Reshaping Healthcare in an Era of Viral Pandemics: Why is Science so Crucial ? 

Novel global paradigms set in by the Covid-19 have ushered in a new era of health management,  reawakening the world to the tough realities of pandemics and far reaching benefits of effective healthcare systems.

In this Alkamba Times big Interview Exclusive, Mr Sainey Marenah Speaks with Data Scientist Dr Neneh Sallah about lessons learnt from the global pandemic and the role of  science and medicine in building a more resilient future.

• Covid-19 is a major turning point that set us on a new crossroad, how much of a crisis are we facing in transforming our healthcare systems to meet new paradigms and challenges created by covid?

COVID-19 has unveiled all the vulnerabilities particularly in our weaker healthcare systems from primary care to supply chains as we have been largely overwhelmed and struggling to cope with impact of the virus. The pandemic has also laid bare how far too many countries have failed to meet the needs of people living with other illnesses. Disruptions to essential health services, including the diagnosis and treatment of important and largely preventable diseases undermines health security with many people being deprived of the care and medicines they need. A large part of the response to the pandemic means building strong health systems, on the foundation of primary health care with significantly increased investments or substantial shifts in investment from curative to preventive interventions including investing in and prioritising medical research. We need to also leverage our existing strengths on outbreak response and adopt tailored strategies that work for us. Much of this response is about political will, so governance too is just as important if not more.

2. You specialise in Data science, which has been a vital tool in accessing a covid vaccine and statistical systems guiding effective pandemic control, How much has data science evolved during the pandemic?

Data science is constantly evolving and is being used on all fronts from speeding up discovery, tracking transmission, understanding factors that are associated with disease, effectiveness of mitigation strategies and management of hospital supply chains. We have seen an increase in the use of genome sequencing technology to capture and catalogue the DNA of the virus, this is crucial in tracking changes that give rise to new variants and their spread globally.  Quick and accurate data analytics has helped deliver an accelerated, more refined picture of where diseases are unfolding and predicting where it might head to next – this is key to fighting infectious disease. Improved technology and digitization too have allowed us to rapidly assimilate different data types from wherever you are in the world and derive and share meaningful information instantaneously – this is particularly important given time is of the essence. Data science on the whole enables evidence-based, tailored decision making and guides policy.

3. Africa has made immense headway in improving scientific data sharing and research amid the covid pandemic. Why is it crucial to strengthen expertise and capacity in Science and medicine?

Scientific research provides the evidence-based rationale for decision making and is the cornerstone of effective disease prevention, control and saving lives with positive ripple effects beyond health that alleviates a country’s economic burden over time. In the Gambia, the research landscape is very thin, thus, the pathway and opportunities from university to becoming a researcher is unclear and very limited because outside of the MRC the infrastructure and resources are simply not there. For us to be competitive in the global arena we must strengthen local expertise and capacity to train and retain the next generation of scientists and cultivate the research culture for scientists to thrive.  We must harness the potential of young scientists and create nurturing environments for talent, otherwise the cost in the long run will be very high, we already see a loss of talent to western institutions resulting in a tragic brain drain and elevated unemployment rates locally. Governments must therefore prioritise strengthening local capacity very highly if they do not wish to be left behind. They also need to have policies in place to protect our science, our data and ensure sustainability and the security of our scientists so that we too can reap the benefits and advancements of science. For decades, we have seen scientists and those making decisions with regards to our science mainly from the west, so it is crucial for us too to be represented at the leadership level, this way we can set our own research agenda, govern our science and direct the transformation that we know will be beneficial to us.

4. How would increased Scientific research and investment support healthcare solutions for the Gambia?

Research funders largely have the upper hand in driving an area of interest. To shift from dependency on foreign institutions and also increase employment opportunities for the next generation of Gambian scientists we must create the infrastructure and fund our science locally. This will allow us to be able to drive our own research agenda and tackle issues that are of direct public health importance for us. Too often Africa remains the last to get access to quality healthcare innovations, the COVID-19 vaccine remains no exception. Increased investments in scientific research can therefore be expected to contribute to greater equity in access to health and improve health quality as innovations and advancements in science will be accessible. With the ownership of our science and technology that we develop we would see a huge drive down in costs resulting in increased affordability and access for the populace. Driving our research under these conditions and translating the science would undoubtedly inform health care practitioners and policy makers, ultimately benefit patients at scale and our economy in the long term.

5. Africa is intensfying its call for vaccine  access and equity amid efforts to protect populations across the continent. What’s the prospect of this conversation changing to Africa developing vaccines within the region? 

