Guidance for Awake Prone Ventilation in the non-intubated Conscious Patient

Foreword
It gives me great pleasure to present the Framework for Action (FFA) that the Partnerships for African Vaccine Manufacturing (PAVM) has prepared under the supervision of the African Centers for Disease Control and Prevention (Africa CDC). The Framework for Action sets forth the key diagnostic findings on the current vaccine manufacturing environment in Africa and recommends eight bold programs to unlock Africa’s potential to grow and scale vaccine development and manufacturing over the next two decades.
The African Centers for Disease Control and Prevention and the African Union together have called for a New Public Health Order which will safeguard the health and economic security of the continent as it strives to meet the aspirations of the Agenda 2063. A key pillar of this mandate seeks to expand the local manufacture of vaccines, diagnostics, and therapeutics. Presently, less than one percent of vaccines administered on the continent are manufactured locally. This places a great burden on the health systems of African countries and reduces their ability to respond to pandemics and other health crises.

The Framework for Action answers the call made by the African Union Commission and the African Centers for Disease Control and Prevention at a summit in April 2021 to develop a framework that will enable Africa to manufacture 60 percent of its vaccine needs locally by 2040. The bold programs it outlines will see Africa become more self-reliant as it addresses its vaccination needs.

These programs advocate for implementing an African vaccines procurement pooling mechanism to provide certainty for African manufacturers; strengthening National Regulatory Authorities and Regional Centres of Regulatory Excellence to build vaccine regulatory excellence; establishing a Vaccine Manufacturing Deal Preparation Facility to help manufacturers build compelling business plans for investors and to support project financing for vaccine ecosystem enablers; establishing a Vaccine Technology Transfer & Intellectual Property Brokering Service to link technology providers and recipients to an ecosystem of support for tech transfers; forming vaccine research and development centres and a research and development coordinating unit to manage research conducted on the continent; establishing Regional Capability and Capacity Centres to enhance human capital; and supporting enabling trade policies for vaccines – all guided by a continental strategy with a delivery and oversight mechanism.

The implementation of these bold programs will be Africa-led, with support from the global system, and will demand that key stakeholders and implementation partners including governments, manufacturers, national regulatory authorities, donors, and funders, work in a coordinated manner.
A coordinated approach will enable Africa to achieve its ambitions faster and will foster collaboration between countries and regions. The Framework for Action will complement and build on efforts already begun by certain countries across the continent to expand vaccine manufacturing. This coordinated approach seeks to augment and expand these efforts.
The ambitions of the Framework for Action require governments to commit to its objectives and align with them. The Framework for Action calls for governments to provide increased financial resources, to shift national health priorities where required, and to advocate for enabling policies, all with the goal of making vaccine manufacturing and trade easier within the continent.
The Partnerships for African Vaccine Manufacturing will aim to coordinate and enable partnerships within and between countries and with the global community of supporters, acting as an intermediary and enabler where required.
We recognise that the vaccine manufacturing ecosystem is a dynamic one, and we therefore view the Framework for Action as a “living document” that will be updated on an ongoing basis by the Partnerships for African Vaccine Manufacturing to account for any significant changes that impact the
vaccine ecosystem.

The bold programs that make up this framework were designed by a Task Force composed of volunteer experts and industry leaders from across the continent. These committed individuals met regularly between July and November 2021 to identify the key problems affecting Africa’s vaccine manufacturing ecosystem and worked to develop programs to address them. We appreciate the time and effort the Task Force invested, and we thank the organisations that allowed them to dedicate time to the project. For their own contributions towards drafting the Framework for Action, we also
thank the advisory committee, the scientific peer review group, and all our partners who attended workshops and other engagement forums over the past months and those who funded some of the complex analyses underpinning the framework.
We are embarking on an ambitious and exciting journey that will strengthen African health systems and secure the future of health responses across the continent. This is a time to work together and to support each other as we build a more resilient Africa for current and future generations. We call
on all stakeholders to embrace this journey ahead of us and to play their part in bringing us to ‘the Africa we wish to see’.

Dr John Nkengasong
Director of the African Centres for Disease Control and Prevention