Epidemic Preparedness: Technological innovations and future directions

The COVID-19 pandemic of 2020 has shown that recent advances in technology can be used to tackle any outbreak of disease. For instance, the period from when the pandemic was officially declared and when the production of the several COVID-19 vaccines was completed was the shortest in the history of vaccine development. Also, all the vaccines produced were different from the old types of vaccine that used killed whole viruses or attenuated ones.

All were products of modern biotechnology advancements. For example, Pfizer-BioNTech and Moderna COVID-19 vaccines are mRNA vaccines, Novavax COVID-19 vaccine is a protein subunit vaccine, and J&J/Janssen COVID-19 vaccine is a viral vector vaccine.

The same thing could be observed in the production of testing kits and diagnostic equipment for the infection. Cutting-edge technologies were employed as real-time qPCR that could provide accurate results in a few hours were used. Rapid diagnostic testing (RDT) kits were also employed in many places as the first line of testing where PCR were not available. This allowed for quick detection of the virus and those asymptomatically infected.

However, none of these vaccines or diagnostic kits were produced in Africa. This became very apparent when supply hoarding and prioritisation of some countries over others were observed. According to a recent report, the Africa Centres for Disease Control and Prevention (CDC) warned that less than 1% of vaccines administered on the continent are manufactured locally, reducing countries’ ability to respond to pandemics and other health crises, and that the global inequities observed in accessing to COVID-19 vaccines, diagnostics, and therapeutics at the height of the pandemic, have prompted a huge push to expand local manufacture of health technologies in Africa.

Coordination in Preparedness and Response Projects

In 2022, Yolanda Botti-Lodovico, the Policy Lead of the Sabeti Lab, who is currently helping to lead the company’s Sentinel work in Sierra Leone in partnership with the broader Sentinel and WARN-ID teams, said that two major technological breakthroughs have powered our global response to COVID-19. First, advances in biomedical and genomic technologies have allowed us to detect and characterise viruses like SARS-CoV-2, and develop countermeasures like vaccines and therapies with unprecedented speed.

Second, powerful new information technologies and systems have allowed us to collect data in real-time, conduct viral surveillance, and coordinate local, national, and regional health systems. But she also noted that technology alone is not enough. She noted that three foundational elements are necessary for the successful implementation and scale-up of each technological breakthrough: (1) regular coordination and collaboration between scientists, public health, and global leaders; (2) equity and community empowerment; (3) and sustainable financing.

The future direction of technological advancements in epidemic preparedness is hinged on these three elements. The availability of technological innovations is not enough. The first element she mentioned about collaboration between scientists for instance, has been a major obstacle in preparing for an epidemic. The key stakeholders in this issue are most times acting in isolation, especially in Africa. Until recent years, One Health approach has been a mirage, with the human health side being the major side getting boosts, while the animal and environmental sides are lagging behind.

In several states in Nigeria for instance, there are no modern diagnostic tools for animal diseases while tools for environmental assessments too are unavailable. And this is backed by human factors that tend to arise from the unwillingness of scientists to collaborate with one another against the onslaught of diseases of public health importance.

On the issue of equity and community empowerment, the disenfranchisement of some communities for a lot of reasons makes harnessing the benefits of technological innovation impossible. As a person who has been involved in community engagement in recent years, I have discovered that communities in rural areas and hard-to-reach places are most times completely cut off during health intervention programmes and even epidemic preparedness. To make technologies far effective in epidemic preparedness, it has to reach everybody without being left out.

The last has to do with sustainable financing, which is where funding comes into place. The issues of funding are not a new thing since it has made Africa to be behind in not only producing new and advanced equipment and technologies needed, but to actually even get the necessary human resources to use them as well. Sustainable fundings are needed to be able to keep operations running, prevent personnel from leaving, and to upgrade the equipment used to recent ones.

While funding is needed from governments of countries where most of the activities will be domiciled, and political will and support for partners are also necessary. Development and supporting partners are needed to provide the additional financial, material and human resources needed to be able to adequately prepare for any future epidemic as shown during COVID-19 pandemic.

This is absolutely necessary because even though the governments of the countries, the major beneficiaries, be the major purchasers of the end products, and partners that are needed to provide the additional funding cannot work without the political will and support of the government. For instance, a $45-million vaccine manufacturing initiative was unveiled in Senegal in July 2023, where the Institut Pasteur de Dakar (IPD) and the Mastercard Foundation jointly rolled out a partnership called MADIBA, which stands for Manufacturing in Africa for Disease Immunisation and Building Autonomy.

But MADIBA’s objective had to align with Sénégal Émergent (Emerging Senegal Plan), a government-initiated development model that aims to achieve the ambitious goal of domestically manufacturing 50 percent of the country’s pharmaceutical products by 2035, in order to become viable.

As seen above, the will and support from governments should not be only political, but also in making their policies encompassing enough to allow partners to be able to work effectively. Even though there are usually issues of finding common grounds in terms of priorities and interests, it is believed that with the supports that partners are ready to provide equally willing governments, who should be ready to divert a chunk of their budget towards health, the matter of sustainable funding for technological innovations should not be a problem in the future.

Source

Rukayyat Sadiq, Oluwatayo Fasuan, Oluwayemi Bamikole, Anthonia Obokoh, Peace Opoggen, Francis Fagbule (2023). Epidemic Preparedness: Fracturing Insights on West Africa. Being a review paper submitted to the Design, Equity, Action and Leadership Fellowship under the West African Institute of Public Health.

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