Who's Who in Southern Africa is an annual print publication distributed in Southern Africa. It offers comprehensive, accurate, up-to-date, and impartial information on thousands of the most significant individuals in South Africa.
The original print publication provided lists of names and some biographical details of notable individuals in Southern Africa. An online listing of the print publication was launched in 2001. This listing includes noteworthy professionals, popular sports men and women, entertainers and politicians.
The online resource was opened to the public in January 2010 to allow anyone 18 years or older living or born in the region to register on the site and create a profile of themselves. The original Who's Whos are differentiated from the new members by a badge or ribbon located on the profile image.
According to sources, publication of the print version was halted in 2007, and remains so to date.
Highly recommended, Who's Who in South Africa is an outstanding biographical reference work containing comprehensive information on the key figures in South Africa. Each honoree provides a role model of excellence whether in government, business, academic, religion, media or public service.
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Key Features of Who's Who in South Africa
- Comprehensive Information: Offers detailed biographical information on key figures in South Africa.
- Historical Perspective: Surveys the country in detail from a historical, political, and economic perspective.
- Online Accessibility: The online resource allows anyone 18 years or older living or born in the region to register on the site and create a profile of themselves.
In this section, you can find details on South Africa in a matter of seconds.
mRNA Technology Transfer Programme in South Africa
In June 2021, the World Health Organization (WHO) and the Medicines Patent Pool (MPP) launched an mRNA technology transfer programme. With a South African consortium serving as the hub, the programme aimed to increase vaccine manufacturing capacity in low- and middle-income countries (LMICs) in view of the “vaccine apartheid” that was observed during COVID-19.
Following Clarke’s “situational analysis,” the present study assessed whether the mRNA programme differs from the approach and practices that comprise current biopharmaceutical production. Numerous documentary sources, including legal agreements underpinning the programme, funding agreements, and patent filings, were reviewed.
Semi-structured interviews with 35 individuals, ranging from the programme’s architects and university scientists to representatives from LMIC vaccine manufacturers taking part in the programme were also conducted. While the mRNA programme may improve the sharing of knowledge, other design features, in particular, weak conditionalities around product affordability, participants’ freedom to contract with third parties, and acceptance of market-based competition, are in line with the status quo.
In June 2021, Afrigen Biologics, a for-profit company based in Cape Town, South Africa, set out to change the global landscape of biopharmaceutical production. Chosen by the World Health Organization (WHO) to serve as the hub of an mRNA technology transfer programme, Afrigen’s initial task was to make an mRNA COVID-19 vaccine against SARS-CoV-2 and distribute the technology to manufacturers located in other low- and middle-income countries (LMICs).
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The motivation was plain: established makers of COVID-19 vaccines, especially mRNA vaccines, had largely neglected populations in LMICs [1,2]. In view of that “vaccine apartheid,”[3] building capacity to make vaccines locally for local populations became imperative. The WHO turned to a model of knowledge-sharing that was previously deployed in response to concerns that the global influenza virus sharing network was under-serving people in LMICS [4-6]. Within six months Afrigen succeeded in producing its own mRNA COVID-19 candidate, “AfriVac 2121 [7].”.
The programme has the potential to be transformative as a model of vaccine production [8], encompassing both upstream research and development (R&D) and ‘end-to-end’ vaccine manufacturing. We set out to study, using qualitative research methods, to what extent the WHO/MPP-managed mRNA programme differs from the approach and practices that comprise current biopharmaceutical production.
We describe the key features of the status quo as a basis for comparison with the mRNA programme under our findings below. Our research followed a “situational analysis” approach-a form of grounded theory, which develops theories through observations and multiple sources of data [15]. Under situational analysis, data collection and analysis occur in parallel, requiring constant comparison between new sources of data and the preliminary, but evolving, analysis.
We describe the multiple sources of data incorporated into our situational analysis below, which has been applied by social scientists to gain insight into complex systems, comprising a variety of actors with diverging interests [16,17]. At the same time, we were cognizant of the power imbalances that afflict global health from the study’s inception [13,18-21]. Multiple types of documents were analyzed by both researchers; a few minor inconsistencies in interpretation occurred but were resolved through discussion.
The first type of document was a range of legal documents that codify the relationships between different actors in the mRNA programme, which, pursuant to a memorandum of understanding, the WHO tasked MPP with drafting and implementing. These “programme agreements [22]” are in place between MPP and the three principal members of the South African “consortium”, that is, Afrigen, another Cape Town-based vaccine manufacturer called Biovac, and the South African Medical Research Council (SAMRC). (Only Bio-Manguinhos (Brazil) and BiovaX (Kenya) have not signed such an agreement).
