Beyond Vaccines – Africa is being locked out of accessing new therapies for COVID-19

 In analysis, infographic, Social Media

Updated Every Month

As COVID-19 social distancing interventions continue to be relaxed in many countries and the world approaches a possible endemic stage of the pandemic, vaccination continues to be pushed as an effective strategy as new variants of COVID-19 continue to emerge.

Simultaneously, progress is also being made around new treatment methods for those who do get COVID-19, to avoid hospitalization and speed recovery – so called “therapeutics”. Our infographics have continually demonstrated the continued efforts of African governments to secure vaccines for their populations, despite hoarding elsewhere, high prices and constraints on local manufacturing. But are new COVID-19 therapeutics any different? Are these better available to African countries? This question is what this month’s infographic tries to answer.

First, a brief explanation of the therapeutics. These are medicines an infected person could use, ideally administered not only in hospital but from the comfort of their home with a prescription, or as an injection or other delivery method offered at a health centre.

Most of the medicines that could be used this way are still being assessed for efficacy and safety and are strictly for use in mild-moderate cases where hospitalization is a risk. However, two treatments of note have now passed the World Health Organisation Emergency Use Authorization (EUA) muster: the Pfizer brand PAXLOVID and Merck-Ridgeback Biotherapeutics LAGVERIO. Both can be administered as oral tablets, making them convenient for prescription use at home by individuals, with efficacy rates of 89% and 30% respectively.

Producing these drugs requires licensing agreements, because the firms that produce them -Pfizer and Merck-Ridgeback – have sought Intellectual Property (IP) protection through international patents, introduced through the World Trade Organisation (WTO) under an agreement known as Trade-Related Intellectual Property Rights (TRIPS) (as an aside – this history of TRIPS is essential reading for both the un-inititiated and initiated!). This makes these original versions of drugs very expensive – over 500 USD for just one course of treatment for both types. Of course, this kind of cost is beyond the reach of most low- and middle-income countries, including in Africa.

As such, somewhat cheaper sub-licenses of both drugs have been facilitated by an international arrangement known as the “Medicines Patent Pool”, with 35 sublicenses for PAXLOVID in 12 countries, and 27 sub-licences in 11 countries for LAGVERIO. The medicines that could be produced under this arrangement are called “generics”. Their cost is significantly lower – as low as 20 or 25 USD in some cases.

However, so far (by June 2022), there are no African manufacturers licensed to manufacture PAXLOVID, but there are at least 4 for LAGVERIO. It can therefore be inferred that this will make PAXLOVID both harder to procure and more expensive in Africa than LAGVERIO.

Further to that, PAXLOVID’s key compound nirmatrelvir takes 7 to 9 months for Pfizer to produce, hence available supplies of the drug are limited and have already been secured by richer countries, a trend we are familiar with for vaccines. As global generic supply is not estimated to pick up until 2023, most supply of these medicines will have to come from Pfizer and Merck. This introduces similar supply constraints as were seen during the vaccine supply bottlenecks of the COVID-19 pandemic lockdown period.

So, where are these two medicines and their ingredients available currently?

The answer: mostly in the United States. Of the 29 million currently available PAXLOVID courses, the US alone has secured 20 million of these – representing nearly 70% of available PAXLOVID treatments; of the 12 million available LAGVERIO doses, the US holds 3.1 million (25%). In comparison, no African country has managed to secure any purchase agreements for PAXLOVID, but at least one African country has a purchase agreement for LAGVERIO – Egypt. It bears mentioning that the 20,000 courses of LAGVERIO Egypt secured barely counts for 0.17% of the available LAGVERIO stock of 12 million courses. However, UNICEF has managed to secure 3 million courses (25%) of LAGVERIO stock, which could be dedicated for use in emergency cases across low-and-middle-income countries, but even these amounts would not be enough to meet all African countries’ needs for COVID-19 therapies.

