Recent investments in the South African Health Products Regulatory Authority mean it has now approved four tests for the new coronavirus.
The novel coronavirus, first reported in China in December 2019, has led to the loss of tens of thousands of lives and massive economic and social loss. A lot of lessons continue to be learned from the global response to the disease, COVID-19, caused by the new virus.
The common consensus is that COVID-19 proved beyond any reasonable doubt that the world was not prepared for a pandemic. Countries have acted differently with differing results. As the virus continues to make its way around the world, countries have the opportunity to build on lessons learned from places already hard hit by COVID-19 as well as previous pandemics.
South Africa has for many years been plagued with the double burden of HIV and TB, with more than 7-million people living with HIV, UNAids estimates, and about 63 000 people losing their lives to TB in 2018.
As the number of people confirmed to have COVID-19 in South Africa continues to grow and with the country having already lost several lives to COVID-19, there are genuine concerns about how COVID-19 will affect the delivery of health services particularly to people living with HIV, TB and other conditions. There are also concerns on how it will affect the poorest South Africans, who often live in densely-populated communities and who don’t have the resources and space for self-isolation.
Though we are facing unprecedented times, South Africa’s leadership in confronting TB and HIV and investing in research and development (R&D) infrastructure have provided some lessons that can be applied to tackle COVID-19.
The South African Medical Research Council (SAMRC) has a mandate is to improve the health of the country’s population through research, development and technology transfer. Bodies such as the SAMRC have been central to health innovation in the country and have a vital role to play in responding to COVID-19. The government — through the departments of health as well as science and innovation — has also critically driven the country’s health research agenda.
The Department of Science and Innovation is working with several partners to investigate the efficacy of repurposing existing drugs to treat COVID-19. South Africa is the only country in Africa and one of only 10 nations globally taking part in the international clinical trial, named Solidarity, which was recently launched by the World Health Organisation. Other countries with confirmed participation in the clinical trial are Argentina, Bahrain, Canada, France, Iran, Norway, Spain, Switzerland and Thailand. This is one example of how the country is leveraging its extensive experience in research and past R&D investments to contribute to finding much-needed solutions to the current pandemic.
It also highlights the importance of continuous investments in health R&D.
In 2018, South Africa made deliberate efforts to invest in the strengthening of its medicine regulatory authority with the creation of the South African Health Products Regulatory Authority (SAHPRA), an independent entity that safeguards public and animal health by licensing safe, effective and good quality medicines and medical devices. It also monitors clinical trials. Now just two years later, that investment is bearing fruit in the COVID-19 response.
SAHPRA has been instrumental in approving tests that are used to diagnose the novel coronavirus even as the body moves forward with recruiting needed personnel and works to clear the existing backlog in approvals. As of April 2, SAHPRA had approved four tests for diagnosing the new coronavirus: the Xpert® Xpress SARS-CoV-2 (GeneXpert) Test by Cepheid; the Abbott RealTime SARS-CoV-2 EUA by Abbott; the SARS-CoV-2 Real time PCR by EUROIMMUN Medical Laboratory Diagnostic; and the PerkinElmer SARS-CoV-2 Realtime RT-PCR Assay by PerkinElmer.
The approval of these tests will shorten the time it takes for a diagnosis to be made and comes as the country ramps up testing capacity, with a target of conducting 36 000 tests a day by the end of April. The National Health Laboratory Service is stepping up its effort to fight the spread of the coronavirus by increasing the number of laboratories performing tests from this month from six to nine.
At a 2011 World TB Day commemoration event at Prince Mshiyeni Memorial Hospital in KwaZulu-Natal, South Africa unveiled the country’s initial GeneXpert testing machine for the diagnosis of TB and other conditions — a first for Africa. It was an investment that would prove a masterstroke a few years later. The recent approval of the GeneXpert as a diagnostic for the new coronavirus should be welcomed as the country has more than 180 GeneXpert machines that can produce results in 45 minutes.
Lessons from the country’s TB and HIV response are coming in handy as government rolls out a massive coronavirus screening and testing drive. President Cyril Ramaphosa has announced that around 10 000 field workers will be visiting homes in villages, towns and cities to screen and test residents for COVID-19. These include donor and government-funded nonprofit organisations. It is such experiences that, if applied appropriately, can define the country’s COVID-19 response.
The announcement that the country will use mobile technology to trace close contacts of confirmed COVID-19 cases and monitor the geographic location of new cases in real-time emphasises the use of technology and lessons previously learned.
The investments countries make into health innovations and health systems strengthening are not only important for today, but they also contribute to making the world more prepared to deal with epidemics and attain the Sustainable Development Goals. This is a path that South Africa and other countries must continue to follow.
Hon. Dr Sibongiseni Dhlomo is a Member of Parliament and the Chairperson of the Portfolio Committee on Health. He was the MEC for Health in KZN from 2009 – 2019