Picture: Christof Stache / AFP – Overdependence on health innovations developed in the global north is not sustainable and cannot continue if Africa is to be on a path to self-sufficiency.

By Susan Winks and Kelly Chibale

Africa’s disease burden continues to cripple economic growth across the Continent. Despite accounting for just about 16.7 percent of the world’s population, Africa bears approximately 23 percent of the global disease burden and represents less than 1 percent of global scientific output, with majority of this concentrated in South Africa and Egypt.

Overdependence on health innovations developed in the global north is not sustainable and cannot continue if Africa is to be on a path to self-sufficiency. Not only do we need to invest in complementary drug discovery and development efforts we must also confront backward ideologies such as “afro-pessimism”, which have often limited our involvement in innovative pharmaceutical research and development (R&D) to participation in clinical trials.

It is time for Africa to rise to the challenge; to tap into its wealth of talent and explore opportunities to build world-class academic research centres with a multi-disciplinary approach to drug discovery.

If we are to become an innovative pharmaceutical R&D hub, we must take a deliberate and systematic approach to develop new capabilities, transfer technologies, leverage partnerships and networks, and train scientists, all while delivering on drug discovery projects to help address the Continent’s – and the world’s – biggest health challenges.

Granted, the Continent faces multiple barriers that hinder the growth of drug discovery, including lack of infrastructure, limited funding, and supply chain constraints. In most African countries, drug R&D expenditure as a percentage of gross domestic product (GDP) is almost non-existent. For example, in 2022 South Africa spent the equivalent of 0.85 percent of its GDP on R&D, compared to an average of 2-4 percent by leading global drug producers such as Germany, the United States, China and Israel.

If we are to reduce reliance on the global north, we urgently need to re-examine the entire value chain of R&D in Africa. This means investing in the necessary infrastructure, attracting, developing, and retaining talent, and creating linkages between researchers, public, private and philanthropic institutions to create pathways to sustainable funding, partnerships and enhanced capacity.

Realistically, it would take years to address all the gaps within innovative pharmaceutical R&D in Africa. That said, the key to success lies not in having everything perfectly set up, but in letting science dictate the partnerships required and allowing project successes to support growth.

This approach, employed by the Holistic Drug Discovery and Development (H3D) Centre at University of Cape Town (UCT) in South Africa, offers an example of how partnerships could set us on the journey to self-sufficiency.

In 2009, H3D Centre partnered with the Medicines for Malaria Venture (MMV), financially leveraged with support from the South African government through the Department of Science and Innovation and its instruments in the Technology Innovation Agency (TIA) and Strategic Health Innovation Partnerships (SHIP) unit of the South African Medical Research Council (SAMRC), on a malaria drug discovery project. Using this initiative as an anchor programme to build the skills and resources needed to expand, the project gave H3D Centre access to additional resources and capabilities through the MMV network and enabled it to systematically implement early-stage drug discovery capabilities in-house.

By demonstrating success with this partnership, the Centre was able to attract additional funders, partners, and collaborators. Over the next decade H3D evolved from a chemistry-focused research group of five, to an integrated multi-disciplinary drug discovery centre employing over 70 staff members with specialties in chemistry, biology, and pharmacology. In 2022 H3D became a Johnson and Johnson (J&J) Satellite Centre for Global Health Discovery, one of only three such centres established by J&J globally, with the other two in the UK and Singapore.

One of the biggest learnings from this experience is that having an anchor partnership with a product development partner (PDP) is a great way for an emerging research centre to build a track record, as the PDP provides access to an established network of experts and the capabilities required in a particular disease area to take a product from discovery through clinical development.

Through such networks local R&D institutions can build relationships and identify synergies with partners in the global health space, and establish scientific exchange programmes and industry mentors for early career researchers. Industry-academia partnerships can also be tailored to the needs of researchers, financiers and consumers of the end product, leveraging the strengths of each to address specific infectious diseases and global health challenges.

For example, local drug R&D organisations have access to the African patient population, and an innate understanding of the regional public health challenges. Industry partners have access to capital, experience with late-stage drug development and commercialisation, and large chemical libraries that can serve as starting points for drug discovery projects.

Africa is ready to be recognised as a source of health innovation. But first, we must tap into the opportunities presented by global partnerships to build capacity, bridge infrastructure gaps and deliver targeted innovative pharmaceutical solutions that will propel our Continent – and the rest of the world – towards the global health goals.

Dr Susan Winks, Head of Research Operations and Business Development, H3D Research Centre, University of Cape Town, and Prof Kelly Chibale, Founder and Director, H3D Research Centre, University of Cape Town

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Sustainable partnerships key to innovative pharmaceutical R&D in Africa