This is the 40th post in a blog series to be published in 2021 by the Secretariat on behalf of the AU High-Level Panel on Emerging Technologies (APET) and the Calestous Juma Executive Dialogues (CJED). This blog is a special edition developed in collaboration with the African Medicines Regulatory Harmonisation (AMRH) programme of AUDA-NEPAD

The COVID-19 pandemic has significantly impacted Africa's healthcare in the last two years. The pandemic has had substantive negative impacts and consequences on Africa's socio-economic activities, considerably defining the global health crisis. As of 9 a.m. East African Time (EAT) 2 November 2021, a total of 8,501,503 COVID-19 cases and 218,568 deaths (CFR: 2.6%) have been reported in 55 African Union (AU) Member States (Figure 1). This represents 3.4% of all cases, and 4.3% of all deaths reported globally[1]. Furthermore, apart from the loss of lives, the COVID-19 pandemic has significantly reduced employment and job creation opportunities for an already vulnerable economy.

Figure 1:  New COVID-19 cases reported by day in Africa by African Union region, 15 February 2020 - 2 November 2021[2].

Most importantly, the COVID-19 pandemic has highlighted Africa's inequalities with respect to amplified food insecurity, healthcare and medical care, and the digital divide, among others. For example, the lack of access to essential medical products and technologies has been a tragic reality for numerous African families. This is evidenced by the nearly half a million children in sub-Saharan Africa that die each year from vaccine-preventable diseases, according to the World Health Organisation (WHO).

Furthermore, Africa accounts for approximately 24% of the global disease burden but only contributes to 3% of the global medicine production and imports approximately 95% of its medical product needs. The COVID-19 pandemic has further exposed Africa's vulnerabilities in ensuring access to vital drugs, vaccines, and healthcare technologies. As such, more and more African governments are now viewing the supply of safe, effective, and affordable medicines and vaccines as a national security issue. When China and India paused the production and exportation of medical supplies due to the spread of the virus in their country, most countries around the world, including African countries, experienced shortages of personal protective equipment (PPEs), medicines and vaccines.

Notably, Africa received its first dose of COVID-19 vaccination in March 2021.[3] However, COVID-19 vaccination implementation across the African continent was significantly delayed. Consequently, this exposed the inequality gap that exists between developing countries such as African countries against developed countries such as European countries, Asian countries, and the United States of America. For instance, some reports demonstrated that approximately 70% of all vaccines produced in 2021 were typically pre-booked by a handful of developed countries.[4] This excluded African countries from preferential and unrestricted access to the COVID-19 vaccination.

Further to this, an average of 61 out of 100 people in high-income countries have received at least one dose of the COVID-19 vaccination. In comparison, Africa has observed approximately 10 out of 100 people to have received at least one dose of the COVID-19 vaccination.[5] Africa CDC reports as of 8th November 2021 indicates that 8.9% of the African population have received one dose of the vaccine (Figure 2)

Figure 2: Latest updates from Africa CDC on progress made in COVID-19 vaccinations on the continent[6]

For the African continent to address the global imbalance in vaccine administration worldwide, the African Union Panel on Emerging Technologies (APET) is advocating for African countries to mitigate the limited COVID-19 vaccination programmes strategically. As such, APET convened the 5th Calestous Juma Executive Dialogue between the 22nd and 23rd of September 2021, under the theme: "Effectively Harnessing Africa's Health Research, Investment, and Innovation in Addressing the Pandemic".[7] This 5th CJED assembled high-level stakeholder engagements from across the African continent with a special focus on how health research and enhanced investment towards innovation and emerging technologies can help African countries combat the COVID-19 pandemic. This executive dialogue was organised in collaboration with the Universities of Oxford and Cape Town under the auspices of the Global Challenges Research Fund (UKRI GCRF) Accelerate Hub.

