Transforming healthcare delivery through technology

Persistence, rigorous enforcement of quarantine, disinfection of premises, provision of adequate funding and political willpower were key factors that contributed to the success story of Ebola Virus Disease elimination in Nigeria.

According to experts, the containment of Ebola is one of the most noted public health crackdowns in the largest African country and this serves as a model for the rest of the world.

Recognizing Nigeria’s successful response to Ebola, according to the health professionals, is an indication that with same commitments and adequate preparations, the clamour for functional health and innovation system is attainable.

The Nigerian example was highlighted at a meeting organized by the African Network for Drugs and Diagnostics Innovation (ANDI) – a pan African initiative hosted by the United Nations in Addis Ababa recently. The meeting focused on the role of technology in transforming health care delivery and Ebola research and development.

Executive Director of ANDI, Dr. Solomon Nwaka said that the meeting recommended that the Nigerian approach to Ebola outbreak be written and publicized broadly, as a model for future outbreaks or emergent infections.

He stressed that “the swift response by Nigeria to contain the spread of Ebola Virus Disease in the country is a positive demonstration of leadership.

The establishment of a properly resourced Ebola emergency operation centre by the Nigerian government under the Nigerian Center for Disease Control of the ministry of health as well as a strong coordination of efforts with functional public and private diagnostic laboratories was important to this success.

“Ongoing development of diagnostics and surveillance tools for Ebola in Nigeria and Uganda as well as the pioneering work of the National Institute for Pharmaceutical Research and Development (NIPRD) Abuja on the development of NIPRISAN from local traditional medicines for the management of Sickle Cell Anaemia, were examples of technologies discussed at the ANDI event.

“These are clear examples of how African countries can leverage local solutions to solve local problems. Advancing and availing such products emerging from Africa laboratories to the people that need them the most require strong political will and leadership as well as engagement with the industry. It requires financial commitment and strong regulatory oversight to ensure that the quality and safety of such products are not in questions,” Nwaka added.

Nwaka’s concern for better functional health and innovation System in Africa started prior to his joining the United Nations Office for Project Services (UNOPS) and serving as the acting Executive Director of ANDI.

He headed different research and development units at the World Health Organization (WHO), special programme for research and training in tropical diseases, such as drug discovery research for infectious tropical diseases, and innovation for product development in developing countries.

The ANDI concept was launched in Abuja, Nigeria in 2008 with a mission to promote and sustain African-led health innovation to address African public health needs through efficient use of local knowledge, assembly of research networks, and building of capacity to support development.

The ideology focuses on addressing Africa’s unmet health needs by harnessing the untapped power of collaboration among African researchers as well as equitable North-South and South-South partnerships and the organization’s vision is to create a sustainable platform for health innovation in Africa.

Also last month, the African Network for Drugs and Diagnostics Innovation in partnership with United Nations Children’s Fund and other stakeholders convened 50 health experts gathered in Addis Ababa to prioritize mechanisms that will enable sustained health innovation in Africa.

The experts highlighted the critical leadership role of ANDI in African health innovation while proposing the establishment of a sustainable financing mechanism to support local technology development, capacity building and Ebola research and development.

The summit stressed the high impact technologies that can transform healthcare delivery and in particular, seminal African discoveries on Ebola Virus with potential for diagnostics and therapeutics were presented and discussed with emphasis that these programmes require the establishment of a sustainable health technology fund to support their development.

It was agreed that the new African-based fund, equipped with grant making and social venture arms to support the initiative would ensure development, implementation and commercialization of technologies emanating from African Centers of Excellence and other sources.

It will also support partnership building, the operationalization of the African regulatory harmonization activities, and promote local research into Ebola and other emergent infectious diseases, and it was noted that establishment of incubators and engagement with the private sector will be pivotal for realizing this ambition.

Nwaka said that the conference had been extraordinary and “the technologies discussed at this meeting demonstrate the health innovation potential existing within the African continent.

