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SPECIAL REPORT| How Africa May Lose Out On The Race To Solve The COVID Conundrum

WANJOHI KABUKURU

TWO French medical Professors Camille Locht of the French National Institute of Health and Medical Research (INSERM) and the head of intensive medicine at Cochin Hospital in France Prof Jean-Paul Mira stirred Africa’s hornet’s nests.

This happened in early April when they were speaking about the BCG-tuberculosis vaccine ability to treat COVID-19 on France TV channel LCI.

The two researchers ended up noting that testing of the much-anticipated vaccine should be conducted in Africa.

The video clip made headlines in the continent and a compressed cameo version went viral with extensive shares on cross-social media platforms Facebook, Twitter and WhatsApp.

Then the reactions started to stream in. Dr Tedros Adhanom Ghebreyesus the World Health Organisation Director General who was a former Ethiopian health and foreign minister termed the French doctors sentiments as “racist remarks”.

Dr Ghebreyesus went on to state that: “Africa cannot and will not be a testing ground for any vaccine. We will follow all the rules to test all vaccines or therapeutics all over the world using exactly the same rule whether it’s in Europe, Africa or wherever.”

Dr. Adhanom was not the only one to chime in.

The head of the Addis Ababa, Ethiopia, based African Centre for Disease Control and Prevention (ACDC) Dr. John Nkengasong also took great exception with the French physicians.

“The Africa Centers for Disease Control and Prevention (Africa CDC) strongly condemns the very disgusting comments made by Professors Jean-Paul Mira and Camille Locht on French Television on using Africans for testing a tuberculosis vaccine in clinical trials to see if it is protective against COVID-19.” Dr. Nkengasong said.

“These racist and condescending comments must be condemned by all decent human beings.” 

Dr Nkengasong went on to insist that, “Africa CDC will continue to collaborate with the World Health Organization (WHO) to ensure that only ethically and scientifically sound clinical trials for vaccines and therapies will be conducted in Africa, using exactly the same standards and principles as those employed elsewhere in the world.”

To cool off the heat that their remarks had generated INSERM lab where Professor Locht works issued a statement.

“Clinical trials to test the BCGs vaccine efficacy against COVID-19 are underway or about to start in European countries (Netherland, France, Germany and Spain) and in Australia.”

The INSERM press release noted and went on to add: “There is currently a discussion around launching a study in Africa but if it is done, it will be done alongside these other studies. Africa must not be forgotten or excluded from research on COVID-19 because this pandemic is global.”

However, this was too little too late.

As he dismissed the two French medics, Dr Nkengasong waxed lyrical of the enhanced capacities of African bio-medical researchers.

The Addis Ababa-based top African medic highlighted some key pointers of Africa’s recent vaccine successes when he noted.

“Professors Mira and Locht have no lessons to teach Africa on the conduct of scientifically sound clinical trials. Africans have extremely capable world-renowned scientists who have played critical leadership roles in conducting clinical trials that have benefited the continent and beyond. Some examples include the leadership of African scientists in conducting an effective Ebola Virus Disease ring vaccine trial in West Africa in 2014, which proved a game changer in ending the outbreak,” Dr. Nkengasong said.

“Similarly, last year, experts from the Democratic Republic of Congo, alongside international collaborators, successfully carried out a clinical trial of Mab 114 monoclonal antibody therapy for Ebola Virus Disease.”

It is Dr Nkengasong’s final admission on Ebola that reveals much more about clinical vaccine trials in Africa.

Even though majority of those who railed against the two French physicians saw it as a racist ploy, the reality is that Africa has been a hot bed of vaccine clinical trials for decades now and Dr. Nkengasong just revealed the tip of an iceberg regarding Africa’s place in the global vaccines agenda.

According to the Global Vaccine Alliance (GAVI) presently there are over 148 corona virus vaccines candidates in development and 17 of them are already on phase two and three human trials across the globe including Africa. CureVac, Moderna, BioNtech, University of Oxford, CanSino, Sinovac Biotech, Merck & Co, Novavax, Gilead, Pfizer, GSK and Sanofi are among the leading firms with promising vaccine candidates.

“When candidate vaccines make it to human clinical trials, they first go through phase 1 trials primarily to test the vaccines’ safety, determine dosages and identify any potential side-effects in a small number of people.” GAVI says.

“Phase two trials further explore safety and start to investigate efficacy on larger groups. The final stage Phase three trials which few vaccines ever make it to are much larger involving thousands or tens of thousands of people to confirmand assess the effectiveness of the vaccine and test whether there are any rare side-effects that only show up in large groups.”

In the last 10 years, vaccine trials on drugs for malaria, rotavirus, Ebola, Zika, Nipah virus, pneumonia and a host of other dangerous infectious diseases have all been conducted in Africa.

