Let Africa learn from COVID-19 and focus more on research

by Amref Health Africa

By Josea Rono & Jacinta Wachira

Africa has received 1 per cent of the global supply of 1.3 billion COVID-19 vaccines. This is why the vaccine administration rates in Africa are comparatively lower (0.7 doses per 100 people) than other regions such as Europe (16 doses per 100 people) and North America (27 doses per 100 people).

Further, one in four people from high-income countries have been vaccinated, compared to one in 500 people from low-income countries, many of which are in Africa. The unfortunate reality is that should another pandemic hit the globe, Africa is likely to have the same predicament – receiving the short end of the bargain.

Thanks to modern scientific tools as well as public, private and philanthropic collaborations and investments, what would have taken an average of 10 years in vaccine development was reduced to one year. Countries and regions cross-collaborated effectively to bring down the cost and time it would otherwise take to have the vaccines ready for use. Africa’s contribution, though present, was non-comparable to the grand scheme of things, given its low levels of domestic funding and hence high reliance on donor funding for health research and development (R&D).

Despite being home to 15 per cent of the world’s population and 25 per cent of the global disease burden, Africa accounts for only one per cent of the global investments in R&D and two per cent of the world research output. For perspective, let us compare the quantum of investments from the global leader in medical research, USA, with that of select leading countries in Africa.

Significantly lower

USA invested USD 40 billion in health R&D at a time when South Africa – the leading African country in quantum of investments in health R&D –  invested USD 163 million. Though significantly lower than the USA, the amount is higher than the combined investments made by Kenya, Uganda and Nigeria for the same time period.

A study by PATH and E&K Consulting Firm showed that despite evidence showing investments by the governments to health R&D, most of the money was was used to foot administrative expenses rather than funding direct health R&D costs. The direct health R&D costs were, almost entirely, financed by donors. This was in spite of empirical evidence showing direct correlation between economic growth and increased quantum of R&D investment.

As a result of the dominance of external funders, the research agenda is often prescribed by the donors and as a result, the research is often geared to meet their (donors) priorities. In the context of the Covid-19 R&D, as regions were cross-collaborating to fast track the development of the vaccine, African researchers were under-represented, and experienced sudden cuts of their donors’ budgets.

Early January 2021 when the African Union secured a provisional 270 million Covid-19 vaccines for Africa, the Afreximbank offered to facilitate payments by providing advance procurement commitment guarantees of up to USD 2 billion to manufacturers on behalf of the member states. In perspective, if this amount was redirected to health R&D in Africa, countries such as Kenya, South Africa and Egypt would meet the 2007 African Union pledge of member states  allocating one per cent of their GDP into R&D.

The timely availability of this funding gives indication that governments face the challenge of demonstrating impact within their ruling period and as such, would opt for more concrete initiatives, such as rolling out vaccine programmes, over abstract long-term initiatives such as investing in R&D.

For the continent to be in a better position should a future global calamity occur, there is merit in streamlining the health R&D landscape. One such avenue could be leveraging on the already existing production capacities in select countries, i.e. Egypt, Morocco, Senegal, South Africa and Tunisia.

While this is a downstream occurrence in the R&D value chain, it presents the lowest hanging fruit for Africa to better integrate itself with the global fight against the Covid-19 pandemic. Investments in this section of the value chain will stimulate a demand for backward integration which now includes clinical development, pre-clinical and discovery research.

Training facilities

Additionally, Africa may consider a forward integration approach where it first focuses on expanding its pool of African scientists. This may be achieved through supporting training facilities to promote science and research-related subjects. Additionally, African governments need to prioritise health R&D in their national health budgets and enact policies that identify R&D as pillars of economic development.

The pandemic presents an opportunity for Africa to learn from her past mistakes, and take charge of its future. The golden question is; will she learn?

Dr Rono is a managing partner at E&K Consulting Firm. Ms Wachira is an associate at E&K Consulting Firm

This Article was first published on The Standard.

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