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Don't Sacrifice Africa to Kowtowing

· Africa

Today the region south of the Sahara Desert has begun to shake off the impact of external and extraneous players on scientific productivity. It is harnessing its own potential to develop its proper technological and scientific advancement.

African science, technology and savoir-faire has gained momentum

There is much to celebrate in the new knowledge being produced by African scientists, both men and women (three out of 10 sub-Saharan researchers are women), at home and abroad. This has been evident in the banking and information and communication sectors. But African scientists are also doing remarkable work and making significant advances in critical areas, such as astrophysics, malaria, HIV/AIDS, agricultural productivity, and oceanography.

The overall contribution might be small compared to richer and more resourced countries like the U.S., France or the United Kingdom. But high quality and important research is happening across Africa, and the range of research being undertaken is remarkable. Also notable, and of great significance, is that irrespective of the disciplines involved, the research is tackling both international concerns and those specific to the African continent and its people’s needs.

But, as I wrote in a previous article, Africa is not a passive subject. It is a trailblazer during the COVID19 pandemic, not a passive subject for others to take or make. It is demonstrating that it’s not just the Western world that has the scientific know-how to beat the virus. So afro-pessimism and kowtowing to others are unwarranted, outmoded and inexcusable.

That is why it was so disappointing that, during the April 28, 2020 Atlantic Council virtual discussion 

on the African response to COVID19, the Africa CDC Director made no mention of the valiant successes achieved in Senegal and South Africa to develop home-grown COVID19 testing capacity.

Africa CDC through the looking glass

According to the Africa CDC, Africa needs more than 15 million test kits over the next 6 months. In this regard, Mr. Nkengasong identified three main sources of test kits: 1) in-house tests from Germany, from whom Africa CDC recently purchased 1 million, 2) kits from China donated by the Jack Ma Foundation, who has already provided 1 million kits (20,000 per country) and is sending 500,000 more shortly, and 3) essential supplies, including personal protective equipment, diagnostics and medical equipment provided through the Global Pandemic Supply Chain Network, a public-private collaboration effort jointly created by the World Health Organization (WHO) and World Economic Forum to drive the emergency supply chain.

But Mr. Nkengasong did not mention the trailblazing expertise used by the Institut Pasteur in Dakar, Senegal in early March, in partnership with Mologic (UK), to develop a COVID-19 diagnostic test that can be done at home and produce results in as little as 10 minutes - all for $1. The kit is now in the validation phase. Once it is ready, and if it meets regulatory standards (whose standards are to be met is a question to be explored), it will be manufactured in the UK and at a new Dakar-based facility managed by DiaTropix, a subsidiary of the Pasteur Institute that focuses on infectious disease testing.

As reported by Aljazeera, according to Amadou Sall, the Institute’s director, the Dakar site will have an initial capacity to produce up to four million tests annually and could be distributed across Africa as early as June. Other local manufacturing sites are also slated to be set up in other parts of the continent.

In South Africa, two techpreneurs - Daniel Ndima and Dineo Lioma of CapeBio, an applied genomics company - have created a trailblazing COVID-19 test kit that provides results in just 65 minutes. These African trailblazers develop and manufacture molecular biology reagents, enzymes, and kits sourced from indigenous African microbial hotspots.

Don’t ignore, discount or demean African-made advances and successes

The COVID19 pandemic will, of course, wreak havoc across Africa, as it is across America and Europe and Latin America and the Middle East and Asia and everywhere in between. And because Africa is still in the early stages of the spread, utmost vigilance and preparedness have been the order of the day for all African governments.

The response to the global health crisis unquestionably, in Mr. Nkengasong’s words, “requires global solutions and global solidarity to address it.” It’s commendable that the African Union from the very outset started gearing up for partnerships across sectors. And, yes, multilateral partnerships and vital knowledge-sharing are critically important.

But Africa’s fighting chance to come out ahead of the worst onslaught from the virus and overcome its after-effects begins at home. It begins by recognizing the advances made by African scientists and laboratories, by bolstering African policy and strategy and by rallying support from multilateral institutions and the mainstream international media, instead of excluding them from the whole-of society approach advocated by the head of Africa CDC. Not including African-made advances and successes in addressing the advance of the pandemic on the continent is an effective way of ignoring, discounting and demeaning them in favor of questionable external solutions.

Africa certainly needs effective partnerships and constructive agreements with the United States, but also with Europe and China and Japan and whoever else can provide meaningful and constructive aid and support. The United States cannot be the only or main partner to help Africa avoid the U.N. Economic Commission for Africa (UNECA)’s predicted 300,000 deaths and protect a predicted 27 million people from being pushed into extreme poverty due to coronavirus”.

It is, of course, just a possible scenario. While the UNECA report is very informative and provides a bird’s eye view of the problems, gaps and deficiencies, it says nothing about how the calculations for death and poverty were made. Nor does it include a section on the impact of African progress with detection, testing and tracing, as well as treatments and development of a vaccine (again, the Institut Pasteur in Dakar, Senegal is applying its scientific know-how in this effort.

Don’t be naïve

The relationship between the US government and Africa CDC may be longstanding, as pointed out by Hon. Jessye Lapenn, US ambassador to the African Union. But the fact is that the lack of a whole-of-America approach to the pandemic in the United States, along with the by now evident incompetence of government intendants (at all levels) and the cut-throat competition among states and between states and the federal government for life-saving and protective equipment, doesn’t really provide a very good basis for a constructively contributing partnership with America to help Africa address this current crisis.

