While the world waits for a vaccine, medication that combats Covid-19 may be our best option. In this interview for BizNews, Tim Modise talks to Khandani Msibi, CEO of Numsa Investment Company and 3Sixty Global, about the possible introduction of Covid-fighting drugs. Approval pending, Msibi and his business partners plan to import two medications – Remdesivir and Avifavir – into South Africa, in a bid to alleviate the burden on the healthcare system and the economy. While the lockdown restrictions have eased, many individuals remain in isolation, fearful of contracting the virus. Msibi discusses what the medication could mean for South Africa. – Jarryd Neves
Tim Modise: South Africa – like many other nations – is going through the pain of managing Covid-19. The debate between livelihoods and saving lives continues. On top of that, some South African businesses have been adversely affected. The consequence is that people are losing jobs. There are many controversial decisions that have been taken by the government and some have been seen to be negative to the growth of the economy as well as the creation of employment. But there are entrepreneurs and business people in this country who have come to the party in different ways to try and grow their businesses and at the same time, make a contribution to stopping or slowing down the spread of Covid-19 in South Africa. One such company is 3Sixty Global, run by Khandani Msibi, the CEO of Numsa Investment Company. Recently, they have made some interesting announcements about the therapies that they are licencing as well as bringing into South Africa. Mr Khandani Msibi, thank you very much for joining me. I’m interested to hear how the moves into the biopharmaceutical sphere have gone. I see you are importing some of the medications now from Russia, for instance.
Khandani Msibi: I think that Covid-19 interrupted our focus in the biotech industry. We were in the process of getting malaria and TB drugs onto the market with the CSIR (Council for Scientific and Industrial Research) when the virus struck. We decided at that time to repurpose our work towards Covid-19. In the intervening period – as a group we have a number of international partners – and we engage with them with regard to their work in their own countries. The response to Covid-19 has seen a rapid development with certain drugs that have been promoted and then discarded, and I think the one drug, Remdesivir – which is from Gilead – received a thumbs up. They gave the licence to one of the companies that we are forming a partnership with from India and they’ve appointed us for the South African distribution.
You cannot deal with a virus by just washing hands, social distancing and wearing a mask. It is a virus. It needs a biological response…
Alongside that, there’s a company we have a relationship with. It’s a Russian company that has given us an ARV that we are in the process of registering with SAHPRA (South African Health Products Regulatory Authority) they have this relationship with a Russian SOE (state-owned enterprise) and they have a product called Avifavir. Now, Avifavir and Remdesivir differ in the sense that Remdesivir is used in a hospital setting for medium to high-risk patients. Avifavir is used for low to medium-risk patients in a home setting. When we saw the use, we called our Russian partners and asked if we can have the drug for South Africa. The drug will be available once it’s gone through the administrative aspect with SAHPRA.
Tell me a little bit more about the deal regarding Remdesivir. Is it now available in South Africa? Is it being used at the state health facilities yet?
Not yet. It’s not yet available. We are finalising the paperwork with SAHPRA. As you know, any medication must get the approval of SAHPRA. Remdesivir is not registered in South Africa as we never experienced a problem for its original use – Ebola. As a result, we’re getting it on a compassionate basis, through Section 21. So, we expect that by the end of this week we’ll get a response from SAHPRA. We’ll hope it’s a nod. As soon as that happens, it will take us two to three days to fly the stock into South Africa.Â
As far as the Russian medication, Avifavir, is concerned. When will that be available in South Africa?
It’s the same situation. Both drugs are in front of SAHPRA for evaluation for use in South Africa. Should we get the nod, it’s a question of confirming with our partners and flying the drugs into South Africa.
I have done a bit of reading on both of them, but you would know better because you are closer to the story and you are talking to your partners all the time about these things. What is the efficacy rate of both these medications?
