By Dr Nik Kotecha OBE DL, Chairman of Morningside Pharmaceuticals
“The Covid-19 pandemic led to many healthcare systems in both the western world and lower-middle income countries being completely over-whelmed.
Tragically, the coronavirus did not discriminate between political borders, but what did differ immensely was the response from individual nations.
The UK created the Oxford-Astra-Zeneca jab, which was heralded as a vaccine for the world, and has so far seen 2.5 billion doses distributed at-cost to 170 countries, globally. Almost two-thirds of these have gone to lower-middle-income countries, including more than 30 million doses donated by the UK through COVAX or bilaterally.
This breakthrough and the ability to manufacture on home soil, led to the UK being one of the first nations to emerge from the harsh pandemic lockdowns and draconian restrictions on freedoms, which still dog some parts of the world.
But where perhaps every country did align, was the national focus on investment in their healthcare systems, as well as medicine supply chains, in order to fight the surge in infections and to treat sick patients.
It is this cross-border effort between nations and the national focus on healthcare investment, which must now continue to ensure healthcare is improved, and the supply of safe quality medicines increased, significantly, in lower-middle income countries.
This season I was honoured to speak at the UK-East Africa Health Summit, which was headline sponsored by my company Morningside Pharmaceuticals and the British Medical Journal (BMJ). The annual summit was hosted at the British Medical Association’s HQ in London, and brought together global leaders, including a number of East African government ministers, senior civil servants and high commissioners; alongside representatives from the House of Lords and senior NHS delegates.
During the event we focussed upon finding proactive solutions to improving the healthcare of African communities and strengthening private sector engagement in the region, post covid. This included promoting more collaboration between our NHS in the UK and healthcare colleagues from East Africa.
I have been doing business in lower-middle income countries for almost 30 years and in that time my company has supplied cost effective, quality medicines directly to African countries by working with the Private sector, Ministries of Health, and through large aid agencies such as UNICEF, The World Health Organisation (WHO), MSF and the Red Cross.
During this time I have seen areas where private sector investment can establish and build sustainable processes and healthcare systems in Africa. Firstly, there are great opportunities to set-up local manufacturing facilities in Africa to ensure the supply of cost effective quality medicines is improved and maintained. This is starting to happen, but still most of Sub-Saharan Africa’s pharmaceutical imports comprise of as much as 70% to 90% of all drugs consumed.
This comes with its own challenges, as the supply chain is fragmented and often has an excessive number of intermediaries between the facility where the medicine is manufactured and the dispensing outlet.
Counterfeit, or ‘fake’ medicine is also a huge problem. It’s estimated that fake anti-malarials contributed to 116,000 additional deaths a year from Malaria in Sub-Saharan Africa alone. While governments need to do more to stop these medicines coming into the system, the private sector has an opportunity to invest in innovations, such as 2D barcoding and tamper evident packaging.
Supply chain resilience offers another investment opportunity to western businesses. Quality medicines require secure transportation and a temperature controlled environment. There is a great opportunity for UK businesses to invest in the infrastructure around the whole supply chain of medicines, as inadequate transportation and storage will lower the quality of the products.
One African healthcare issue that is also a concern to the West is antibiotic resistance, which includes finding new ways to fight drug-resistant super-bugs. Many African communities are still using the older antibiotics. These antibiotics are used less in established economies because newer antibiotics have been introduced. Resistance is a big problem mainly because there has been so much over prescribing of antibiotics. Not enough Research and Development is taking place to allow us to come up with new molecules.
Some of the newer drugs work better than the older ones. But that’s the nature of these types of medicines, there will always be resistance of some sort when trying to treat these diseases. It means you need investment in new molecules and medicines to take place, which is where private sector businesses have the answers and will play a pivotal role.
One of the ways to address this is to significantly increase spending on Research & Development (R&D), which the BMJ reports only accounts for 1.1% of global investments in Africa, despite the continent being home to 15% of the world’s population. Another way to illustrate this disparity is to show that there are only 375 drug manufacturers in Africa that serve 1.1 billion people. Whereas in India, there are 10,000 serving 1.4bn and China around 5,000 serving about 1.4bn people.
Africa has a highly intelligent and skilled population, but significant investment is needed from the international private sector to help mentor, guide and train medical professionals to fully utilise their skills. This is why a summit of this kind is so important. An outcome will hopefully be that skills and expertise that we have in the UK’s National Health Service (NHS) will be provided to our African colleagues, and we are also learning from some of the great work that’s happening in Africa. Nursing was a particular focus of the summit, with health and political leaders looking at ways to help our African partners reach their full potential.
I hope to see some collaborations where we can send NHS nurses and doctors out into Africa to help with techniques and knowledge bases there, as well as invite people from East Africa here for training.
It’s clear there are no easy answers to some of the healthcare challenges faced by the African nations and other lower-middle income countries.
But if politicians, healthcare professionals, Aid agencies and business leaders can work more closely together, then we stand a great chance of making significant progress.
The opportunities are out there, now let’s work together to ensure everyone has access to essential healthcare, no matter where they live in the world.”