Between the years 2000 and 2001, Uganda experienced an Ebola outbreak in three of its districts. This outbreak was then considered to be the largest on record, infecting over 425 people. Of course, the mortality and morbidity rates of this outbreak have since been dwarfed by the more recent outbreak in West Africa. Ebola epidemics can be quite scary, causing chills to run through the bodies of the bravest of health workers and indeed medical students. However, far from being terrified, for a young student of the Makerere University Medical School, Misaki Wayengera, the recurring Ebola outbreaks in Uganda only served as a source of inspiration for innovation of biomedical interventions – including a filovirus vaccine, and a point-of-care (POC) rapid diagnostic test (RDT).
Dr Wayengera
Shortly after finishing his medical internship in 2005, Dr. Wayengera joined graduate training in Bio-entrepreneurship at the Medical and Related Sciences (MaRS) discovery district, University Health Network (UHN), University of Toronto to gain skills that would enable him to accomplish his dreams, which included inventing an HIV-1 cure and rapid tuberculosis diagnostics. On his return to Uganda in 2008, Dr. Wayengera embarked on his journey of innovation. He kicked off his research with the Ebola virus disease (EVD) RDT under start-up (2008) biotech Restrizymes Biotherapeutics (U) Limited; the idea was to come up with a simple and accurate test which would be able to detect several strains of Ebola in less than 15 minutes for use at the community level. It has always been known that containing an Ebola outbreak through case management can prove to be futile unless cases are picked up rapidly, but progress in the invention of effective point-of-care rapid diagnostic tests has been sluggish, at least till the outbreak in West Africa.
Despite the dire need for a rapid EVD RDT, Dr. Wayengera’s efforts were constrained by the lack of funds. It took two full years for the President’s office to respond to a letter he wrote in 2008 requesting for financial support. In response to his letter, the President’s Office acknowledged the importance of his research for biodefense and pledged to offer all the necessary support. Yet, despite the fact that the President of Uganda decried the fact that it had taken two years for the letter to get to his office, Dr. Wayengera’s follow-up efforts fell on deaf ears. He attributes the delay and neglect to the lack of clear structure and focus on research within the President’s office and the inability to look beyond self-interests.
Undeterred, Dr Wayengera then resorted to applying for funding from Grand Challenges Canada in 2013; he was awarded a grant worth CAN$100,000. In addition, Grand Challenges Canada was willing to award to him an extra one million dollars for his research, if matched by financial commitment [of any value] to the project by his home Government. Subsequent efforts to secure local funding from the Ugandan government through follow up letters and social media pressure were futile. Luckily, in a rare turn of events, a breach of the prevailing rules and in a show of trust, Grand Challenges Canada offered Dr. Wayengera and his research team CAN$1.5 million, possibly due to the devastating EVD in West Africa and beyond. The money enabled Dr. Wayengera and his team to continue with their research which led to a breakthrough innovation. His RDT for EVD is able to detect Ebola recombinant antigens in less than five minutes; he has already filed a patent with both the World Intellectual Property Oganisation (WIPO) and the African Regional Intellectual Property Organisation (ARIPO).
Dr Wayengera’s troubles underscore the plight faced by many young researchers in Africa, missed opportunities and the lack of political commitment towards innovation, research and development.
It is no secret that innovation can boost economic growth. It is equally important to support innovative approaches in health relevant to the local context and resources. Low-income countries have to take increasing responsibility for their own health financing, including investing in innovation and intellectual property. Innovations are more likely to be taken up when there is a window of opportunity. The Ugandan government claims it is committed to science and innovation, demonstrating this by sponsoring science students over arts students at the universities; and has been lately encouraging its citizens to be patriotic (as in ‘assist in steering national development’) through a proposed patriotism bill due for discussion by the Parliament.
However, had this young scientist received support for his research in due time, the country, indeed the world would probably have benefitted from a rapid diagnostic test for Ebola, when the disease hit West Africa. It is unclear as to why a government that is allegedly pro-patriotism, pro-science and pro-innovation, and governing a country that has repeatedly been struck by haemorrhagic fevers was not able to invest a single dime in an Ebola RDT.
Dr. Wayengera now strongly believes that the most sustainable way to manufacture and scale up the RDT will be through engaging with a North American Partner. “If my government never showed interest while we were in the tunnels, I don’t think they deserve much of the benefits thereafter. The systems here are broken, infiltrated by naivety and intrigue, let alone corruption and are not favourable to the local innovators. Don’t get me wrong, the Ugandans deserve pride for this innovation, but someone must stand up and tell the leadership that their planning is mis-directed and short sighted, and detrimental for the local economy. This is my way of fighting the forces that drive brain-drain” Dr. Wayengera remarked (in a personal conversation). “I will stay and continue my work on other things including an HIV cure, but if the trends continue, then the tax benefits of that too will go elsewhere. We must assume some level of investment and ownership if we are to claim partnership in an innovation; this is not like the case where the donor simply gives and does not expect any benefit in return”.
Well, we wish Dr. Wayengera good luck and hope that the Ugandan government will be more responsive in the future, if only to live up to its own rhetoric.