Experts in science, technology, and innovation (STI) and practitioners challenged African policymakers and decision-makers to deliberately harness emerging technologies and African-based innovation to bolster the continent's health research activities. This can be accomplished through robust investment and funding policy frameworks. The idea is that such policy recommendations should adequately address the COVID-19 pandemic effects as African countries are currently rebuilding their economy. Africa's STI experts further advised African countries to incorporate STI-enabled solutions into their national development plans and pursue effective healthcare research and development frameworks. By so doing, African STI experts believe that this can substantially bolster Africa's advancement in innovation and emerging technologies suitable for healthcare service delivery and management. In addition, such efforts will also promote the culture of health research and investment in healthcare innovation and emerging technologies based on local African citizenry.

The COVID-19 pandemic has presented African countries with a unique opportunity to bolster their health innovation and research frameworks. Fundamentally, despite the overwhelmingly negative impacts of the COVID-19 pandemic, African countries have exhibited resilient and innovative solutions towards hastening the continent's COVID-19 pandemic recovery efforts. For example, African countries have started boosting the continent's youth entrepreneurship frameworks. This is meant to allow the youth to innovate and develop life-saving healthcare technologies. Such technologies can be utilised by hospitals and local clinics to combat future healthcare challenges and pandemics. But as it currently stands, experts noted that most African Member States had limited capacity needed to bolster and augment their healthcare innovation and research. This was predominantly because of the limited funding investments towards entrepreneurship and emerging technologies. Therefore, by increasing healthcare investments, African countries will adequately strengthen their healthcare innovation systems and adapt them to rural Africa.

Africa's STI experts further presented that African countries should ensure adequate access to vital drugs administration and vaccination programmes. This can be accomplished through a supply of safe, effective, and affordable medicines and vaccines. However, to bolster the distribution management systems, African countries can utilise digital technologies and mobile clinics to enhance vaccination outreach programmes. As such, African countries should not heavily rely on vaccines, medicines, and PPEs that have been imported from China, Europe, and India. Rather, we should pursue local and continental manufacturing programmes. This will help African countries build national healthcare systems enabled by STI frameworks aligned with the Science, Technology and Innovation Strategy for Africa (STISA-2024), African Union's Agenda 2063, and United Nation's Sustainable Development Goals (SDGs).

Currently, African countries are almost totally dependent on vaccine imports and only produce just about 1% of the vaccines that are currently being administered to the citizenry. As such, during the COVID-19 pandemic, African countries have received most of their COVID-19 vaccine doses through bilateral agreements and the COVID-19 Vaccine Global Access (COVAX) facility. The COVAX initiative was launched in the year 2020 by the World Health Organization, Coalition for Epidemic Preparedness Innovations (CEPI), Gavi (Vaccine Alliance), and the United Nations International Children's Emergency Fund (UNICEF).[8] However, these provisions are inadequately addressing Africa's challenges. Therefore, African countries should develop local capacity to strengthen vaccines and medicine production. On a positive note, as of September 2021, there are at least twelve COVID-19 production facilities (FIGURE 3) set up or in the pipeline across six African countries[9]

 

FIGURE 3: COVID-19 Vaccine Production in Africa as of September 2021[10]

In response to the COVID-19 pandemic, the African Union established an African Taskforce for Coronavirus (AFTCOR) mandated with spearheading the response to COVID-19 under the auspices of the Africa Centre for Disease Control (CDC). The task force was established to essentially support pan-African cooperation so as to promote Africa's leadership and share information on pandemic best practices. Such efforts can help African countries build technical capacity, formulate high-quality policy decision making, and effectively coordinate the detection and control frameworks at African country's borders during the pandemic.

Further to this, the African Union Development Agency (AUDA-NEPAD) has significantly supported the African continent's advancement towards science and technology research, development, and innovation that could bolster healthcare service delivery. This is aimed at finding solutions to Africa's healthcare challenges across the African continent. Some policy and programme interventions included strengthening regulatory systems within African Member States, spearheading health research and innovation, and providing a platform for public-private partnerships and engagements within the healthcare and medical sectors. Moreover, to further combat COVID-19, the African continent has galvanised and participated in developing sufficient healthcare delivery technologies and innovations. These technologies have been piloted in some countries and are progressively being adopted and implemented across the African continent. Such cases studies have helped African countries establish innovative ways and diagnostic technologies to improve Africa's analytical and decision-making processes so as to reduce COVID-19 transmission. Furthermore, several of Africa's local innovators have been progressively developing the manufacturing of PPEs, ventilators, and other life-saving technologies.

