Research Article: Developing ANDI: A Novel Approach to Health Product R&D in Africa

Date Published: June 29, 2010

Publisher: Public Library of Science

Author(s): Solomon Nwaka, Tshinko B. Ilunga, Jorge Santos Da Silva, Emiliano Rial Verde, Doan Hackley, Raymond De Vré, Tom Mboya-Okeyo, Robert G. Ridley

Abstract: Solomon Nwaka and colleagues discuss ANDI, the African Network for Drugs and Diagnostics Innovation, which is intended to help stimulate health research and development on the African continent.

Partial Text: The health status of the African population remains behind that of populations in Europe and North America, as well as many other developing regions with similar affluence (Figure S1). For example, Africa is especially affected by a series of infectious diseases that are responsible for more than half of its disability-adjusted life years (DALYs) and over 6 million deaths per year (Figure S2). For the 18 diseases listed in Figure S2 Africa has over 30%, and in some cases over 90%, of the worldwide disease burden, even though it represents only 15% of the global population. Currently, there are limited or no affordable therapies or vaccines for many of these conditions, and diagnostic methods, where they exist, are often inadequate to deploy in the field for large populations [1]–[5]. Accurate quantification of the economic impact of disease burden is difficult. However, the negative impact of these diseases to the African gross domestic product (GDP) may run into tens of billions of dollars (US) each year [5]–[7].

We mapped the African health research landscape by building a database of all peer-reviewed research articles in biomedical fields that had at least one African-based author, during the 5-year period 2004 to 2008. The methodology for data collection and analysis is presented in Figure 2 (additional information is also provided in Text S1 and Table S3). The affiliation of authors in a total of 31,279 articles identified were processed to determine the lead and collaborating institutions in each article. For every institution, the number of individual collaborations was quantified and mapped.

While the extra-African collaboration should be encouraged, the lack of intra-African collaboration suggests that African institutions do not have adequate leadership and ownership of the research being done in the continent. The sustainability of research undertaken in Africa may also be an issue, especially when it is undertaken with short-term funds coming from, and directed from, external sources. The poor intra-African collaboration was confirmed by interviews in Africa. Over 170 stakeholders were interviewed across African countries/regions including ministries of health, science and technology, and higher education; national academies of science; pharmaceutical companies and research centers; and networks and universities in South Africa, Nigeria, Egypt, Kenya, and Burkina Faso [6]. These interviews identified key factors believed to hamper collaboration, ownership, and leadership of research in Africa. These include the lack of knowledge about R&D done in other African countries, the deficient networking infrastructure, and the absence of financial incentives to spur cooperative research within the continent.

The global momentum to increase participation and leadership of low-income countries in their own R&D programs received a major push through World Health Assembly resolutions on the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property [8],[9]. This guiding framework calls for improvement in health R&D innovation through greater engagement of developing countries, investment in local capacity and capability building including support for regional R&D collaborative networks, and devising mechanisms to ensure financial sustainability of local R&D efforts. This is consistent with other high-level pan-African declarations, for example the Algiers declaration of 2008 [18]. This is a propitious moment to address the need for medicines in Africa, with a pragmatic and sustainable model that: (a) promotes the assembly of African R&D networks that can better use the technology and human capital already present on the Continent, (b) sustainably funds R&D projects aligned with African health priorities and led by African R&D centers, (c) ensures African ownership of the R&D agenda, and (d) supports broader south–south and south–north collaboration and technology transfer.



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