Somewhere in the deep unexplored depths of Madagascar, an unknown herb is probably on its way to becoming a global panacea for the pandemic.
This is Africa, a continent ripe with possibilities, where you cannot rule out that a cure for Covid-19 could perhaps come from nature itself. Just like Madagascar, currently touting Artemisia Afra (umhlonyane in Nguni languages and previously used as an ingredient for treating malaria) as a potential cure for Covid-19, bigger economies like South Africa are also looking to the botanical world for answers. Its national Department of Basic Education has reassigned R15 million ($960,982) of its budget on Covid-19 interventions such as Artemisia. Nigeria has also made a move towards a more homeopathic approach, as a ministerial committee has been put in place to further examine the potential natural compounds hold in combating the Covid-19 pandemic.
But the focus of this story is exploring humanity’s race to uncover a universal vaccine – or any cure – that can assuage a health crisis confronting the entire world.
Currently, there are over 60 possible vaccines the world over being put through the paces. Of these, only nine are in the third phase of trials. The road to finding a Covid-19 vaccine since the start of the pandemic this year has been long and arduous. For the layperson, desperate to see an effective vaccine come online soon, the deluge of news on vaccine trials can seem complex. This article will discern the facts around them.
In comparison to its European and American counterparts, Africa has seen a relatively lower rate of virus spread and a lower death rate. As of November 11, Africa accounted for 3.7% of the world’s total number of cases; and southern Africa the worst hit with over 800,000 cases.
Scientists are yet to definitively map out the effects of the Covid-19 virus and its ability to recur within individuals who have had it before. Fear of public spaces and physical interactions have become the norm. Face masks and sanitizing products have become staples in every handbag and car cubbyhole.
Put simply, a clinical trial is a series of phases within an experiment being conducted to test a new drug, type of therapy or new medical device. It also looks at the efficacy of pre-existing medical interventions in the treatment of numerous illnesses and different types of patients.
Clinical trials can be performed on both healthy and ill participants. There are a number of protocols and regulations that accompany a clinical trial to ensure that the well-being of the participant is maintained as far as possible. It ensures that the benefits of the medical intervention being tested outweigh the risks and each phase of a trial plays a part in testing this.
Clinical trials usually happen in four phases (see box). Before these phases occur, a preclinical test is done. Each phase needs to produce a favorable result in order for the next phase to be conducted. In order for a medical intervention to get to the stage of manufacturing and distribution, all four phases need to have occurred successfully. The success of each phase is measured by the number of medically adverse events that have occurred as a result of the medical intervention being tested. These adverse events include mild to serious medical side-effects that have occurred to the participants of the trial.
Dr Sinead Delany-Moretlwe, Director of Research at the Wits Reproductive Health and HIV Institute in Johannesburg, South Africa (see interview in box on next page) explains how innovations made with expediting the clinical trials for the Covid-19 vaccine could reshape how clinical trials are done across the board. She has also been the lead on HPTN 084, an injectable form of an antiretroviral (ARV) used to prevent HIV in women in sub-Saharan Africa.
The frantic search for a Covid-19 vaccine is being closely watched by every country on earth. At the time of going to press mid-November, there were currently 51 trials between Phases I and III of the clinical trials (see boxes on following pages for more info). When they will be available to all is a question on everyone’s mind.
South Africa’s Health Minister, talking to FORBES AFRICA about vaccine manufacturers, says: “Collaboration across global institutions has led to the transfer of technology and therefore new developments and new discoveries in combating the pandemic.”
In an interview with Aspen Pharmacare CEO and founder, Stephen Saad, he highlights to FORBES AFRICA the need for efficient manufacturing and distribution channels for the vaccine, once it becomes available. Aspen recently partnered with Johnson & Johnson for their vaccine Ad26.COV2-S (now known as JNJ-78436735). This partnership will see the manufacturing and distribution capacity of Johnson & Johnson increase significantly.
WHAT GOES INTO A CLINICAL TRIAL?
This phase within a study is most intensive and can often require the most amount of time and extensive research into possible cellular reactions between the intervention being investigated and the body’s immune response. This phase is often tested thoroughly with the use of animal test subjects before proceeding to Phase I.
This initial phase is conducted on a relatively small number of participants (six-10). It allows scientists to closely study and examine any effects or interactions that the intervention being investigated has in human participants. This phase is used to determine the safety and tolerability elements that an intervention may have in treating human participants. Participants are closely watched for the possible occurrence and severity of any side-effects that may occur.
The size of the participant pool could vary greatly here as the size is dependent on the type of illness being investigated (typically between 20-300 participants). In this phase, the dosage is often experimented with. This is done to successfully determine the dosage required for the intervention to be most effective and safe to administer. Different dosages of the intervention could produce different results. As such, multiple simulations of Phase II may occur for a single intervention, being tested within numerous populations of interest.
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