For example, some of the interventions include strengthening the regulatory systems in regional economic communities (RECs) and African Union Member States through the African Medicines Regulatory Harmonisation (AMRH) initiative, African Union's Smart Safety Surveillance (AU-3S), and African Medicines Agency (AMA). In addition, AUDA-NEPAD is spearheading the implementation of the Health Research and Innovation Strategy (HRIS) and Pharmaceutical Manufacturing Plan for Africa (PMPA). This includes providing a platform for private sector engagements within the health sector and supporting RECs to establish Regional Health Financing Hubs.

African countries should also leverage Africa's healthcare financial capacity to bolster Africa's supply chains as they are currently reliant on foreign investments. This can adequately help African countries access the relevant COVID-19 medical products such as vaccines, PPEs, and ventilators. In addition, stringent intellectual property regulatory frameworks, including robust technology transfer mechanisms, should be enacted and implemented to ensure the continent's ability to benefit from existing global technologies and innovations. This can improve Africa's capacity concerning local production and manufacturing of medicines and vaccines.

Notably, African countries are challenged to enhance local production and manufacturing of medical products for the pandemic. However, African countries should improve their policy frameworks to facilitate the regulatory frameworks and private sector participation in Africa's health research, development, and innovation. This can provide a conducive environment to benefit the private sector's job creation and youth entrepreneurship opportunities. Thus, African countries should create solid governance structures that will ensure and promote ethical and research integrity. This can, in turn, enhance public trust in Africa's health-related innovation and technological outputs. Consequently, the African public will easily engage in clinical trials and trust the opinions of healthcare authorities across the continent. Hopefully, further engagements with Africa's citizenry can strengthen and harmonise the regulatory systems and ensure high-quality medical innovation and technological products.

It was further recommended that African countries enhance the continent's healthcare infrastructure and pursue regional integration and infrastructure. This can be accomplished by leveraging platforms such as the Economic Community of West African States, the Common Market for Eastern and Southern Africa, and the new African Continental Free Trade Agreement (AfCFTA). Therefore, African countries are encouraged to consolidate their resources towards private sector-led investments in research, development, and innovation to promote trading within regions. Such markets cannot only empower local communities' entrepreneurship but also afford Africans the opportunities to explore local innovative and strategic healthcare solutions. African countries are also challenged to allocate more financial resources to bolster Africa's human skills capacity and basic infrastructure necessary for healthcare facilities. This includes hospitals, clinics, and mobile clinics with the accompanying infrastructure such as communication technology, roads, and medicines.

African countries are further encouraged to pursue vigorous private sector engagements and formulate policy and regulatory frameworks that could improve the business climate for health-related issues. This includes pursuing investment towards augmenting Africa's manufacturing capacity of medical products and technologies across the continent. Fundamentally, African countries can implement long-lasting financial solutions to strengthen a multi-sectoral approach when addressing the continent's healthcare challenges. Thus, Africa should seek long-lasting solutions by involving several governmental ministries of health, education, science and technology, economic development, trade, and finance, as well as other stakeholders such as the private sector, innovators, academia, civil society, and many more.

African countries should also address the industrialisation and trade bottlenecks that are derailing the manufacturing efforts across the African continent. By establishing and strengthening the existing coordination platforms and partnerships at governmental, industrial, entrepreneurial levels, African countries will sufficiently expand healthcare coverage. Additionally, establishing and strengthening coordination platforms and partnerships at governmental, industrial, and private sector levels can enhance the dialogue on investment, human resource development, and innovation. Notably, such efforts will expand health coverage and enhance equity, quality and efficiency in health service delivery. This can also help foster the import and export consortia, provide capacity to negotiate better prices, and secure relevant quantities for health products.

