Africa: Africa Must Build Epidemic Preparedness Before the Next Outbreak

Build Bridges for the Future: Africa Prioritizes Emergency Response and Clinical Trial Strengthening

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Africa’s ability to respond to the next epidemic will depend less on how many researchers it trains or scientific papers it publishes and more on whether the continent can detect outbreaks, conduct research and make critical decisions faster when a health emergency strikes.

That is the challenge the Ministry of Health has put to researchers as Uganda and 10 other African and European institutions embark on a five-year programme to strengthen clinical trials and epidemic preparedness.

Dr Daniel Kyabayinze, Director of Public Health at the Ministry of Health, said the real test of the Advancing Clinical Trials and Epidemic Preparedness Research Capacity in Africa (SCTREP) programme would be its ability to translate research capacity into faster and better responses during future outbreaks.

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“When the next outbreak comes, will we be able to detect it faster, conduct research faster, and make better decisions because of what we have built through this project?” Kyabayinze asked.

His question highlights a persistent challenge for African health systems: the continent often confronts disease outbreaks with limited capacity to generate and apply evidence at the speed required during an emergency.

Kyabayinze said research should therefore be designed with government involvement from the beginning so that findings can be translated into policy and improvements in health services.

He also called for greater cooperation among African countries, arguing that national boundaries offer little protection against infectious diseases.

The SCTREP programme is expected to train more than 10,000 scientists, students and health workers over five years, including 15 PhD students and 10 postdoctoral researchers. It will also support laboratory upgrades and strengthen systems for clinical trials and epidemic research.

But the scale of training alone does not resolve the continent’s research problem.

Prof Rhoda WanyeZene, Dean of Makerere University’s School of Public Health, said Africa continues to experience a high burden of disease outbreaks while having limited capacity to conduct clinical trials.

“Africa has the most limited clinical trial capacities around the world, and yet we have the largest numbers of disease outbreaks,” WanyeZene said.

“Sometimes we do have existing tools to use, but sometimes we have new tools coming,” WanyeZene said. “So we have to have the capacity to quickly investigate those tools and whether they work for us.”

The capacity gap extends beyond researchers. WanyeZene identified shortages of skilled personnel, laboratories and infrastructure, as well as weaknesses in ethics and regulatory systems, as barriers to African-led research.

In some cases, she said, African researchers have had to send samples to laboratories in the United States or Europe for analysis because the necessary capacity is unavailable locally.

That dependence can become particularly costly during an outbreak, when delays in obtaining results can affect surveillance, treatment decisions and the development or deployment of interventions.

SCTREP is therefore designed around institutional partnerships as well as individual training. Germany’s Bernhard Nocht Institute for Tropical Medicine will work with Uganda’s National Health Laboratory, while Uganda will share experience in research ethics, regulation, surveillance and outbreak response with countries including South Sudan and Somalia.

Partnerships with institutions in the Democratic Republic of Congo are also expected to support cross-border research.

For Makerere University Vice Chancellor Prof Barnabas Nawangwe, however, the larger issue is Africa’s position in global health research.

He said the continent should move from being primarily a consumer of externally generated knowledge to becoming a producer and leader of research on epidemics.

“I don’t think that anybody around the world has more knowledge about Ebola than the School of Public Health and IBI,” he said.

He said collaboration with European institutions should therefore involve a two-way exchange of knowledge, with African researchers contributing expertise developed from the continent’s own experience.

“The ultimate test, Nawangwe said, will be whether the capacity created through SCTREP remains after its five-year funding period ends.”

“When the next outbreak comes, we should not have to start looking for the expertise, the systems, the laboratories, or the people we need to respond.”

That places the emphasis of the programme beyond training numbers and infrastructure upgrades. Its significance will ultimately be measured by whether those investments leave Africa better prepared before, rather than after, the next epidemic begins.

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