This is a slightly modified and edited version of an opinion piece published by the EU Observer on 16 February 2022.
As European and African heads of state gather in Brussels to discuss deepening ties – including the burning issues of equitable access to COVID-19 vaccines and treatments and the need for drug manufacturing in Africa – we, as African and European scientists, believe another issue should feature high on the agenda: the development of robust clinical research infrastructure across the continent.
This is critical, not only to be prepared for future disease outbreaks, but also to support the Summit’s objectives of building lasting prosperity across Africa. Outdated, ‘trickle-down’ approaches to scientific cooperation, inherited from colonial times, will not work. And the EU-AU summit presents a historic opportunity to do things differently by discussing investment in science infrastructure in Africa.
We speak with the confidence of researchers who have witnessed the outstanding achievements of African scientists who, with adequately resourced research infrastructure, have more than proved their capabilities. But throughout the COVID-19 pandemic, we have also observed with dismay the lack of proper global investment and coordination in key areas to address the health needs of African communities. Fewer than 6% of clinical trials for COVID-19 worldwide have been carried out in Africa.
This story is not new. The African continent is home to around 15% of the world’s population and 25% of the global disease burden. Yet only 1.1% of global investment in health research and development (R&D) is spent in Africa.
This imbalance increases the risk of a ‘brain drain’ of Africa’s talented scientists, who may have no choice but to exercise their skills outside the continent in research environments with better funding and more modern equipment.
It’s time to turn the tide.
COVID-19 has highlighted the importance of building African clinical research infrastructure to support pandemic response and preparedness. The African Centers for Disease Control (CDC), based in Ethiopia, has played a major role in coordinating pandemic control efforts. We have seen how those African countries with strong medical research capacity were better able to respond to COVID-19. For example, Botswana was the first country able to detect the emergence of the Omicron variant, thanks to its sequencing capacities.
The European & Developing Countries Clinical Trials Partnership (EDCTP) funded the setup of the African coaLition for Epidemic Research, Response and Training (ALERRT) and the Pan-African Network For Rapid Research, Response, Relief and Preparedness for Infectious Disease Epidemics (PANDORA-ID-NET) after the Ebola crisis. These networks dedicated to research in epidemics have proven useful in marshalling forces to conduct important research in Africa and support the COVID response.
That is why investing now to strengthen African-based, African-led collaborative research platforms is a smart move. True global pandemic preparedness requires robust infectious disease surveillance and control networks everywhere on the globe, including in low- and middle-income countries. Bolstering African research infrastructure will allow the continent – and the world – to respond more effectively when faced with the next infectious threat.
The good news is that African medical research expertise and experience is plentiful; too often missing, however, are the resources and platforms needed to bring that talent together.
For those diseases for which such platforms do exist, there has been an impressive track record of success. An outstanding example is the response to the 2014-2016 Ebola crisis in West Africa, which saw African and global networks mobilizing quickly to conduct robust vaccine research in one of the most difficult social and medical environments ever faced by researchers. Vaccine trials in Guinea, Liberia and Sierra Leone, for example, were conducted in the most trying circumstances but deployed pioneering research, paving the way for safe, effective and widely accessible Ebola vaccines in the future.
Or take the Democratic Republic of Congo (DRC), where scientists have carried out clinical trials to the highest international standards in extremely remote areas and under challenging conditions. The game-changing drugs they developed for a neglected disease called ‘sleeping sickness’ have helped the DRC to envision the elimination of a disease that killed hundreds of thousands in the past century.
The ANTICOV consortium is another collaborative medical research initiative in Africa, now testing treatments for patients with mild-to-moderate COVID-19 across 13 African countries with researchers from leading African institutions in the driver’s seat.
ANTICOV could be seen as an example of the wider research platforms that we are calling for to connect science and public health institutions, ensure research is relevant to the needs of different countries, support faster development of treatments and testing tools, and later provide rapid response to future disease outbreaks.
From past successes, we believe that building such a clinical network is within our reach. However, to be sure of achieving this, we need to see sustained investment in the human and technical resources needed to ensure platforms can be flexible, autonomous, able to respond promptly and effectively to emerging outbreaks, and capable of supporting efforts to tackle ongoing health priorities across the continent.
We see enormous competence and commitment among African scientists, but also the frustration and anxiety that comes with not having all the tools needed to respond to future health crises. With dedicated resources and political will, we believe the future of medical research on the continent can be bright.
We need European and African decision makers gathering this week in Brussels to see and harness this potential, to promote scientific excellence, and contribute to a shared healthy future for us all.
By Samba Sow (Director of the Center for Vaccine Development in Bamako, Mali), Marie-Paule Kieny (Director of Research at INSERM in Paris, France), John Amuasi (Group Leader of the Global Health and Infectious Diseases Research Group, Kumasi Center for Collaborative Research in Tropical Medicine, Ghana), Serge Eholie (Head of Infectious Diseases at Treichville University Teaching Hospital in Abidjan, Côte d’Ivoire), Francine Ntoumi (Founding Director of the Congolese Foundation for Medical Research in Brazzaville, Republic of Congo), Jürgen May (Chairman of Bernhard Nocht Institute for Tropical Medicine in Hamburg, Germany), Dieudonné Mumba (Head of Parasitology at the National Institute of Biomedical Research in Kinshasa, RD Congo), Bernhards Ogutu (Chief Research Officer at the Kenya Medical Research Institute in Nairobi, Kenya), Nathalie Strub-Wourgaft (Director at the Drugs for Neglected Diseases initiative in Geneva, Switzerland), Marc-Alain Widdowson (Director of the Institute of Tropical Medicine in Antwerp, Belgium) and Yazdan Yazdanpanah (Director of ANRS Emerging Infectious Disease Funding Agency in Paris, France)
Photo credit: Kenny Mbala-DNDi