To sufficiently enhance local production of medical products and technologies, Africa's STI and health policy frameworks should be sufficiently revised to relevantly address African challenges. For example, African countries are being challenged to establish institutional frameworks for epidemiological modelling in Africa. This will harmonise the scientific and technological innovation outputs as well as the sharing of best practices among various organisations across the African continent. This will also enable African countries improve the coordination and implementation of the vision for manufacturing of medical products and technologies as outlined in the PMPA framework. Therefore, African countries are encouraged to cooperatively accelerate the implementation of the PMPA framework. This can be accomplished by building on the existing efforts towards facilitating policy and regulatory reforms. These efforts should encompass encouraging the private sector participation in health research, development, and innovation. In addition, African countries should provide a conducive policy environment suitable for investment, trade facilitation, and intellectual property in health-related issues.

Most importantly, African countries should establish and strengthen financial solutions for the continent. Such frameworks can educate entrepreneurs on financing their enterprises at all levels. These institutional financing mechanisms will enhance investment opportunities within the health sector and prevent risky investments. These financial institutions should also develop financial vehicles that are tailored towards private health sector investment. They should also be equipped with strategic methodological frameworks to help assess investment risk, originate loans, and adapt lending products to the health sector.

Some emerging financing instruments have vividly demonstrated the potential to harness private capital towards financing health sector stakeholders. These include financing instruments such as Medical Credit Fund, Open Doors Africa Private Healthcare Initiative, and African Export-Import Bank (Afreximbank) partnerships with other private sector partners. Notably, the global financial technology revolution is envisaged to triple access to financial services in Africa and consequently create a new market of approximately 350 million customers. Financial technology innovations such as mobile money and digital payments are financial instruments and platforms that have demonstrated significant progress in Africa. Therefore, upscaling these within the health sector can help advance Africa's health sector. Furthermore, the development of investment-based crowdfunding platforms can also provide a unique financing opportunity for start-up companies and micro, small and medium enterprises.

The world, including the African continent, has faced a challenging and gruelling pandemic. This has tested not only the healthcare resilience of the African continent but also the socio-economic capacity of the African continent. However, the defining outcome emerging from this pandemic is the lessons learnt. This can be accomplished by sufficiently addressing the lessons learnt from the pandemic. This will determine how African countries can take advantage of the opportunities for future healthcare challenges. This means that African countries should drive and pursue forward innovation, ingenuity, and entrepreneurship that comprehensively addresses their healthcare challenges in Africa.

Finally, APET is supporting the efforts of African countries in exploring better methodologies, practices, innovation, and emerging technologies suitable for sufficiently managing their healthcare frameworks and future pandemics. Notably, tremendous progress has already been accomplished in addressing and fighting the pandemic. However, APET is urging African countries to accelerate their efforts towards effectively harnessing Africa's health research, investment, and innovation frameworks.

To access the recording of this webinar or be included in future webinars of the Calestous Juma Executive Dialogue, please send an email to barbarag@nepad.org.

 

Featured Bloggers – APET Secretariat

Justina Dugbazah

Barbara Glover

Bhekani Mbuli

Chifundo Kungade

 

Featured Bloggers – AMRH

Margareth Ndomondo-Sigonda

Chimwemwe Chamdimba

Julia Kiguru

Paul Tanui

 

 

 

[1] https://africacdc.org/download/outbreak-brief-94-coronavirus-disease-2019-covid-19-pandemic/

[2] The dates are at a two-week interval; the last date is 2 November 2021. https://africacdc.org/download/outbreak-brief-94-coronavirus-disease-2019-covid-19-pandemic/

[3] https://www.who.int/news/item/01-03-2021-first-covid-19-covax-vaccine-doses-administered-in-africa.

[4] https://news.un.org/en/story/2021/09/1100192.

[5] https://theconversation.com/want-to-know-about-vaccine-rollouts-in-africa-click-on-a-country-here-and-find-out-168621.

[6] https://africacdc.org/covid-19-vaccination/

[7] https://www.nepad.org/news/5th-calestous-juma-executive-dialogue.

[8] https://www.brookings.edu/opinions/africa-must-produce-its-own-vaccines/.

[9] https://carnegieendowment.org/2021/09/13/is-there-any-covid-19-vaccine-production-in-africa-pub-85320

[10] https://carnegieendowment.org/2021/09/13/is-there-any-covid-19-vaccine-production-in-africa-pub-85320