Sadly, even though vaccines have been trialed and tested in Africa there are no African biotech or pharmaceutical firms and labs involved in the current vaccine development competition.

That there is an intense international race and scramble to find a vaccine is not in doubt. In fact it has turned out to be a war like operation with the major powers deploying their militaries to synchronise their quests for a vaccine.

In early July the US Senate confirmed four-star General Gustave Perna as the Chief Operating Officer of “Operation Warp Speed” which the US’ historic operation to accelerate the development, manufacturing and distribution of Corona virus vaccine by early next year. In China Major General Chen Wei, a People’s Liberation Army (PLA) immunologist well known for her groundbreaking discoveries of vaccines for SARS and Ebola is currently leading China’s advanced COVID-19 vaccine hunt.

In March the world witnessed a Germany-US vaccine tiff when CureVac, a German bio-tech company rejected a proposal by US President Donald Trump to purchase exclusive rights to a promising coronavirus vaccine developed by the firm.

This rejection elicited a tough stance by the German federal government, which gave itself powers to veto any takeover bid by foreign firms over its two leading vaccine developers namely CureVac and BioNtech.

BioNtech is collaborating with Pfizer Laboratories and they expect to secure regulatory approvals for their vaccine by end of October this year. In June, the German government sweetened its veto deal by buying some 23 per cent stake in CureVac for a sum of $337.4mn.

The European Union on its part has set aside some $6.9bn to ensure fair distribution of vaccines within the EU bloc boundaries.

The German biotech firms seems to have attracted intense interest as in late July GlaxoSmithKline announced that it will spend $163.67mn to purchase some 10 per cent stake of CureVac with special interests in vaccines to treat and prevent infectious diseases.

This was not the only basket where GSK had invested its funds and resources.

Earlier in April, GSK and French pharmaceutical giant Sanofi had announced that they had signed a letter of intent to collaborate in the development of an adjuvant vaccine for COVID-19.

It is significant to note that during the 2014 Ebola Virus Disease (EVD) outbreak in Guinea, Sierra Leone and Liberia, which claimed over 10,000 lives in West Africa a host of Ebola vaccines candidates were trialed in 10 African countries.

Subsequently a number were approved and Africa’s role as a bystander in the vaccine development was acknowledged.

The continent remains a laboratory owning no patent rights on numerous vaccines developed in Africa’s soil.

According to WHO records between October 2014 and April 2015 EVD vaccine trials were conducted by different pharmaceutical companies in Mali, Gabon, Kenya, Uganda, Tanzania, Cameroon, Ghana, Mali, Nigeria, Senegal, Guinea-Conakry, Liberia and Sierra Leone.

The vaccine candidate drugs included VSV-EBOV which trialed in Liberia, Guinea and Sierra Leone by Newlink Genetics and Merck Vaccines of the US.

The same drug was in March 2015 also being tested in Guinea Conakry by MSF, WHO and the Guinean government.

At the same time the Guinea Conakry trials were being conducted ChAd3-ZEBOV was being tested in Cameroon, Ghana, Mali, and Liberia by GSK and PHAC.  

As of May 2018 the WHO Vaccine Tracker notes that MSF Epicenter was testing vaccines on Pneumococcal infections, the University of Oxford was testing on Ebola and Marburg.

Others who tested their vaccine candidates in the said period included Johnsons and Johnson, Bavarian Nordic, Oxford University among others.

Some of these vaccines tested for Ebola are now becoming more useful in combating COVID-19 as trial results have indicated.

Indeed the world breathed a sigh of relief in early May when the US National Institutes of Health proclaimed that an Ebola vaccine candidate Remdesivir was accelerating recovery of COVID-19.

Remdesivir which is manufactured by the US based Gilead Sciences Inc. had previously been tested in Africa.

That same month of May saw Gilead Sciences signing non-exclusive licensing pacts with five generic drug makers based in India and Pakistan namely Cipla, Ferozsons Laboratories, Hetero Labs, Jubilant Life Sciences and Mylan to help supply Remdesivir in 127 countries.

The five licensed companies are free to set their own prices for the Remdesivir generics they produce and the licenses signed will remain royalty-free until another vaccine other than Remdesivir or the WHO declares the end of the COVID-19 pandemic.

Interestingly, while Africa has provided perfect venue for vaccine trials in sites like Manhica, Mozambique, Kilifi in Kenya, Lambarene in Gabon, Bioko Island in Equatorial Guinea, Bagamoyo in Tanzania, Luapula in Zambia and Haut-Katanga in DRC among other trial sites it has no major player in the form of a vaccine maker or drug manufacturer in the current global vaccine race.

The pharmaceutical and biotechnology entities currently leading in the hunt for a COVID-19 vaccine are drawn from US, UK, France, China, Russia (all of them coincidentally Permanent Members of the UN Security Council), Germany and South Korea.

