By Shruti Bengani, Communications Support, GBCHealth
Traveling in almost any remote region of the world you will undoubtedly stumble across three things: Coca-Cola, cigarettes and beer. Leveraging these distribution systems to deliver high quality health and wellness products presents an opportunity to reach communities that continue to suffer from the highest burden of preventable disease. In 2012, ColaLife, a UK-based charity, partnered with local bottling plants and shopkeepers to transport antidiarrheal kits to the remote areas of Zambia by packaging them in the empty space in Coca-Cola crates–a simple yet innovative solution to addressing the challenge of diarrhea.
ColaLife is a good start, but providing comprehensive care to remote communities will require long-term investments in systems that can consistently deliver high quality health products, information and services across a number of disease areas. Today, as donors and businesses shift focus from philanthropy to smart investments and efficient partnerships, there is an increasing pressure, or rather opportunity, for Africa to increase its domestic commitment to health and create an environment conducive to local innovation and the gradual development of more sustainable systems.
Africa needs to be part of the solution
As we move forward on the path of development, Africa’s ability to create sustainable and efficient health systems will depend largely on its capacity to invent, deploy and scale-up solutions that are sensitive and appropriate for local communities.
By having experience with challenges on-the-ground, African entrepreneurs and scientists are well-positioned to address the needs of communities, while considering the existing structural, cultural and political nuances – something that is often overlooked in aid-driven health programs. Local healthcare innovations also drive the economy by promoting opportunities for growth, employment and finance –potentially providing new paths out of poverty for millions.
But how then do we ensure that African-based innovations are encouraged and have the greatest potential for impact?
Catalyzing health innovations
There are a number of conditions that can help spark innovation. In Africa, some key enablers include Digital Technology, Research/Scientific Capacity, Local Innovators and Innovative Financing. Here we will review these enablers and provide some concrete examples of local African innovations with the potential for genuine impact.
Leveraging Digital Technology–Existing and New
The drivers of demand and supply for health services in low-resource settings are more complex than they seem. In Africa, poverty and low access to adequate sanitation creates a high demand for healthcare services but the limited infrastructure restricts supply. In such situations, smart innovations that apply existing platforms in a local context could provide wider population –including the underserved— with the opportunity to access services.
BabyCenter is a global website providing information on conception, pregnancy, birth and early childhood for parents and parents-to-be. Based on this model, the mobile app Totohealth was developed to provide personalized information to parents in East Africa on breastfeeding, nutrition, child development and vaccinations, during and after pregnancy. With mothers lacking access to clinics, limited to no internet connectivity and illiteracy, Totohealth‘s SMS and voice support in local languages, empowers mothers across Africa.
The website Gozee connects Ugandan patients and doctors to book appointments and share health indicators data for faster and accurate diagnosis at no cost to patients. The website will soon expand its offerings to reach Kenya and Nigeria.
New technologies are also transforming the health industry, and adopting a bottom-up approach allows for tailored inventions for Africa. Dr. Imogen Wright of South Africa developed Exatype – a software program that allows healthcare workers to determine whether HIV-positive patients are resistant to certain ARV drugs used in treatment. The governments’ efforts in promoting ‘treatment for all’ are often ineffective due to growing resistance in patients, but Exatype increases the effectiveness of drugs and fights HIV at a deeper level. Exatype may also assist in curbing TB and Malaria, emphasizing the importance of scalability.
Leveraging technology to raise a healthy generation not only fosters economic and social stability but also presents the chance to gather valuable data for advancing research of new methods to better monitor, treat and support patients.
Expanding Research Capacity
Africa is potentially the largest data provider for research across the globe but yet, very few researchers thrive locally. According to New Partnership for Africa’s Development, Africa carries 25% of the global disease burden but only produces 2% of the global research output. By laying the groundwork for continued scientific study, Africa can encourage international and local support for research and development of scientific discoveries.
The recent establishment of the Africa Health Research Institute brings together the expertise of local academics from the Africa Centre for Population Health and KwaZulu-Natal Research Institute for TB-HIV with international support from the US-based Howard Hughes Medical Institute and the UK-based Wellcome Trust. In its pursuit to end TB, HIV and other related diseases, the institute leverages mutual strengths but functions in a local context, enabling relevant research, security and robust infrastructure.
