Dr Leonardo Simão represented EDCTP at the emergency meeting of African Ministers of Health on COVID-19 in Addis Ababa, Ethiopia, on 22 February 2020. The meeting was organised by the African Union and the Africa Centres for Disease Control and Prevention (Africa CDC). The objective of the meeting was to consider actions for strengthening the preparedness and response to the COVID-19 epidemic in Africa.

Dr Simão: “The meeting clearly showed the importance of having an institution dedicated to disease and epidemics control. Fortunately, the Africa CDC was already up and running. Through Africa CDC, all stakeholders have access to heads of state. Our initial wake-up call was, of course, the Ebola Virus Disease epidemic in West Africa. The need for a regional coordination mechanism became more than clear and now, with the COVID-19 pandemic, coordination again is key.

What we are seeing is an unprecedented collaboration between governments, between research institutions, and regional and international organisations such as WHO. Africa CDC invited the Ministers of Health early on, facilitating and coordinating the search for a pathway through the epidemic. Intra- and inter-continental coordination is happening with various partners. Of course, the main reason for this unprecedented collaboration is that we all experience the same threat and face a common challenge. Regionally, nationally, and even within countries, solutions will have to vary, to be tailored to the strengths and weaknesses of the local contexts. But in the end, it will be a common pathway.”

Dr Leonardo Simão and Professor Marcel Tanner, the EDCTP High Representatives for Africa and Europe, are involved in many national and international policy and strategic partnership engagements on the response to the COVID-19 pandemic and its impact on public health. They are both in national advisory roles in, respectively, Mozambique and Switzerland and have many responsibilities in global health (research) networks, including representing EDCTP. We asked them to share some observations on possible lessons learnt that could inform and shape the future partnership programme.

Professor Marcel Tanner was closely involved as an advisor in the development of the response to the pandemic, both nationally and internationally, through various research networks and political contacts. One of his efforts has been to discuss more financial support from EDCTP member countries for the enlargement of the budget for EDCTP’s COVID-19 emergency call.

Prof. Tanner: “In such a crisis, it becomes clear that EDCTP has been building the platforms that are needed to develop the necessary interventions, globally and locally. It has consistently supported working partnerships between European and African centres. Through its support, actors were established that can now respond to the pandemic.

“It sounds a bit abstract, but I am happy to say that EDCTP has become ‘system relevant’. The programme takes a systemic view and diversified approach, including thinking in terms of portfolios. The long game of investing in research capacity is paying off. Many African centres are now relevant to the needs of the population areas they serve and government policies as well. At the same time, they are part of complex international research networks.”

Dr Simão: “It is too early to draw lessons, but I think that the start of the African response was timely. We knew what could be coming because of what had happened in China and Europe in a matter of a few weeks. We knew we had to act quickly. Two other factors made a difference. Many African countries already had experience with epidemics, most notably with the Ebola and yellow fever outbreaks. Secondly, WHO has ensured that African authorities and researchers are jointly involved in the response.

“
EDCTP has consistently supported working partnerships between European and African centres. Through its support, actors were established that can now respond to the pandemic.

”

I wish to be optimistic. The pandemic created an immediate political awareness of the value of health research, also in African countries. For example, in my country, the President urged scientists to step up their efforts. Hard and tragic as the pandemic is, I am confident it will also lead to a policy environment that is more conducive to R&D in Africa. In a way – I say this with humility – what we are seeing is a confirmation that EDCTP has been on the right path promoting clinical research in Africa and strengthening local capacity to do this work. EDCTP is very relevant, the path is good, and even its focus on infectious diseases is well justified.

This is not to say it is the only path; what we need is coordination with others with complementary and synergistic approaches. Africa’s needs cannot be exhausted by any organisation acting alone. As we progress, we also must adapt. EDCTP evolved from its focus on HIV, malaria and tuberculosis to a more inclusive programme with other poverty-related and neglected diseases, and a broadened intervention scope covering all phases of clinical development, including product-focused implementation research and better disease surveillance.

“
EDCTP has been on the right path promoting clinical research in Africa and strengthening local capacity to do this work. EDCTP is very relevant, the path is good, and even its focus on infectious diseases is well justified.

”

Professor Tanner: “I agree, for our mission, I think, the One Health approach is as essential a component as improving surveillance and diagnostic capacities to allow rapid and situation-tailored public health responses. Again, it comes back to a systemic view. Also, allow me to bring up one of my favourite adages: ‘No roots, no fruits’. Let’s not forget our roots. EDCTP has an inclusive approach and is a programme rooted in partnerships and broadening them.”

Dr Simão: “That’s how we will adjust to the new realities. Outbreaks of emerging or re-emerging diseases will be more common and migrations of viruses and microbes to human hosts are more likely to happen. In the next EDCTP programme, emergency preparedness including for emergency research should have a bigger place. This is still consistent with our roots and objectives. As Michael Makanga said, ‘COVID-19 is not a distraction from our mission, it highlights the interconnectivity of diseases and its relevance to the future of the programme’.

Dr Leonardo Simão

Prof. Marcel Tanner