‘Aggressive Advocacy is Required to Stimulate Vaccine Production in Africa’

On 06/Apr/2019 / In Articles

Oyewale Tomori, Professor of Virology and pioneer Vice Chancellor of the Redeemer’s University, Ogun State, has made his mark in the field of health science both at home and abroad. His passion for a healthy continent of Africa is not in doubt. He has been in the forefront of advocacy for independence for African nations on economic and health security from the western nations that would rather prefer to keep Africa as its ready-made market for medical products.
 
Tomori is a player in health and medical research fields on global stage. He had served as African Regional Virologist for the World Health Organisation, WHO; member of the Polio Research Committee; Member of the Strategic Advisory Group of Experts on Immunisation; board member, Global Alliance for Vaccines and Immunization – GAVI Alliance and got inducted into the United States National Academy of Medicine. For Africa, his work has signposted a paradigm for laboratory networks for measles, yellow fever, influenza and other viral hemorrhagic fevers such as Ebola virus.
 
Tomori actively participated in a week-long conference hosted by two conclaves of African medical scientists held at Aberdeen, Freetown, Sierra Leone recently. Both the African Vaccine Manufacturing Initiative (AVMI) and The Global Emerging Pathogens Treatment Consortium (GET) which focuses on biosecurity held their separate conferences at the same venue, same week and with a number of same participants.
 
In his presentation at the AVMI conference, Tomori, whose choice of words and style of presentation richly demonstrated his sense of wits and oratorical prowess, left no one in doubt about the need to rescue the weakening sovereignty of Africa in economic and health prosperity despite her bountiful human and natural endowments. He lamented the level of ignorance about the huge health challenges confronting Africa by her political leaders. He believes strongly that not much could be achieved by concerned groups, individuals or non-governmental agencies without the backing of the regional or continental governments. In clear terms, funding is the bane of well-meaning organisations like AVMI and GET.
 
In this interview, MICHAEL AWE, who attended the conference spoke with Prof. Tomori
 
What are the major impediments to achieving scientific breakthroughs and independence especially in vaccine production in Africa?
A lack of national pride, political will and commitment plus the absence of good governance, an unworkable and unfriendly scientific and economic environment, for vaccine production
What is your view on the relevance of scientific research and data analyses contained in the presentations at the Freetown conference to solving our continental health challenges?
The foundation of vaccine manufacturing is basic and applied research without the two, safe and efficacious vaccines cannot be produced. Add to these the meticulous analyses of field epidemiological data of disease trends to allow a reliable forecast of vaccine needs.
 
Funding has been a major problem for research in Africa, how do you think organisations like GET and AVMI should go about it?
GET and AVMI both have important advocacy roles in convincing African governments to see institute and sustain good governance, accountability and transparency, so African countries will see the health security implications and the danger of not addressing vaccine production in Africa. Depending on foreign sources is like handing over the security of your house to a well-known night robber and thief.
 
What effort is being placed to get African political leaders and governments to listen, understand, appreciate and implement your findings and buy into your vision?
Both AVMI and GET are discussing and working with a few governments to get support and commitment for local vaccine production, through meetings with Ministers of Health and in some cases, Ministers of Trade and Industries. AVMI and GET need to push for a more aggressive advocacy not only with governments, but also with the business and industrial communities in Africa.
 
You serve on the board of Global Alliance for Vaccines and Immunization, GAVI, why was it difficult for Nigeria to graduate from being dependent on donor agencies like GAVI?
Ordinarily, graduating from GAVI support, or to be free of dependency on donor funds to take care of the health of one’s children (which hits the nail on the head) should be an occasion for celebration. It is a recognition that a country, after years of depending on others to take care of her children, has now reached the level where through good governance, judicious use of resources in a transparent and accountable manner, can boldly proclaim her true independence. A country that asks for an extension of dependency after she is deemed ready for independence, should be ashamed of herself, no matter the reason for her seeking continued dependency. For Nigeria, we know our current predicament of begging for an extension of dependency has nothing to do with our lack of resources, in any ramification. We are beggars because of our flagrant and absolute misuse, misapplication and wastage of our resources.
 