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Additionally, research agreements shared by interview participants were analyzed, including a funding agreement between scientists at the University of Cape Town and the SAMRC, a research collaboration agreement between the United States’ (US) National Institute of Allergy and Infectious Diseases (NIAID, a component of the National Institutes of Health (NIH)) and Afrigen, as well as sample clauses from Afrigen’s collaboration agreements with entities outside the programme. Powerpoint presentations and other information shared at the programme’s inaugural meeting held in Cape Town, April 17-21, 2023, as well as a regional meeting in Bangkok, Thailand, October 31 -November 1, 2023 were also incorporated into the study.
To gain insight into the relationship between countries sponsoring the programme and WHO/MPP, an access to information (ATI) request was filed with the Canadian government, which is the second highest funder of the mRNA programme. Our ATI request yielded 153 pages of correspondence, agreements, and other documentation that we incorporated into our analysis.
We used a purposive sampling strategy, contacting individuals that hold leadership positions within their respective organizations or who have relevant experience, for example, in a relevant scientific field. Within the consortium (n = 12), we interviewed executives of Afrigen (3) and Biovac (1), as well as officials from SAMRC and other parts of the South African government (3), and university-based scientists (5). We also interviewed WHO (3) and MPP (4) officials, which we refer to as the ‘programme’s architects’ (n = 7), and representatives from vaccine manufacturers based in Argentina (2), Brazil (2), Serbia (1), India (1), Bangladesh (2), and another LMIC (2), which are now described as programme partners (n = 10). Finally, we interviewed scientists from the global North and other outside experts, businesses, and organizations (n = 6) that have supported or taken part in the programme in some fashion or work in the field of epidemic preparedness.
South Africa's Afrigen COVID vaccine: A game changer for the continent? | DW News
Only one individual (of 36 that we contacted) declined to participate in an interview. The majority of interview participants (29 of 35 that chose to participate) agreed to be interviewed ‘on the record’, allowing quotations to be attributed to them by name. (Table 1) One researcher (MH) traveled to Geneva, Cape Town, Chicago, and Bangkok to recruit and run interviews in person (n = 16).
We received ethics approval to conduct this study from Dalhousie University’s Social Sciences and Humanities Research Ethics Board (REB# 2022-6457) and Yale University’s Institutional Review Board (IRB#2000034524). After discussing the purpose, benefits and risks associated with our research, all individuals we interviewed provided verbal consent to participate in the study at the outset of each interview. Consent was thus recorded as part of each interview transcript.
Consistent with situational analysis, data collection and analysis occurred in parallel. We created memos summarizing key exchanges or text, interpreting both interview and documentary data to identify lines of inquiry and points to follow up during future interviews. MH and XB generated a list of concept areas, in turn, developing a set of situational maps to define relationships between all the entities involved in the mRNA programme as well as key dynamics (e.g., influence of funding organizations; competing institutional priorities) that are often operative in the field of global health and access to medicines.
Our research process, data analysis, and preliminary findings were developed in consultation with an Independent Equity Advisory Committee (IEAC). Comprised of six members with diverse expertise in clinical trials, global health policy, access to medicines, and bioethics, the IEAC has extensive experience working with or inside organizations, such as WHO, the South Centre, Universities Allied for Essential Medicines, Médecins Sans Frontières, and the Health Justice Initiative.
We first examine the mRNA programme’s origins (2020-2021) and then compare its design to the four paradigmatic features of global biopharmaceutical production, which we abstracted from a review of literature and evidence from numerous scholarly disciplines; namely, 1) weak conditionalities attached to publicly funded science; 2) secret, transactional R&D partnerships; 3) a high degree of financialization; and, 4) market-based governance.
Foreseeing access challenges from the start of the pandemic [2,24,25], WHO became home to several attempts to improve access to COVID-19 vaccines and other needed interventions in LMICs. Each differed markedly in terms of their approach to mitigating access challenges and the actors involved.
The first, the “Access to COVID-19 Tools Accelerator” (ACT-A), was launched in April 2020 by a mix of public and private actors, including WHO, the government of France, the European Commission, the Bill and Melinda Gates Foundation, and three biopharmaceutical industry associations [25]. The vaccine-focused arm of ACT-A, COVID-19 Vaccines Global Access or “COVAX” (governed by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and WHO), was intended to procure vaccines for LMICs by leveraging the collective purchasing power of high-income countries (HICs). With HICs prioritizing domestic populations at the expense of equitable global distribution, however, COVAX’s charitable approach failed to secure vaccines for LMICs [26-28].
A second initiative, the COVID-19 Technology Access Pool (C-TAP), created by WHO, the government of Costa Rica, and other member states, followed in May 2020 [29]. In contrast to ACT-A’s charity-based approach, C-TAP sought to distribute control of the intellectual property (IP), data, and knowledge related to COVID-19 interventions.
