At the height of the COVID-19 pandemic, African states were left to fend for themselves as high-income countries stocked up on vaccines. Furthermore, most African countries could not manufacture vaccines because of international trade regulations. Thanks to global health advocacy, efforts were made to address this inequity. Africans were grateful for the help, but many were also upset. They wondered why African states had to wait on high-income countries to bail them out, and whether Africa was unable to conduct research and develop a vaccine itself. After all, the continent has significant experience dealing with infectious diseases.

I was one of the people asking these questions. I became even more upset when I found out that Africa had contributed significantly to the research behind some of the vaccines. I began to wonder why Africa's contributions gained very little recognition and why the dominant narrative about African research was negative, despite the continent being the epicenter of most global health disease conditions and research.

As I sought answers to my questions, I came across a systematic review that showed that almost half of health research in Africa has foreign first authors, and this percentage drops significantly if co-authors are from North America or Europe. I concluded from this that there was a difference between "African health research" and "Health research in Africa."

This discrepancy matters. When reading about health research in Africa, one can see the disconnect between local priorities and research priorities. This divergence begs the questions: "Who determines Africa's research agenda?" and "Where do the priorities of African leaders and investors lie?"

Identifying this paradigm is one thing; proposing solutions to it is another. This realization was not clear to me until I listened to Ghanaian immunologist Yaw Bediako. Dr. Bediako is CEO and co-founder of Yemaachi Biotech, an African biotech company aimed at increasing focus on precision oncology within the African continent.

According to Dr. Bediako, few things are as symptomatic of low local research ownership as the ongoing brain drain. If Africa keeps losing its bright minds to high-income countries, it leaves the bulk of the issues on the shoulders of a few. These few will seek any help they can get and will be more willing to accommodate requests from their high-income country partners. After all, the majority of health research funding in Africa comes from non-African institutions.

Dr. Bediako argued that the current brain drain is worse because it has replaced a brain drain that loses people after high school with an even more expensive brain drain that loses people after a Ph.D. Understandably, African Ph.D. graduates are leaving for greener pastures because they lack opportunities locally. The opportunities provided by the public sector are limited and the private sector is underdeveloped. For Dr. Bediako, this last point is an opportunity for growth.

In Dr. Bediako's opinion, a private biotech industry promises to operationalize locally developed research and employ African Ph.D. graduates. Unfortunately, biotech is an unknown risk for most African investors, as it is not well known to overseas biotech investors. Despite these challenges, Dr. Bediako founded Yemaachi because he believed a strong business proposition could benefit African patients, health workers, and investors. Notable health and business actors have bought into this belief and have contributed to Yemaachi's growth. Examples include Grand Challenges, Y Combinator, and angel investors.

After listening to Dr. Bediako, I understood the root cause of having a local health research agenda determined by foreign actors. The day African scientists take up their responsibility of getting engaged and intentional about improving the level of research without dependence on foreign bodies is the day they will determine the African research agenda. For Dr. Bediako, that day has come.