The pandemic has exposed the vulnerabilities of African health systems and highlighted the urgent need to improve public health infrastructure and address inequalities in access to vaccines.
The theme of the 75th World Health Assembly being held in Geneva, Switzerland, from 22-28 May is Health for peace, peace for health. This is the first time stakeholders have gathered in person since the onset of Covid.
Speaking at the opening of the assembly, World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus said “the pandemic has demonstrated why the world needs WHO, but also why the world needs a stronger, empowered and sustainably financed WHO.
“I welcome the recommendation of the Working Group on Sustainable Financing to increase assessed contributions to 50% of the core budget over the next decade. I also welcome the recommendation to consider a replenishment model, to broaden our financing base, and to provide more flexible funding for the programme budget.”
“WHO also established the mRNA technology transfer programme in South Africa to support countries to build local manufacturing capacity, using cutting edge technology.”
It is against this backdrop that Global Health Strategies convened a media roundtable with Kelly Chibale, Professor of Organic Chemistry at the University of Cape Town, where he holds the Neville Isdell Chair in African-centric Drug Discovery & Development, to discuss the urgency of Africa building a pipeline of products and robust systems to fight the pandemic and simultaneously deliver on other health outcomes.
Chibale began his talk by noting that the pandemic has exposed the vulnerabilities of African health systems and the urgent need for Africa to improve its public health infrastructure to address the inequalities experienced when people try to access vaccines.
Chibale cautioned that not prioritising this would be at the cost of citizens and that the development of this infrastructure should be seen as an opportunity to think of partnerships, not just for local production, but also to boost investment in science and technology on the continent.
Chibale said there were five key lessons learnt from Covid, namely the need for innovation, intellectual property and technology transfer, strengthening regulatory systems, skills development and partnerships.
On innovation, Chibale told the roundtable this needed to be prioritised and that investing in local innovators was key. He said there was a need to take pride in homegrown innovations that went beyond surveillance and sequencing of products and that health infrastructure should be developed for the production of pharmaceuticals.
“The transfer of IP and technology is important and necessary because it enables the creation of an ecosystem of innovators. When you file a patent, you have the responsibility to move the IP forward for the benefit of the patient,” said Chibale, a point he stressed as critical, since the ultimate purpose of medicines was to assist patients.
He also noted that this needed to be accompanied by the requisite resources to be effective. Chibale explained that a patent needed to be maintained. The cost of moving the process forward and maintaining the patent also extended to its maintenance in multiple other countries where there was a potential benefit.
He emphasised that the process could be costly, with the potential to run into millions of rands.
Chibale said that strengthening regulatory systems was critical because “even if you got a free donation of any vaccine or product, there’s no way it will simply find its way to clinics and hospitals. Sahpra [the SA Health Products Regulatory Authority] has a responsibility to regulate first.
“Many African countries since gaining independence have embarked on massive training efforts, sending their nationals abroad for training. Today, as we speak, we’re still talking about a shortage of skills…
“The Achilles’ heel of everything we do is skills development. If you are given that licence to manufacture a product that is based on a new technology, you won’t be able to implement it immediately — you have to develop the skills.
“So when we think about local manufacturing, it’s more than just getting the licence to the technology… It’s also to train the people with the skills that are needed.”
On partnerships, Chibale was of the view that “there is no way we are going to do this on our own. It’s going to require and take a network of partnerships both at the research and development level, but also a network of funders, academia and government.
“We have to recognise what gaps we have and look for partnerships so that for the sake of the next generation, at some point we will have addressed all the gaps that are in the supply chain of local manufacturing.”
Responding to the issue of IP waivers, Chibale said when the world is dealing with an emergency like Covid-19, it makes sense to waive IP because “if we don’t deal with it in one region, it will spread to the rest of the world, virtually rendering the IP worthless anyway”.
He pointed out there was evidence of pharmaceutical companies who conceded to voluntary technological transfer and IP waiving, such as Merck and Pfizer.
Further explaining the importance of IP, Chibale told the roundtable that it was also a necessary measure of control, or there would be chaos when it came to licensing a product.
“There is an issue of fake products and medicines, and that’s why a regulator is important — so that people cannot take advantage and sell unregulated products for profit.”
Chibale said it was important to be realistic and acknowledge that Africa was not homogenous and that there was a need to think about which countries, regionally, would be best suited based on infrastructure, political stability and good governance, to be a local manufacturing hub.
“We have a long way to go to integrate our systems. Of course, there are very encouraging signs with the Africa free trade zone, but that’s into the future.”
Article published by Daily Maverick here