerba Lancet Africa to add new diagnostic facilities, prioritizing poor and fragile countries with limited diagnostic services.

In addition, we are sharing with governments our expertise on how to contract with the private sector. An ongoing project in Uzbekistan, for instance, is aimed at improving the quality and volume of the country’s dialysis services, an important aspect contributing to a stronger health care system. On the human capital side, since 2018 we have deployed our IQ-Healthcare team of advisors to dozens of hospitals and clinics to guide staff in everything from infection control protocols to establishing smart medical equipment purchase practices. In all, IFC financial support for the health care services sector has totaled $3.8 billion during the pandemic.

As we start to see positive signals in the fight against COVID-19 in emerging markets, we should draw lessons from the failures we have seen. They can point us to the path we need to take to create stronger, more rapidly responsive systems which through more diverse and locally sustained supply chains create better and more equitable outcomes.

Join us at the Annual Meetings and watch the “Ending the Pandemic” flagship event.

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Elena Sterlin

Senior Manager for Global Health and Education, IFC

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