As the global COVID-19 pandemic continues to spread, much of the world’s population remains in lockdown, social distancing, heightened personal hygiene and increased health awareness as safety protocols to control infections. These safety protocols do not eradicate the coronavirus or the disease but are important efforts at flattening the curve. For the reason that there is currently no vaccine or specific medication to treat COVID-19, the curve is flattened by reducing the infection rate in order to avoid overloading any given local healthcare system beyond its capacity to take care of normal facility users and the virus infected.
Since the now routine safety protocols are not on their own a Covid-19 panacea, scientists especially in developed countries like Britain, France, China and United States are scrambling to find a vaccine for Covid-19. The research for a vaccine is largely domiciled in these countries because the road to discovery of vaccine is treacherous and extremely expensive, outside the league of developing countries such as African countries.
Once a prototype vaccine is developed, trials typically begin with tests on animals. The trials normally take several months, and in some cases in excess of a year as they check for the vaccine’s safety before transitioning to human testing. In the human trials, not only is safety again checked but most importantly the efficacy of the vaccine. The regulations in the standardization of vaccine development is rigorous and complex hence the discovery and use of vaccine takes a long time. However, in pandemic crisis like the one Covid-19 has caused, these timelines are sometimes tinkered with however ethical obligations demand that the process remains within the boundaries of good science.
In the global scramble for a COVID-19 vaccine, it appears that scientists have made major strides as a select number of human trials seem to be under way in Britain, China and proposed trials in Australia and German are scheduled for early May. Because of the African countries’ limited involvement in vaccine development, and the unfortunate reckless communication on proposed Covid-19 vaccine trials on the continent, the vaccine trial process has sparked a ‘racism backlash.’
The hostility from Africans is not only a product of anxiety, given the unquantifiable risks to the recipients of vaccines in early stages of vaccine development. It is also informed by the fact that in the world of medicine, the process of vaccine development has come a long way from the days of trials in which an unsuspecting people, unfortunately mostly Africans, meekly submitted to experimentation and sometimes even catastrophic procedures. In some cases, victims of vaccine trials suffered at the hands of well-meaning learned people whom none of them had ever met or would ever meet again. While the risks in human trials of a vaccine are very real, this particular risk of unauthorized or unethical vaccine trials does not have a scapegoat.
According to the World Health Organization, over 70 different potential Covid-19 vaccines are currently in the works, and the efficacy of these vaccines will never be ascertained until and unless there is human trial on a large population across the world. Therefore, even as some Africans protest to what seems to have been careless talk by some ‘scientist’ in the international media, as well as dramatization of mistrust in African government’s ability to assure safety and security in human trials, Africans shouldn’t and mustn’t be forgotten or excluded from these vaccine trials given that Africans too are key stakeholders in what is a global pandemic.
All large-scale human vaccine trials present ethical conundrums because typically the vaccine is given to people who are healthy. It also requires huge numbers of experiment participants to determine both safety and efficacy. Therefore, this stage of vaccine development requires a well-thought-out approach guided by ethical principles. The commonly applied principles in the vaccine trials include respect (autonomy), beneficence, non-maleficence and justice. The principle of respect demands elaborate communication with study participants and communities; these may include local health services and academia. The communication should be such that it takes into account participants’ traditions, sensitivities and concerns. Beneficence principle implies that the vaccine will benefit the targeted population including trial participants, and that the benefit may be extended to strengthening local health and academic capacities. Non-maleficence is similar to beneficence, and requires that vaccine trials inflict no harm to participants and the general population. Lastly, the principle of justice ensures that the hardships and benefits of vaccines development are distributed with fairness.
Based on the foregoing and the fact that vaccine trials on humans share ethical requirements with all forms of human scientific experimentation, Africans shouldn’t play into self-exclusion for fear of ‘unknown dangers’ in vaccine trials. Individual Africans must wrestle with the question of whether to volunteer for proposed human trials; they must be alive to the altruism of their act of self-sacrifice to the good of all humanity. In fact, the demand for Covid-19 vaccine trials volunteers requires that mankind including Africans engage in acts of supererogation instead of just altruism. Supererogation acts are good human actions that no one would condemn you for if you absconded, but you are praised for the bravery if you undertook the action. For instance, it is from supererogation acts that our Catholic saints, human right defender icons, our martyrs and our war heroes are birthed.
The fight against Covid-19 has been described in metaphors and imageries of war. Africans fore-fathers, who put their lives on the line in the wars for Independence across the continent, engaged in supererogation acts. This generation must embrace this war on Covid-19 like their fore-fathers embraced struggle for freedom from colonialism. Ultimately vaccine trials require human beings, volunteering for the vaccine trial is like signing up for war; and therefore, some Africans will have to step forward for this supererogation act. Also, let’s face it; it might be the case that Africa’s major contribution to Covid-19 vaccine development is its people volunteering for vaccine trials. In addition, it is selfish that other countries would spend their human and capital resources to innovate and create a vaccine but when African countries are invited on board for what is specifically to their benefit, they would want to shirk that responsibility. Africans cannot transfer all the burden of vaccine trials to other human beings, but then position themselves for the benefits. Furthermore, on the global challenge of recruiting vaccine trials volunteers, it is time that some of us, Africans, daringly talked to the person in the mirror and asked: “if not me then who?”
By George Nyongesa
The author [email protected] is a Senior Associate at the Africa Policy Institute (Nairobi, Kenya).