Why do you think Nigeria was begging for an extension of support when the country had initially announced her intention to be independent of GAVI support list?
It was a case of misused funds which Nigeria was asked to refund as a condition to be considered for support extension. One of the conditions given for discussing the issue was that Nigeria must pay back the Gavi money misused in previous years. Gavi had conducted a full scale Cash Programme Audit (CPA) covering the period January 1, 2010 to March 31, 2015. The initial audit exposed irregular and/or ineligible use of funds totaling US$2.2 million, and the final one discovered an additional misuse of US$5.4 million; hence, in total, for the period under review, Nigeria had misused a total of US$7.6 million. After a prolonged, contentious and intractable back and forth communication between Gavi and Nigeria, the country agreed to pay back the misused fund to Gavi, in the face of overwhelming and incontrovertible evidence. The first amount of US$2.2 million was paid in 2015. The minister who authorised and ensured that the misused money was refunded, was declared a national traitor. We then agreed in 2017 to pay the second tranche of the misused US$5.4 million in two instalments. We paid the first installment towards the end of 2017, and promised to pay the second instalment after the budget approval in 2018. Payment of the second tranche of a little over US$2 million was the condition upon which the discussion for our request for the transition extension to 2028 was anchored. Gavi insisted that the money must be credited to its account before the matter would be tabled.
 
But if Nigeria has been refunding the money should there be any issue again?
A day before the discussion on the matter, Nigeria had produced documentary evidence that instruction had been given for the money to be paid, but Gavi had not yet received an alert of the payment. At the Gavi Board meeting of Wednesday June 6, 2018, the discussion on the issue of Nigeria transiting from Gavi support, was both tense and traumatic. It may not have been the first occasion when being a Nigerian has brought debilitating pains. We met during the tea break to discuss the issue: In and outside the meeting rooms, led by Ngozi Okonjo-Iweala, the Nigerians present engaged other Board members in discussions on garnering support for Nigeria. It was in this state of uncertainty that the meeting resumed after the last tea break for the day, and Nigeria’s request was tabled for discussion.
 
The Board chair, our own Ngozi Okonjo-Iweala, introduced the matter, followed by comments from the Gavi Board CEO, Seth Berkley, confirming that Nigeria was yet to fulfil her commitment to pay the final instalment of the misused funds, a pre-requisite for discussing the request. The discussion was then thrown open, for Board members to decide whether to suspend or go ahead with the discussion. A dozen or so name plates stood on their legs, indicating the desire to contribute to the discussion. By this time, all Nigerians on the Board – (none of whom was actually representing Nigeria, but different constituencies) were recused from contributing to the discussion to avoid any appearance of bias. Speaker upon speaker pleaded, not for Nigeria, but for the over five million children of Nigeria who may not receive, annually, the necessary vaccines and may end up maimed by polio, or die from other preventable diseases – whooping cough, tetanus, diphtheria, measles, diarrhea, pneumonia, yellow fever, meningitis, to mention a few. Along with the pleadings, and in subtle and diplomatic language, Nigeria got some bashing. Where I sat, mute as the famous Owerri Zuma statue, their words came as flying darts to my heart, my pride, my ego, my patriotism, and my being. Their nice words metamorphosed into questions in my mind, producing different interpretations. How come a nation so rich with enough resources to fully vaccinate every child and more, is asking for such a long extension? It is good that the Nigerian government accepted to refund the misused funds, but has any individual being held accountable? Or is the government endorsing misuse of money? Why does Nigeria have to wait until the last minute to fulfil her obligation? Why should a country like Nigeria, with such talented individuals, become pawns in the hands of a few unscrupulous leaders? Incredible that such a high level of GDP can translate to Gross Domestic Poverty? Is Nigeria’s paper commitment worth the piece of paper it is written on? When Nigeria says we are on the same page, confirm that what is written in the first paragraph is not the opposite of what is in the second or final paragraph.
 
The discussion was long. To us Nigerians, each minute was like an hour, each word, a ton of lead on our weary soul. At the end, there was unanimity in approving Nigeria’s request. However, it came with conditions. Nigeria must fulfil her financial and programmatic commitments, set in place an accountability frame work, and be ready for high level annual reviews and a comprehensive mid-term review in 2022-2023 on the progress of Gavi’s support.

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