A medical model, Personalised Medicine (PM) uses characterization of individuals’ phenotypes and genotypes (e.g., molecular profiling, medical imaging, lifestyle data) to tailor the right therapeutic strategy for the right person at the right time and/or to determine predisposition to disease and/or to deliver timely and targeted prevention. PM is gaining momentum globally, but in Africa, where the disease burden is comparatively high, the progress has been slow.
EU-Africa PerMed (Building Links between Europe and Africa in Personalised Medicine) is a four-year project funded by the European Commission H2020 Programme with the final objective of integrating more African countries into the global PM research agenda. This is by facilitating their participation in the International Consortium for Personalised Medicine (ICPerMed) activities and strengthening the research collaboration between Africa and Europe in mutual interest. The project will foster joint PM projects and programs between Europe and Africa and strengthen bilateral EU-AU science, technology, and innovation relations in health.
Since its launch in 2021, the EU-Africa PerMed Consortium has been implementing a series of successful activities, among them, the mapping of the scientific and policy landscape of PM in Africa, two stakeholder-based surveys to understand the situation concerning PM in Africa, a series of webinars on pertinent issues; and a virtual stakeholder workshop that brought together over 200 key PM stakeholders.
Most recently, on November 23, 2022, the African Population and Health Research Center (APHRC), one of the 13 project partners, brought together stakeholders virtually to share experiences and discuss the opportunities and challenges of implementing PM in Africa from the perspective of the practitioners. The webinar had a rich participation of relevant stakeholders ranging from researchers, academics, policymakers, development actors, and PM practitioners.
Participants benefited from insightful discussions driven by a panel of three PM experts – Yaw Bediako (Co-Founder and CEO, Yemaachi Biotech), Ghana; Julie Makani (Department of Haematology and Blood Transfusion at the Muhimbili University of Health and Allied Sciences (MUHAS), Tanzania; and Godfrey Sama Philipo (Research and Patient Outcome Coordinator, ECSA Health Community), Tanzania. Dr. Evelyn Gitau, Director of Research and Related Capacity Strengthening at APHRC, moderated the session.
Why does Africa need Personalised Medicine?
A collective understanding among the webinar participants was that PM presents great opportunities in preventing disease, promoting health, and reducing health disparities faced by African Countries. Africa has high genetic diversity, creating situations where therapy is ineffective across all populations. The continent also faces a high burden of communicable and non-communicable diseases, which is met by poor public health infrastructure. PM is, therefore opportune as it addresses the challenges of common medicines not being effective in treating large numbers of patients and rising healthcare costs due to more prevalent chronic diseases and an aging population.
The implementation of PM in Africa, however, faces various challenges such as cost, infrastructure – technology and expertise, poorly optimized tools, and poor data representation from the continent, among others. Nevertheless, even with the development challenges combating Africa, PM is another opportunity for Africa to leapfrog – address and equalize the healthcare system, and provide better patient care.
The time to fully advance PM in Africa is now, there is the need, and there are the people. Of course, it has to be structured and consider the specific elements of PM that are more suitable now than later and vice versa. The global movement on PM is progressing. As Dr. Evelyn Gitau put it, “if we [Africans] exclude ourselves because we do not have the capacity, infrastructure or we have more important priorities, we are going to be left behind!”
Call to action to progress PM implementation in Africa
Webinar discussions and contributions from the panelists provided practical suggestions that, if taken up, have the potential to drive the successful implementation of PM on the continent.
The successful implementation of PM in Africa requires a multi-pronged and multi-sectoral approach. Collaboration between researchers, clinicians, policymakers, patients, and industry in Africa has an opportunity to drive the success of PM on the continent. No one stakeholder or organization has all the capabilities and resources needed to realize the promise of PM.
Over 80% of the data available in oncology or other areas that can benefit from PM is from people of European or Caucasian ancestry, and only 2% for people of African descent. Therefore, Africa must look for ways to get and exploit this data to understand the diversity in the continent’s populations, understand the disease mechanism and make our medicine more precise. Data goes beyond scientific evidence but considers perspectives from patients, their families, physicians, and other relevant stakeholders. Data-driven R&D will go a long way in capacitating Africa to carry out its own pre-clinical work and inform priority aspects of PM to implement, when, and how to do it within its context.
- Patient-centered approach
There is a need to work in concert with the patients and listen to them. This calls for allowing patients and/or patient groups to participate in PM conversations and innovations and creating the platforms for them to do so. The approach will require a true partnership between the patients and care providers/PM innovators with priority for health care that is respectful of and responsive to the real needs of the patients, their perspectives, and preferences. The utmost patient value should guide all clinical decisions.
- Opportunities for work in PM and mentorship
The era of PM comes with the need for leaders in the discipline. PM trainees require new skills to lead and optimize PM implementation in mainstream healthcare. While training programs should look into management, teaching, and clinical skills for practitioners, there is also an urgent need to ensure that the spaces where they can come and invest their knowledge are well invested in. They also require mentorship to be able to conceptualize, implement and lead a complete PM ecosystem – from the diagnosis to implementation to the impact.