This call is long overdue, COVID-19 has exposed the huge gap in Africa in which we have had the least access to vaccines and thus undermining global health security as we continue to rely on the west. There is already existing vaccine manufacturing capacity in Senegal, Egypt, Tunisia, Ethiopia, and South Africa, where currently other vaccines such as Yellow Fever are produced. This existing capacity means the continent doesn’t need to start from scratch in terms of expanding manufacturing capabilities to produce a COVID-19 vaccine. The first vaccine technology transfer hub is also being established in South Africa where interested manufacturers from low- and middle-income countries can receive training and any necessary licenses to the technology. This will drive vaccine innovation, development and manufacturing capacity on the continent through partnerships with universities and research councils. Countries should therefore prepare to build up their infrastructure now to strengthen supply chains, so that they are ready to distribute a vaccine when it becomes available.

6. Scientists have always been at the frontier of virus control and vaccine development. How much have we benefited from listening to science during the global emergency. 

The pandemic has placed scientists in the spotlight now more than ever before and rightfully so given they are the experts in this battle. Science is complex and expertise should not be taken for granted. Doing the science, sharing the discoveries to fight the virus and saving lives in real time under heavy public scrutiny has been an arduous task. We have seen how the science has delivered a better understanding of infection, effective mitigation strategies such as a masks and vaccines to control spread of the virus, save lives and guided public health decision making. Seeing and hearing from scientists via the media demystifies the science to the non-scientists while counteracting misinformation and is crucial in building trust, confidence and reassurance to overcome this crisis.

7. Open science and collaboration played a key role in tackling the scourge of the pandemic. What lessons has science learnt from covid in terms of broadening coordination for pandemic and disease control

Science is a collaborative effort and sharing scientific data is essential for advancing discovery. The COVID-19 pandemic has accelerated the rate at which new research and data from all over the world are shared in order to inform international and national responses and to accelerate the development of diagnostics, treatments and vaccines and this has worked really well. The pandemic response requires a galvanised effort and through open science we have learnt what works, where and when, what doesn’t, what others are doing so we aren’t re-inventing the wheel but can make additive contributions. In Africa, we have been reminded that response needs to be in the context of our environment and health settings as most of the research and data arising from the pandemic has been from white populations and interventions implemented by high-income populations such as blanket lockdowns have not worked equally well in our context. This reiterates the necessity for us to do our own research, implement policies informed by local data, trust our experts, put them in the forefront of decision making and leverage our existing strengths that we have in responding to such crises as we have done previously for other outbreaks such as Ebola and cholera. The experiences over the last 2 years should guide our preparedness efforts so that when the next threat arises, we will be armed with lessons, expertise and hopefully the life-saving tools to avert a crisis.

Who is Dr Neneh Sallah? 

Dr. Sallah is a Gambian scientist and global health consultant with over 15 years’ experience in medical research. Her research career began in 2006 when she joined the MRC in Fajara as a lab technician investigating diseases of public health concern through which she was awarded a scholarship to pursue a BSc. degree in Biomedical Sciences at the University of Manchester, UK in 2008. She then completed her PhD in Bioinformatics and Genomics at the University of Cambridge in 2016 after being awarded a highly competitive international scholarship by the Wellcome Sanger institute. Following her Ph.D she worked for several years as a Research Fellow at the London School of Hygiene & Tropical Medicine where her research focused on understanding the influence of genetics and interactions with the environment on how people respond to infections (eg. Viruses). She also lectures on data science in public health to postgraduate students and led capacity development efforts in bioinformatics in south-east Asia and Africa. In 2020, she joined the UCL Institute of Health Informatics as Senior Research Fellow where she contributed to genetics research on heart disease and diabetes on South Asian populations and lectured on Health Data Science. She has immensely contributed to evidence of whether our genetic differences explain why people respond so differently to infection (i.e no symptoms, mild, moderate or severe disease), which is instrumental for clinical intervention. Her work has been published in prestigious academic journals.

Neneh’s most recent achievements include being nominated by the African Academy of Sciences which selected her as 1 of 650 “Leading Young Scientists” globally to join the prestigious and exclusive Nobel Lindau Laureate Meeting. She was also selected as 1 of 350 Next Generation Women Leaders by McKinsey & Co from an applicant pool of 6000 women. Her achievements also include recognition from Johnson&Johnson as a “Champion of Science” for contributions to STEM and innovation in Africa.