Is brain drain limiting Africa’s genomics potential?

Around noon on Friday, March 8, 2024, Room 3073 at Stellenbosch University’s Biomedical Research Institute in South Africa was the venue for “Scientific Happy Hour,” a regular event of the Centre for Epidemic Response and Innovation. During the session, the host, Tulio de Oliveira, who was recently named deputy director of the genomics surveillance unit at the Wellcome Sanger Institute, revealed his team adapted and successfully used their COVID-19 sequencing platform for dengue and chikungunya. “It’s the same process and it worked. Those are the kind of things that we can learn,” de Oliveira said. Participants welcomed the news that Africa’s genomic capacities are being expanded beyond COVID-19 with success stories from Nigeria and South Africa. But noted that a wide human capacity gap threatens how far and fast the continent can go as the audacious expansion goals require more experts skilled in genomics and bioinformatics. While there are not enough scientists capable of sequencing on the continent, the few that have been trained over the years are migrating abroad in search of better opportunities, creating a vacuum that the training centers across the continent are not filling quickly enough. Expanding capacity Nearly 7,000 kilometers from Stellenbosch, a similar adaptation of COVID-19 genomic sequencing platforms is already underway at the African Centre of Excellence for Genomics of Infectious Diseases, or ACEGID, in Nigeria. A week before the Scientific Happy Hour at Stellenbosch, a new publication from the center revealed the prevalence of multidrug-resistant bacteria in healthy children in Nigeria, using genomic sequencing. Lead author of the publication, Jessica Nnenna Uwanibe, a doctoral candidate at the institution, told Devex that it was easy to adapt the center’s sequencing platform for different pathogens although costs and accessibility can be barriers. “It is easy to switch, it has to do with protocol because the same platform we use for Lassa [fever], is the same platform we use for mpox, it is the same platform we use for COVID. The only thing that was different was the protocol being used and maybe some of the reagents,” she said. The center’s director, professor Christian Happi, told Devex that ACEGID has expanded beyond COVID-19 and other infectious diseases to include noncommunicable diseases, and they have obtained new technology to support this shift. The developments at Stellenbosch and ACEGID are not in isolation. They represent the actualization of what the Africa Centres for Disease Control and Prevention aims to achieve with the Africa Pathogen Genomics Initiative, or Africa PGI 2.0, that was officially launched at the third International Conference on Public Health in Africa in 2023. The initiative recognized Africa’s growing genomics capacity and now seeks to leverage the progress and lessons learned during COVID-19 to consider emerging needs, evolving priorities and changes on the perception, utility and application of genomic surveillance. The initiative aims to implement high-priority use cases, enable timely sharing of genomics data, and strengthen the regional community of practice. It also wants to ensure sustainability by advocating for the right policies, governance, and funding, and expanding the capacity and skilled workforce in genomics across the continent. ‘A big, big gap’ Sofonias Tessema, program lead for Africa PGI, however told Devex that while there are wide potentials for the application of Africa’s genomic capacity as being demonstrated at de Oliveira’s and Happi’s laboratories, the continent does not have the human capacity to fully maximize its current capacities — let alone for expansion. Tessema said the continent needs more expertise and experience at the national level to integrate genomic data into disease surveillance systems and public health decision making. He emphasized the need to build sustainable bioinformatics capacity through training programs and fellowships. "Bioinformatics capacity and having people who know how to analyze the data; having people who know how to interpret the data and really bring it into meaningful information for the public health decision makers. is a big, big gap," he told Devex. Happi said his center is actively helping to expand human capacity for genomics across the continent by training experts from every country in Africa. Over the past few years, Happi said ACEGID has trained over 1,600 young African scientists from 48 African countries. They recently began training scientists from the remaining seven African countries, indicating they have covered the whole continent. These scientists are expected to return to their respective countries to train more people. Happi noted the goal is to build bioinformatics capacity across Africa and he agreed with Tessema that there is currently a shortage, with a need for lots of trained people. "Africa is a continent of 1.3 billion. So if you want adequate capacity and capability in bioinformatics, we need a few millions of them. But also remember that there are not many centers that are equipped to perform this training. Bioinformatics is relatively new, and is not in the curriculum of Africa," he said. ‘As we are training, they are leaving’ In a piece he co-wrote for the Science journal, de Oliveira noted that in addition to many African countries lacking the required resources, the continent is also losing its scientists to talent migration. “Aspiring scientists frequently seek educational and career opportunities abroad, leading to a substantial loss of talent and expertise from the continent. This talent migration, referred to as “brain drain,” exacerbates the existing training gaps and hampers the sustainability of research within Africa,” the piece stated. Even though Happi expressed optimism that the ongoing training of trainers that his center is offering, coupled with similar efforts elsewhere would start making an impact in a few years to come, he is also concerned about brain drain. “We're dealing with all these brain drain,” he told Devex. “As we are training they are leaving and it is difficult to replace.” Although he did not provide figures regarding the brain drain problem at his center, noting that it is difficult to keep track of the churn, about three years ago, the center uploaded a video of eight research fellows alongside Happi and a laboratory manager explaining how they carried out the first COVID-19 sequencing on the continent. Of the eight fellows, only Uwanibe remains at the center while the others have left for opportunities abroad. Happi described this trend at his center as a self-inflicted problem because the center is thoroughly training its students thus making them attractive for recruitment by institutions abroad who promise them higher pay than what they can get on the continent. Happi and de Oliveira have very limited options in retaining their scientists considering they do not have unlimited war chest of funds to counter the offers that their scientists are getting from abroad nor are able to solve the broader issues that are driving brain drain from the continent across the various sectors. Moreover, for the doctoral research fellows at the respective institutions, securing postdoctoral fellowships at reputable laboratories abroad is regarded as a dream career move. But they believe the establishment of several well-funded postdoctoral fellowship opportunities at the numerous reputable centers on the continent could still help in reducing the churn and ensuring that there are scientists trained by African laboratories working at the laboratories. “We need competitive salaries and benefits packages. As they are spending money on new machines and technologies, there should also be that aggressive investment in creating opportunities for career advancement and professional development within our institutions as these can incentivize us to stay,” Ibukun Adewoye, a doctoral candidate at the University of Ibadan, told Devex.