The State of the Nation Address 2022 said little about innovation, bar noting that broadband spectrum allocation was holding us back. True, but this hasn’t deterred Amazon from setting up a large software engineering house up the road from the gutted National Assembly. Amazon’s tenfold larger facility is currently under construction near Mowbray. So, all is not gloom and doom.
Another truth is that South Africa remains the continental leader in research and innovation, across both the natural and social sciences, and is a creative powerhouse to boot. She has drawn on the latent expertise of being the most diversified economy in Africa to trade globally, entering and opening new markets. Think of Discovery; think of Naspers.
The overall ratio of research and development expenditure to GDP has tanked over the past three years, even though expenditure on basic research to GDP is at the OECD average. What this means is that we are lagging on applied research and development – a red flag for sure.
On the science output side, the number of scientific publications places us at world rank 28, and normalised to GDP, we are the most prolific among the BRICS group. A third of all publications are in the medical, health sciences and allied fields. The usual measure of publication quality is the publication citation score. Relative to the world level, clinical medicine, physics and space science are citation stars, with economics and business lagging. And in absolute measure, immunology, molecular biology and genetics also shine.
These observations beg the question: why have we not produced a Covid-19 vaccine? After all, don’t we have the capabilities of Onderstepoort, the National Institute of Communicable Diseases, the Medical Research Council, the University of Cape Town, the University of KwaZulu-Natal, Tukkies, Maties and the skills of generic pharmaceutical hegemon Aspen Pharmacare, and and and?
Once upon a time vaccines for human use were produced by the State Vaccine Institute, until cost considerations led to its mothballing in favour of imports. The point is that the institute produced, but did not originate, vaccines. Making heartwater or foot-and-mouth vaccines at Onderstepoort is not the same as re-engineering proteins or manipulating mRNA for people.
We are starting from basics when it comes to vaccines for humans. To originate a vaccine requires at least three things: time to acquire knowledge, deep pockets to buy equipment and a large corps of dedicated researchers. Germany’s BioNTech built a team of 500 full-time researchers who succeeded in engineering the mRNA vaccine. The Astra-Zeneca vaccine emerged from Oxford University and the Jenner Institute which marshalled a similar number of researchers and could draw on their knowledge of engineering influenza vaccines. They were not driven by blue-sky research goals, rather the need to undertake use-oriented basic research. Timescale? Twenty years.
Down south we have a similar number of researchers spread across all health science research areas – lungs, ears, virology, epidemiology and so on. A local team of 10 or 20 experts in genome sequencing is too small to become a near-market drug developer, but as we know, it can identify a SARS-CoV-2 variant such as Omicron.
Second, our top-line expertise isn’t focused on genetic engineering, although we do have pockets of expertise in genome sequencing, immunology, infectious diseases, public, environmental and occupational health, virology and parasitology.
Many researchers in these fields are first-rank and engage in top-line research with international peers on the burden of disease, drug resistance, the aetiology of disease, and clinical trials. Measured by publication counts, our national research effort on genomics is about two-thirds that of Oxford alone.
For us to engineer vaccines requires the declaration of a state-funded national mission to support use-oriented basic research that will originate local solutions. Over to you, Marianna Mazzucato, adviser to President Cyril Ramaphosa. What choice to make? Mission impossible?
A first goal must be the expansion and retention of talent. In purchasing power parity dollar terms our researchers are well paid and this should attract peers from abroad. Yet barriers to inward migration prevent this. We train thousands of international doctoral students but retain in the order of 5%. The rest go home, which in and of itself is no bad thing for the graduates, their families and countries of origin. Our universities thereby contribute to brain “circulation”, not brain drain. But what is the benefit to our science system?
On the innovation front, Aspen Pharmacare invested R3-billion at Gqeberha to develop a new sterile production factory as the precursor to the formulation and filling of the Johnson & Johnson vaccine. This innovation involved setting up new manufacturing lines, and skills development, as a major contribution to Africa’s vaccination drive. Later in 2022 the company will market its own vaccine, Aspenovax, based on the J&J feedstock.
In Cape Town, at the original State Vaccine Institute, Biovac with French firm Sanofi and BioNTech, is developing the capacity to finish and fill mRNA vaccines. However, Biovac has but 50 staff with bachelor’s or higher qualifications. A homegrown vaccine is some way off.
And then there is NantSA, the initiative of Gqeberha-born billionaire Dr Patrick Soon-Shiong, whose R3-billion greenfield investment in Cape Town is intended to produce Covid-19 vaccines, anti-cancer drugs and immunotherapies. At the ribbon-cutting ceremony, South African Medical Research Council president Glenda Gray observed: “We have very great academic scientists who are good at discovery… Taking that vaccine to scale requires skills that we don’t have in South Africa. That’s where Dr Soon-Shiong is investing, in the next step to be able to take something to market.”
What the above teaches is that operating at the research and innovation frontier requires openness: the willingness to import the best equipment and skills, concentration of talent, determination and the realisation that bringing a vaccine to market is a journey on a long and winding road.
So, the statement in the 2019 Foresight Exercise for Science, Technology and Innovation, that “health should be focused on meeting the needs of local marginalised communities rather than the adopting and adapting of imported health solutions developed for affluent First World populations”, is troubling to say the least. That position resonates with the resistance, about 15 years ago, to participation in international clinical trials. This techno-nationalism aligns with the reborn import substitution and localisation agenda, which may have a place in the steel sheet, pots and pans sun, but not as far as the pandemic is concerned.
Innovation calls for openness of thought and sharing of knowledge, employing the best, using the best equipment and working with the best, wherever they may be. DM
Professor Michael Kahn is an independent researcher and adviser on innovation policy, strategy, measurement and evaluation. He works locally and internationally with government, higher education, public research organisations, multilaterals, development banks and consulting firms.