Unlocking Africa's Health Innovation Potential
With African-led innovation in drug discovery lower than other continents, the government has a responsibility to address the barriers that stand in the way of creating an innovation-friendly environment.
IFPMA encourages diverse discussions on global health issues and respects varied views. Here we share the perspectives of Professor Kelly Chibale, University of Cape Town
Africa accounts for 15% of the global population and 25% of the global disease burden (measured as disability adjusted life years) – yet, less than 2% of global clinical trials take place on the continent, mainly in South Africa and countries such as Egypt.
African-led innovation in drug discovery has historically been hampered by a number of factors, including but not limited to the absence of a critical mass of appropriately trained scientists, as well as poor access to infrastructure, enabling technology platforms and expertise. There is a lack of continuity with respect to long-term funding that impacts the sustained pipeline of projects.
The implications warrant serious consideration. At the preclinical stage, there is an absence of relevant tools to aid prioritisation of drug candidates during their chemical lead optimisation phase based on their predicted pharmacological profile in African patients. On the other hand, the African perspectives on intrinsic factors (such as physiology, genetics), extrinsic factors (such as the practice of medicine), and at what point during the stage of a disease (early v late) a patient undergoes treatment are not properly considered during the clinical drug development stages. Furthermore, African clinicians and patients only acquire experience and access to newer therapies much later than those who work and live in the more developed nations.
The barriers to innovation are diverse.
Currently, Africa’s “innovation ecosystem” is severely challenging, and this creates a major barrier to the continent as a whole becoming an attractive destination for the innovative pharmaceutical industry who are the main funders of clinical trials, research and development.
In Africa, shorter timelines and predictability in the clinical trials’ approval process cannot always be guaranteed. Capacity and capabilities to do regulatory quality clinical trials is low and concentrated in only a few centres on the continent – and even these are not very well known to clinical trial sponsors. Finally, a major concern is the ongoing uncertainty around regulatory and ethics approval processes on the continent – a major bottleneck preventing clinical trials being implemented on the ground.
Moving forward, there is no doubt that government has a key role to play in addressing the above barriers and creating an innovation- friendly environment.
On a broader level, it would be encouraging to see border controls for business inside the continent relaxed and more amenable to intercountry exchange of knowledge.
At a country level, global partnership with industry can be fostered when government provides tax incentives to encourage public, private and academic partnerships and sponsorships – the kind that have the potential to take advantage of technology transfers and, separately, enhance retention rates of scientists.
Similarly, government prioritising committed and forward-thinking expenditures in the areas of human capital development, healthcare and IT would undoubtedly assist in laying the groundwork for industry innovation.
Moreover, governments need to invest a higher percentage of GDP on science, technology, engineering and maths (STEM) education beginning at primary school through to university. Singapore, South Korea, China and India have done so and it is largely responsible for them leap-frogging the US and the west more broadly.
This key competitive investment in education ought also to include “coding” being added to the curriculum so that African kids can acquire this skill of taking instructions and translate it into a language the computer understands in order to transform the data into a form suitable for computer-aided analysis. Africa can’t benefit from the digital revolution if African kids are not taught coding at school and university levels.
Further down the pipeline, we need to address regulatory barriers. We need to drive regulatory harmonisation, at a regional and ultimately continent level, as a means to enhance efficiency where not only the workload can be reduced at participating agencies, but different regulatory expertise can be used for the benefit of multiple African countries.
Regional regulatory harmonisation initiatives – the establishment of the African Medicines Agency by the African Union and major projects to support regulatory systems, strengthening from the World Bank, and the Bill & Melinda Gates Foundation in cooperation with the private sector such as the innovative pharmaceutical industry – are significant steps forward in the right direction.
The very same logic should also drive a change in thinking and perspective within the African financial sector, one that promotes the development of venture capital capacity at a local level. This would motivate young African scientists to raise capital and form biotechnology companies without having to literally mortgage their homes, as is now the case. A key to attracting investment and motivating innovators is securing intellectual property rights. African inventors and their partners need to progress with knowledge that their efforts and investments are fully protected within a proper business environment equal to that of any developed ecosystem. It is encouraging that African leaders and politicians have a growing awareness of the importance of intellectual property to boost innovation and progress on the continent. But more still needs to be done.
Innovation by its definition drives creativity and so it is the case in the other direction – creativity can drive innovation.
The University of Cape Town’s drug discovery and development centre (H3D) is perhaps Africa’s best distillation of all these above mentioned factors and offers very useful clues as to the kind of innovation potential that can be unleashed on the continent when vested interests can be coalesced around the same goal.
Founded in 2010 and officially launched in 2011, H3D is focused on developing research platforms that allow for the customisation of medicines to the needs of African patients as well as discovering medicines for diseases that predominantly affect African populations, such as malaria, tuberculosis and antibiotic-resistant microbial diseases.
It does so by strengthening and integrating medicinal chemistry, biology, and pharmacology under one umbrella in partnership with the industry and government. H3D now plays a vital role in the implementation of the South African government’s bio-economy strategy approved by the South African cabinet in 2013. It is solid proof that home-grown African drug discovery using local resources and driven by entrepreneurial and government commitment can become a reality across the continent.
About the author: Kelly Chibale is professor of organic chemistry at the University of Cape Town, the Neville Isdell Chair in African-centric Drug Discovery and Development, South Africa Research Chair in Drug Discovery, and the founder and director of H3D research centre at the University of Cape Town. In 2018 he was recognised as one of Fortune magazine’s top 50 World’s Greatest Leaders.
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