Let me start with Remdesivir. It improves the recovery rate by something like 65% based on the studies that have been conducted. So it does contribute significantly to the recovery. Avifavir is very good in the sense that the use of it can prevent the rush into hospitals. I mean, we don’t have a sufficient hospital infrastructure. We don’t have enough ICU beds. If we can have a drug that will prevent people from getting to a point where they are critical and improve the recovery rate at home, it’s a winner. There was talk about a vaccine and nobody knows when you’re going to have a vaccine that works. A lot of studies are being done. When a vaccine that works has been formulated, it’s going to take a long time to get to a point where everybody that needs to be vaccinated gets vaccinated.
Read also: Outrage over ‘excessively high’ price of Covid-19 drug, Remdesivir – Wall Street Journal
The reality is that we cannot stay as we are for too long. The economy is declining – and has now entered a deep recession. The impact of this virus is so severe that some businesses are not coming back. The level of fear that exists is such that even though you can visit a restaurant, people don’t. Businesses aren’t getting the same amount of trading they had in the past. I don’t know how the are covering their overheads.
You can walk into any shopping mall. It’s a ghost town. Retailers and property owners are suffering. Many people and businesses are working from home, which means that when the leases expire, they will question whether they need offices or not. But if there’s a treatment, then there’s hope. Because now the impact of our fear on the economy is going to be bigger than the impact of the virus in our lives.Â
Drugs like Avifavir and Remdesivir should restore a little bit of a hope and confidence. I’m obviously sitting here with a commercial interest, but we are a business that is committed to this country. We are prepared to engage for one reason. You cannot deal with a virus by just washing hands, social distancing and wearing a mask. It is a virus. It needs a biological response and it’s only with a biological response that we know we have a winning chance.
But if all we do is avoid it and not fight it, we will remain vulnerable. We’ve seen countries that thought they have cleared themselves of the virus, only for it to re-emerge. A number of people say the solution is a vaccine. That is an indication that the solution is indeed biological. But the major intermediate steps would be the use of Remdesivir and Avifavir and other drugs that get approved for the purpose of fighting Covid-19 without any severe side effects.
You have alluded to the problems with the economy as a result of Covid-19. I want to find out from you: What do you think of the restrictions that have been placed on economic activity?Initially, people were accepting the new restrictions from the government during the lockdown, but they look at things like alcohol and cigarette restrictions. On the other hand, they look at the taxi industry being allowed to transport people at full capacity and they wonder why there are such inconsistencies where alcohol and restaurants are involved, but taxis are allowed to transport people. What do you think is going on in terms of the restrictions?
I think we are very bad at debating as a country. This means we usually don’t have the most optimum outcome. At the end of the day, there’s give and take in this situation. If you say your treatment regime is that the people that are in a critical condition must be hospitalised, on a ventilator in the ICU, then you have a situation whereby as a result of alcohol, your hospital and health care infrastructure is overburdened. So you’re going to need to make choices there. I don’t think the whole thing is about alcohol per se, but it’s about the effects of alcohol.
Then there’s the issue of the taxi industry. People don’t say “But why is the taxi industry allowed to operate and the alcohol industry isn’t?” Remember, the taxi industry is not subsidised by the state. It’s actually the only form of public transport that isn’t. The taxi industry transports 55% of all workers in the country. They were faced with a situation where if they didn’t let the taxis operate at full capacity, they would have had to pay them in order to survive.
Read also: SA taxi drivers ‘fill seats, hope for the best’ as others face strict lockdownÂ
To conclude, I want to go back to my earlier question regarding the medications that you are bringing in from the United States and Russia. If everything goes according to plan, when do you think they are likely to be available in South Africa? What is the timeframe that you’re looking at?
We’re expecting that we should get approval from SAHPRA by Friday. If that approval comes through, we should have the plans in the country. They are ready for shipment. So the stock is ready – it is from Russia and India. We’re getting our stock from India. Donald Trump has nationalised all of it
I see. I noticed the excitement was very much high in the United States, to the extent that I thought they would be the ones who actually have a direct interest. But you say it’s produced in India?
Yes, it comes from India. They were granted the licence to manufacture by Gilead scientists.
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