Innovations in Healthcare in Africa.

By Dr Ian Clarke

I attended a scientific conference in Nairobi run by a large data company called IQVIA which carries out clinical trials for organisations such as WHO and CDC. The conference was to highlight what is going on in Africa in the healthcare sector at present, including vaccine trials, pharmaceutical manufacturing, digital healthcare, data collection, and gene sequencing.

Covid laid bare how far behind Africa had fallen, and without paying attention to areas such as vaccine development and drug manufacture on the continent itself, Africa could again find itself begging at the back of the line. I was asked to attend the conference by a digital healthcare company, CTI, which recently appointed me to their advisory board.

Although the chairman of the company works from New York, while the CEO works from the west coast of America, all the coding for the development of the platform is being carried out by a team in Uganda.

I have witnessed developments in healthcare in Africa over many years, and believe that we are now entering the phase of digital healthcare, where bricks and mortar will not be so important, but healthcare workers will need to be trained in digital technology. Rather than spending our limited funds trying to keep up with the west by buying expensive machines, we need to adopt disruptive digital technology, which will make it simpler to bring healthcare to the people. Using smartphones, health-workers can be guided through diagnostic algorithms to make correct diagnoses. The health-worker would not even need to be in the same location as the patient, and need not be so highly trained. Consider the expense of getting a highly trained doctor to a remote location compared to the cost of some data, a smart phone and a trained digital healthcare worker.

If we also digitise patients’ records to make them available to the treating doctors, this adds tremendously to the correct tailoring of appropriate treatment.

If anonymised medical data is available on a large scale for analysis by artificial intelligence, patterns of disease, and disease prevention can be analysed so that public health measures can be put in place for prevention and early detection. Uganda has a number of start-ups in the field of digital healthcare, some of which connect patients and their medical records to specialists in other countries. The patient, or his physician, can simply go on the app, scan through the list of specialists, check the price and time for the consultation, pay through credit card or mobile money, and log on for the virtual consultation. There is another start-up which allows patients to save small amounts of money on their mobile phone for medical emergencies. When the patient attends the clinic and the money on his account is not sufficient, he can then borrow from the app to cover the cost and pay back later.

A big issue which the conference highlighted was vaccine inequity. This has resulted in the formation of the organisation CEPI (Coalition for Epidemic Preparedness Innovations). CEPI not only has the goal of ensuring equity in the provision of vaccines for poor countries, but of shortening the time for the development of a vaccine to 100 days. We achieved the target of 300 days for Corona virus, but if we are to shorten the period to only three months many prior measures must be in place, particularly in Africa.

These involve gene sequencing likely pathogens, so that if there is an outbreak much of the groundwork has already been done and vaccine trials can be carried out. Richard Hatchett, the head of CEPI, had passed through Uganda on his way to the conference, and was amazed by the work being carried out by the Ugandan team, led by Bruce Kirenga, in setting up the vaccine trial for Sudan Ebola Virus. He was impressed by the speed at which the team had pivoted from work on Covid to Ebola.

These examples in innovation and research are being carried out in Africa by Africans. Another positive development is the setting up of the Africa Medicines Agency to shorten the time for registration of new drugs across the continent. Another remarkable accomplishment is the rapid roll-out of gene sequencing labs across Africa by the African CDC (through a remarkable Kenyan lady with a PHD in genomics). Another is the rapid scaling up of clinical trials in Africa led by the drug firm Roche. I left the conference feeling a little more proud and a little more hopeful. Proud of what is being done in Africa, and hopeful because we are focused in the right direction – in the development of digital healthcare, data collection, vaccine research and clinical trials. Plus, we are now being supported by some large organisations such as IQVIA, CEPI, CDC Africa, and AMA.

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