Africa must plan for global pan­demics

Business Day - - LIFE - Morena Makhoana Makhoana is CEO at The Bio­vac In­sti­tute.

The Ti­tanic had enough lifeboats to ac­com­mo­date fewer than half of the peo­ple on board. It doesn’t take much to imag­ine the scale of that hor­ror: the re­main­ing men on board shov­ing, push­ing and fight­ing to get into that last lifeboat as the ship listed.

Such is the hu­man con­di­tion. When your life is on the line, the pri­mor­dial re­sponse is to do any­thing to save your loved ones and your­self first.

Now hold that thought and con­sider a dev­as­tat­ing global in­fec­tious dis­ease and the same pri­mor­dial re­sponse at a macro level — ev­ery coun­try, rightly so, fend­ing for their own first.

One ef­fec­tive weapon that will surely be used will be a vac­cine to pre­vent fur­ther trans­mis­sion. But will there be enough lifeboats for all 7-bil­lion peo­ple on Earth? There is no doubt that self-pre­serv­ing na­tion­al­is­tic ten­den­cies would kick in even be­fore a pan­demic was of­fi­cially de­clared. Every­one else would sim­ply have to wait in the hope they were high enough in the order of pri­or­ity of those that not only had the ca­pac­ity to pro­duce vac­cines, but that were will­ing to share.

Just imag­ine that wait: ter­ri­fied and de­fense­less, much like the sink­ing Ti­tanic.

Re­mem­ber the re­cent Ebola out­break and the Zika virus? And re­mem­ber how preg­nant women were the most af­fected group dur­ing the 2009 H1N1 flu pan­demic? In SA, the high bur­den of HIV in­fec­tion com­pounds the chal­lenges. In an in­terim re­port of H1N1-as­so­ci­ated deaths dur­ing 2009, more than 25% of deaths oc­curred in preg­nant women.

SA re­ceived the nec­es­sary vac­cines from over­seas only in

March 2010 — nearly a year af­ter the ini­tial out­break started claim­ing lives.

Bill Gates is among a grow­ing num­ber of world lead­ers who have ex­pressed con­cern that the world is not ready for a pan­demic. He is right to ar­gue that sys­tems for re­spond­ing to a

global emer­gency are still not strong enough.

His con­tention is that the jus­ti­fied source of stress has shifted (since he was a child) from the risk of nu­clear war to a threat of an in­fec­tious virus that could kill more than 30-mil­lion peo­ple in less than a year.

Know­ing this, surely it is in­cum­bent to plan for that pos­si­bil­ity and safe­guard the health of the na­tion and con­ti­nent?

The only African coun­tries where hu­man vac­cine pro­duc­tion — al­beit lim­ited — ex­ists are SA, Sene­gal, Egypt and Tu­nisia; four out of 54 coun­tries that are likely to be the most af­flicted by such an out­break.

But what is the like­li­hood of such a cat­a­clysmic event oc­cur­ring? Is this all just fear­mon­ger­ing? The 1918 flu pan­demic killed be­tween 50-mil­lion and 100-mil­lion peo­ple, more than the com­bined to­tal ca­su­al­ties of the world wars. With hu­mans hav­ing be­come more vul­ner­a­ble today than they were 100 years ago, this is am­ple cause for con­cern.

Add to that the fact that the num­ber of peo­ple on the planet has dou­bled in the past 50 years, and there is the pos­si­bil­ity of a po­ten­tial dis­as­ter on a dev­as­tat­ing scale.

In this so­cial me­dia age, peo­ple have be­come ac­cus­tomed to ig­nor­ing the hy­per­bole and scoff­ing at the ma­ni­acs who proph­esy doom and the end of the world. But this is no Hol­ly­wood script with a happy end­ing. This threat is real and plau­si­ble and could re­sult in the deaths of many African chil­dren and fam­i­lies.

New ini­tia­tives such as the Coali­tion for Epi­demic Pre­pared­ness In­no­va­tions, which was formed fol­low­ing the dis­as­trous Ebola crises of 2013 to 2015, are en­cour­ag­ing.

The ini­tia­tive aims to en­cour­age re­search and ef­forts to bet­ter re­spond to the ne­glected dis­eases that have epi­demic or pan­demic po­ten­tial.

But even with these ef­forts, the ques­tion still re­mains: will Africa be ready to man­u­fac­ture those vac­cines?

Does it have the ca­pac­ity, tech­no­log­i­cal abil­ity, hu­man cap­i­tal and fa­cil­i­ties to an­tic­i­pate and meet the ex­po­nen­tial de­mands a cri­sis will elicit?

To its credit, SA’s gov­ern­ment has been a pi­o­neer. The Bio­vac In­sti­tute, es­tab­lished in 2003 as a pub­lic–pri­vate part­ner­ship, is the only vac­cine man­u­fac­turer in sub-Sa­ha­ran Africa.

But more man­u­fac­tur­ing ca­pac­ity is needed in SA and across the con­ti­nent, al­low­ing more Africans to ac­cess the life­sav­ing ad­vances that Bio­vac’s man­u­fac­tur­ing will de­liver.

How­ever, given that it might take sev­eral years rather than months to in­tro­duce com­mer­cial pro­duc­tion of each ex­tra vac­cine prod­uct, a con­certed push from all for­ward-think­ing African govern­ments is clearly needed to in­cen­tivise and grow lo­cal vac­cine man­u­fac­tur­ing to se­cure ad­e­quate sup­ply.

At the very least, the gov­ern­ment should con­sider ad­just­ing the sup­ply chain re­quire­ments that favour low­est price over lo­cal pro­duc­tion and it should put pres­sure on neigh­bour­ing coun­tries to do the same.

Up­front and con­tin­u­ing in­vest­ment fi­nanc­ing can and should also play a role in supporting lo­cal ca­pac­i­ties.

And even if SA were to in­sti­tute the best pos­si­ble pre­pared­ness, that alone would not be enough. “Dis­ease knows no bor­ders” is a uni­ver­sal tru­ism, but here in Africa, with its por­ous bor­ders, it is a clear and im­me­di­ate dan­ger.

SA needs Africa to be do­ing its ut­most to have the best pos­si­ble pro­tec­tion — not only out of a sense of good neigh­bourli­ness, but be­cause the coun­try’s health and wel­fare de­pend on it too.

SA is a re­spected leader and in­no­va­tor. It needs to place much more pres­sure on the AU, re­gional eco­nomic com­mu­ni­ties and in­di­vid­ual coun­tries to act quickly.

The out­break will come. There will be a mad rush for vac­cines. Will Africa have its own or will we stand help­lessly, el­bowed in the global queue?

Will we all clam­ber aboard the lifeboats, clutch­ing our chil­dren and loved ones? Or will we go down with the ship?

The time has come for Africa to make those de­ci­sions — now — be­fore treach­er­ous ice­bergs draw into view.


Pro­tec­tive jabs: A Con­golese woman is vac­ci­nated dur­ing an emer­gency cam­paign against yel­low fever in Kin­shasa. Africa needs a con­ti­nent-wide plan to deal with po­ten­tial pan­demics.

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