By Professor Arthur Mutambara
Clearly, it is not sufficient to merely articulate the lack of collective agency facing the African continent and its diaspora with respect to the COVId-19 pandemic. We must proffer solutions that address both ‘what’ should be done and ‘how’ it could be accomplished.
The work to be done on the African continent
Several strategic initiatives can be executed to assert Africa’s agency in the fight against the COVID-19. These efforts require prioritisation, sequencing and a detailed implementation matrix anchored by a monitoring and evaluation framework. An inexhaustive list of what Africans and their brothers and sisters in the African Diaspora should immediately do on the continent include the following:
1) Clinical trials on local remedies such as Zumbani/Umsuzwane (Lippia javanica) and Moringa (Moringa oleifera) to demonstrate drug safety, efficacy and side effects (if any) leading to professional packaging of medicines with specific clinical dosages. Clinical trials to formally establish the impact and limitations of other natural solutions such as steaming, culminating in the development of technical guidelines for the interventions.
2) Clinical trials of human formulation of the ‘wonder drug’ Ivermectin for use in prevention and treatment of COVID-19 to establish drug safety, efficacy and side effects among African populations.
3) Development of laboratory capacity to test the safety, efficacy and side effects of all the COVID-19 vaccines – without exception – being brought into the continent. Africans must independently do this evaluation before using any of the externally developed vaccines. As the first batch of vaccines arrives in SA on 1 February 2021, it will be prudent to adhere to this philosophy. We must ensure this testing and verification capacity is available throughout the African continent.
4) Development of manufacturing capacity, so that we can partner with owners (from the Global North) of the already developed COVID-19 vaccines and related drugs and manufacture these products in Africa. This will be cheaper than receiving pre-manufactured drugs. It will also address the challenges of transport, storage and other logistical concerns in the movement of the drugs from the Global North to Africa. This is a long-term strategy to develop the capacity to supply the entire continent with all its drug requirements. African needs to strive towards drug self-sufficiency and the time to develop that capacity is now.
5) Building in-country capacity to develop, manufacture and service COVID-19 related equipment and technologies such as ventilators, oxygen tanks, oxygen concentrators, diagnostics, PPEs, testing facilities and contact tracing capacity.
6) Development of regional and continental research centres to study the virus, its mutation, transmissibility and disease pattern. The work such as that of Nigeria, SA, and Kenya to detect local COVID-19 variants (through genome sequencing) must be enhanced, continentally leveraged and systematically replicated. The commendable efforts of Africa CDC must be strengthened, heavily resourced and granted the requisite political commitment.
7) Revamping of and investment in healthcare facilities across the continent. COVID-19 has exposed the inadequacy and fragility of our healthcare systems. We have learnt valuable lessons that we must act on. Furthermore, we must build world-class hospitals across the continent. African elites must never travel outside Africa for treatment.
8) Building of world-class vaccine research and development capacity, so that in the case of future pandemics, we participate in vaccine development as Africans. The ineptitude of the COVID-19 experience must never be repeated.
9) Continent-wide coordination of systems and mechanisms to detect and eliminate counterfeit medicines, with respect to COVID-19 and in general.
10) Establishment of regional and continental research centres to investigate the efficacy of COVID-19 lockdowns and the impact of the pandemic on lives and livelihoods, leading to the formulation of appropriate policy responses for countries, regions and the continent.
How Africa and its Diaspora can Accomplish this Agenda
The articulated plan is achievable if Africans work together in regional bodies such as SADC, EAC, COMESA and ECOWAS, but primarily as the African Union, while leveraging the financial and global influence of the African diaspora and harnessing the vast resources of the African private sector. Of course, front and centre in this endeavour will be the African health experts and professionals, together with their research institutions such as universities and teaching hospitals. As Africans, we must emphasise regional and continental integration, which gives us the economies of scale to achieve our objectives.
