The online event was opened by Franz Schmidjell from the VIDC who welcomed the panelists and participants. The event should deepen the understanding of the COVID-19 pandemic on the African regions and help to learn more about the response by African institutions, especially the African Center for Disease Control and Prevention (Africa CDC). Secondly, it discussed possible risks concerning the unequal access to medicine and future vaccines because of intellectual property rights regimes and profit interest by pharmaceutical companies. Approximately 70 people participated in the online event; many more joined the Facebook live stream.
The moderator Rita Isiba, a communications expert and initiator of the Frontier of Dialogue Forum in Vienna, introduced the speakers. She asked Mr. Africa Kiiza, a trade expert at the economic research institute SEATINI in Kampala, for clarification on how the development of low priced generic medicine for COVID-19 is affected by the WTO rules (World Trade Organization) and the TRIPS agreement (Trade related Intellectual Property Rights).
Access to medicine for all
Mr. Africa Kiiza criticized that everything has been put under the logic of profit, treated like commodities, including health. As a consequence, many big companies benefit from pandemics like COVID-19 through intellectual property rights. Since the inception of the WTO and the TRIPS agreement (Trade-Related Aspects of Intellectual Property Rights), African countries and developed countries demanded more flexibility to allow low-income countries to produce generics in order to enable them to access essential lifesaving medicines. He proposed a framework and an environment where low-income countries are supported with human, technical and financial resources. This would allow them to look into alternative, low cost medicines and protective equipment. Some African countries already put in place alternatives like cheaper ventilators or facemasks. He added that Madagascar has come up with a traditional medicine, but more tests are necessary to prove its efficiency. Mr. Kiiza mentioned another shortcoming. Because of low national health budgets, the majority of financial resources is coming from outside and tied up to address specific areas. This makes it difficult to develop autonomous health programs and to quest for health alternatives.
Dr. Marcus Bachmann, pandemic and public health expert at Doctors without Borders in Vienna (MSF Austria) agreed with Mr. Kiiza regarding his criticism towards the big pharmaceutical companies and the need for another international framework. He mentioned the Pneumococcal vaccine against pneumonia as an example. He recommended that this should be included in vaccination programs of all nations, because many people lost their lives because of pneumonia. But the vaccine is unaffordable in many low-income countries. The manufacturing capacities are another limiting factor in these countries. GAVI, the private-public global Vaccine Alliance, has the goal to increase access to immunization in poor countries and made vaccination against Pneumococcal disease accessible for many low-income countries. But during his work in South Sudan, he made the experience that humanitarian organizations like Doctors Without Borders were denied access to the GAVI Pneumococcal vaccines. He asked for an end of the blockages at the level of intellectual property rights, to implement the flexibilities enshrined under the TRIPS agreement and the Doha declaration and to increase the manufacturing capacity in the Global South. At the global fundraising event for the accelerated initiative of the World Health Organization (WHO), 4.4 billion dollars was pledged for research and development of COVID 19 vaccines. This is funded by governments using taxpayer’s money. The public has a right to get something in return.
Response by the African Centre for Desease Control
Mrs. Rita Isiba introduced Dr. Raji Tajudeen, the Head of Public Health Institutes and Research at the Africa Centers for Diseases and Prevention (Africa CDC is part of the African Union) in Addis Ababa, Ethiopia.
Raji Tajudeen asserted that per June, 18 th 2020, there were 270,000 positive COVID-19 cases in Africa which is just 2% of the global total. More than 40% of the cases in Africa have recovered. In terms of death, there are over 6700 dead, which is around 1% of the global total. But the number of tests has to be increased to get a more representative picture. Furthermore, he mentioned that only 5% of Africa’s GDP is spent on health, whereas 15% were agreed upon in the Abuja declaration. He also mentioned the deficiency of health workers and other epidemics going on at the same time. For example, there are cases of EBOLA in the Democratic Republic of Congo (DRC).
Africa CDC emphasized the need to coordinate, collaborate and to communicate by sharing information as a continent. Africa CDC has been able to endorse and set up a taskforce and continental strategy which focuses on testing, tracing and treatment. The high level coordination involves ministers such a health, transport, trade and industry, science and development, the private sector and the regional economic communities.
He reiterated that testing is of paramount importance, and should be a major focus, adding that member states should engage in smart testing. He adds that there is the scaling up of testing to around 3.6-3.8 million (based on aggregated data). Test possibility rates are now up to 7%. This also includes the scrutiny of treating mild, major, and suspected cases as a whole.
