What are Aspen Pharmacare’s plans for Africa?

‘We need to ensure that when procurement takes place by international procurement agencies they procure for Africa, from Africa, for Africans’: Stavros Nicolaou – senior executive, Aspen.

FIFI PETERS: Let’s set our eyes on Egypt, which recently hosted a major health conference – this week, in fact, and some of the topics of conversation discussed included a New Public Health Order, where things currently stand right now and where to go from here.

Aspen executive Stavros Nicolaou is fresh from Cairo – having attended the conference there – to tell us a little bit more. Stavros, thanks so much for your time. Did you get to see the pyramids?

STAVROS NICOLAOU: Fifi, good evening and thanks very much for having me on your show. Did you mention something about permits? Sorry, I couldn’t hear you clearly.

FIFI PETERS: Yes. I said ‘Did you get to see the pyramids?’ Or was it touch-and-go – land at the airport, go to the conference centre, talk, talk, talk, go back to the airport, come home?

STAVROS NICOLAOU: Fifi, regrettably not. The only pyramids I saw were inside a conference centre and they were miniature pyramids, unfortunately. So no luck this time. I’m sure on the next trip we will probably get to see them.

FIFI PETERS: Yes – the downside of business travel. But on to more important matters. Tell us what was happening. What took you to Egypt initially?

STAVROS NICOLAOU: Fifi, I think the most important thing is that Covid has taught us the importance and relevance of health policy and health agendas. It was interesting that this conference I attended – I was a speaker at the conference on, as you said, a New Public Health Order for Africa – was actually hosted and conducted under the auspices of the president of Egypt, President Abdel Fattah el-Sisi.

This demonstrates how seriously health agendas are being taken during this Covid period. I don’t want to say we’re at the end of the Covid period; we aren’t as yet. We don’t know what trajectory Covid will take, but it has brought home the importance and relevance – in public health terms but also in economic terms – of health agendas. The central thematic throughout the two days that I was there, I was there for a day-and-a-half, is Africa building its own capacities, [something] very close to my and Aspen’s heart, of course.

And then, secondly, Africa ensuring that it has health sovereignty [and] doesn’t depend on other continents or other countries for its health needs. We saw how clearly that played out with vaccines and other important medicines during the Covid pandemic.

FIFI PETERS: I think Aspen has been a great example in terms of the ability of the continent to build its own health capacity – your plant there in Gqeberha, the initial turning around of vaccines from Johnson & Johnson, and now actually manufacturing them on your own. But when you talk about the importance of health sovereignty, that’s a pretty big step. I’m just wondering what ingredients need to be put in the equation or the mix in order to truly achieve health sovereignty for the continent that [is] not dependent on external forces and we don’t find ourselves in a situation whereby we are crying out against injustice.

STAVROS NICOLAOU: The thing that characterises Africa is that we have the most disproportionate disease burden of any continent anywhere in the world. Most people associate the continent in public-health terms as only infectious – what we call communicable – diseases like HIV, TB, malaria, etc.

That in fact is an inaccurate portrayal, because you have a combination of that plus what we call a rising tide of non-communicable diseases. These are things like diabetes, and arguably diabetes in the last 18 months has claimed more lives on the continent than Covid; not arguably, I can tell you that for a fact.

So we’ve got this unique blend. It’s a very uncomfortable blend, of course, for the continent to have infectious diseases, plus a rising tide of now diabetes, cardiovascular disease, strokes and hypertension.

All of this is manifesting. The interesting thing is one would assume that if you’ve got such a disproportionate disease burden, you would have gone a long way to setting up your own capacity, and strengthening healthcare systems appropriately so that we can manage these pandemics.

Of course we need to manage [them], not only because we’ve got to save lives and improve the quality of lives, but we also need to look at the economic impact on countries. We’ve seen that Covid has devastated African economies more than the rest of the world. We’ve seen the impact of it; in the early 2000s there was an uncontrolled HIV pandemic, and [we saw] what that did. Now add onto that diabetes, hypertension, and it’s almost a cataclysmic type of situation.

So health sovereignty is about us as a continent saying:

‘Thanks very much to the donor fund agencies and these international procurement agencies, but there is a downside to that because you don’t develop your own capacity. You become dependent on others, you become dependent on handouts.’

That was a central thematic at this conference, to say ‘We appreciate the donor funds. However, the way donor funds operate needs to change.’ We need to retain our own talent on the continent because, if there’s no capacity on the continent, these highly skilled people leave. So if you cannot make vaccines on the continent because you forever and a day are dependent on imports, then the scientists that we train across the continent – and this is the entirety of the continent – are not going to stay on the continent.

That then affects the developmental status of the continent, it affects any ambition around localisation, which is something else the African Union is very strong on, and it affects our ability to industrialise the continent – and we forever lag that. So our sovereignty means precisely that. It means a reorientation of the global dynamics, particularly with procurement dynamics. It also means setting up our own capacities and sustaining them on the continent.

This is the last point. I cannot emphasise how important it is to sustain these capacities.

So if we are going to put up vaccine manufacture on the continent – and there are many aspiring vaccine producers on the continent, Aspen has already done that – then we need to ensure that when procurement takes place by international procurement agencies they procure for Africa, from Africa, for Africans.

It shouldn’t be that we’re procuring elsewhere, and then these facilities we put up on the continent become white elephants.

FIFI PETERS: Agreed. Stavros, thanks so much for sharing your key takeaways and your learnings from Cairo. Stavros Nicolaou is the senior executive for strategic trade development at the Aspen Pharmacare Group.

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