High-income countries’ limited COVID-19 vaccine donations to Africa are prolonging the pandemic and worsening its social and economic impact here. African governments need to allocate more resources to making their own vaccines (J. N. Nkengasong Nature 567, 147; 2019), forming alliances with wealthy Africans and African businesses to build local manufacturing capacity (Nature 592, 487–488; 2021).

With some 200,000 deaths reported so far in a population of 1.3 billion, Africa accounts for 4% of COVID-related deaths worldwide. Just 2.8% of Africans were fully vaccinated against COVID-19 by the end of August (see go.nature.com/2vp7gmw). The situation could deteriorate further as high-income countries embark on booster jabs for their citizens.

Foreign aid to Africa provides treatment and care for prevalent diseases and conditions, such as tuberculosis and AIDS. The continent’s health systems, already badly affected, must not be further crippled by any diversion of this aid into COVID-19 vaccination. In addition to mobilizing its own resources, Africa must seek more donated doses, patent waivers and technology transfer.