Charles Wambebe is a professor of Pharmacology and the pioneer Director-General/Chief Executive Officer of the National Institute for Pharmaceutical Research and Development (NIPRD), Abuja. He is the Chair of Product Research and Development for Africa and President of International Biomedical Research for Africa and also a Professor ExtarOrdinaire, Tshwane University of Technology, South Africa as well as Honorary Professor of Pharmacology, School of Medicine, College of Health Sciences, Makerere University, Uganda. In this interview with CHUKWUMA MUANYA, Wambebe warned that Nigeria should be wary of the aggressive nature that China has put in place to engage various African countries while insisting that antidote for COVID-19 should come from Africa.
You pioneered the research and development of the first Nigerian HIV-1 candidate vaccine (1999–2002) in collaboration with the United States Centers for Disease Control and Prevention, Atlanta and the Institute of Human Virology, Baltimore. You also developed the Draft Nigerian National HIV Vaccine Plan with support from the Joint United Nations programme on AIDS (UNAIDS) based in Geneva, Switzerland. So, how far with the quest for an effective vaccine for COVID-19?
Research and development of vaccine is a complex process. Usually it takes many years to develop a candidate vaccine. A vaccine may contain the weakened vaccine or parts of the virus. For example, in one the coronavirus vaccines recently developed, it contains only a small piece of the genetic code of the virus called mRNA. The mRNA was extracted from coronavirus and amplified in the lab so that it can encode the viral spike protein. Such protein is vital for entry of the virus into human cells. It is anticipated that the vaccine will stimulate the human immune system to develop antibodies against coronavirus. Ordinarily, if someone has antibodies against a particular virus, he/she becomes immune against that particular virus. However, all of us are still learning about the new coronavirus.
Recently people who had antibodies against the virus were re-infected. The challenges facing scientists include whether or not any vaccine developed against coronavirus can effectively protect against re-infection. If so, how long is the immunity? The other challenge is the safety of the coronavirus vaccine. Furthermore, the scientist is keen to know the immunogenicity of the vaccine. According to the World Health Organisation (WHO), there are 70 coronavirus vaccines under development. Three of them are already being used for phase 1 clinical trials to evaluate safety and immunogenicity. The phase 1 trials involve few healthy human volunteers (20-50) while phase 2 recruits (100-500) patients. In fact, another coronavirus vaccine developed by Hong Kong Biologics and Beijing Institute of Biotechnology has moved to phase 2 human trials. Thus, within the next six months, results from these trials will become available. Let us pray that one of the 70 coronavirus vaccine candidates will successfully pass through phases 1, 2 and 3 clinical trials and adjudged as safe, effective and of good quality.
As a former DG of NIPRD, what are your recommendations on how best to contain the coronavirus in Nigeria?
I am happy the way some states have aggressively responded to the coronavirus pandemic. The keys necessary to effectively battle this invisible army are testing, tracing, isolation and treatment. For example, we must target establishing testing centre at each local government area. I am aware that the Nigeria Centre for Disease Control (NCDC) may not have the human capacity and or laboratory facilities, testing kits and reagents to supply to establish a testing centre in each local government area. That should be the goal of each state. I am happy to know that the scientists at Pasteur Institut, Dakar, Senegal in partnership with Mologic, a British Biotechnology company have developed coronavirus rapid diagnostic kits (results in 10 minutes and the test can be done at home). The project was sponsored by the British Government and Bill & Melinda Gate Foundation. The candidate vaccine is currently undergoing validation at Liverpool School of Tropical Medicine & Hygiene as well as St George’s University, London. The plan is to market the vaccine at one dollar per test. Once the validation process is completed and the candidate vaccine passes, then the massive scale up of testing can become a reality.
The second recommendation is appropriate information at all levels in various local languages to dispel rumours and fake news and emphasise the plan and actions of government.
My third recommendation is strengthening of the health systems in a comprehensive manner. We just thank God that so far we have not seen massive numbers of confirmed cases in Nigeria as in Europe or United States of America (USA). I am not sure we have up to 1000 functional Intensive Care Units (ICUs) with ventilators in Nigeria. This situation must change. We must train more specialists. Not just because of coronavirus but for even routine management of serious conditions. I read that we have only about 380 intensive care nurses in Nigeria.
My fourth recommendation is that the Nigerian Academy of Science (NAS) should engage the innovators to ascertain scientific credibility and the novelty of the technology. Thereafter pass their findings to government so that any technology (example ventilators) can be supported by government while the NAS serves as the monitoring body.
Furthermore, research institutes must be supported to engage in product development leading to licensing of products and technologies to the private sector. I mentioned the vaccine developed at Dakar through partnership with a United Kingdom (UK) company. The UK Government supported the work with one million British pounds. I am totally convinced of the gift of intelligence and talents God had bestowed on Nigerians. That is why everywhere in the world Nigerians perform excellently. We just need to support these young and talented researchers. I am sure the outcome of such support will surprise us.