In late May, the US-based Novavax bought Praha Vaccines, a unit of Cyrus Poonawalla Group, which owns the Serum Institute of India (SII).

This acquisition was made just as Novavax embarked on its Phase one trials on its vaccine candidate NVX-CoV2373 that was its lead SARS-CoV-2 candidate currently underway in Australia.

The preliminary immunogenicity and safety data was expected in late July and Phase 2 trials will be conducted in multiple locations across the world.

The vaccine is based on “proprietary recombinant nanoparticle technology”.

Apart from Novavax, which is a US-based biotechnology company, specializing in next-generation vaccines for infectious diseases, GSK had also announced in May that it intended to produce a billion doses of COVID-19 pandemic vaccine adjuvant in 2021.

To this end, GSK has formed scientific partners in Europe, China and the Americas. GSK manufacturing sites are in UK, US, Canada and Europe.

“We believe that more than one vaccine will be needed to address this global pandemic and we are working partners around the world to do so,” Roger Connor President of GSK Vaccine says.

“We believe that our innovative pandemic adjuvant technology has the potential to help improve the efficacy and scale up of multiple COVID-19 vaccines.”

In the same week Novavax made its move, another US vaccine maker Merck & Co intensified its coronavirus vaccine race by buying Austrian drug maker Themis Bioscience.

Both Merck and Themis now have two vaccine candidates on trial.

Themis together with Institut Pasteur had used a technology that was based on a modified measles virus to combat COVID-19.

The second vaccine trial is derived from Merck’s Ebola vaccine candidate.

That there were interesting almost coincidental developments around vaccine development in May is no longer in doubt.

Still in late May, Astra-Zeneca and Oxford University recruited 10,000 adults and children for the second and third phase trials of their coronavirus vaccine candidate AZD1222.

Encouraged by the initial trial results the US government pledged some $1.2bn for a third of the first billion doses of AZD1222.

AstraZeneca had also signed a £65.5mn deal to manufacture 30 million doses and deliver 100million doses in total to the UK government. 

Other vaccine manufacturers such as Moderna with its SARS-Cov-2 vaccine mRNA-1273, Johnson and Johnson, Sanofi, Merck among others are currently ramping up their vaccines production capacity with several “at-risk investments” aiming for the production of 1 billion vaccines by 2021 should their respective candidates get the go ahead.

A significant strand ties most of these vaccine manufacturers. It is the Coalition for Epidemic Preparedness Innovations (CEPI), which was founded by the Wellcome Trust and the Bill and Melinda Gates Foundation in Davos in 2017 and is now headquartered in Oslo, Norway.

CEPI is funding Novavax, University of London, CureVac, Inovio Pharmaceuticals, Moderna and University of Queensland among others.

“Investing in vaccine development now is an investment in the future health of all our societies,” Richard Hatchett, the CEO of CEPI says.

“An urgent global, concerted effort is now needed to raise the money required to advance the development of COVID-19 vaccines.”

While African and Latin American governments through their own state-led medical research institutions have been deeply involved in most of these vaccines trials in agreements that are rarely public and favouring the pharmaceuticals it is clear Africa, Caribbean and Latin American are missing in action in the mega-bucks of vaccine development.

COMPANIES AND COUNTRIES LEADING IN THE CORONAVIRUS VACCINE TRIALS|

CHINA:

CanSino Biologics

SinoVac BioTech 

Beijing Institute of Biological products

Wuhan Institute of Biological Products

Clover Biopharmaceuticals

People’s Liberation Army (Academy of Military Sciences/Walvax Biotech)

Shenzhen Geno Immune Medical Institute – Lentiviral Vector Vaccines

Anzhui ZhifeiLongcom Biopharmaceutical and Institute of Microbiology – Chinese Academy of Sciences.

GERMANY

CureVac

BioNtech

Max Planck Institute

US

Moderna

Inovio Pharmaceuticals

Dynavax

Pfizer

Johnson and Johnson

Gilead

Arcturus Therapeutics

UK

GSK

University of London

Astra-Zeneca

Imperial College

FRANCE

Intitut Hospitalo-Universtiaire

Sanofi

Pasteur Institut

RUSSIA

R-Pharm

Gamaleya Research institute

SOUTH KOREA

Genexine Consortium

WANJOHI KABUKURU is a multiple award-winning international media trainer, editor and journalist, with a specialty in environmental journalism. Over the last 20 years his articles have been published in top-notch publications such as New African, African Business, Seychelles News Agency, African Banker, Radio France International (RFI), Inter Press Service (IPS), Diplomat East Africa, BBC Focus on Africa, Mail & Guardian, Africa Renewal and 100Reporters among other numerous publications.
He is the current editor and head of the Indian Ocean Observatory Media Unit. He is also a correspondent for the UN’s Africa Renewal.

(COMPILED BY INSIDE EDUCATION CORRESPONDENT IN NAIROBI, KENYA)

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