The rapid global response to COVID-19 disease was unprecedented achieving sequence identification to an effective vaccine with shots in arms in less than a year. We also saw rapid development of antibody therapeutics and small molecule antivirals. However due to hoarding in wealthy nations access to vaccines and therapeutics to vulnerable communities globally was limited and delayed. It became evident that Africa had to build its own capacity to manufacture vaccines to avoid being at the ‘back of the line’ when the next pandemic arises. The next emerging viral infection may create a regional epidemic in Africa without incentives for western countries and the pharmaceutical industry to rapidly develop therapeutics. Building the capacity to not only manufacture but also identify potential novel therapeutics and design vaccine immunogens is important for Africa.
The capacity to develop vaccines and immunotherapeutic for infectious diseases requires significant investments in basic immunology research. African countries have rightly called for more vaccine manufacturing on the continent given the experience with access concerns during the coronavirus disease of 2019 (COVID-19). The absence of vaccine manufacturing capabilities on the continent meant that Africa was last in the line for access. Currently there are over 10 efforts throughout the continent to support either end to end manufacturing or fill/finish of vaccine production for a variety of vaccines across different platforms. Although the focus has been on vaccine manufacturing, we would argue that the focus should be broader with a sustainable model built on expanding the local capacity to conduct the basic science discovery research that is the foundation of any drug development endeavour.
Investments in basic and preclinical sciences are required for future pandemic preparedness in Africa. The next pandemic or regional epidemic may come from Africa and may only be restricted to that continent. This may result in reduced socioeconomic and commercial incentives for the pharmaceutical industry to finance and support the rapid development of effective vaccines and therapeutics. It is critical in the current period between this pandemic and a future event to establish the right ecosystem that will support future vaccine development on the continent. This will require local scientists to have the capability to rapidly evaluate the fundamental biology behind a novel infectious agent, identify possible strategies to mitigate the infection including be capable of isolating neutralizing antibodies or designing vaccine immunogens. The global mandate is to be able to develop a vaccine within 100 days to address the next global pandemic. This cannot be achieved if Africa remains the weakest link in the vaccine value chain.
Decades of research into structural biology in HIV and immunology were leveraged to support the rapid development of COVID-19 vaccines. Although there have been decades of research in HIV in Africa, much of that research in the early period focused on epidemiology and later on clinical trials. As the interest in global health and research expanded African scientists often became collaborating sample gatherers and were not involved in crucial elements of study design or the most innovative basic science. To address some of these inequities a few world class laboratories were established on the continent. Unfortunately they were often staffed by western scientists in the lead or African scientists that did not represent by race or gender the populations that they studied. As samples shipment also became unacceptable, where possible technology was transferred. However the analytical capabilities often remained restricted to the partnering western institution. Most of the Africans in the high technology institutions located in Africa were in junior and supporting roles, with few opportunities for career advancement. The science research agenda was not driven by the African scientists or the needs of the communities that they are a part of but by the sponsors and principal investigators.
The COVID-19 pandemic exposed the vulnerabilities associated with this model. Western principal investigators sheltered in place in their home countries and focused on funding opportunities in their own communities. Although the advancements made by the collective scientific community were globally beneficial it exposed the vulnerabilities for Africa. There was limited locally generated and trusted data available for both policy decision making and the development of local solutions. Although there may be a few exceptions and examples of some scientists in Africa who led the local response are available, it is clear that Africa did not take the global scientific lead to develop vaccines and therapeutics to meet local needs. This gap needs to be address by building the capacity and the ecosystem required to support basic research in Africa led by African scientists.
Research efforts must be focused on building the capacity for understanding the virology and immunology of infectious diseases in African populations. We need to take advantage of the biotechnology revolution that has made sequencing and bioengineering cheaper and make it more accessible to African scientists. Young Africans took advantage of the chip revolution and cell phone technology to even the playing field becoming leaders in telecommunications, ecommerce and fintech. We need to create environments where young Africans with ideas to solve biological problems in their own community can come together, leverage accessible technology to engineer biological solutions in health, agriculture, manufacturing and various forms of industry. Let this pandemic be a wake up call so that we use this relative ‘peace’ time era to strengthen the research and biotechnology ecosystem on the continent. This will require robust public private partnerships. Visionary leadership from national, regional and continent wide governments to support researchers and biotech entrepreneurs on the continent.