For African countries, inequities in new therapeutics availability create a dangerous context, with global public health crowd restrictions measures waning, new COVID-19 variants are expected to emerge, and infection/ re-infection outcomes changing unpredictably. As our infographic shows, still today less than 20% of the African population is fully vaccinated, with only 17 (often the relatively richer) countries of the 55 on the continent having vaccinated over a quarter of their populations.

So what next? Our data suggests two key action points:

First, the world must move in the direction of enabling local production by enabling more sub-licencing and generics production, to permit the rapid sharing and proliferation of treatment options for the most vulnerable countries and populations. However, African publics saw a disappointing end to the June 2022 WTO negotiations on a proposal to waive IP rights. In the end, the decision settled on offering limited waivers for vaccines, but excluded trade secrets and manufacturing methods, and deferred waivers for therapeutics and other essential items for another 6 months. Yet, these are literally life and death issues. How many lives will be lost in this 6-month period, or longer?

Second, albeit highly dependent on the above, Africa must grow its vaccine and therapeutics manufacturing capacity, including beyond fill-and-finish facilities to include API production – and build the associated expertise necessary. Not only is there significant economic incentive now for this on the continent, but it will also avoid the effects of richer countries hoarding resources, while improving future access to innovation, such as new treatments and diagnostics for the health challenges of the future.

We’ve set out and explained our data with several enlightening visuals below – have a read, check out the graphics and numbers – do let us know what questions these have raised with you, and what you’d like us to find out next time!


To find out how Development Reimagined can support you, your organisation or government to respond to COVID-19 and other global crises in a sustainable way, please email the team at

Special thanks go to Osaru Omosigho, David Tinashe Nyagweta, Sena Voncujovi, Chenyu Wang and Qiu Yu for their work on the graphics and collecting/analysing the underlying data and preparing this accompanying article.

The data was collated primarily from Africa CDC, as well as other sources including: government websites and media reports, the IMF policy tracker;  Worldometer and the New York Times Vaccine Tracker. Our methodology is entirely in-house, based on analysis of vaccines, testing, spending, social distancing, income categories and other trends.

If you spot any gaps or have any enquiries, please send your feedback to us at , we will aim to respond ASAP!

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Research Analyst

Edmond is a research analyst who is passionate about sustainable development, innovation, and the environment. Passionate about climate financing, he firmly believe there is a more reliable system to promote equality, growth, and welfare in societies without affecting the ecosystem. Through his skills, knowledge and experienced gained over 7 years, he wants to make an impact in the world of development. Edmond holds a Master’s Degree in Public Policy from Korea Development Institute and a BA Degree (Honors) in Business from University of Derby.


    Founder and CEO

Hannah Ryder is the Founder & CEO of Development Reimagined. A former diplomat and economist with 20 years of experience, named one of 100 most influential Africans in 2021, she is also Senior Associate for the Africa Program of the Center for Strategic International Studies (CSIS), sits on the Board of the Environmental Defence Fund, and is a member of UAE's International Advisory Council on the New Economy. Prior to her role at DR, Ms Ryder led the United Nations Development Programme (UNDP)’s work with China to help it scale up and improve its cooperation with other developing countries, including in Africa. She has also played various advisory roles for the UN and OECD and co-authored the seminal Stern Review of the Economics of Climate Change in 2006.


Deputy Director

Leah Lynch is Deputy Director of Development Reimagined (DR), and head of the China office. Leah has over 10 years of experience in development and has lived in China for over 8 years. Leah has also travelled extensively around Asia and Africa for research. Leah supports the strategic direction of the team across China, with a mission to deliver high quality research on sustainable development and poverty reduction. Leah is also Chair of the Sustainability Forum at the British Chamber of Commerce in China, providing direction on sustainability initiatives for British and Chinese business. Leah has also consulted on various evaluations on UK aid (ICAI) and is a specialist on development cooperation from the UK and China. Leah has also consulted on various UN projects, including providing support to the UN China team during the COVID-19 Pandemic. Prior to DR, Leah was at the United Nations Development Programme (UNDP) China, supporting the UN’s portfolio on communication strategies, China’s South- South Cooperation and the Belt and Road Initiative (BRI). Before UNDP, Leah lived and worked in Kenya developing sustainable water policies for the Kenyan government.


