Genomics

I have always been intrigued by genomics. Yes genomics! For someone with a legal background, that sounds like an elephant being interested in tree climbing right? Well for someone whose childhood dream was to become an Aeronautics engineer, you can guess where I veered off.

Back to genomics. That field of biology focusing on the mapping and editing of genomes amongst other beautiful things. My particular interest is with the gene sequencing bit. Being able to sequence the information of organisms in an attempt to understand the structure and function of these sequences and of downstream biological products, I think is absolutely genius.

Now, the role this plays in mapping disease progression and the overall relevance to public health in human populations in general has pretty much proven that technology continues to be the modern-day savior of the world. ‘pun’ intended. To the lay man like me, being able to identify and map disease progression means that we can then be able to prepare and advance treatment options accordingly.

Recently, I was opportune to speak about how we were in ‘peace time’ at the moment, and how the world and particularly Low- and Middle-Income Countries (LIMC’s) like majority of the African continent must begin to make efforts to prepare overall for pandemics, and someone asked me what I meant by ‘peace time’.

Well, peace time in this sense is literally the absence of any type of pandemics regardless of the scale. Pandemics tested healthcare systems and infrastructures on this side of the world and proved how fragile they were. At the time, we all but wished governments on the continent had brushed up health infrastructures to a point where we could cater for our huge populations without looking to other economies for handouts.

The recent pandemic also mainly exposed large scale global health inequalities and developing countries in return struggled significantly. For African countries, not being able to respond in an efficient, cost-effective, and robust manner for obvious reasons meant that they recorded needless casualties. Thus, being prepared for these countries would mean being at a state of readiness to be able to diagnose, treat and perhaps prevent major diseases that burden their populations.

Worthy of note is the fact that the WHO worked with countries to scale up pathogen surveillance through genome sequencing during the covid-19 pandemic, particularly as it related to covid surveillance. Perhaps this same structure will be utilized to further continue to strengthen capabilities on the continent beyond covid. One must also acknowledge the great partnership between the WHO and the South Africa National Bioinformatics Institute (SANBI) which set up the Regional Center of Excellence for Genomic Surveillance and Bioinformatics in Cape Town. While this and a handful of centers in existence around the continent are a step in the right direction to getting us to that state of preparedness, we need to keep up and sustain the drumbeats in again, ‘peace time’.

Now back to the basis of this write up. A simple analogy is, I believe we need to get from point A to B, and to get from point A to point B where point A is our ability to progressively identify and map disease progression in time, and point B being our ability to produce vaccines at scale to meet our needs in the event of another pandemic.

Now between these two points I believe there are lots of actual deliberate and practical steps that countries need to take to get there. Steps that will be ordered and driven by a purposeful leadership of the African Union at the helm of Affairs, and then cascaded and implemented by countries because they see and prioritize the need to level the playing field.

The Africa Center for Disease Control and Prevention (ACDC) is trying to get something going with critical partnerships like the one it just went into with the Clinton Health Access initiative and PATH, following an assessment of Vaccine Manufacturing in Africa this October. The assessment which is the base of this partnership looked at two critical components or steps needed in the vaccine manufacturing process.

1. Producing the active vaccine component, or antigen, which is the most cost-intensive and technically challenging step, and

2. Producing the final vaccine which includes formulation, fill-and-finish etc.

While I must say that there exist excess fill-and-finish capabilities on the continent today, the first part is the real challenge, and partnerships like the Partnership for Africa Vaccine manufacturing (PAVM) with a goal of reaching 60% local manufacturing of Africa’s routine vaccine needs by 2040 will do their best to support and grow the ecosystem. However, an assessment of this project and the likes in a six to twelve months timeframe will indeed determine if foundational concrete steps have been taken to bridge the inequality gap in the area of overall pandemic preparedness for Africa.

Although I speak loosely of LIMCS, this writeup is mostly about African countries and the need to make the proverbial hay while the sun is shining.

#pandemics World Health Organization (WHO) Publichealth summit Gavi, the Vaccine Alliance Clinton Global Initiative