With the establishment of the right enablers such as a sustainable financing mechanism, African research and development institutions and entrepreneurs will be able to collaborate in order to solve the health challenges of the continent and contribute to development.

“The development of innovation capacity in developing and emerging economies has been my passion for many years. I am pleased to see the momentum around ANDI after the initial transitional challenges it faced last year,” he said.

In 2011, thirty-two African research institutions including three Nigerian establishments were recognized as Centers of Excellence in health innovation by the ANDI. including the National Institute for Pharmaceutical Research and Development as in phytomedicine research and developments, university of Ibadan for malaria translational Research and university of Lagos for malaria diagnosis.

The objectives of the Centers of Excellence is to form a vital African network that will link and increase research and development and manufacturing done by African institutions and the Centers will have opportunities for funding and partnering, through ANDI and other funding agencies.

The ANDI Centers of Excellence are spread across the five sub-regions of Africa and are conducting research and development, and innovation activities on drugs, diagnostics, vaccines, medical devices and traditional medicines. They will implement ANDI projects and build research capacity on the continent.

Nwaka noted that “this is the beginning of a process that we hope will encourage African governments to invest in their institutions and scientists to become world class facilities in order to advance health innovation in Africa” while lamenting that the main challenge facing ANDI is that of financial and human resources to implement the ambitious agenda, and expressed the hope that donors and governments will support ANDI.

Approximately 117 applications for accreditation as Centres of Excellence were received from 26 countries across Africa.
According to Director of Economic Commission for Africa’s Information Communication Technology, Science and Technology Division, Aida Opoku-Mensah, “the short listed Centers will form the first pan-African network of health institutions capable of undertaking high quality research and supporting the development of urgently needed pharmaceutical products. The network will comprise centres involved in research and development, clinical trials and manufacturing facilities, among others.”

Opoku-Mensah stressed that promoting excellence at each stage of the process is “a key enabler in the organisation’s mission to enable African researchers and manufacturers to sustainably identify, develop, register and commercialize health products designed to address Africa’s unique health challenges.”

The 62nd World Health Assembly in 2009 on global strategy and plan of action on public health, innovation and intellectual property the resolution stated that on “welcoming the reference in the report by the secretariat to the implementation of the ANDI, which supports and promotes African-led health product innovation for the discovery, development and delivery of drugs and diagnostics for neglected tropical diseases, and reiterates the need to fast-track activities to reach neglected people who are sick and suffering from neglected tropical diseases” and decided to incorporate into the plan of action additional agreed stakeholders.

The congress accepted the proposed progress indicators as outlined taking note of the need to periodically review and refine. where the indicators are quantitative, the Secretariat shall provide complementary information on the implementation of the specific actions

The Assembly requested the Director-General of WHO, Margret Chan to significantly increase support towards greater efficiency and effectiveness in the implementation of the global strategy and plan of action on public health, innovation and intellectual property and prioritize concrete actions in the area of capacity-building and access.

Two late stage projects funded by ANDI are the evaluation and local production of a suite of medical devices to treat respiratory distress in neonatal and jaundiced children in Africa, being implemented by investigators at the University of Malawi with partners at Rice University in Houston, United States of America and the co-formulation of the locally produced drug NIPRISAN with another standard drug used in the management of sickle cell disease, being implemented by the NIPRD in Nigeria and partners.

But Director–General of NIPRD, Prof. Karniyus Gamaniel said that the funding from ANDI is crucial and appreciated but lamented that the memorandum of understanding signed by Nigeria has not been remitted to the institute since 2010.

Asked how NIPRD is faring as a Centre of Excellence, Gamaniel said that the institute “has been faring well but of course there are challenges.

What is going on is our relationship with ANDI in the sense that through that relationship as a whole ANDI has carried us along in our programmes of networking.

The first was the meeting with the Korean team where the (former Minister of health, Prof. Onyebuchi Chukwu) led a delegation to Seoul and we had very fruitful discussions and two follow-up meetings actually.”