The positive memories of my first trip to Africa will last long in my memory. The negative ones, specifically the traveler's diarrhea that I've just recovered from, won't, although it did symbolize for me how much of a blight infectious diseases are. Progress in the life sciences matters to the daily lives of Africans in ways that we can't begin to fathom.
The good news is that substantial investment is beginning to pay dividends both in the development of new therapies and in delivering them through effective, integrated healthcare interventions. There is a palpable air of optimism, exemplified by the cautious use of the e-word in relation to malaria for the first time in 40 years. E as in eradication.
Efforts to control infectious diseases need to be doubled and redoubled. But other monstrous problems must also receive attention.
First, there's chronic malnutrition and the need to secure the food supply. Huge numbers of people are constantly on the brink of disaster. Right now, Ethiopia and Somalia at the tipping point of humanitarian crises.
Second, there's the specter of noninfectious diseases: cancer, diabetes, and chronic heart disease are as rampant in Africa today as they are elsewhere in the world, and obesity and mental health problems promise to run amuck tomorrow.
Third, African economies are in freefall. Over the past 50 years, the continent has soaked up $558 billion in aid with no noticeable effect. In 1970, 11% of Africans lived on $1 per day; by 2015, a staggering 68% may have to get by on that paltry sum.
For all three of these problems, as for infectious disease, research and development lie at the heart of the solutions. New tools must be developed while optimally applying existing ones. As things currently stand, however, there will be little or no contribution by African scientists working in Africa. That can, and should, be changed.
"African science" is almost a misnomer. Sure, there are pockets of outstanding research, but they are restricted to satellite institutions funded by overseas agencies and their (American and European) staff. African scientists do healthcare implementation work and even for that, according to the local people who I met on a recent trip to Uganda, "those who do the work and those who write it up are separate."
An African researcher who wants to perform cutting-edge laboratory research has essentially nowhere to go, and absolutely no funding is available to do noninfectious disease research. The well-trained scientist faces a stark choice: Work outside Africa or abandon your cutting-edge technologies and skills.
Why not build capacity in high-level basic research in sub-Saharan Africa? In time this could add a new research culture to the world, as China, India, South Korea, and others have done. These increasingly powerful science communities do not work exclusively on local issues. Think of stem cell research in South Korea, bioinformatics in India, genomics in China - all cutting-edge science that has obvious commercial potential.
In contrast, research in Africa is restricted to international initiatives addressing infectious diseases. Essential as this is, it is not enough. To see why, contrast the poverty rates given above for Africa with those of Southeast Asia: In 1970 56% of the population lived on a dollar per day, with an expectation to reduce it to 13% in 2015. While investment in the life sciences wasn't the first step to reducing poverty, it could be a giant one for Africa.
How might investment in basic research come about? Could a Max Planck Society institute (see a profile of the molecular genetics group) or a Salk Institute be persuaded to set up shop? Could the African nations, with African entrepreneurs, come together to build a facility to showcase what African research can do? Could this in turn attract pharma investment, a biotech community, contract research and manufacturing, VC money, the whole panoply of the life sciences enterprise? With the right commitment, the answer is yes.
The key step must be to get some decent seed funding for basic science. This might seem like a luxury but it isn't. It should be a central part of the strategy to dig Africa, and Africans, out of their perpetual nightmare.