It would be an understatement to say that international coordination to the COVID-19 response has been wanting, with global organizations and national governments frequently at odds and confusion prevailing generally. The problems resulting from this lack of coordination are especially serious in low and middle-income countries (LMICs), notes Patrice Matchaba, Group Head of Global Health & Corporate Responsibility for Novartis, in a new op-ed for The Telegraph. Matchaba argues that part of the solution has to be building up clinical trial capacity in LMICs, including Africa.
- Previously, when combating HIV, “medicines which worked well on Europeans or Americans were deployed without trials in Africa, where we discovered that Africans metabolised them differently or that African strains were less susceptible.”
- There is already substantive progress in some areas, as “national governments, a European initiative called EDCTP, other international actors and companies like mine, Sub-Saharan Africa has become a leader in trials for malaria, tuberculosis, and other tropical diseases.”
- However, significant gaps remain, as talk about COVID-19 vaccines demonstrates. Currently South Africa is planning a trial for COVID-19 vaccines, but no other big countries on the continent are doing so.
- Matchaba proposes two solutions, while noting the hurdles: “First, more people must participate in Africa’s clinical trials, including both individuals and African academic institutes. This decision is based on trust – but everywhere we look, institutional trust is cratering… Losing this trust can have a chilling effect on clinical trial participation – especially trials of solutions developed in the same doubtful north. Ultimately, it could lead to low Covid-19 vaccination adoption rates in Africa.”
- “Second, Africa needs many more trial sites, quickly. Lockdowns and the economic downturn have taken a toll on many of them. Those with robust capacity are more likely to weather Covid-19. As other trial sites face challenges, we could potentially see a geographic concentration of study data. The result could limit our interpretation of the data, making it harder to know if the study outcomes we see apply broadly or only to certain populations.”