Although the technology is not new, it is relatively unexplored in low- and middle-income countries
Monoclonal antibodies are used to address different kinds of diseases, not just infections. Representative photo: iStock. Every year, Africa faces over 100 health emergencies, more than any other region in the world, according to the World Health Organization (WHO).
As the global health body said, the region is battling several health challenges triggered by outbreaks of communicable diseases, humanitarian crises, climatic shocks, as well as the rising burden of chronic diseases such as cancer and diabetes. Technologies such as Monoclonal antibodies (MAb) can help the continent with disease prevention and control.
In an exclusive interview with this reporter, Dr Said Jongo, consultant physician and clinical epidemiologist at Ifakara Health Institute (IHI), a health research organisation based in Tanzania, explained about MAb.
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They are lab-made copies of B cells that mimic the body’s immune system. He said the aim is to enable the production of proteins that are very specific to the foreign bodies called antigens.
“They’re called monoclonal because they are produced by single clone of the B cells. So, you can have the exact copies of the same protein produced many times over and this way they are called MAb.” MAb can be produced outside the body, he said.
“But when you produce them outside human bodies, you have to focus on the type since what is produced in our bodies are of different types, hundreds of them. Whatever infection you have, there is an antibody produced in the body, but if we are producing it from outside, it has to be specific,” he said.
MAb are used to address different kinds of diseases, not just infections. “Cancer is not infection, but you can use the monoclonal antibodies against it. Autoimmune diseases are not infections, but you can use MAb,” Jongo added.
At the same time, they can be used against infections like malaria or others as they are made to target anything that is interpreted as outside, he said.
“For example, cancer cells in human body may be interpreted as from outside, you can make MAb that are specific to cancer cells in the human body to attack those cells,” he clarified.
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To treat cancer, the standard method is chemotherapy — the use of drugs. “But those drugs are usually cytotoxic. They kill everything — both the normal cells and the cancer cells. Sometimes, we give radiation; even radiation cannot choose which cells to kill. But MAb can target specific problems and attack those cells,” he explained.
Although the technology is not new, it is relatively unexplored in low- and middle-income countries because the previous indication for use was not primarily to treat infections, according to him. It has been used in developed countries in Europe and US.
“The previous indication for use was treatment of non-infectious diseases like cancer and so forth. And of course, we have a lot of cancer cases here, but our primary problem is infections. So, now there is more interest to use them,” he said.
WHO Regional Director for Africa, Dr Matshidiso Moeti, in her World Health Day 2022 message, said a warming world is seeing mosquitos spread diseases further and faster than ever before.
Serious consequences can be seen in African countries, which reported 94 per cent of the 229 million malaria cases recorded globally in 2019, while deaths due to malaria in Africa accounted for about 51 per cent of all malaria deaths worldwide.
MAb can be used for fighting malaria for either prevention or treatment, according to Jongo. “For Africa, I think the primary target is to use it for prevention. But also, it can be used for treatment,” he said.
In Africa, the policy to use the technology — already in phase II of the clinical trial — on the continent was not there before.
“There are many African countries now participating in the discussion to see how this can be developed. There are researchers from Tanzania, Kenya and Mali that have been involved in the discussions and the next step is to test this product in areas with certain levels of malaria, for example, Mali,” he said.
He explained that Mali was chosen for clinical trial as malaria is still very high in the country. “You don’t want to test this, for example, in the middle of the town where the transmission is very low. To see the efficacy, you need to test it in areas where the transmission of malaria is ongoing”.
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In the past 10 years, Africa has had a lot of success in reducing malaria prevalence and deaths by using many tools in combination.
“All the tools were used in combination. And then, it reached a stage where we are not getting additional benefit from existing tools, but that is not a failure; it’s just a progress,” he said.
“Now we need to introduce these additional new tools that will bring malaria further down, hopefully to zero. We have vaccines, and introduction of the MAb also is intended to bring the level of malaria to the level where we can declare malaria to be eliminated,” he added.
Although the technology might be expensive, it is likely to be affordable, owing to its growing demand. Increased production to cater to the demand would lower the manufacturing cost. Moreover, he expects that it may not take long.
“After the COVID-19 pandemic, we have learned that you can manufacture new product and get it into use within two to three years,” he said.
Africa’s Heads of State recognise that technology is critical to accelerating the continent’s economic development, as embodied in the African Union’s (AU) Agenda 2063.
To this extent, the AU directed its development agency to establish the Africa Union High-level Panel on Emerging Technologies to provide expert advice on matters of technology and development. The establishment allows the continent to leverage current and emerging innovations and technologies with a high potential to transform Africa’s science base into a competitive advantage.
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