Where are Covid-19 innovations?

Tuesday January 12 2021
specialpix

Professional healthcare workers wearing personal protective equipment (PPE) attend to a patient inside the temporary ward dedicated to the treatment of possible Covid-19 patients in Pretoria, South Africa, yesterday. Shortage of PPEs hinders fight against Covid-19. PHOTO/AFP

By Tonny Abet

Developers of products for preventing, testing and treating Covid-19 have blamed the delay to release innovations on limited internal capacity to do pre-approval tests, funding shortfalls and bureaucratic processes to get approval. 

The Covid-19 outbreak spurred local innovations but a number of the products that raised hope in curbing the virus spread have not yet made it to the market.  Some of the innovations utilised public funds while others were financed by individuals and companies.

Among the leading innovators in Covid-19 fight were scientists from Makerere University. The institution spent a significant portion of the Shs30 billion special government funding of 2019/2020 on research to support Covid-19 innovations, according to the management of the institution.
In March, Ms Rebecca Kadaga, the Speaker of the Parliament, said Uganda would start manufacturing treatment for Covid-19 locally.

“A professor who manufactured the treatment for Coronavirus in the U.S., and he has donated the patent to Uganda and within a fortnight, the treatment will be made here. It will be available on the market here in Uganda. It’s being made by a company called Dei International. Not that we should be relaxed, but there’s hope,” the Voice of America quoted Ms Kadaga to have said.

It turned out that the product was a hand sanitiser, when the Uganda Medical Association (UMA) scrutinised the claim about the cure.

President Museveni had promised that Ugandan scientists were looking for Covid-19 vaccine and that they would get the medicine before developed countries.

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East African Centre for Investigative Reporting’s online publication Vox Populi, quoted Mr Museveni to have said on April 18: “Our scientists are also doing wonderful things.

 They are working on the vaccine. The ones in Entebbe have understood the virus’ structure and some of them are developing materials to use like diagnostic materials. They are doing very well.”

The publication quoted the NRM presidential candidate to have said in another address to the nation on June 22 : “Even this Coronavirus, we can get this medicine even before Europeans get it. I am very hopeful on the front of the vaccine and treatment.”

However, Dr Monica Musenero, the presidential advisor on epidemics, who is coordinating the drive to develop the vaccine and drugs, has always maintained that they will give an update when they have reached some stage.

Other top scientists, who earlier spoke on condition of anonymity, said there is no vaccine development going on in the country.

“If we can’t even develop quality face masks, how do you develop a vaccine? Let us focus on things we have a competitive advantage in,” a research scientist at Makerere University said.

The latest update on the country’s progress in Covid-19 treatment and vaccine was on November 29 when President Museveni said Ugandan scientists had developed seven products for treating Covid-19 and that some were going to be tested on patients by December 15 and others are already being used.

But this reporter asked Dr Musenero about the said clinical trial, she said they were still working on the protocol for the trial. 

Dr Musenero, who is coordinating the scientists, had also said Uganda was considering herbal medicine for treating Covid-19.
“We only take the ingredients to the factory to mix the ratios that we have. Natural is like you have got it from a plant. We are going to start with 20 people and then we broaden the number to 200,” Dr Musenero said last month.

Dr Grace Nambatya, the head of the Natural Chemotherapeutics Research Institute at the Ministry of Health, said they would inform the public later about their progress.

 Bulamu ventilator

Bulamu Ventilator, alias low-cost ventilator, was one of Makerere University’s most important products made to manage Covid-19 cases that has not yet made it to the market, six months after its official launch.

The product was developed by Makerere University’s Resilient Africa Network (RAN) programme and its partner firm Kiira Motors Corporation (KMC). RAN is a partnership of 20 African universities in 16 countries led by Makerere University, according to information on the university website.

Unveiled by the Minister of Health, Dr Jane Ruth Aceng, the developers of the ventilator had promised that they would acquire emergency approval from the National Drugs Authority (NDA) for use in Covid-19 cases.

Mr Paul Musasizi, the central executive officer of KMC, had said the machine would be installed in ambulances and Intensive Care Units in hospitals.

Dr Roy William Mayega, the deputy chief of party of RAN programme, on Sunday said the Bulamu Ventilator  is still being tested in guinea pigs, adding that he was unsure when the product would be ready for use.

“People who are doing the trial in animals at Makerere University College of Veterinary lacked some equipment that they needed to import and this delayed the trial. From that stage, there will be first and second stages of a clinical trial [test on humans] which we expect to start in January 2021. And if the results are satisfactory, it will progress to the third stage of the clinical trial,” Dr Mayega said. 

Dr Mayega, however, believes that they will be able to combine the first and second stages of the clinical trial to fasten the process and gain approval early, but he was not certain of the time the product is expected to be approved.

However, the Vice Chancellor of Makerere University, Prof Barnabas Nawangwe, on Thursday last week said the ventilators delayed because the government did not give them permission to start mass production. 

In a copy of the August 25 letter to the permanent secretary of Ministry of Health, Dr Diana Atwine, Prof Nawangwe asked her to facilitate the uptake of the technologies that Makerere scientists had developed.

“The purpose of this letter is to request you to take leadership in facilitating up-take of these innovations [low-cost ventilator, epi-tent and touchless handwashing kit] by government,” the letter read. He added: “My fear is that if there is no uptake of these innovations by government when they are needed most, our researchers and innovators will be discouraged.”

Speaking to this newspaper last week on Thursday, Prog Nawangwe said: “The ventilator was supposed to undergo some tests in hospitals and the Ministry of Health or National Drug Authority (NDA) was supposed to provide that permission. 

