Opening Ceremony and keynote addresses

The official opening session of the Tenth EDCTP Forum was greatly honoured by the presence of His Excellency Mr Filipe Jacinto Nyusi, President of the Republic of Mozambique,. A fine choir marked his arrival at the conference centre with the national anthem.

Leonardo Simão – as Chair of Local Organising Cmmittee, said it was a pleasure to welcome the President and thanked him for finding room in his busy agenda. He reminded delegates, most of whom are attending online only, of the hybrid nature of the conference. He spoke again of the important role of Pascoal Mocumbi in the development of EDCTP.

From Canada and as Chair of the Forum Programme Committee, Catherine Hankins said it was a great pleasure for her to work with such a committed and well organised local committee. The Forum had already been delayed one year and we could not let a further year go by before sharing the wealth of scientific findings that will be presented here! It had been very difficult to choose which of the studies presented for consideration to include. She urged delegates to remember to look at those studies presented as poster sessions. The Forum was utilising a ‘stellar’ platform that offered all sorts of opportunities to participate and interact. Young researchers should make sure they took advantage of this. She highlighted the equity debate, the vaccine plenary and sponsored symposia and said delegates should look out for the blog and the newsletter. She thanked all those who had submitted abstracts, and also the hosts and all the delegates

Mariya Gabriel, EU Commissioner for Innovation, Research, Culture, Education and Youth addressed the meeting by video. The Forum is now established as a valuable opportunity to develop and reinforce cooperation and synergy in combattng poverty-related disease, promoting capacity development and networking. This year it will be crucial in identifying key aspects in achieving equity in health research – progress has been made in recent years but now COVID-19 is increasing inequality globally in access to vaccines and treatment. The EU is now more committed than ever to contribute towards achieving healthy lives for all, especially in sub-Saharan Africa which bears the highest burden of infectious disease, and also to improve preparedness for future epidemics. Her team has been working on the launch of the Global Health EDCTP3 Joint Undertaking, which will aim to reduce the socioeconomic burden of infectious disease and increase health security in sub-Saharan Africa and globally. It will draw on the experience of previous programmes, which have supported over 150 clinical trials and trained over 500 African scientists and strengthened clinical research and regulatory systems across the continent. The total budget will be €1.6bn. The new partnership will harness investments from the EU’s Horizon Europe Research Framework Programme and from European and African countries. It also brings in contributions from industry and foundations. With meaningful involvement of the sub-Saharan African countries in the decision-making process, the partnership will develop research priorities to address the challenges posed by infectious diseases. It will also link with the newly created Health Emergency Response Authority (HERA), which is intended to improve cooperation between health agencies and industry, as well as collaboration within the EU and with its global partners. The pandemic has shown us that research innovations save lives and there is a need for more coordination and collaboration to improve our preparedness for pandemics and response to infectious diseases. We must use this opportunity to reinforce our investment in research and capacity building, and ensure equitable and fair access to its results for all. Only this way will we be prepared for the next crisis.

Jutta Urpilainen, EU Commissioner for International Partnershipsbegan by telling delegates that their work in advancing health in Africa, both before and during the pandemic, had been outstanding. It had resulted in a pooling of research from 62 countries and 35 institutions. This is an example of the collaboration that is needed to fight global threats such as COVID-19. The EU has disbursed €6.7bn to help its partners in Africa respond to COVID-19. It also leads the world in its support for COVAX (the vaccine sharing and distribution programme). But we need to go further. Countries need strong health infrastructure, manufacturing capacity and access to medicines and technology to tackle this pandemic and the next one. And so the EU has committed at least €1bn to boost efforts to produce vaccines for Africa in Africa. It is partnering with numerous African institutions including the Africa Centres for Disease Control and Prevention (Africa CDC). EDCTP is one of its most important partners and this Forum connects research conducted on the African continent with local pharmaceutical and technological production. Recently, the first vaccine against malaria was approved and it could save the lives of tens of thousands of children every year. The Eradicate Malaria Initiative, supported by the EU, also seeks to take advantage of the latest mRNA technology. She hoped that the Forum would help in the forging of further relationships between institutions.

Soumya Swaminathan, Chief Scientist of WHO, focused on the impact of the COVID-19 pandemic and how it has exposed health inequalities. It has, for example, reversed decades of progress against TB. It appears to have affected the delivery of essential health care service and to have increased poverty and malnutrition. This is an appropriate moment, therefore, to find ways of mobilising new technology, including: digital innovations, mRNA vaccine technology, and new ways of conducting multinational clinical trials. We have already come a long way in understanding what this virus does to our bodies and to our communities. It has also helped us understand more about some older diseases. But we must think of achieving equitable access to whatever new products come out of all the research that is now taking place. It is therefore encouraging to see scientists around the world coming together at this Forum.

