Scientific training and funding key to addressing health challenges in Africa

Africa is a continent of contradictions. It is the land of new opportunities and home to some of the most globally acclaimed and disruptive technologies. It is also home to many weak political, social and economic systems and millions of poor, disease burdened population. And while the continent has in the last few decades leveraged its people’s unbridled spirit, ingenuity and capabilities and in effect recorded some good progress in some areas, the reality is, there are sectors that are still lagging behind. The health sector is one such areas where Africans’ resourcefulness has not been adequately harnessed to address inequalities and disparities in the system which sadly, continue to widen.

Where the western world has managed to put in place public health interventions and strategies that have reduced mortality and raised life expectancy, the African continent is still burdened and grappling with treatable and preventative diseases. For instance, African children are 16 times more likely to die before the age of five than those in the developed regions.

And while the situation can be attributed to several major factors, the one that is often not given the deserved prominence, is the underinvestment of scientific funding in the health system. The insufficient public sector funding in health research and development, means that not only is there limited innovation in the development of knowledge, medicines, vaccines or diagnostics but the continent’s health systems are not equipped to handle emerging and in some cases re-emerging catastrophic and infectious diseases. This makes is that much harder to improve its performance of the health-related Sustainable Development Goals.

Globalization has brought with it complexities in the spread of these diseases that are hard to treat or manage despite the efforts being made to address such issues. And while there’s consensus that funding of medical research should be a key priority for all governments especially those in our continent, it is also a fact that the health sector ranks lowly on many governments’ priority national agendas if their commitment to the Abuja Declaration of 2001 is anything to go by. Nearly 17 years after they pledged to commit 15 percent of their annual budgets to public health spending, only six African Union countries have reached and or surpassed the target.

Given the complicated nature of the new diseases and emerging issues, the ever rising national health expenditure and the serious impact that diseases have on the continent’s social, political and economic development, it is increasingly becoming clear that both the public and private sectors need to forge mutual partnerships that would enable them to come up with innovative and sustainable ways that can address not only the funding challenge but the disparities in the health system.

As such, researchers from the different African countries cannot continue to work in silos. Supported by the governments, they should find ways to be integrated into the larger continental community. Only then will they be able to tap into the already existing knowledge pool and at the same time harness their potential in the sector.

The continent can draw lessons from Afrique One-ASPIRE, a research programme that is designed to significantly expand research capacity and promote sustainable interactions among professionals in human, animal and environmental health in sub-Saharan Africa. This is in recognition that the three areas are intimately interlinked and therefore for optimal health, challenges must be addressed holistically and not in isolation.

Afrique One-ASPIRE, which is funded by a consortium of donors including 9 African institutions, is especially focused on endemic zoonotic diseases that are transmissible between animals and humans and aims to put into practice the One Health approach. To achieve this, the programme has recruited more than 60 African scientists, drawn from 12 East, Central and West African countries, to conduct research on rabies, tuberculosis, brucellosis and other food and nutritional diseases. This approach opens avenues for them to share and improve their knowledge which in effect helps to effectively detect, respond to, and prevent diseases and outbreaks.

As a testament to the effectiveness of this model, fellows researching on brucellosis have proved in recent preliminary findings that it is easier to detect the DNA of Brucella, the bacterium that causes brucellosis, in plasma rather than in the blood as is currently the case. This preliminary finding opens the possibility of improving the diagnostics of brucellosis in infected people and animals and leads to differential diagnostics with other febrile diseases such as malaria. Another team of the Afrique One-ASPIRE fellows have discovered in the research that it is possible to eliminate rabies in Africa through large scale sustained vaccination of 70% of the dogs.

These encouraging results will help the continent to not only shine a spotlight on neglected diseases and therefore detection and diagnostic solutions but also bring the work of African scientists to the attention of the global scientific community. Ultimately, having a critical mass of internationally competitive and acclaimed African scientists and research groups will also ensure that the continent has informed data and evidence that stakeholders including policy makers can rely on to develop or support innovative, cost-effective interventions.

By proving that they can develop Africa-led solutions, the continent’s scientists can begin contributing in a large scale to the global knowledge pool and only then can Africa command respect and a seat at the global table.

By Prof Bassirou Bonfoh, Director, Afrique One-ASPIRE

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