Meanwhile, individuals inside and adjacent to WHO began crafting a third proposal, predicated on building capacity to manufacture vaccines in LMICs for LMICs. Martin Friede, the WHO’s lead coordinator for vaccine research, and Marie-Paule Kieny, the Chair of MPP’s Governance Board and formerly an Assistant Director-General at WHO were especially influential.
Drawing upon a “hub and spoke” model of vaccine manufacturing that WHO deployed once before [5,33,34], they envisioned a centralized knowledge sharing system with a view to enhancing local vaccine production capacity in LMICs. [I]t was very easy finding experts in terms of the vaccines because the world is full of retired people used to making influenza vaccines, but […] we realized these were generally quite old gentlemen and they got very tired going around the world teaching the same process at each facility […]. And this is when the concept was born of us creating a central hub, again, a corporate direction of interest.
Several crucial questions about the design of the model, in the context of COVID-19, nevertheless remained: How would it fit within WHO and the organization’s other newly launched COVID-19 access initiatives? Who would oversee its operations? Would there be one central hub or several spread across different regions?
According to the lead of WHO’s IP Unit, Erika Dueñas Loayza, the original plan was to embed the COVID-19 hub within C-TAP. On behalf of WHO, Loayza’s team was actively seeking voluntary licenses from COVID-19 vaccine manufacturers.(EDL) Any new IP generated by the hub or its spokes would in turn become part of C-TAP’s pool, thus distributing control to LMIC-based manufacturers as their productive capacity increased.
However, as industry opposition to C-TAP grew because of the threat that it posed to IP-holders’ control over COVID-19 interventions [32], then-WHO assistant director general (ADG) of access to medicines and health products, Dr. Mariângela Simão, and then-WHO Chief Scientist Dr. Once positioned inside ACT-A, WHO issued a call for expressions of interest for “one or more” technology transfer hubs in April 2021 [35].
Afrigen’s chief executive Petro Terblanche remembers recognizing the opportunity: “We are small, but we know tech transfer.”(PT) Terblanche’s strategy of assembling a “consortium” together with Biovac and SAMRC for the WHO application proved wise. [T]he WHO’s PDVAC, which is the production and development of vaccines advisory committee, decided that mRNA was the first platform to go for first because of its flexibility, potentially lower cost, and speed with which you could look at different antigens and whether they work or not. […] Then WHO put out a call for expressions of interest to be the hub initially, and a number of companies applied. South Africa came with a consortium, which is the only one that did come with a consortium, consisting of Afrigen as the hub, Biovac as the first spoke and the South African Medical Research Council as the research institute to feed into potentially new pathogens, potentially second-generation technologies and so on.
Brazil’s Bio-Manguinhos, a non-profit, state-owned company that is part of the Oswaldo Cruz Foundation, submitted a competing bid. Africa was announced first, but I think it’s important to say that, in the beginning, at least, what we had understood […] was that the model was going to be a decentralized model. So there were going to be two hubs in Africa [and] there were going to be two hubs, regional hubs in Latin America. There were going to be two regional hubs in Asia. […] And each of them then would have spokes, potentially, that would be partners that had an interest in producing and accepting the technology. So we applied to be original hub. We didn’t apply to be a spoke, ever. And we got selected. […] What I didn’t know was that, at some stage, […] there was a decision taken from WHO or whoever, that as there was increasing political and financial pressure, many people wanted to come in.
It remains unclear why the change in plans occurred. Bio-Manguinhos learned of their ‘spoke status’ when they visited Afrigen in April 2022-six months after WHO indicated they would be a regional hub.(SM,PN) [36] The minutes from WHO’s PDVAC meetings show that multiple hubs were still being contemplated as late as November 2021 [37]. According to Patricia Neves, project manager for Bio-Manguinhos’ center for vaccines using mRNA, MPP officials queried “why are you here [in Cape Town visiting Afrigen] if you are developing your own technology?”(PN) At the time, MPP was focused on securing a voluntary license from Moderna or another more established mRNA manufacturer even though WHO had previously tried and failed to secure such a license.(EDL) MPP’s track record shows that it adheres to the norms of market-based competition and contract-based solutions even though voluntary licenses fre...
| Category | Number of Participants | Affiliation |
|---|---|---|
| Consortium | 12 | Executives of Afrigen (3), Biovac (1), SAMRC and South African government officials (3), University-based scientists (5) |
| Programme Architects | 7 | WHO (3) and MPP (4) officials |
| Programme Partners | 10 | Representatives from vaccine manufacturers based in Argentina (2), Brazil (2), Serbia (1), India (1), Bangladesh (2), and another LMIC (2) |
| Outside Experts | 6 | Scientists from the global North and other outside experts, businesses, and organizations |
Map of South Africa
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