Dr Bongani Ngqulunga, Director of JIAS
Dr Beth Vale
Ladies and gentlemen
Let me thank the JIAS leadership for inviting us to be a partner in this important workshop. As we are gathered here to try to find African solutions for African problems, let us keep in our thoughts and prayers the people of Malawi, Zimbawe and Mozambique, who have been devastated by Cyclone Idai, which has left hundreds stranded, missing or dead. The scale of the disaster will only be known in the coming weeks, but at this moment the death toll is over 750, with more than 110 000 now in camps. What is even more concerning is that the devastated areas are now bracing for the spread of waterborne diseases such as cholera and malaria.
The UNICEF health and nutrition chief, James Patterson, has warned that people in the camps are at risk of infectious disease such as diarrhoeal disease and measles. Having lost everything, many families are sleeping in the open and the risk of pneumonia, particularly among children, is high.
This potential disease outbreak in our neighbouring countries is a stark reminder that the African continent still has very serious health challenges to overcome. The question is: Are we, as Africans, doing enough to overcome these challenges?
In the past 10 years, African economies have experienced tremendous growth rates. However, the continent is still confronted with the world’s most serious health challenges. Of the 20 countries with the highest maternal mortality ratios worldwide, 19 are in Africa. Of the estimated 300-500 million malaria cases that occur worldwide every year, more than 90% occur in Africa, where most deaths from malaria are in children under five years of age.
Donor funding has gone some way in reducing infection and mortality rates, and improving health conditions and access to treatment and medicine for the multitudes of African people affected. However, it has not created conditions that drive self-sustaining healthcare systems in Africa and pharmaceutical innovation towards solving Africa’s health problems. This calls for countries to increase their capacity and investments in research and innovation for the improvement of health in partnerships with developed countries.
According to the Council on Health Research for Development (COHRED) report on The Role of Research and Innovation in the Post-2015 Development Agenda, “progress [in] developing new interventions targeting poverty-related and neglected diseases has faltered because these diseases occur almost exclusively among the world’s poorest and most marginalized populations in low and middle-income countries”.
Goal 3 of the 17 United Nations Sustainable Development Goals calls on us all to “ensure healthy lives and promote well-being for all at all ages” by 2030. One of the targets under this goal is to “support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS agreement and public health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all”.
Currently, various countries, in partnership with organisations such as the World Health Organisation and COHRED, are working to address this global health research inequity. It has been estimated that only 10% of all the funds spent globally on health research and development are devoted to the problems of the poorest 90% of the world � this is called the “10/90 gap”. These institutions strive to develop solutions to overcome various difficulties, such as a lack of financial and intellectual resources, which hamper efforts to build a solid research community in low and middle-income countries.
In addition, WHO and COHRED have begun to draw attention to the neglected research needs of the developing world. Already there is evidence of success; new drugs and vaccines are increasingly being developed to treat neglected tropical diseases. However, building national health research capacity in low and middle-income countries remains essential to correcting the 10/90 gap that undermines global health by concentrating research effort away from the populations who suffer the overwhelming burden of disease. COHRED and the WHO have in recent years encouraged countries to reorganise their own national research approach in order to meet this global challenge.
Although important declarations have been made with regard to investments in research and development in the African continent, these commitments have not been met by countries. In 2006, a high-level ministerial meeting on health research that was held in Abuja led to a declaration mandating all African governments to allocate at least 2% of their health budget to fund health research. To date this declaration has not been implemented.
Most investments in research and innovation have as a consequence come from external partners, such as bilateral or multilateral development agencies; although there is concern that this may distort investments to reflect the priorities of the partners rather than those of the countries. While aid for health research has been critical for development, the resources made available are likely to make a sustainable impact if used for enabling countries to establish the foundations for their own sustainable development.
With all its health challenges, South Africa has made significant strides in dealing with the burden of disease.
South Africa suffers from four disparate but colliding epidemics, namely, a high burden of disease for HIV and TB, followed closely by a non-communicable disease burden that is almost three times that of the average in developing countries, a high maternal and child health disease burden, combined with a very high homicide rate � which is indicative of serious mental health issues.
In response to these challenges, South Africa is building its health innovation system using the “quadruple helix” model to integrate existing role players � the government, academia, industry and civil society � into a unified and coordinated system. In accordance with this model, industry operates as the seat of production, government provides the framework for secure contractual relationships, universities provide new knowledge, innovation and technology, and civil society provides inputs as users of the innovations, holders of knowledge and co-innovators.
The Department of Science and Technology (DST) has established a funding model under the national Bio-economy Strategy that has led to the creation of the Strategic Health Innovation Partnerships (SHIP) � a programme that funds and manages innovation projects focused on the development of new drugs, treatments, vaccines, medical devices and prevention strategies. The DST manages SHIP in partnership with the South African Medical Research Council.
The purpose of the SHIP initiative is to harness the capacity, capabilities and research projects situated at universities, science councils and the private sector and, through collaborative efforts, combine abilities and knowledge towards product development.
Another component of the Bio-economy Strategy is the Indigenous Knowledge Programme, under which we are seeking to develop, validate and mainstream products derived from indigenous knowledge, in a manner that makes the knowledge holders and their communities the primary role players and beneficiaries. There are currently over 30 organisations involved, from government, academia, business and civil society.
The investment by DST in the various programmes seeks to create a multifaceted and holistic approach to the well-being of our citizens.
In the end, we must find an optimal way of employing our resources so that we can maximise the desired output. Evidently, a transdisciplinary approach to diseases is the most effective way to find our own solutions to this burden of diseases. I believe that we can overcome our problems.
Let me conclude with the words of Chinua Achebe who, having witnessed many challenges on the African continent, still retained his optimism about the birth of a new Africa. This is what he said: “I am used to seeing problems in Africa. Historically the continent has had a bad time, but we are older than problems, we do not collapse in the face of problems.”
I thank you.
Source: Department: Science and Technology (DST)