Developing ANDI: A Novel Approach to Health Product R&D in Africa

The health status of the African population remains behind that of populations in Europe and North America, as well as many other developing regions with similar affluence (Figure S1). For example, Africa is especially affected by a series of infectious diseases that are responsible for more than half of its disability-adjusted life years (DALYs) and over 6 million deaths per year (Figure S2). For the 18 diseases listed in Figure S2 Africa has over 30%, and in some cases over 90%, of the worldwide disease burden, even though it represents only 15% of the global population. Currently, there are limited or no affordable therapies or vaccines for many of these conditions, and diagnostic methods, where they exist, are often inadequate to deploy in the field for large populations [1–5]. Accurate quantification of the economic impact of disease burden is difficult. However, the negative impact of these diseases to the African gross domestic product (GDP) may run into tens of billions of dollars (US) each year [5–7]. Despite some welcome increases in global R&D investment in recent years (e.g., through public private partnerships), it is generally agreed that research and product pipelines for the diseases that disproportionately affect developing countries are grossly inadequate. This has recently been reinforced by the 192 countries composing the World Health Assembly through resolutions supporting GSPOA (the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property) [8,9]. There is urgent need for enhanced research in developing countries. Our analysis suggest that, in addition to the scant research for several diseases, only 21% of total biomedical research publications and 31% of clinical trials in Africa are related to diseases that account for approximately 50% of the African disease burden (Figure 1). One of the underlying emphases of the GSPOA was that a sustainable global solution requires greater efforts to build and utilize innovation capabilities in developing countries, enhance their access to information and technology, and forge collaborative networks. Implementing these goals and a sustainable pan-African health product R&D endeavor requires capacity, infrastructure, leadership, financing, and an understanding of the status of health R&D in the African continent. In a related development, the African Union have committed to raising spending on scientific research and innovation to 1% of GDP in recognition that such funding is a necessary prerequisite for sustainable development [10]. We therefore assessed the African biomedical research landscape including the level of intra-African expertise and collaboration to support the development of the African Network for Drug and Diagnostics Innovation (ANDI) in contributing to the implementation of these goals.