Yazdan Yazdanpanah, Chair of the EDCTP Board, spoke on Europe’s commitment to reaching the Sustainable Development Goals (SDGs). EDCTP, launched in 2003 and re-launched in 2014, was part of this commitment. The leadership of Africans in this initiative is so important, as is the fact that not only research but capacity building institutions and training are supported. He briefly summarised the scope of EDCTP’s activities and highlighted that the preparations were underway towards the establishment of a successor programme, the Global Health EDCTP3 Joint Undertaking, which will have a €1.6bn budget.

Armindo Tiago, Mozambique’s Minister of Health then outlined his country’s priorities in health research, acknowledging the support received from partners, in particular EDCTP. Equity is the goal. Despite the current challenges the government wishes to allocate 1% of GDP to research. It is important to acknowledge those who have advanced our understanding and contributed to better health. Awards such as the Dr Pascoal Mocumbi prize help us to do so.

The His Excellency Mr Filipe Jacinto Nyusi, President of the Republic of Mozambique welcomed national and international delegates, saying that his presence witnessed the commitment of his government to health research as a means of addressing poverty. He hoped the Forum would facilitate an exchange of information between researchers on best practices to address the issues affecting Mozambique’s citizens. For example, in this season of the year it is the waterborne diseases that are the main concern; technology created by scientists can help address this is issue. Despite the restrictions imposed by the pandemic, he hoped that those delegates present at the Forum in person would enjoy their visit to Mozambique.

Following the departure of the President at this point, Michael Makanga gave a formal welcome to delegates, saying that there had never been such an opportune time to hold a Forum, right in the middle of the pandemic. It was also appropriate that Mozambique should be hosting as one of the few Portuguese-speaking countries actively collaborating with EDCTP in international research.

Keynote addresses

Lindiwe Makubalo, Assistant Director of WHO’s African Regional Office, acknowledged the work of EDCTP. Equity is at the heart of WHO’s mission. Africa still suffers a major burden from many infectious diseases, but now we are seeing changing priorities and the pandemic makes clear the inequalities in global health. There are huge disparities in knowledge translation between rich and poor nations. Vaccine roll out began so far ahead in wealthier nations; it has hardly started in Africa. Rich countries have been able to expand health their spending but this is harder for Africa to do. We are also now witnessing the phenomenon of ‘vaccine nationalism’. How is WHO responding? Firstly in terms of leadership – it has taken the lead to keep the world informed At the technical level WHO’s emergency and response teams have been active on the ground. WHO has used its leverage to ensuring that political leaders understand the urgency of the situation. It is working with many partners and really good support is now coming in from developed countries. The science community is playing a huge role in developing vaccines at unprecedented speed. WHO is responding to national concerns and sees equity as a priority. It want to shift resources from Geneva and regional Headquarters to countries themselves.

John Nkengasong, Director of (Africa CDC), focused mainly on the COVID-19 pandemic in Africa. Infection rates are much likely to be much higher here than serological test results suggest. To bring the disease under control we need to vaccinate about 60% of the population. (Currently the level is only around 7.5%.) This will need 1.6bn doses. The inequity in global vaccination rates is striking. Supplies of vaccine are arriving in Africa and progress is being made. Morocco has reached a level of 55%. South Africa is also effectively ramping up its programme. But Africa manufactures only 1% of its own vaccines. Many African leaders are now calling urgently for more local vaccine manufacture. It has been proposed that Africa should make 60% of what it needs by 2040.

Meanwhile there is hope! New COVID-19 vaccines and treatments are being developed. mRNA technology in particular has much to offer. Expanded serological testing is essential to follow how the virus is developing and Africa CDC has established a network of labs across the continent.

Africa’s population is growing rapidly and more people will therefore require effective delivery of healthcare. Endemic and non-communicable diseases have now been joined as threats to health and wellbeing by the emergence of new diseases. He reminded us that a new disease emerges in Africa about once every ten years. These diseases do serious economic harm. We have to stop COVID-19 becoming endemic here and vaccination is the only way we can do this.

Michael Makanga asked Dr Nkengasong what he might do differently in the light of the appearance of COVID-19. He replied that COVID-19 flew in the face of the principles of evidence-based medicine – with a new disease there is no evidence! More research at a very early stage is needed for new epidemics.

Armindo Tiago reminded the meeting participants that ‘no one is safe until everyone is safe’ and spoke of the need to persuade the leaders of wealthier nations to help Africa respond to the pandemic. Dr Nkengasong agreed but said there were limits to the power of multilateralism. He called for more ‘regionalism’ – African countries working together on issues like COVID-19.