/ 10 May 2013

China comes to Africa’s medical aid

'Made in China' has saved lives. Why not share it, in the form of cheaper commodities such as Chinese-produced medicine, with Africa?" asked Ming-Hui Ren, director general of the Chinese government's international co-operation department. He was speaking this week at the first meeting on African soil to consolidate health collaboration between the giant of the Far East and the continent.

About 200 African and Chinese government officials, UN agencies, international aid organisations and Chinese drug companies attended the meeting at the Gaborone Sun in Botswana's capital. 

China's deputy health and family planning commission minister Xiao-Wei Ma, said the gathering signified a "new historical line" in China and Africa's relationship by setting it on "a fast track of overall development".

While China and Africa have been meeting on health co-operation annually since 2009, all meetings until now were held in China and this was the first time the Chinese pharmaceutical industry and international aid organisations joined the collaborations.

In August, the health ministers of African countries will gather in Beijing to further consolidate "mutually beneficial health co-operation".

A question of ulterior motives
While China has experience to share, it has been criticised for allegedly providing health assistance to Africa only to secure access to natural resources and economic markets. But Ren maintained that his country has no interest in Africa's natural resources. He insisted that China's sole motivation in co-operating more in Africa's health spheres is to "save African lives and battle disease together". 

China, the world's second largest economy, has achieved remarkable improvements in health indicators over the past few decades: Chinese government data shows that life expectancy increased from 45 in 1960 to 74.8 in 2010 and maternal mortality was cut by two-thirds between 1991 and 2011 to 30.1 per 100000 women – 10 times lower than South Africa's rate. 

The focus of collaborations does however seem to be swayed towards increased business for China through the facilitation of the entry of cheaper Chinese medical products into the African market. 

According to Ming Xu from China's ministry of commerce, China and Africa need to develop an "array of matchmaking platforms" to help Chinese drug companies with the registration of their products in Africa, dealing with local authorities, as well as the preparation of the required documents". 

Feng Zhao from the African Development Bank said some countries, such as Ethiopia and Uganda, spend up to half of their health budgets on importing expensive medicine, yet on average the continent's countries only have access to 38% of essential medicines prescribed by the World Health Organisation (WHO). 

Vaccine industry booming
China has one of the world's fastest growing vaccine industries, which produce immunisations at a fraction of the price of the Western world. According to the Gates Foundation's China director, Ray Yip, a dose of oral polio vaccine costs between three and four US cents in China, while the WHO says it's produced for up to five times that amount elsewhere. 

China has mostly been unable to sell such products internationally, as their standards have not been vetted by the WHO, which requires manufacturers to adhere to stringent guidelines in order to obtain "prequalification", or approval. 

On May 13, a WHO team will be visiting a Chinese vaccine manufacturer for the final step in prequalification approval for a vaccine for Japanese encephalitis. According to Jian-Kang Zhang, the China programme leader for health organisation Path, several other "African disease" vaccines, such as rotavirus, pneumonia and polio vaccines are in the pipeline for prequalification.

Daniel Berman, the director of the aid organisation Médecins sans Frontières in South Africa, said adding China's products to the vaccine market will result in increased competition and "massive reductions in cost from which Africa could heavily benefit". 

Botswana's permanent health secretary, Kolaatamo Malefho, said he would have faith in Chinese products, despite perceptions that some are substandard – as long as they have been prequalified. 

However, Yip added: "You get what you pay for. African governments would therefore have to carefully vet their buying companies so they are able to trust them to buy quality products." 

According to Alastair Robb from the British government's department for international development, the department will commit funds to the health collaboration, although the amount has yet to be determined. The department strongly supports Africa-China partnerships and has already given £10-million to a project that focuses on transferring Chinese agricultural technology to Africa. 

Berman said it was "interesting" that China is "asking Africa what it wants … There has been good consultation, but we need to keep in mind that all development aid, including China's, is tied to 'objectives'." 

Janet Byaruhanga, health officer at the African Union, cautioned that China should remember "Africa is not a country. There are 54 of them and each one is different with a different culture and level of development." 

No South African government representative attended the meeting. The health department's director general, Precious Matsoso, was listed on the programme as a speaker, but told the Mail & Guardian after the conference: "What is the meeting about? I didn't know about it. No one contacted me about it."


Innovations will contribute to healthy, better sex

Woman's condom
The health organisation, Path, and its research partners have redesigned the female condom to something "much softer and thinner", which got "high marks from female testers", according to Path. The traditional female condom's inner ring, which was painful for some women, has been replaced with four small dots of soft, absorbent foam, which hold the condom in place. To make insertion easier, a rounded cap was added to the end of the condom. The cap dissolves in less than a minute. Path licensed the Woman's Condom to Dahua Medical Apparatus Company of Shanghai, China for manufacturing and distribution. South Africa is one of the target markets for the new woman's condom, which has received SABS certification and European Union approval.

Shang ring
The Shang ring reduces a medical male circumcision procedure from 25 minutes of surgical time to about four minutes of nonsurgical time (no surgeon is needed). Two plastic rings lock together over the foreskin of the penis and are then removes seven days later. The Shang ring is expected to recieve World Health Organisation approval later this year or early next year.

The Sino-implant is a low-cost, highly effective injectable contraceptive implant. It works for up to four years with 99% effectiveness. At $8, it's far more affordable than Western-produced alternatives, which cost about $18. – Sources: Global Health Strategies, China-Africa Health Collaboration policy document