Africa Needs to Step Up on Preparedness and Prevention of Pandemics
Early this year, a new international partnership — the Coalition for Epidemic Preparedness Innovations (CEPI) — was launched in Davos with aim of accelerating the development of vaccines for emerging infectious diseases in order to prevent future pandemics. Here, we think of pandemics of infectious diseases like Ebola.
An Ebola vaccine was created in 2003 and tested in 2005. It then sat in a freezer until 2016, when it was proven to be a hundred percent effective at preventing infections. The vaccine stalled because it is extremely expensive to develop. It usually cost up to one billion U.S. dollars to test vaccines in large clinical trials and for the whole manufacturing process to take place. Big pharmaceutical companies do not invest in developing medicine for diseases like Ebola which tend to hit poor countries (There is simply no significant return on investment).
The recent outbreak in West Africa, soaring prices of medicines, and the lack of new antibiotics to address the spread of microbial disease are a wake up call to make systematic changes on research and development, regulations, and supply of vaccines and medicines.
CEPI will focus on three diseases within the next five years: Middle East Respiratory Syndrome (MERS), Lassa fever, and Nipah. With up to four hundred and sixty million U.S. dollars — from the Wellcome Trust, the Bill & Melinda Gates Foundation, and the governments of Germany, Japan, and Norway — it will fund the development of vaccines against the likely pandemics of the future, testing them as far as possible, and stockpiling millions of doses. When outbreaks happen, the vaccines will be immediately ready for field-testing and mass-manufacture. GAVI, the Vaccine Alliance similar to CEPI, committed to further develop, license, and stockpile an Ebola vaccine previously owned by Merck & Co., Inc., an American multinational pharmaceutical company.
It is unfortunate that epidemics such as Ebola, Zika, HIV, tuberculosis, Malaria, among many others, are still claiming millions of deaths — an unacceptably high number — in poor countries, particularly in Africa and, even more appalling, that pharmaceutical industries choose to make medicines for profit and not for people.
With these pressing challenges, it can be disgruntling how African countries are not actively contributing to these efforts to design new tools and build systems to fight these diseases and ensure vaccines and drugs are available to the people who need them as quickly as possible. This lack of involvement is even aggravated by many roadblocks that these countries establish in terms of regulatory systems that they, at least, can control if cost of medicines and delivery systems are out of reach. Some drugs would remain inaccessible in most African countries while available in others. In developed countries, a drug may be approved within six months while it might take up to seven years to have it approved in some of our countries.
From my engagements with W.H.O. on health policy in the past three years, I have realised that many African countries choose to simply remain at the receiving end. As the W.H.O. is undergoing a structural change and rethinking bio-medical research and development, African countries should accelerate their efforts to redress the inequity perpetuated by current systems. There is a desperate need to move towards public funding and launch strong initiatives by the “Global South,” especially Africa.
One of laudable Initiatives, the African Network for Drugs and Diagnostics Innovation (ANDi), was launched in Abuja in 2008. The goal of ANDi is to promote and sustain Africa-led product R&D innovation through the discovery, development, and delivery of affordable new tools; including those based on traditional medicines. ANDi also supports capacity and infrastructural development, the creation of a sustainable platform for R&D innovation in Africa to address the continent’s health needs.
However, ANDi has been facing funding challenges. If no funding comes soon, W.H.O. believes, it will have to close doors. Now it's up to African countries to help ANDi as it is promoting innovation in Africa for Africa. This case has also made me very sceptical about how long the recently launched African Center for Disease Control (already understaffed and underfunded) will be sustained if continent remains focused on political matters and gives very little attention to the health sector.
Preventing and curing diseases should be among top priorities for all countries in Africa. Even though national capacities are still inadequate, the best defense is a multi-stakeholder global architecture for pandemic response that integrates public and private partners into a coordinated national, regional, and global response. Hence the obligation to adequately fund and strengthen initiatives such as the ANDi, and the African Center for Disease Control.
There is also a need for significant engagement in the reform of the W.H.O. and its activities, in addition to an extensive participation in collaboration projects such as GAVI and CEPI.
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