By guest contributors Madhukar Pai and Katri Bertram “There is no thing as a single-issue struggle because we do not live single-issue…
African biotech holds the key to transforming not just the health of African people, but our economies as well
By guest contributor Yaw Bediako, PhD
The COVID-19 pandemic has had a profound and unprecedented impact on the lives of people all over the world. Most economies are still recovering from the devastating effects of the pandemic and the long-term health effects of those previously infected are yet to be fully understood. One of the most disappointing legacies of the pandemic has been the significant disparity in vaccine access between high income and low- and middle-income countries (LMIC). Over a year since the first COVID-19 vaccines were licensed only 27.3% of people in Africa have received at least one dose of a licensed vaccine, compared with 80% and 75% of the populations in the United States and the European Union respectively. This inequity has understandably resulted in calls for increased investment in vaccine manufacturing capacity across Africa, however lack of vaccine manufacturing capacity is a symptom of a much larger issue. The pandemic has highlighted the fragility of an African scientific ecosystem that is underfunded and currently unsustainable.
In Khartoum in 2006 the Executive Council of the African Union endorsed the call for African countries to raise their national science budgets to 1% of gross domestic product (GDP). Often referred to as the Khartoum Decision, this declaration was further emphasised in 2007 in Addis Ababa as African governments were strongly urged to put in place measures to ensure that at least 1% of GDP was allocated to research and development (R&D) by 2010. These measures, it was hoped, would spur the expansion of scientific capacity and lead to a significant increase in tangible scientific and technological outputs across Africa. Beyond simply promoting scientific and technological innovation on the continent, this strategy was also viewed as a key component of the strategy to promote economic and social development on the continent.
There is clear evidence that increasing R&D expenditure directly translates into an increase in GDP; with GDP increasing by as much as 2.2% for every 1% increase in gross domestic expenditure on research and development (GERD). Unfortunately, more than a decade since the Khartoum Decision, Africa’s GERD as a proportion of GDP is estimated as 0.5% compared to a global average of 2.2%. The weakness of the African R&D ecosystem is further exacerbated by a relentless flow of talent out of the continent. Within the healthcare sector alone, it is estimated that Africa loses over $2 billion a year due to the brain drain. It is therefore not surprising that despite accounting for 15% of the world’s population and over 25% of global disease burden, Africa contributes less than 2% of global scientific output.
So what has gone wrong? Why has over a decade of political rhetoric and unprecedented donor support for scientific capacity building not translated into more tangible scientific output?
A closer look reveals a glaring gap in the current structure of the scientific ecosystem in Africa – the almost complete absence of the private sector. African scientific R&D is almost exclusively restricted to academic and public research institutions. In Ghana for instance, over 68% of funding for R&D (which includes salaries of academic and research staff) comes from the government, and well over 90% of this is spent in public institutions. Apart from not translating into scientific outputs, this over dependence on the public sector also has a detrimental effect on retention of scientific talent, with most countries in Africa having less than 100 scientists per 1 million inhabitants, compared with the global average of 1200 per 1 million. The strongest case for the role of the private sector in supporting sustainable expansion of scientific R&D, is found when one examines the countries who have crossed the 1% GDP threshold. Every country that has successfully made this transition, did so when business accounted for a larger proportion of GERD than the public sector. In the Republic of Korea, an increase in the private sector share of GERD from 3% to 81% between 1960 and 1990 was associated with an increase of GERD from 0.25% of GDP to 1.87% of GDP. Similarly in the U.S. business currently accounts for 72% of GERD and actually performs 75% of the R&D activities in the country.
The evidence would suggest that it is unlikely that the Khartoum Declaration will be realised without sufficient engagement and involvement of the private sector. Simply put, African R&D will not achieve its full transformational potential until it begins to create jobs – and that will largely occur in the private sector. This calls for a change in strategy and will require an intentional effort to encourage the commercialization of research activities and promote establishment of tech start-ups. Given the relative maturity of life science and biomedical research on the African continent (relative to the physical sciences and engineering) African biotech is a logical area of initial focus.
Establishing a viable biotech sector on the African continent will take commitment and effort from a number of important stakeholders in the African scientific ecosystem:
- African governments will need to work to decentralise scientific research and provide incentives for scientists to establish private research enterprises. Governments must create enabling environments by providing resources for the establishment of incubators and innovation hubs where young companies can work on refining their products and business models. Governments can also set aside a number of government contracts for local biotech companies, providing much needed revenue that will not only support these fledgling businesses but also help attract private investment.
- Healthcare providers (both public and private) must embrace R&D as a key component of improving the quality of care they provide. While many have now established institutional review boards (IRBs) there needs to be a greater focus on promoting innovation and translation by extending research collaborations beyond academia to include local biotech companies. The establishment of institutional R&D offices will ensure that such partnerships are mutually beneficial and all data is securely and ethically managed.
- Global health partners will need to diversify their funding portfolios, setting aside funds to support African start-ups, both as non-dilutive grants, but also by way of strategic investments. Additionally, facilitating access to business and investment consultancy support would be extremely important to young start-ups. Beyond directly investing themselves, global partners have a role to play in using their significant convening power to draw large investors into the ecosystem – highlighting the opportunities that African biotech companies present not just in terms of return on investment but also the impact of the work being done.
Though blessed with immense natural resources, Africa has not derived much benefit from the exploitation of her natural wealth because the majority of industrial endeavours have focused almost solely on the extraction of raw materials, with value addition happening elsewhere. Mineral wealth notwithstanding, Africa’s biological diversity (both human and non-human) may be her most valuable resource. In order to take full advantage of these resources, Africa must transition from a consumer of scientific knowledge and intellectual property to a producer of such knowledge. African biotech has the potential to spearhead this transition, creating countless new job opportunities for Africa’s young and talented population and catalysing significant and sustainable economic growth across the continent. As devastating as the COVID-19 pandemic has been, it may provide Africa with an opportunity to build a much more sustainable scientific ecosystem capable of responding to future challenges- taking advantage of this potential will however require a concerted effort from all stakeholders and must focus on a lot more than simply addressing deficiencies in vaccine manufacturing capacity.
About the author:
Yaw Bediako is a Ghanaian immunologist and entrepreneur. He obtained a PhD from Northwestern University in the United States and post-doctoral fellowships in Kenya and London. In 2020, Yaw founded Yemaachi Biotech to develop novel diagnostic and therapeutic targets for cancer, that work uniformly well irrespective of genetic background. Yaw is a 2021 Calestous Juma Science Leadership Fellow (Bill and Melinda Gates Foundation), a fellow of the Ghana Young Academy and an affiliate member of the African Academy of Sciences.