China-Africa Policy Analyst

Yike Fu is a Policy Analyst and has been responsible for leading numerous areas of work, including on debt analysis in Africa and beyond, and China-Africa trade and investment logistics and analysis. She is the co-author of “African Debt Guide”, in which she challenged the narrative that Africa is in the midst of a new debt crisis by analysing data back to the 1970s and adopting new metrics to present the real story behind the data. She also developed a benchmark to compare the financial distribution of development partners such as the UK, US, Japan, France and China in Africa. Prior to her role at DR she worked at the International Finance Corporation and African Union Representational Mission to the US. She holds a Masters in International Affairs from George Washington University.


Research Analyst

Judith is a Research and Policy Analyst, where she specialises in Africa-China relations, international development, and diplomacy. During her time at Development Reimagined, Judith has co-authored several articles published in The Diplomat on debt and China-Barbados relations and was quoted by China Daily in a piece on Women Rights in China. Previously, Judith worked as a research analyst for an Advocate and Commissioner and Oats office in Kenya.


Policy Analyst

Ovigwe specialises in geopolitics with particular reference to Africa in a changing Global Order. He is adept at critically analysing the politics of contemporary development processes and providing insight into the geopolitical interests that influence them. His work includes research, publications, tailored briefings and advising on global and regional trends, and issues at the nexus of geopolitics and development. Ovigwe appears frequently in media around the world such as Al Jazeera, TRT World, SABC, CGTN, BBC Radio, and other platforms.


Policy Analyst

Jing leads China-African health and agriculture cooperation research at Development Reimagined, having managed our FOCAC Policy Analysis and Advocacy project. She is also the co-author of “China-Africa Health Cooperation under FOCAC Umbrella”, in which she analysed China’s commitments around health cooperation since the first FOCAC summit and deepdived into four African countries’ health overview, challenges and cooperation with China as cases studies. Before DR, Jing worked at GIZ Cambodia on M&E of a disability advocacy project. She also worked as a translator with Chinese medical team in Benin.


Trade Policy Analyst

Patrick is an International Trade Policy and Trade Law Expert with over 5 years of experience. His expertise includes trade law, trade policy analysis and regional integration. He is currently engaged with Development Reimagined as a Senior Trade Analyst and was the lead author of Development Reimagined's recent Report on Africa-China Relations titled "From China-Africa to Africa- China: A Blue Print for a Green and Inclusive Continent-Wide Strategy Towards China." and “Reimaging FOCAC Going Forward.” Patrick has previously consulted for the East African Community, UNECA and for the Kenya Ministry of Trade.


Senior Policy Analyst 

Rosemary is our Senior Policy Analyst. She is a skilled policy analyst and has previously worked as a UK civil servant. She is studying Human Rights at Birkbeck, University of London with a research focus on international law in the context of health crises such as the COVID-19 pandemic.


Project Manager and Africa-China Communication Assistant

Jade is a Project Manager for Development Reimagined’s flagship project Africa Unconstrained, which focuses on financing needs and debt vulnerabilities of African countries. Her research focuses on China-Africa development finance alongside debt vulnerabilities, infrastructure needs and South-South cooperation. She has worked with a breadth of stakeholders from China, Africa and the wider international community, including governments, private sector, NGOs and civil society. Her writing has appeared in a number of publications, including The Africa Report, The China-Africa Project, The Diplomat and more. Jade holds a Master’s in China and Globalisation studies from King’s College London.


Programme Manager

Rosie is the Project Manager of Africa Reimagined (AR) at Development Reimagined (DR) where she supports high-end African brands with entering the Chinese market by operating services such as trademark protection, Chinese market research, Chinese partnership building, and Africa to China logistical support and import/export services. Rosie has worked with DR for over two years now with proven success in helping high-end African brands navigate the Chinese market. She is extremely passionate about her work because more African brands selling in the Chinese marketplace means African countries can export MORE value-added goods, create MORE jobs and foster MORE innovation in African countries.

