Across Africa, health security is no longer just about access to medicines, but about the ability to produce them. As countries rethink their place in global supply chains, conversations around vaccines are shifting from donation and importation to capacity, science, and sustainability. At the center of this shift is a growing focus on local manufacturing and long-term preparedness. In Nigeria, this conversation has gained new momentum following recent engagements between Nigerian and Russian stakeholders on vaccine cooperation. Beyond diplomacy, the issue touches on something deeper: how Africa can move from being a consumer of lifesaving tools to becoming a producer of them.