Perhaps the Africa CDC Director was catering to the institution that was hosting the conversation. After all, in an April 17, 2020 Atlantic Council blog reflected the generalized American-focused doom-and-gloom view of the pandemic in Africa.

The Atlantic Council blog on barriers to mass testing for COVD-19 in Africa argued that the breakthrough made by Senegal in developing a $1 rapid-testing kit will just not cut it alone. It emphasized that the “need for quick and low-cost tests is immediate and immense but laboratories are still too slow and often understaffed.” It then added that, anyway, the kit will likely not come in time, whatever that means. “Beyond these top-line concerns over supply, other imminent challenges to mass testing include logistical constraints surrounding access to rural and densely populated urban areas, limitations on healthcare personnel and facilities, distrust of healthcare workers, and stigma associated with the virus itself.”

But let’s not be naïve. Encouraging pivotal partnerships also entails helping nations who are actively and pressingly courting Africa now to get a head start in securing a piece of the post-COVID African pie. It is therefore behooves leaders like Dr. Nkengasong to lead responsibly and without blinders. Such partnerships can certainly become an operating tool to obstruct collaborative and coordinated African non-random and carefully developed policies designed in benefit of Africa first so they can deliver in benefit of others first. And they will certainly be instrumental in establishing the bases for a just-in-time control of the unlocking of the supply chain for the continent.

Of course there’s distrust in Africa of foreign-imported health solutions. African countries have for decades been sites for clinical trialsby large pharmaceutical companies, in violation of leading ethical guidelines and the Declaration of Helsinki. There have been numerous claimed and prosecuted incidents of unethical experimentation, clinical trials lacking properly informed consent, and forced medical procedures: from meningitis in Nigeria, to HIV/AIDS and forced contraception in Zimbabwe, to forced sexual reassignment in South Africa, to infectious and vector-borne diseases experimental treatment in Gambia. So when two French doctors had the gall to suggest on TV that Africans be used as guinea-pigs for COVID-19 vaccine trials, it’s no wonder that an international and a continent-wide “NO” was ardently voiced against what WHO Director General Dr Tedros Adhanom Ghebreyesus, Ethiopian, called a hangover from the "colonial mentality".

Yet the Director of Africa CDC seems to still be thinking with that colonial hangover mentality. He did, to his credit, emphasize that the African response must be contextualized. He also pointed out that success depends on a whole-of-society approach, with a focus on 1) community-led and owned response, with community leaders and champions undergirding a strong sociological response that supports public health efforts and 2) widespread tracing, testing and tracking. But in the Atlantic Council discussion he exclusively promoted looking to the U.S. and other external players to take the lead in rolling out Africa’s response to COVID-19.

Promote the PACT instead of kowtowing to others

Of course a testing kit will not cut it alone, in Africa or anywhere else. But that’s precisely the importance of Africa’s new Partnership to Accelerate COVID-19 Testing (PACT) for CDC-T3 (Trace, Test & Track). This initiative was recently launched by the African Union Commission and the Africa Centers for Disease Control and Prevention (Africa CDC) with the aim of strengthening capacity to test for COVID-19 across Africa.

The mission of the PACT partnership is driven by the principles of cooperation, coordination, collaboration and communication to facilitate implementation of the Africa Joint Continental Strategy for COVID-19. Needless to say, those very principles are absent in the U.S. chaotic efforts to shape its response to the pandemic.

PACT was endorsed by African Ministers of Health on 22 February 2020 in Addis Ababa, Ethiopia and approved by the Bureau of the Assembly of the African Union Heads of State and Government on 26 March 2020. The goal of the continental strategy is to prevent severe illness and death from COVID-19 infection in African Union Member States and to minimize social disruption and the economic consequences of COVID-19. Emphasis is on countries that have only minimal capacity. This will ensure that at least 10 million Africans, who would have not been tested, get tested in the next six months.

According to Matshidiso Moeti, the World Health Organization’s Africa region head, all 47 member states will have the facilities to diagnose the virus in the next couple of weeks. At the beginning of the year, only Senegal and South Africa already had facilities in place. By March, 33 countries in the region had facilities in place. By the beginning of May, the entire sub-Saharan region will have testing capacity. More than 1 million coronavirus tests will be rolled out starting beginning of May to address the “big gap” in assessing the true number of cases on the continent.

In comparison, the United States has no national strategy, widespread testing is still proving elusive, and continued glitches in the U.S. testing system threaten impede it. In fact, the FDA is still in discussions with the White House about whether changes to the testing criteria are warranted.

Meanwhile, U.S. labs are undergoing huge efforts to retool for COVID-19 testing. However, even commercial giants like Quest and LabCorp are being held up by regulatory, logistic and administrative obstacles. They are also stymied by the fragmented US health-care system and supply shortages or because hospitals won’t send them samples. They are performing at half capacity while demand continues increasing. And the results take 12-24 hours.

Would that the U.S. took its cue from Africa to get its act together and its capacity in working order! The U.S. has now passed 1 million confirmed COVID-19 cases and will very soon exceed 60,000 reported deaths.

Astrid Ruiz Thierry, Principal, Upboost LLC

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