Her Excellency Ameenah Gurib-Fakim 

US Phamacoepia 

September 19, 2017

New York

Thank you, Ron, for your generous introduction, and to USP for inviting me to address you this evening. It’s a pleasure to be with you here in New York to be able to participate in the rich discussions at the United Nations General Assembly. 

I am proud to represent my country and my people. Mauritius is an island country, 680 miles off the East coast of Africa. Its population of 1.3 million people makes us one of the smallest nations in Africa and in the world. But as I think you will agree as you hear about our economic, regulatory and cultural progress, we punch far above our weight. 

Two years ago, world leaders met at the UNGA to adopt the Sustainable Development Goals.  Among these 17 ambitious goals is to achieve universal health coverage, including access to quality health-care services, including safe, effective, quality and affordable medicines and vaccines for all.

You in this room should be both proud of this bold ambition, and humbled by the enormity of delivering on it. There is nothing more noble than the commitment to ensuring that essential and quality-assured medicines are made available to the people who need them. To see that goal realized will require the combined efforts of policy makers, NGOs, industry, academia, and the public

Where do we start? Our individual and joint efforts must be focused on the things that really matter, and understanding what really matters depends on getting our facts straight. Thus, rigorous research is needed to understand the impacts of quality medicines. This is something with which I have personal experience: as a professor of organic chemistry and a biodiversity scientist, I have spent my professional career exploring the medical and nutritional secrets of the plants of Mauritius. Moreover, I have spent a significant part of my professional life teaching, advocating and championing initiatives to modernize the manufacture and use of our traditional medicines.  

One of the outcomes of this work is the creation of what is now the Centre International de Development Pharmaceutique, which I co-founded, that searches for ingredients from our local species with the potential for commercial development. Moreover, I am one of the signatories to the Centurion Declaration, pledging Africa-wide support for the establishment of an association dedicated exclusively to the preparation of international trading and quality control standards for Africa’s most important medicinal plants. 

I suggested earlier that Mauritius is a country whose progress is disproportionate to its size and geographic isolation. Let me offer you some facts to make my case. Our GDP per capita is the fourth highest in Africa. We have developed and passionately cultivate a diverse, multi-lingual, multi-religion social fabric through democratic government, strong rule of law and a vigorous, sustainable economy based in great part on the financial and banking sectors. Africa, India and much of the rest of the world turn to Mauritius as a trusted, transparent business partner. And we have the privilege and the responsibility of being a biodiversity hotspot, home to unique plants with promising biomedical applications. These natural endowments, if developed sustainably, also of course offer economic opportunity and, even more importantly, an opportunity to advance human health.

   

Medicinal plants constitute an extremely important resource for the development of the global pharmaceutical industry. More than 40% of licensed drugs worldwide are of plant origin, including the mainstay for malaria treatment, based on Artemisinin extracted from Artemisin annua. A recipe from the San people of southern Africa has led to standardized extracts of the plant Sceletium tortuosum to be tested for their tranquilizing properties. And an extract from the hoodia cactus-like plant, also long used by the San, is being tested by Pfizer and Unilever as an appetite suppressant.  

But more must be done to responsibly exploit the unique natural resources of Africa to contribute to drug development. I find it concerning that while about 25% of all plant genetic resources reside in Africa, just 83 of the 1,100 plant-derived drugs marketed globally are synthesized by African species. On our continent, 45,000 plant species are still unexplored for their potential to serve as the molecular basis of pharmaceuticals. And African species are disappearing at almost twice the global rate, driven by climate change, habitat loss and development.

As we all know, nothing occurs in a vacuum. The challenges are deep and wide all over the world, especially in Africa. Our continent is home to 15% of global population, but produces only 3% of global GDP while carrying 25% of the disease burden. Africa accounts for just 2% of world research output, 1.3% of world research spending and zero-point-one percent of patents.

