Demographic trends classify Africa as the world’s fastest-growing continent, with its population potentially doubling by 2050. Yet the rise of non-communicable conditions and the possibility of developing pandemics is adding weight to already pressurised healthcare systems and posing new challenges to the continent’s economic goals. In an interview with Dr Duduzile Ndwandwe, Deputy Director of Cochrane Africa, we learn how the scaling up of clinical research in Africa can assist in building a healthier Africa.
As a leading researcher and pioneer of clinical trials on the continent, Dr Ndwandwe underscores the significance of clinical trials in healthcare research. “Africa has a high rate of transmittable diseases such as malaria, tuberculosis, and HIV/AIDS. Clinical research is important in establishing the health-care interventions for these diseases.”
Clinical trials are the backbone of the vaccine development process. Even though over 18 percent of the global population lives in Africa, less than 3 percent of clinical trials are conducted here. Given Africa’s aspiration for vaccine manufacturing, there is an obvious need to ramp up research that includes the use of clinical trials.
According to Dr Ndwandwe, one of Africa’s main challenges is not having a seat at the table in the global health space. The “West holds the health narrative and the agenda of what is funded and how research is done.” Similar to most of our interviewees, she underscores the need for funding that would both increase Africa’s influence and agency in the global healthcare space. She commends African leaders for their sense of unity and solidarity while grappling with the COVID-19 pandemic and calls for that same unity and solidarity in African leaders to chart a common health agenda for the continent.
Dr Ndwandwe also made a compelling recommendation that the relationship between Africa and the West transition from a donor-receiver model to a partnership model. If adopted, this shift would be a natural progression following the historical shift outlined by Professor Muhammed Ali Pate, who spoke of the transition from trade protection to a social contract.
At the domestic policy level, she advocates for governments to place greater emphasis on capacity building of healthcare skills and expertise. Dr Ndwandwe also proposes increased involvement of the private sector as investors who can fund healthcare research and development.
“If we have the human capacity and funding in place, then we will be able to drive the innovations that can contribute to building a resilient continent.”
“We need to create our own forums that bring African funders together to co-create the continent’s research priorities and build a shared agenda for identifying, sponsoring, and undertaking the relevant research.”
Africa’s priorities should be diminishing our dependence on external funding sources and increasing African funding to research and development, capacity building, and strengthening our defences against current and future pandemics.
Dr Ndwandwe passionately decries the systemic inequalities perpetuated during times of pandemics. On the current Mpox challenge, she directly highlights the issue of Denmark stockpiling Mpox vaccines without a single case recorded, while countries like the DRC are facing a vaccine shortage and an M-pox outbreak. She warns that “If you do not provide protection for a country where the outbreak is rife, you are putting the world at risk.” The reality is that there is a greater risk of mutation if the virus is left unchecked, and that puts the entire world at risk. It’s not a problem for only Central Africa, as it could spread beyond the region. With mutations, the current vaccines would not be as effective.
“If Africa is protected, then the whole world is protected. A healthy Africa is a continent where we are thriving, using our own resources to advance the betterment of our population.”
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