Covid Vaccines Produced in Africa Are Being Exported to Europe

Johnson & Johnson’s Covid vaccine was supposed to be one of Africa’s most important weapons against the coronavirus.

The New Jersey-based company agreed to sell enough of its inexpensive single-shot vaccine to eventually inoculate a third of the continent’s residents. And the vaccine would be produced in part by a South African manufacturer, raising hopes that those doses would quickly go to Africans.

That has not happened.

South Africa is still waiting to receive the overwhelming majority of the 31 million vaccine doses it ordered from Johnson & Johnson. It has administered only about two million Johnson & Johnson shots. That is a key reason that fewer than 7 percent of South Africans are fully vaccinated — and that the country was devastated by the Delta variant.

At the same time, Johnson & Johnson has been exporting millions of doses that were bottled and packaged in South Africa for distribution in Europe, according to executives at Johnson & Johnson and the South African manufacturer, Aspen Pharmacare, as well as South African government export records reviewed by The New York Times.

Dr. Glenda Gray, a South African scientist who helped lead Johnson & Johnson’s clinical trial there, said companies needed to prioritize sending doses to poorer countries that were involved in their production. “It’s like a country is making food for the world and sees its food being shipped off to high-resource settings while its citizens starve,” she said.

Many Western countries have kept domestically manufactured doses for themselves. That wasn’t possible in South Africa because of an unusual stipulation in the contract the government signed this year with Johnson & Johnson. The confidential contract, reviewed by The Times, required South Africa to waive its right to impose export restrictions on vaccine doses.

Popo Maja, a spokesman for the South African health ministry, said the government was not happy with the requirements in the contract but lacked the leverage to refuse them. “The government was not given any choice,” he said in a statement. “Sign contract or no vaccine.”

Johnson & Johnson had always planned for some vaccines produced by Aspen to leave Africa, but it has never disclosed how many doses it was actually exporting. The export records reviewed by The Times shows that Johnson & Johnson had shipped 32 million doses in recent months, although that does not capture the full number that have left South Africa.

Germany in April received shots produced by Aspen, a spokesman for Germany’s health ministry said. In June and July, Spain received more than 800,000 doses, according to the country’s health ministry.

Critics say the shortfall in South Africa partly reflects a power imbalance between a giant company and a desperate country.

“The disproportionate amount of power that Johnson & Johnson has exercised is really concerning,” said Fatima Hassan, a human rights lawyer in South Africa. “It is harming our efforts to get speedy supplies into the system.”

The picture is bleak across the continent. While several African countries last week received small initial shipments of Johnson & Johnson doses, it is a sliver of the 400 million doses that the African Union has ordered or has the option to order for its member countries. About 2 percent of Africans are fully vaccinated.

Johnson & Johnson’s chief scientific officer, Dr. Paul Stoffels, said the Aspen plant is part of a production network in which vaccines are routinely shipped between countries for manufacturing, quality inspection and delivery.

“We have done our best to prioritize South Africa as much as we can,” he said. He noted that Johnson & Johnson early this year provided about 500,000 doses to vaccinate South African health care workers. He said the Aspen plant would exclusively supply doses to African countries later this year.

Aspen is responsible for the final stage of vaccine production, a process known as “fill and finish.” The company receives mass quantities of the vaccine, bottles it into vials and then packages it for final inspections and delivery.

Some of Aspen’s doses never got used because of worries they might have been contaminated at the Baltimore plant that handled their first stage of production, according to Johnson & Johnson and Aspen executives. The problems at that plant, run by Emergent BioSolutions, wreaked havoc on Johnson & Johnson’s vaccine supplies, leading the company to fall behind on orders all over the world.

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Stephen Saad, Aspen’s chief executive, blamed the lack of South African doses on the Emergent plant. He said Aspen cannot control where its doses are sent, but “I would have liked to see it all go to Africa.”

Aspen is now finishing doses that were made at a plant in the Netherlands, with 40 percent of those doses going to Europe and the remaining 60 percent to Africa through the end of September. Previously, the plan was for only 10 percent to go to the continent, but the European Union agreed to change the distribution in light of South Africa’s crisis, said Daniel Ferrie, a spokesman for the European Commission.

South Africa’s vaccination campaign has accelerated in recent weeks, thanks largely to Pfizer doses ordered by the government and shots donated by the United States. But about four million of the country’s 60 million residents are fully vaccinated.

That left the population vulnerable when a third wave of cases crested over the country. At times in recent months, scores of Covid patients at Helen Joseph Hospital in Johannesburg were waiting in the emergency department for a bed, and the hospital’s infrastructure struggled to sustain the huge volumes of oxygen being piped into patients’ lungs, said Dr. Jeremy Nel, an infectious disease doctor there.

“The third wave, in terms of the amount of death we saw, was the most heartbreaking, because it was the most avoidable,” Dr. Nel said. “You see people by the dozens dying, all of whom are eligible for a vaccine and would’ve been among the first to get it.”

Critics say South Africa’s government shares blame for the low rate of vaccinations. Early on, the government relied on a United Nations-backed clearinghouse for vaccines that has fallen behind on deliveries. South Africa was slow to enter negotiations with manufacturers for its own doses. In January, a group of vaccine experts warned that the government’s “lack of foresight” could cause “the greatest man-made failure to protect the population since the AIDS pandemic.”

Johnson & Johnson’s deal with Aspen was announced last November. Aspen’s facility in Gqeberha, on South Africa’s southern coast, was the first site in Africa to produce Covid vaccines. (Other companies subsequently announced plans to produce vaccines on the continent.)

Understand the State of Vaccine and Mask Mandates in the U.S.

    • Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
    • Vaccine rules . . . and businesses. Private companies are increasingly mandating coronavirus vaccines for employees, with varying approaches. Such mandates are legally allowed and have been upheld in court challenges.
    • College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
    • Schools. On Aug. 11, California announced that it would require teachers and staff of both public and private schools to be vaccinated or face regular testing, the first state in the nation to do so. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.  
    • Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
    • New York. On Aug. 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required of workers and customers for indoor dining, gyms, performances and other indoor situations, becoming the first U.S. city to require vaccines for a broad range of activities. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
    • At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.

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