The challenges are fundamental, from education, to economic development, to climate change. All these factors and many more bear upon our ability to contribute to the SDG of access to health care for all. Climate change, as I mentioned earlier, has a direct impact on plant diversity and habitat.  We must look beyond the extractive industries to develop renewable resources to curb climate change and ensure sustainable economic development. Climate change also has a direct impact on our oceans, home to about 2 million plant and animal species. In fact, marine biodiversity far outweighs that on land. Aside from providing about a billion people with their primary source of animal protein, the oceans regulate global climate, mediate temperature, and drive the weather, determining rainfall, droughts and floods. They are the world’s largest store of carbon: an estimated 83% of the global carbon cycle is circulated through marine waters. Our flora is highly dependent on the environment, and our environment is profoundly impacted by climate. All these moving pieces and more must be accounted for as we pursue the discovery and development of standardized extracts of medicinal plants.

Moreover, we must invest sufficiently in the full spectrum of R&D to ever hope to reach our ambitious goals for drug discovery. The “spectrum” exists on multiple dimensions, and we will need to exploit all of them to be successful: from basic to translational research, on every Continent, by people appropriately incentivized, driven by the best talent of both genders and all cultures. This is the premise of Coalition for African Research and Innovation. CARI, whose leadership committee I am proud to chair, is based on the premise that world-class, pan-African science and innovation can and will be led by Africansin Africa, with priorities set by Africa, for Africa. It is gathering public and private investment in basic scientific research and R&D to build a dramatically scaled-up infrastructure for science in Africa. It also advocates for the policy and governance conditions that enable Africa to claim her rightful place as a driver of global prosperity.

Thus the work of USP is also a critical element in our ability to deliver robust primary health care systems worldwide. Front and center among the challenges is a lack of rigorous standards to guide pharmaceutical manufacture and use. There is space and scope for standardized extracts of medicinal plants to help fill the breach in this environment. This is especially true for many important African medicinal plants.

It is time to develop standards to assure the safety and benefit of our traditional medicines, because without standards, there can be no guarantee of quality, safety and positive health outcomes. They are also essential to assure the credibility of our research and development and therefore to protect our long term economic interests.  

To echo Ron, a healthier world needs a strong foundation. To build this foundation, a top priority of my presidency is to transform my country into a research and development center for science and pharmaceuticals. We have already taken important stepsrecently my government announced incentives to attract more pharmaceutical companies to manufacture in Mauritius, including an investment tax credit of 15% over three years and the establishment of a pharmaceutical village in the south. 

As we drive investment in R&D, we must also invest in quality systems to support public health, innovation and development. We must strengthen our institutions in our fight against substandard and falsified medicines. While the benefits of medicines like Artemisinin are evident, we also know the risks to patients and the public when these medicines are substandard or falsified.  Unfortunately, many of us across the world share in this burden.  And we bear the costs of wasted resources, ineffective treatment, hospitalizations, and further spread of resistant bugs.

The work of USP to help protect and improve the health of people around the world is critical. USP brings its nearly 200 years of history and expertise to bear to help build the foundation for a healthier world. That better world is one that establishes quality, sets the bar for scientific rigor and technological progress, and epitomizes collaboration among industry, nonprofits, government, and academia.  

USP has invested in several areas to achieve this goal, including public standards for identity, strength, purity and quality. It has also worked to strengthen regulatory systems and support manufacturing to quality standards. The establishment of USP’s Quality Institute is the next step in its dedication to quality medicines. By conducting rigorous scientific research, the Quality Institute will enable evidence-based policy decisions that can help increase the availability of quality medicines around the world.

To state the obvious, the quality of medicine is important. Just today we heard experts discuss how quality is essential to stemming the rise of antimicrobial resistance, an increasingly serious threat to global public health that requires action across all government sectors and society.

That is why I am enthusiastic about the launch of the Quality Institute and look forward to following its progress in enhancing the understanding of the benefits of quality medicines for individuals, populations and global public health. It will facilitate the ability of countries like Mauritius to invest in smart, effective systems that foster quality medicines and support public health and economic development. 

As USP’s Good Will Ambassador for medicine quality, I call upon all stakeholders—regulators, manufacturers, civil society, patient advocacy groups and health practitioners—to advocate for quality research, demand quality regulatory environment, insist on quality constructs and supply quality medicines, both conventional and traditional, for the benefit of our people and all the people of the world. 

Thank you again for the invitation to speak this evening.