The Nigerian Medical Association (NMA) and other health workers have rejected the invitation of Chinese doctors to help Nigeria in the fight against COVID-19? What is your position on this?
I am in total agreement with the NMA and the other health professionals. I know that our health professionals are well trained. We have regulatory bodies that regulate their training in addition to National University Commission (NUC) that provides the basic academic inputs for each course. All they need is adequate facilities and motivation to carry out their functions. In this pandemic, Personal Protective Equipment (PPE) is mandatory for our health workers and first line responders to protect them from being infected.
There is also allegation of conspiracy theory that China wants to use the opportunity to enslave not just Nigeria but other African countries? Do you agree? If yes or no, why?
I am definitely wary of the aggressive nature that China has put in place to engage various African countries. I am not aware of the conditions agreed between China and our African countries vis-à-vis exploration of our rich natural resources. Everyone knows that Africa is the richest continent in the world based on our natural resources. Yet Africans are the poorest people in the world. Why? I believe lack of wise management of our natural resources is partly responsible. In some cases, complete neglect of such natural resources is responsible. Look at agriculture. Africa has the largest arable land in the world. Due to our diverse climate, we can cultivate various crops all year round. Yet, we are still importing food. To me as a scientist, it does not make sense that we should give away our natural resources to any country just for immediate benefits, which are not measurable to the value of our resources.
The US has reportedly spent hundreds of billions of dollars on COVID-19 and Nigeria is also spending our foreign reserves to tackle the pandemic. What are the health and economic implications of this?
I believe that funds being released to fight coronavirus can be wisely used for both immediate management of patients and acquiring facilities that will remain after the pandemic. In that way, our hospitals, ICUs, infectious disease centres will be more equipped for any other pandemic in future. Surely, the economic consequences are huge. But human lives first. I believe that if the scientists, government and the private sector work in close partnership from henceforth, new products and technologies will emerge from Africa to the rest of the world. One important lesson that I hope we have all learned from this pandemic is that we are on our own. We must look inwards. We must look for solutions of our problems from Africa. For example, I understand that in Senegal, a ventilator has been developed and sold for $30 as against $16,000 on the international market. Such a feat is highly commendable. I know we have young highly talented Nigerians who can do same. They need to be identified, supported and mentored.
The US has not just threatened but is already cutting help to the WHO. President Donald Trump did not participate over the weekend when other world leaders supported the WHO in launching a plan to provide new technologies etc.?
What is your position on this and what are the implications?
I believe at a time of such a pandemic like this, we should all be working in solidarity to look for solutions. To me, it raises a challenge for us to become self-sufficient as much as possible. I was surprised to know that although we have over 100 manufacturing pharmaceutical companies in Nigeria, we are still importing essential medicines like analgesics, antibiotics, etc. We must change our policies that no longer serve our national interests
Do you recommend the extension of the lockdown order in Lagos, Abuja and Ogun? If yes or no, why and for how long?
For sure, we must extend the lockdown initially for another two weeks. The major determinant regarding further extensions should be the number of new cases and logistics in place for tracing, isolation and treatment.
Several models have worked globally such as Singapore and Taiwan. Why model do you recommend for Nigeria?
Our epidemiologists should determine the suitable model for Nigeria.
Another school of thought recommends gradual easing of the lockdown by allowing workers between the ages of 20 and 30 to resume first as well as those that have survived the virus. What is your take on this?
I also believe in reopening in phases. Unfortunately, the virus afflicts individuals of all ages, although it is more lethal in elderly who have underlying health conditions. My suggestion is to start with manufacturing sector and some businesses, which can be given guidelines to put in place before reopening. One of such guidelines is screening for symptoms of coronavirus. Such companies should have basic facilities for screening and testing. Training workshops can be organized for health workers of such companies, which can be virtual, by the NCDC.
It is obvious that NIPRD has failed in meeting its mandate by providing the solutions for COVID-19. Why? What happened? What is the remedy for reactivating the institute?
I am happy to inform Nigeria that NIPRD now has a young dynamic Director-General who is passionate about regaining the past glory of the Institute. The huge challenge he faces now is financial resources. When I served as the Pioneer DG of NIPRD, I was privileged to have support from the World Health Organisation (WHO), United Nations Development Programme (UNDP), United Nations Industrial Development Organization (UNIDO), Japanese Government and the Federal Government of Nigeria (through extra-budgetary allocations).
Thus, we had research facilities for drug development that were the best at that time in the country.
Second, the facilities on their own cannot give you results. You need brilliant and well-trained staff. During my time, I was able to recruit first class science graduates from our old universities and then motivate them to register for their postgraduate studies at University of Ibadan, University of Lagos, Ahmadu Bello University, Obafemi Awolowo University, etc. Furthermore, I used to send my young colleagues to USA, Europe, India, etc. for short training programmes as well as conferences. To engage in such activities, finances are needed.
How far with the novel herbal drug for sickle cell anaemia that was patented by NIPRD and approved by the WHO?
The Federal Government in April last year licensed Niprisan to May & Baker for commercial manufacturing and distribution.