Global efforts to discover an effective coronavirus vaccine need to include scientific advances made on the African continent, for the good of global health. Infectious diseases have been a leading causes of death and economic losses across the continent for decades, and Africa has become a critical partner in the identification of and search for new drugs and vaccines to fight them. Speed and safety are essential in finding an effective vaccine. But so is inclusive knowledge.
What happened to ubuntu?
Over 40 world leaders came together in a virtual summit Monday, May 4, 2020, to galvanize global efforts to develop a coronavirus vaccine. The summit was organized by the European Commission and co-chaired by Germany, Norway, France, Spain, Canada, UK, Italy, Japan and Saudi Arabia. Also in attendance were Switzerland, the Netherlands, Japan, Israel, Jordan, Turkey, Canada, China, South Africa, and at least 22 other countries.
Curiously enough (or perhaps to be expected), while Saudi Arabia was identified as the current chair of the G20, South Africa was not identified in the press as the current chair of the African Union, a continental body consisting of the 55 member states that make up the countries of the African Continent. Nor were other African nations, or, for that matter, any Latin American nations, identified as present or represented.
This presents a problem, in that
1) Africa is a continent of 55 nations with a wide diversity of scientific knowledge and experience with infectious diseases that can be of immense value in the search for an effective COVID-19 vaccine and
2) South African President Cyril Ramaphosa pledged $1.3 million from his country towards global research into a possible vaccine and treatments for COVID-19 as well as support from Biovac Institute of Cape Town to support the global effort to develop, manufacture and distribute a COVID-19 vaccine.
South Africa is the current ceremonial chair of the African Union, elected by the Assembly of Heads of State and Government for a one-year term. In this capacity, he chairs the biannual summits and represents the continent in various international fora. His role as President of the AU is to use these platforms to create or promote opportunities for wider African involvement in global issues in support of the African Agenda, rather than just his own nation’s economic interests It’s about ubuntu (human kindness), not wetiko (virus of selfishness).
Whatever happens to one African nation happens to all of Africa, and whatever happens to Africa as a whole happens to a single nation, which means that South Africa is African through the other African nations. That is the essence of representing the African Union at international forums like the virtual vaccine summit. Other African Union members would do well to remind South Africa of this.
Recognition and profits reign supreme
The virtual vaccine summit was a call for international solidarity. In the words of UK Prime Minister Boris Johnson, “to discover the vaccine to defeat this virus is not a competition between countries but the most urgent shared endeavor of our lifetimes.” Yet the race for a vaccine is on, as is the aspiration to be one of the front runners for national prestige and huge profits to be made from sales and distribution of the vaccine to resource-challenged countries supported with funds from the wealthier countries who will mass manufacture it.
The concern for public health and the vow to make the vaccine available globally was in clear collision with the underlying spirit of vying for the position of “king of the mountain” of massive profits for whoever wins the race to come up with a successful coronavirus vaccine. Drugs research and development is, of course, very costly and fraught with high risk. So it’s usually driven by market forces and led by private firms, which usually results in wealthier markets being served first because patients can pay higher prices.
But market-oriented vaccine development also carries the risk of being exclusive in the sense of addressing how a virus changes and adapts to different environments. As Denis Chopera, the program executive manager of the Sub-Saharan African Network for TB/HIV Research Excellence at the Africa Research Institute (SANTHE) in KwaZulu-Natal in South Africa, explained, viruses can easily change form to adapt to the environment and evade recognition by the immune system and drugs. It’s therefore crucial to understand all the different aspects and behaviors of a virus.
Sidelining Africa limits COVID-19 vaccine success
The growing global body of evidence from Africa is essential to understand the behavior of the COVID-19 virus outside China. It serves to show how African scientists are using genomics technologies to address health problems specific to Africa, especially infectious disease. It also facilitates outbreak response while reducing the knowledge and economic gaps between the rest of the world and Africa.
If, as Melinda Gates told summit participants, "COVID-19 has reminded us that viruses don't obey borders or customs laws. They don't care about what nationality you are," then why were African pioneers in virology like Nigeria, Senegal, Ghana, Cameroon and Kenya, among others, so conspicuously absent from the conversation? Were they absent by choice or by exclusion?
If scientists outside of Africa are so concerned about the spread of coronavirus in Africa, why is African scientific prowess being sidelined from the global conversation on the search for an effective vaccine? After all, as Munyaradzi Makoni writes in a March 30, 2020 The Scientist, “In recent years, laboratories on the continent have ramped up genomic sequencing capabilities, offering in-country analyses rather than outsourcing the job.”
Scientific progress in African genomic medicine has brought about enormous health, scientific and economic benefits not just for the continent, but for the entire world. The ability to conduct genomic sequencing locally and the availability of sequencing data from infectious pathogens in Africa represents a unique opportunity for identifying new drugs and vaccine targets with enormous value for single country and cross-border disease management and control.
African scientist and experts in virology have made invaluable contributions to global health since the 1970s. Remarkable progress has been made in medical genetics and genomic medicine since the African Center of Excellence for Genomics of Infectious Diseases (ACEGID) at Redeemer University in Ede, Nigeria was created with a 2013 World Bank Grant. So much so, that ACEGID provided the first analysis of SARS-CoV-2 in Africa. ACEGID-established laboratories and researchers are also known for having performed the first diagnosis of Ebola virus disease in Nigeria and Sierra Leone; they were able to track its origin and evolution in West Africa.
ACEGID’s research focuses on characterizing fevers of unknown origins through microbial metagenomics and uses field deployed and state-of-the-art genomics technology to identify the pathogens driving febrile illness. It employs new sequencing technologies and bioinformatics to discover novel pathogens and to develop and deploy new tools for field diagnosis of new and known microorganisms. It is also building human and infrastructural capacity and field-deployable genetics to inform work on microbial infection in Africa, and it is creating a foundation for a critical mass of African scientists to carry out tractable and important genetic research projects entirely in their own country, support the clinical management of the most devastating diseases and enable a surveillance network for some of the world’s greatest health threats.
In Senegal, the Institut Pasteur in Dakar is a reference in Africa. Designated by the African Union as one of the two lead centers for COVID-19 detection, it has trained experts from the continent on how to prepare to manage the pandemic. In addition to now being in the process of validating a point-of-need, rapid and easy-to-use test kit developed with Mologic, a leading developer of lateral flow and rapid diagnostic technologies in the UK, the scientific personnel at the Institute’s secure laboratories are tirelessly researching the virus in “real time”. It is also leading a pan-African effort to expand the already existing network of laboratories of medical research supported by Africa CDC.
African medical research and development is important
In Africa, where infectious diseases are highly prevalent, research on pathogen genomes has enhanced understanding of disease transmission, virulence mechanisms and avoidance of host defenses. African medical research is already enabling the development of new diagnostic tests and therapeutic agents. It is also invaluable for developing new approaches for vector control and gaining understanding of why individuals and populations vary in their susceptibility to infectious diseases.
A whole-of-Africa contribution is critical. This is no time for doublespeak or misplaced paternalisms. Nor is supporting the efforts to develop a global vaccine a platform for projecting power, however real or imagined it is. It is time to lead by listening and learning from others, whether resource-challenged or resource-overbearing.
It is critically important for African scientists and virologists to participate in the development of a COVID-19 vaccine. The contribution of African researchers will ensure wider public understanding of, attitudes to, and understanding of the key role of genomics in modern vaccine and drug design for emerging infectious diseases, such as the novel coronavirus.