Monique Wasunna, Head of DNDi Africa
As Head of DNDi Africa, I was honored to bear witness to the special event recently co-hosted in Nairobi by DNDi and the Kenyan Medical Research Institute (KEMRI) to celebrate a decade of Research & Development (R&D) for Neglected Diseases (ND) in Africa. Ten years ago, about 70 participants met in Nairobi to discuss the first steps of what was to lead to 10 years of experiences, learning, and first successes of DNDi in Africa. On June 4th and 5th, we were more than 430 committed and passionate researchers, scientists, decision-makers, and donors to explore the opportunities and remaining challenges for R&D for neglected diseases in Africa. The presence of representatives from 33 countries, of which 21 African countries, and the keen interest of African and international media for the issues we covered is, in itself, an achievement for those who fight to place and keep neglected diseases on national and international public health agendas.
During the week of events, we could clearly distinguish what I call ‘a new face of African R&D’. Over the past decade, African scientists have taken their place among the top researchers: Africa today is producing quality science and has set up regional networks of excellence for clinical trials. Combining North-South and South-South collaborations has been key in this process. Today, even in the most remote areas of our continent, international-standard clinical trials are being conducted by our researchers.
We have taken huge steps forward, but the road ahead is still long.
While health research overall is now rapidly growing in quantity and complexity in Africa, research on neglected diseases is still wanting. Globally, only 1.4% of clinical trials target neglected diseases. As mentioned by Dr Charles Mgone, EDCTP Executive Director, quoting Mary Lasker ‘if you think research is expensive, try disease’. Neglected diseases still represent a massive economic burden for our countries, and concerted and sustained efforts need to be placed on addressing the diagnostic and treatment needs of millions of people in Africa. Ethics and regulatory review capacities were also discussed as they remain heterogeneous on the continent, whereas an increase in both quality and efficiency through harmonization of ethics and regulatory activities is required. The functionality and independence of ethics and regulatory structures in Africa need to be promoted through strengthening local infrastructure and human resources. But standards for harmonization are also needed to accelerate approval processes and ultimately patient access to medicines and vaccines. Initiatives have been undertaken with notably the African Medicines Regulatory Harmonization (AMRH) Programme that aims to promote sustainable capacity building strategies in the African Region. Dr Annalene Nel, IPM, mentioned the need for a ‘TRUE collaboration: Transparency, Respect, Understanding of Expectations and Enthusiasm’ with national regulatory authorities.
Capacity strengthening was another point that was largely discussed since it has been a powerful tool to position Africa on the research scene. Continued capacity strengthening will sustain the move of African research centres from being trial executors to being trial generators. The success of the LEAP and the HAT platforms that are centred around capacity building and strengthening to conduct clinical trials were presented. All participants agreed with the need of such platforms to also share technology, innovations and challenges as well as the need to ensure their sustainability.
The fight against neglected diseases in Africa is far from over. As said by Marcel Tanner, Chair of DNDi Board, ‘we should focus on where the needs are the greatest’, by harmonizing efforts across Africa to turn research into concrete solutions for the most neglected. This will be critical as well as strong leadership, coordination, and sustainable funding. We performed well over the past 10 years, and we need to do even more and in even more synergized ways to keep performing as best we can for the patients we are all mobilized to test and treat. I believe Africa will play a key role in this mission, and as said by Hon. Mr. James Macharia, Kenya’s new Cabinet Secretary of Health who honored us with his presence at the meeting: “Africa is ready to take a step further” and must now invest in R&D, allocate resources towards research (…) and we must not forget that the right tools for elimination are necessary to really see the elimination of many of these diseases”.
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Dr Monique Wasunna, Head of DNDi Africa