It is fitting that the Africa Centres for Disease Control and Prevention (CDC) picked a country home to the mighty Mosi-oa-Tunya (“The Smoke that Thunders”) to host the third edition of its International Public Health in Africa conference (CPHIA 2023).
The four-day meeting in Lusaka, Zambia, took place under the theme “Breaking Barriers: Repositioning Africa in the Global Health Architecture” and revealed Africa’s grand ambitions in global health that appear just as large and steep as the famous waterfall.
More than 5,100 delegates gathered at the Mulungushi International Conference Center from 27-30 November to tackle Africa’s biggest healthcare challenges and indeed, this was a uniquely African affair.
More than 76% of delegates attended from across the African continent and leaders from African Union (AU) member states and the World Health Organization African Region (AFRO) assembled.
And while discussions centered on Africa’s specific health challenges, African leaders demonstrated an appetite for the continent’s brightest minds to usher in a new era of innovation for the continent, and consequently the world.
In opening remarks, Africa CDC director Dr. Jean Kaseya outlined Africa CDC’s vision to reshape the African healthcare landscape through an emphasis on 5Cs: Community, Connectivity, Capacity, Collaboration, and Climate.
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Front and centre of the agency’s ambitious agenda is to ensure that by 2040, a minimum of 60% of vaccines and medicines used in Africa are manufactured within the continent.
Delivering a bold statement at the conference’s opening plenary, Kaseya said that local manufacturing of medical supplies will represent the “Second independence of Africa” and a pathway to mitigate reliance on the international community, while promoting local innovation, job creation and economic growth.
“The excessive dependence on imports for essential healthcare products is a matter of grave concern,” said Kaseya.
“Less than 1% of vaccines, 5% of diagnostics and 30% of therapeutics used in Africa are currently manufactured in Africa. This imbalance underscores the urgent need to strengthen our medical manufacturing capabilities to enhance self-reliance and reduce vulnerability to supply disruptions.”
First focus – local manufacturing of diagnostics
Professor Abderrahmane Maaroufi, Director of Morocco’s National Public Health Institute called for local manufacturing of diagnostics to be Africa’s initial focus.
In a key presentation, the public health leader underscored the challenges that the continent faces in disease detection and surveillance, highlighting how research efforts can support development of new products pertinent to the population’s unique challenges, such as diagnostics for Neglected Tropical Diseases (NTDs) which impact more than 600 million people in Africa.
“We need to strengthen political commitment and have member states and policy makers accelerate local manufacturing of diagnostics. The role of state and public sector is imperative,” said Maaroufi.
The Covid-19 pandemic proved that coordinated efforts in data sharing across the continent can be essential in developing platforms that scale, he added. “We need to act now and mobilise private sector investment through public-private partnerships.”
However, a lack of trust in local manufacturing solutions must also be addressed according to Maaroufi. “There is a mindset shift that needs to take place as research shows there is a lack of confidence in solutions that are produced here on the African continent.”
To this end, African health business successes were championed during CPHIA 2023. Discussions focused on success stories across the continent, with presentations heard from Zimbabwean pharmaceutical manufacturer Varichem Pharmaceuticals and South African biotech firm Afrigen.
The World Health Organization (WHO) Regional Director for Africa, Dr. Matshidiso Moeti, took to the stage and highlighted the progress occurring in pandemic readiness since the Covid-19 outbreak.
However, the WHO health leader stressed the importance of regional cooperation in consolidating the buying power of Africa and overturning fragmented approaches to future crises. In a keynote address, Moeti urgently called for community engagement and a shared continental responsibility.
“No village or person should be left behind,” said Moeti. “We need everyone involved and to work together.”
The threats posed by climate change to the health of Africans was also discussed. According to the Africa Development Bank, Africa loses 5-15% of its GDP annually due to the impact of climate change. The continent is also facing a growing risk of of outbreaks caused by zoonotic pathogens which is worsened by climate change.
“As I speak, we have 18 countries affected by cholera with more than 4,000 deaths,” said Kaseya.
