Our next conversation from The World Vaccine Congress welcomed Africa CDC‘s Dr Yewande Alimi to our interview zone. Dr Alimi joined us during the AMR Workshop for a panel on “defining the value of vaccines against AMR”. Dr Alimi is Africa CDC’s AMR and One Health unit lead.
The burden of AMR in Africa
Considering Dr Alimi’s panel on AMR, we asked how significant the burden of this threat is to the continent that Africa CDC serves.
“Antimicrobial resistance remains one of Africa’s biggest and greatest challenges.”
This problem is not unique to Africa, as it is globally considered a “top” health priority, but Dr Alimi states that Africa bears the “highest burden”. This means that “many more” Africans are at risk of drug resistant infections. Furthermore, Africa “bears the burden” of “very highly” infectious diseases, which demand these drugs. Dr Alimi refers to a study that suggests that around 250,000 million deaths a year are attributable to AMR on the continent. She kindly puts this into context, acknowledging that it’s hard to grapple with numbers in isolation:
“The big three, the HIV, the TB, the malaria, that we have known for decades and decades as the greatest killers across the world, AMR is already surpassing the numbers of deaths.”
Africa CDC’s efforts
Dr Alimi goes on to explain Africa CDC’s contributions to the global fight. A multi-country, multi-year study had “shocking findings” for Member States, and Dr Alimi is particularly concerned about the unique challenges for lower- and middle-income countries.
“A lot of people think about antimicrobial resistance as just overuse. Yes, it’s driven by overuse, but there are also other complexities when you think about challenges in the health system, particularly in LMICs.”
These complexities include tension between demand and availability, which forces health workers to the “only options that they have”. Dr Alimi’s passion is evident as she explores concerns such as IPC-WASH strategies, laboratory capacity, access to antibiotics, and the need for “behaviour change”.
“I think one of the things that we are starting to look at now is how can prevent infections and subsequently we reduce the need for antibiotics?”
This is where vaccines could play a significant role:
“If I’m able to invest in one patient, I could potentially prevent an infection or even an outbreak that may require use of antimicrobials.”
This is also a cost effective mechanism, so Dr Alimi calls to “raise investment in preventing infections”.
“Think about it in a holistic, One Health approach.”
This applies for agriculture as well as human infection prevention, particularly for a “lot of the population that are in very resource-limited settings”.
“If I’m able to invest in one patient, I could potentially prevent an outbreak that would require use of antimicrobials.”
For Dr Alimi, use of vaccines could be a “potential game-changer” in this sense.
Equity
A key concern for the Africa CDC team is equity, and Dr Alimi emphasises that the work that happened around COVID-19 showed a “very jarring” situation around vaccines, therapeutics, and diagnostics.
“One of the things that we have done at Africa CDC is really change the landscape of what the ecosystem looks like in local manufacturing.”
Leveraging its political mandate, Africa CDC has made immense progress in supporting heads of state in efforts towards regional empowerment, and Dr Alimi is “starting to see the progress”.
“More than ever right now, the challenge we are seeing with antimicrobial resistance and the vaccines available for some of those bacterial infections is despite the progress that has been made in producing them, when it comes to efficacy and thinking about things like clinical trials, the African continent is not very well represented.”
Therefore, seeing the “value of vaccines”, Africa CDC is striving to “close that gap”.
More on Africa CDC’s strategy
We then asked Dr Alimi for a bit more detail on her team’s strategy against AMR, and how vaccines come into play.
“I think our strategy for antimicrobial resistance is quite broad, and knowing that AMR is very multi-faceted; it’s not one sector only; it requires a One Health approach.”
To start with, Africa CDC is estimating the burden of AMR, to understand how to make “real life progress” through improved surveillance. They are also working on “stewardship” and ensuring access to essential antimicrobials . Dr Alimi’s passion lies with prevention of AMR using IPC-WASH strategies and potentially vaccinations.
“Reducing or preventing infections will be able to reduce the need for antimicrobials.”
Here, with efforts to empower local manufacturing, vaccines are important to reduce infections.
“I think one of the things we are also good at is the advocacy.”
Another reflection is that “there is the evidence” but not the appropriate investment in vaccine rollout. Therefore, Africa CDC is trying to understand the economic value to “drive” research and support advocacy.
Why WVC?
It was great to welcome the Africa CDC team back to the event, and we asked Dr Alimi about their expectations or intentions for their time with us. Dr Alimi highlights the importance of advocacy and “championing equity”:
“The challenge we are seeing with antimicrobial resistance and potential value of vaccines to reduce these bacterial infections is access for many LMICs. It is important to get them to those who need them and that the African continent is very well represented in clinical trials.”
She recognises the “remarkable work” that her colleagues at the Congress are doing, and suggests that they need support in identifying collaborations within the African continent. As “custodians”, Africa CDC is able to offer this. Within the New Public Health Order, Africa CDC is ensuring that the continent has strong institutions and strong national systems. Another key focus for Dr Alimi was able to bring to the event was a question about bringing research to “guide policy”.
“Most importantly this conference gives us opportunity to meet the right partners, the right stakeholders.”
All of these efforts contribute to a “shared outcome”:
“A safer and healthier Africa.”
It was great to hear these insights from Dr Alimi, and we hope that you enjoy the interview!
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