Early June, Mali enrolled its first patient in the ANTICOV clinical trial, a pan-African collaborative scientific study whose objective is to find treatments that can prevent mild-to-moderate COVID-19 cases from becoming severe.

The Principal Investigator of the ANTICOV trial in Mali is Dr Samba Sow. He is a medical doctor, epidemiologist and Director of the Centre pour les Vaccins en Développement (CVD-Mali) du Ministère de la Santé du Mali, a public organization doing research and training on infectious diseases.

Dr Sow is a widely-recognized public health authority in the region: he was Minister of Health and Public Hygiene for Mali from 2017 to 2019 and was appointed in 2020 WHO Special envoy for COVID-19 in West Africa.

Dr Sow, what is the impact of the COVID-19 pandemic in Mali right now, in June 2021?

It is having a huge impact, not only in our daily lives but also on the delivery of primary care and on our healthcare system – which were already under major stress. We were not ready for such an emergency. Key health care activities such as maternal and child health, prenatal visits, childbirth, etc., delivery of treatments for tuberculosis, HIV, leprosy, malaria, or national programmes such as the one against blindness have been disrupted.

The repercussions on public health will be frightening and I am very worried for the future. To rebuild our healthcare system, it will require lots of time, efforts, energy, and collaborations.

I am also concerned by the attitude of many Malians, who seem to think that since vaccines now exist, the pandemic is over. The exact contrary is happening – it is getting worse. An aggravating factor is that our screening and pandemic surveillance activities are not working properly, which means we have trouble to evaluate the epidemiological situation.

What should be Mali’s answer to this massive public health crisis?

We need to open as many collaborations as possible. In the global fight against infectious diseases, a country can never go alone. Even a continent cannot go alone. The answer should be global. This is why ANTICOV is so important.

Even the most remote places, from every corner of the world, must join this global effort as early as possible, from the research phase, to become part of the solution. This is what my own country, Mali, must do.

We can see that vaccine research, for example, started in countries with high incomes and that this effort converted very fast into public health responses. The more deeply a country is involved in medical research, the easier it is to rapidly develop a response – because the results from this research are informing recommendations, policies, and public health decisions. If you do not conduct research from the start, you end up at the back of the queue. This is why Mali joined ANTICOV.

Could you explain your role in the ANTICOV trial?

I am the principal investigator, which means I am in charge of following, coordinating, and supervising all scientific, technical, administrative, and communication activities of the trial. A principal investigator is a linchpin of the trial and must spend a lot of time on the field, to work with his team and talk to the communities. A principal investigator cannot do anything without a strong team, and I am lucky to have one! Approximately 40 people are working directly on the ANTICOV trial in Mali.

What are your expectations for the trial?

It is critical that ANTICOV succeeds. A success will be crucial for Mali and for all Africa – not only for the 13 participating countries.

ANTICOV’s objective is to find treatments for mild to moderate cases of COVID. These  are the most frequent cases we are seeing, and they are fuelling most community transmission. The number of beds in intensive care units in Mali is very limited, which means we must cure patients before their symptoms become severe. This is why this study is important.

Today, when we are talking treatments or vaccines, Africa is not in a good position. It is very important that Africans and African research organizations join the global effort to conduct trials.

How you do gain trust with your communities, to ensure that they will participate in the trial?

This is a very important question.  Without communities’ trust and support, even with the best study protocol of the world, you will go nowhere.

Fortunately, at the CVD-Mali, we are working closely and very early on with communities: we discuss with them the trial protocols as soon as they are approved. In every village, neighbourhood, or ‘commune’ we meet with representatives such as traditional or religious leaders, presidents of cultural, youth or women associations, etc.

Sometimes, during those meetings, people express doubts and have difficult questions. So we open our labs to them, we show them what we do with the samples we collected, we explain them the drugs we will distribute. These are truly transparency operations.

This is how we can convince communities that they will be the first to benefit from the research we do with them.

Photo credit: Kenny Mbala-DNDi, CVD-Mali