“We have multiple West African countries affected by dengue. The flooding in a number of countries including Libya, the earthquake in Morocco and a number of other natural disasters are showing the linkage of climate change and health in Africa. Therefore, Africa CDC is committed to supporting African countries to adopt a comprehensive One-health approach to tackle these climate-related challenges.”
Deep investment needed to scale African health tech
As mobile technology sweeps Africa’s 1.2 billion population, the optimism around digital technologies in Africa’s healthcare future abounded. The Covid-19 pandemic is reported to have galvanised the development of 120 new health innovations in Africa, but technologies are struggling to scale.
In a panel discussion titled “Unleashing digital innovations” experts discussed why health tech has failed to receive the same enthusiasm as Africa’s fintech sector which has raised more than $2.7 billion in VC funding in the last two years.
Nigerian entrepreneur and founder/CEO of health tech company Advantage Health Africa, Abimbola Adebakin, said overall healthcare remains a hard sell and private sector funding is not being leveraged.
“Some people still think it is a misnomer to have the private sector investing in healthcare due to the social aspect and therefore serious money is not easily accessible,” said Adebakin.
“While yes, it is true that innovators want to make money, innovators are also seeking impact and the type of funding that supports impact isn’t quite the same type of funding as pure play businesses,” she explained. “Serious money is needed to scale, and that serious money is just not around easily.”
According to Adebakin, a reorientation across Africa’s health ecosystem is required for people to understand that healthcare can be a business and one that is fundable.
“Debt and all forms of finance are required to back healthcare innovation,” stressed Adebakin. “We need deep long-term funding and deep pocketed investors.”
The skills needed to bring products to market are also lacking. “We need more people with experience in product marketing and experience in human needs and business,” Adebakin noted. “An infrastructure of people and skills must be created to bring health technologies from concept to market.”
However, Sharon Batamuriza, director of entrepreneurship program Bridge By Billions, said regulatory uncertainty is holding back potential investors from committing to health tech startups.
“The discussions we need to have at the very foundation of innovation are about policy, regulation, and guidance because today there is no clear understanding of what’s being built,” said Batamuriza.
“There needs to be clarity around the continent in general about what type of policies guide solutions and how they will allow companies to operate or serve the patients they need to.”
Batamuriza highlighted the Pan-African health tech accelerator HealthTech Hub Africa which nurtures health tech startups through partnership with governments and the public sector. “It’s the same problem we hear from a founder in Kenya, Rwanda to South Africa,” she explained. “Regulation is a common challenge that needs to be addressed.”
Ngasuma Kanyeka, a doctoral candidate at Harvard T.H. Chan School of Public Health, emphasised how ultimately Africans must be the creators of technologies and not consumers. Referencing the rise of artificial intelligence (AI) in healthcare, Kanyeka said Africa must have a seat at the table.
“Anyone and everyone with an ability to influence and support African innovators should be prioritising this,” said Kanyeka. “We are already seeing with technologies like large language models (LLMs) and automated devices that they are biased. Why? Because we are not part of the design team, and this has huge implications for our future and our children’s future.”
Pan-African political will
The genesis of the AU’s Agenda 2063 manifesto in 2015 was a blueprint and master plan to transform Africa into the global powerhouse of the future. Since its formation in 2016, Africa CDC has become a strong champion for change in the African continent, but it is evident that without strong political backing, the agency will be limited in its influence.
More than anything, CPHIA 2023 highlighted the multifaceted challenges that Africa faces in breaking barriers and positioning itself in the global health architecture, but the meeting also showcased a continent that is enthusiastic and hungry for change.
To build resilience, investment across the continent must align to create a skilled and well-equipped workforce for Africa’s future. Unification in regulatory and investment strategies will be the quickest way to achieve the continent’s ambitions. And for the private sector it presents an array of opportunities to collaborate with African innovators and governments to accelerate change in the digital and manufacturing sectors.
For Africa CDC, they are tasked with a monumental mission to lobby AU member states to commit to specific healthcare initiatives that can realise the objectives of this Pan-African agenda. As speakers reiterated across the four-days – only political leadership can drive change and political will is needed to champion the vision of Africa’s health sovereignty.
But the hope seems to be there. Zambia’s former president and founding Father Kenneth Kaunda famously said, “Ambition never comes to an end.” It appears Africa is listening.