Rosie is also alumni of the School of International Studies at Peking University in Beijing where she is also an editor at the Peking Africa Think Tank. PATT is led by a diverse group of scholars who specialise in African Studies within the context of Sino-Africa relations.



Lauren has lived in six countries from the Americas to Europe and Asia and speaks both French and Spanish proficiently. At Development Reimagined, Lauren’s research focuses on climate action both in the Asia-Pacific and in Africa, and how countries are using tools such as SDGs and Covid-19 action to build a more climate-resilient future. She holds a Masters in International Relations from Leiden University.



Etsehiwot holds a Masters’s degree in Development Studies from the London School of Economics. She has diverse experience in humanitarian and development issues by working in both multilateral organizations and international non-governmental organizations. Etsehiwot is currently a consultant focusing on the SDGs and development finance.


Economist Consultant

Dibekulu is an economist by training. He holds an MSc in International Development Studies from Palacky University Olomouc, an MSc in Development Economics from the University of Clermont Auvergne, and an MSc in Economics, Finance, and International Integration from the University of Pavia. At Development Reimagined, he works as an Economist consultant. He has strong data analysis skills, with research interests centring around development finance, impact assessment, food security, and agricultural insurance.


Project Manager

Osaru is a health professional with an MSc in Health Systems Policy and an interest in women’s health and population management. At Development Reimagined, she applies her health sector experience to global health research and collating locally applicable development insights from China.


Research Analyst

Ferdinando’s research at Development Reimagined is centred on South-South Cooperation dynamics, specifically on the analysis of Chinese investment and debt flows in Africa and their linkages to African industrialisation. He is currently a Yenching Scholar at Peking University, after having graduated from the University of Cambridge with an MPhil in Development Studies.


Research Analyst

David is a Research and data analyst at Development Reimagined. His scholarly focus is mostly on interdisciplinary research in demographic economics and development with interests in migration, economic development and policy, education, health and subjective well-being. He is currently a PhD scholar at Nelson Mandela University from which he also holds Economics and Statistics and respectively.


Research Analyst Kenya

Ivory is a Kenyan lawyer with experience in policy research and analysis. She also supports the communications team at DR. Ivory speaks English, Swahili and French.


Research And Data Analyst China 

Joy Ene is a Research and Data Analyst at DR. Joy is passionate about African/global development, poverty eradication and trade policies between underdeveloped and developing countries. She is also a fourth-year student of International Economics and Trade at the  Liaoning University, Shenyang, China. She serves as the President of the Student Union, Liaoning University, International Students chapter.


Research Analyst 

Chensi Li is a research analyst. She has previously worked for local NGOs in Nigeria and Cameroon and think-tanks in China.  Her research areas include Sino-African relations, African foreign affairs, public diplomacy, state-building and national governance.

Yixin Yu

Research Analyst 

Yixin is a Junior Research Analyst and her focus areas is on public-private partnership and entrepreneurship. She has over three years of working experience in both private and public sectors in Ethiopia. She was the China Liaison Officer for project ‘Partnership for Investment and Growth in Africa’ at International Trade Centre, where she accumulated rich experience in investment and trade promotion


Founder and CEO

Hannah Ryder is the Founder & CEO of Development Reimagined. A former diplomat and economist with 20 years of experience, named one of 100 most influential Africans in 2021, she is also Senior Associate for the Africa Program of the Center for Strategic International Studies (CSIS), sits on the Board of the Environmental Defence Fund, and is a member of UAE's International Advisory Council on the New Economy. Prior to her role at DR, Ms Ryder led the United Nations Development Programme (UNDP)’s work with China to help it scale up and improve its cooperation with other developing countries, including in Africa. She has also played various advisory roles for the UN and OECD and co-authored the seminal Stern Review of the Economics of Climate Change in 2006.