Pfizer will turn to a plant in Africa to help supply the continent with vaccines next year. - The New York Times

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Pfizer and BioNTech said on Wednesday that they have reached an agreement with a South African vaccine manufacturer, starting next year, to handle the final stages of manufacturing for doses of their Covid shot that will be supplied exclusively to African nations.

The deal represents the first time Pfizer’s Covid vaccine will be partly produced in Africa and it could eventually help increase supply to a continent where months of severe vaccine shortages have resulted in only about 1.5 percent of people being fully immunized.

But the agreement comes with caveats that will significantly limit its impact at a time when the fast-spreading Delta variant has driven a surge in infections and hospitalizations and sent the continent into the most devastating phase of its pandemic.

Crucially, the South African producer, Biovac, will only be handling distribution and “fill-finish” — the final phase of the manufacturing process, during which the vaccine is placed in vials and packaged for shipping. It will rely on Pfizer facilities in Europe to make the vaccine substance and ship it to its Cape Town facility.

Public health activists have called on Pfizer and other major vaccine manufacturers to transfer their technology to local producers in poorer parts of the world so as to ramp up production and alleviate shortages. Sharing recipes in this way can either be voluntary or forced.

Matthew Kavanagh, director of the Global Health Policy and Politics Initiative at Georgetown University, called Wednesday’s agreement “deeply disappointing.”

“What we have seen from all of these licensing agreements that only are fill-finish and keep the full production capacity to high-income-country producers is that they continue to just perpetuate the inequalities in distribution,” Mr. Kavanagh said.

A company spokeswoman, Pamela Eisele, said that in trying to rapidly scale up Covid vaccine manufacturing, Pfizer is “primarily focusing on multiple existing sites, looking to external contract manufacturers to support the important fill-and-finish and distribution steps.”

Michelle Viljoen, a spokeswoman for Biovac, said that starting with fill-finish is “the quickest manufacturing step to making vaccines accessible.” Ms. Viljoen added: “We will continue to pursue our vision of drug substance manufacture. We view this initiative as a stepping stone towards the realization of that vision.”

Pfizer has pledged that it will supply two billion doses of its vaccine to low- and middle-income countries through various channels by the end of 2022, but so far, only a small fraction of those doses have been delivered.

Pfizer said that efforts would begin immediately to transfer technology and install the necessary equipment at Biovac’s facility. Pfizer said the plant would be able to fill-finish more than 100 million doses annually at full capacity, though it did not say when that would be reached. Those doses will be supplied only to the 55 member states that make up the African Union, the company said.

To people “who have expressed concern that Africa is being left behind in part due to lack of vaccine manufacturing, I want to say that we hear you,” Pfizer’s chief executive, Dr. Albert Bourla, said in prepared remarks to a meeting put on by the World Trade Organization on Wednesday.

But Mr. Kavanagh said he was worried that Pfizer would not send enough drug substance to Cape Town, especially if wealthy countries sought third booster shots for their populations. In that scenario, he said, “what likelihood is it that most of the drug substance is going to shift to Africa to do first vaccinations instead of doing boosters in high-income countries that pay more and have political power to demand it?”

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