Africa must plan for global pandemics
Planning for the possibility of a pandemic is necessary to safeguard the health of the nation and the continent, writes Morena Makhoana
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 fear-mongering? 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 life-saving 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.
• Makhoana is CEO at The Biovac Institute.