We must also share COVID-19 best practices, lessons and innovations across regions and the continent and minimise unproductive and disruptive competition among ourselves. The intellectual property of African knowledge systems and medicinal remedies must be protected and leveraged to benefit the continent and its people financially. There is a need for a change of mindset and a paradigm shift by the African from worshipping external medical solutions to embracing local remedies, including locally developed and manufactured drugs.
Some of the strategic activities that will enable us to attain the outlined COVID-19 African agency initiatives include the following:
1) Pooling of national (governmental) resources into regional and continental centres of medical excellence with specific mandates. Emphasis must be on regional and continental plans and strategies and not national ones.
2) A regionally funded – say SADC – research laboratory into African COVID-19 remedies and their codification, including clinical trials of such solutions. Efforts such as those of Madagascar with its Artemisia annua COVID-19 drug must be embraced and supported by Africans and African institutions such as Africa CDC.
3) A vaccine efficacy and safety testing facility in each of the regional blocks (SADC, EAC, ECOWAS, etc.). Regional centres of excellence must be established to run clinical trials for COVID-19 and other infectious diseases.
4) Four AU-driven world-class drug manufacturing plants, one in West Africa, North Africa, East Africa and Southern Africa, all focusing on COVID-19 vaccines and other infectious agents and drugs. We must deliberately build African drug manufacturing capacity, and then approach those who have developed vaccines to partner with us and manufacture the vaccines on the continent. Collaboration such as that between SA’s Aspen Pharmacare and the US firm, Johnson & Johnson, must not be ad hoc but systematically motivated and incentivised by states, regional bodies and the AU.
5) Three AU-driven world-class drug development research laboratories on the continent. For future pandemics and other diseases, we must conduct research and develop our own vaccines and medicines.
6) Development of an Africa-wide drug distribution infrastructure and network, driven by the AU.
7) Direct appeal and incentives at national, regional and AU levels to African businesses in particular well-endowed entrepreneurs to participate in funding the outlined projects. African governments must deliberately identify African philanthropists willing to partner with private sector technocrats, medical experts and academic institutions to jump-start the efforts. COVID-19 partnerships such as that between AU and MTN on vaccinations must not be an exception but the rule. Resources, involvement and agenda ownership must also be mobilised and cultivated from ordinary Africans and civil society organisations.
8) Leveraging continental bodies such as the AfCFTA, the AU Commission and UN Economic Commission for Africa to mobilise buy-in and resources for the projects. More importantly, the AU vehicle – Africa CDC, must be enabled and empowered as the Africa COVID-19 response strategy and implementation engine.
9) Partnership with the African diaspora to establish collective COVID-19 (and related infectious diseases) African agency. In particular, we must reach out to the leadership, conscience and resources of the Black elites, entrepreneurs, enterprises, intellectuals and medical experts in the United States, Europe and the rest of the world.
10) Establishing COVID-19 partnerships with the Global North driven by African agency and priorities. This collaboration must be buttressed by the clear understanding that the COVID-19 crisis is a global problem that requires both global solutions and leadership. In fact, the pandemic will only be defeated if the virus is eradicated globally – in every country. The sooner this is achieved, the better, as the COVID-19 virus has shown the capacity to mutate into variants that make existing vaccines ineffectual.
Achieving African agency in the fight against the COVID-19 is not mission impossible. It simply requires both political will and commitment to deploy effective regional and continental strategies, anchored by visionary African leadership in both the private and public sectors. The financial resources are there. The medical expertise and skills to do the research and development are in abundance. The enabling tools of the 4IR such as AI, big data, virtual reality and 3D printing are here. In fact, COVID-19 has catalysed innovation and the uptake of these new technologies.
Let us get to work.
The current status quo where African leaders pay lip-service to regional and continental integration and strategies (and their implementation) must be challenged. We are Africans first, citizens of regional blocs second and national citizens third. There is no space for national plans, visions or strategies. The continent is the only viable unit of analysis. COVID-19 has amply demonstrated the immortality of this fact. Let us move forward as a united and harmonised continent in sync with its diaspora.
The destiny of our health is in our capable collective African hands.
Professor Arthur Mutambara is a former deputy Prime Minister in Zimbabwe and an Oxford University graduate