Main points

• Africa is the region that has suffered most from inequity in the global distribution of Covid-19 vaccines. Limited regional vaccine manufacturing capacity has been a contributing factor.
• Corruption risks are present across the value chain for manufacturing. Pharmaceutical firms are in a position of power, which can be exploited to capture policy for narrow commercial interests. Financial structures, including forms of blended finance, need to be fully transparent to prevent conflicts of interest and the misuse of funds.
• The literature points to registration of vaccines and public procurement processes as being key areas of risk. These systems have been disrupted in the pandemic response. Clearer guidelines are needed in this new context to lower vulnerabilities to corruption.
• Geographic shifts in vaccine manufacture should be accompanied by an increase in transparency. Different groups of actors must collaborate to make more information available for scrutiny, including on the public funding and financial incentives offered to manufacturers to diversify, clinical trial and pricing data, as well as contractual terms.