Overcoming CMC, manufacturing, and supply chain challenges in vaccine production: a review of efforts in the Global South, with a focus on Africa

This article investigates the challenges and potential solutions associated with establishing robust and resilient vaccine manufacturing and supply chains in low- and middle-income countries (LMICs). While these regions face significant constraints in manufacturing capabilities and supply chain logistics, they also present unique potential for scaling up global vaccine manufacturing capacity and, therefore, achieving global health security, equitable access and rapid response in outbreak situations. The article explores the technical, infrastructural, and financial barriers that hinder vaccine manufacturing in LMICs, including limited technical know-how, lack of skilled workforce, and insufficient funding. It also examines supply chain pain points for input materials and distribution of finished goods in these regions. The review highlights successful case studies and innovative approaches being employed, particularly by the Coalition for Epidemic Preparedness Innovations (CEPI) and partners, to overcome these challenges. By addressing the critical need for capacity building and international collaboration, the article aims to provide a comprehensive understanding of the current landscape and prospects of vaccine manufacturing in the Global South.