Africa CDC created a procurement platform to enable the continent to purchase medical supplies. It will train 1 million health workers, especially to the vulnerable and fragile states. The game changer regarding the issue of COVID 19 is the availability of affordable and equitable access to the vaccine. A conference is going to take place on June, 24th and 25th 2020 with focus on research and development and also affordability and equitable access to manufacturing vaccines in Africa.
An understanding of the risk factors needs to be developed. Insights on people who are most vulnerable due to non-communicable existing diseases such as hypertension, diabetes, obesity cancer, HIV/AIDS, malaria or malnutrition is crucial. It is important to understand how these different ailments make patients more susceptible to death by the virus.
Trade agreements must enable affordable medicine
During the panel discussion, Raji Tajudeen came back to the WTO-initiated TRIPS agreement. He stated that the ministers of trade and industry are part of coordinating ministers and the above-mentioned conference. The agendas to be discussed include manufacturing and availability of vaccines. The history of the Pneumococcal vaccine, which did not reach Africa until 10 years after developed countries have used it, must not repeat itself. Africa Kiiza added that the TRIPS negotiation towards HIV access was a tug of war for Africa to manufacture a generic medicine at affordable cost. This time the WTO should promote more flexibility (note by editor: e.g. compulsory licenses) for other countries to manufacture a generic medicine. He criticized that some Free Trade Agreements try to go behind WTO rules, which erodes the flexibilities which were fought hardly to achieve.
Marcus Bachmann emphasized that the struggle against the pandemic must be fought globally, not individually by each country or continent. Furthermore, excluding the Global South would result in the loss of many lives. He called for mechanisms for sharing technology, especially for the equitable creation of the vaccine as soon as it is made available.
In terms of transparency of the agreements with producers, Marcus Bachmann stressed that the civil society must be included in all oversights and governing bodies, to define the rules and to oversee and monitor the allocations of vaccines. Dr. Tajudeen stated that Africa CDC recognizes the importance of sciences in emergency preparedness and response. In the up-coming conference, there will be an own session about community involvement and the civil society will be represented.
Participants asked, if the secondary effects of the COVID-19 pandemic, especially other health problems and lockdowns, did cause more damage. The speakers agreed and stressed the need to invest more in non-Covid 19 healthcare services as well to prevent excessive loss of life when it comes to malnourishment, sexual and reproductive health, treatment of chronic disease and ongoing epidemics.
is a Medical Doctor with postgraduate qualifications in Pediatrics and Public Health. He is the Head of Public Health Institutes and Research at the Africa Centres for Disease Control and Prevention (Africa CDC), the public health agency of the African Union in Addis Ababa, Ethiopia. He coordinates the establishment and strengthening of National Public Health Institutes across the 55 African Union Member States and oversees the establishment of the five Africa CDC Regional Collaborating Centers. He has years of senior level experience in Child Health, Health System Management, Health Diplomacy, Maternal and Child Health, and Health in Humanitarian Emergencies. He has worked in different settings in the developing world; Nigeria, Saudi Arabia, Liberia, Guinea, Sierra Leone and Ethiopia. Raji Tajudeen heads the healthcare preparedness and countermeasures section of the Africa CCD COVID-19 response and co-chairs the case management technical working group of the Africa Taskforce on COVID-19.
is Program Officer Trade Policies & Negotiations Programme at the Southern and Eastern Africa Trade Information and Negotiations Institute (SEATINI, Uganda). He has research and advocacy experience on issues ranging from WTO Negotiations, the Economic Partnerships Agreement (EU AU EPA), the implementation of the Sustainable Development Goals (SDGs) in Uganda, the the African Continental Free Trade Area (AfCFTA) Negotiations and the African, Caribbean and Pacific (ACP)-EU Post Cotonou Negotiations
is the advocacy & humanitarian affairs representative of “Doctors Without Borders” in Vienna (MSF Austria). He is a natural scientist with many years of professional experience in the pharmaceutical industry. Between 2005 and 2019 he was on numerous missions with MSF, among others in the Democratic Republic of the Congo, Kyrgyzstan, Bangladesh, Sierra Leone and South Sudan. He coordinated emergency relief activities in a variety of contexts - from natural disasters such as earthquakes and floods to epidemics such as Ebola and cholera.
is a moderator and communication expert. In 2016, she founded Aphropean Partners, a specialised communication agency to provide decision-makers, NGOs and government agencies a natural extension of marketing to streamline the process of change management for the future of work, cultural and gender diversity management in the workplace and society. Previously, she has worked for various UN agencies, marketing agencies and investment banks, including leading to West Africa. Rita Isiba graduated from Hertfordshire University, England with a degree in Business and European Studies and Masters of Business Administration at the Heriot-Watt University (both in the UK). She obtained a certification in business consultancy by Oxford College.