But that has not happened.”  Dr David Nahamya, the NDA secretary, on Monday said NDA has not yet received any application from Makerere University where they are seeking approval for ventilators.

Dr Atwine in response to Prof Nawangwe’s claim said she was not aware of any Makerere University application seeking clearance for production of the ventilator and that the Ministry does not test equipment.  


Sanitisers
A number of sanitisers have been developed by local firms and they are dominating the consumer market.

However, the National Drug Authority has approved 14 of the sanitisers that are in the market, according to information on their website. The approved sanitisers include Saraya, Humarub, Med-gel, and Rene Hand saitiser.

The Uganda National Bureau of Standards (UNBS) also released a list of companies certified to manufacture sanitisers as of April 1, 2020 and the ones that had failed.

The UNBS said manufacturers that failed had shortfalls in regarding the alcohol content and PH of their products.
Five brands that failed the laboratory tests regarding the alcohol content(min 60 per cent and pH: 6-8 and Bactericidalefficacy), according to the UNBS included Lovillea Gelly Cologne Hand Sanitizer, Blue++ King Hand Sanitiser, Blue++ King Hand Sanitizer and  Yoza Hand Sanitizer.
We did not verify whether there have been some changes.


Rapid testing kits

Prof Vinand Nantulya, a senior researcher and proprietor of one of the firms that makes diagnostic kits in the country, in June last year said he had designed rapid testing kits for Coronavirus which give results in five minutes.

He said the “antibody testing kits” were already being assessed for accuracy and sensitivity in testing in the laboratory and field tests.

Prof Moses Joloba, the head of the Makerere laboratory, had also confirmed that they had validated the kits and submitted the results to the Ministry of Health.

Prof Nantulya last Monday, however, said the field validation where the kits are used to test patients and its accuracy compared with another standard kit, had not yet been completed.

Unlike the PCR (polymerase chain reaction) test, the antibody tests are not the gold standard for testing the Coronavirus, but it can assess whether a population has been exposed the virus, according to information from the Ministry of Health.

Dr Misaki Wayengera, a Makerere University scientist, who has manufactured Ebola testing kits, had said he was developing much cheaper and faster test kits that will not need a laboratory and that it would be out by June 2020.

Dr Misaki in April, however, said he was struggling with funding.

“Today, we received rabbit derived polyclonal antibodies against SARS-CoV2 [the Coronavirus] to be used for making our swab tube dipstick antigen agglutination (STD-AgX) assay. The prototypes should be ready and validated in the next 1month,” he said on his twitter handle on August 18 last year.  The testing kits are not yet out.

Touchless handwashing machines
 Islamic University In Uganda and Makerere University scientists manufactured touchless handwashing machines to lessen contacts. The automated machines at the entrance to the Covid-19 treatment unit of Mulago Hospital was still in use when this reporter visited last month, December 2020.

Face masks
Face masks manufactured in the country continue to be used in preventing Covid-19 spread, although issues of poor quality have been brought out.

The Uganda National Bureau of Standards  said by July last year, it had certified 45 companies to produce non-medical facemasks that were being distributed by the government.

Other innovations 
Covid Convalescent Plasma (CCP)

Covid Convalescent Plasma (CCP), a medical intervention, is the process where blood from recovered Covid-19 patients would be used to treat those with severe disease.

The project was introduced in June and on September 16 last year,  Health Minister Ruth Aceng launched the CCP as an investigational new drug to pave way for the trial to assess the safety and efficacy in treatment of Covid-19. Six months later, the product has not yet been approved.

Dr Bruce Kirenga, the director of Makerere University Lung Institute, said the drugs for treating the disease are still few.  Some of them such as hydroxychloroquine are not efficacious or have serious side effects, according to past studies by the World Health Organisation.

The CCP needs to undergo a rigorous trial to assess the efficacy and safety before approval, according to Dr Roy William Mayega, the deputy chief of party of Makerere University’s Resilient Africa Network (RAN) programme.

 Epi-tent
Dr Mayega said other Covid-19 innovations that do not need much-formalised approval process such as epi-tent have made it to the market and are already in use. “That one we developed and the Ministry of Health took interest in it and has been deployed in five regional referral hospitals and also at the border post in Malaba,” he said.

This reporter could not independently verify whether epi-tent was actually being used. 


Sanitisation booth

Companies such as Wuza Limited and Bakawa and Sons Holdings manufactured sanitisation booths, which allow spraying the whole body of people entering premises to kill Coronavirus.

“I have found this sanitisation booth highly effective, especially if used in conjunction with the other SOPs. We promise that this equipment is going to be put to proper use because this donation will go a long way in protecting the lives of Ugandans at Mulago hospital,” Dr Baterana Byarugaba, the Mulago hospital executive director, said while receiving the machine from Wuza Limited in August last year.

However, a security guard at the western gate told this reporter that the machine broke down a few weeks after it was donated.

Sanitisation booth

Companies such as Wuza Limited and Bakawa and Sons Holdings manufactured sanitisation booths, which allow spraying the whole body of people entering premises to kill Coronavirus.

“I have found this sanitisation booth highly effective, especially if used in conjunction with the other SOPs.

 We promise that this equipment is going to be put to proper use because this donation will go a long way in protecting the lives of Ugandans at Mulago hospital,” Dr Baterana Byarugaba, the Mulago hospital executive director, said while receiving the machine from Wuza Limited in August last year.

However, a security guard at the western gate told this reporter that the machine broke down a few weeks after it was donated.


Face masks
Face masks manufactured in the country continue to be used in preventing Covid-19 spread, although issues of poor quality have been brought out.

The Uganda National Bureau of Standards  said by July last year, it had certified 45 companies to produce non-medical facemasks that were being distributed by the government.

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