“Long-standing threats such as TB, HIV and increasingly the non-communicable diseases, will only be solved with a strong research base which combines different approaches. Individuals and teams at the Africa Health Research Institute will play a leading role in shaping and driving world class, locally driven and relevant research that improves human health. Ultimately, solutions to health crises will be driven by African scientists and, increasingly, African investment.” – Mike Turner, Wellcome Trust Acting Director of Science & Head of Infection Biology
A robust research landscape also fuels growth in new treatments which are suited to locals. Dr. Valentin Agon developed Api-Palu, an anti-malaria drug out of natural plant extract, making it more affordable than other current drug options in Benin. Dr. Agon also sought to keep packaging costs to a minimum to further enhance accessibility. As an African solution to a disease that affects Africans at large, intensified efforts in research and science serve as powerful tools in the development of new ideas, treatments and vaccines not only for Africa, but for the entire world.
Encouraging Local Innovators
Innovations are often misconstrued to be technological advancements but a simple idea that addresses local situations can be equally innovative. The use of rapid diagnostic blood tests to detect malaria is largely limited in rural African communities due to its risky and complex diagnostic procedure. Dr. Eddy Agbo from Fyodor Biotechnologies observed a prevalent use of anti-malaria medicine for all fevers in Africa, when only 30% of them were actually malaria-related. These communities were also unable to comply with WHOs ‘Test Before You Treat’ policy.
Dr. Agbo developed the Urine Malaria Test, the world’s first non-blood test that diagnoses malaria in 25 minutes. This fast, safe and home-friendly innovation caters directly to African communities and the challenge of seeking the right information about treatment options and drug usage.
“Imagine a world where African countries, initiatives and laboratories are contributing significantly in the discovery, development and delivery of the health products that they need the most. Local regulatory and policy frameworks that support such efforts should be fast-tracked, including through capacity building. A successful implementation of the SDGs would require such a bottom up approach.” -Solomon Nwaka, Executive Director, African Network for Drugs and Diagnostics (ANDI)
Funding continues to be the most immediate challenge to sustainable development. The Guardian reported that Africa is losing more than $50 billion annually due to tax evasion, draining funds that could be used for development projects.
Global Voice Group(GVG) has creatively harnessed the potential of telecommunications in Africa by raising capital through micro-surcharges on international calls. With government support and local operators’ partnerships, GVG has raised more than $1.5 billion over the last 10 years. These models support the government as it seeks to raise additional revenue.
Financial instruments like Social Impact Bonds that are able to leverage global private capital investments into results-based health programs offer exciting opportunities to ensure multisector support for sustainable and impactful programs.
However, innovative financing solutions must be complemented with support from broad-based partnerships which include the private sector. This can be made possible through increased government leadership in fostering a trustworthy environment for investors.
“We must move away from the idea of official development assistance as charity, towards it being a more sustainable engine for growth, making sure that we are bringing the private sector, civil society and other key partners to the centre of development policymaking.” –Michel Sidibé, UNAIDS Executive Director
The Power of Private Sector and Partnerships
The private sector plays a significant role in spearheading innovations across Africa. In addition to providing capital investment, businesses can share strategic logistics and marketing know-how, source from local distributors and assess the scalability of projects –all key measures in ensuring lasting social and economic value. The private sector also drives other stakeholders to advocate for sound policies, tailored solutions, improved infrastructure and relevant research.
To ensure solutions are scalable, sustainable and impactful, governments, businesses, academics and NGOs must all bring their respective strengths to the table. Philips and Johnson & Johnson, have engaged with Africa through innovation hubs, that focus on the entire continuum of health – from research to production to implementation. Combining local and international capacities in advocacy, fundraising, business expertise, scientific knowledge and data, holistic and integrated solutions can be developed, resulting in a larger positive impact – a win-win situation for all involved.
“We’ve learned over time that solving last-mile challenges through local empowerment and partnerships offers the greatest potential impact in the fight against public health challenges, and that it can also help fuel the local economy and catalyze infrastructure investments.” – Alma Scott, Vice President of Global Operations and Partnerships for Johnson & Johnson
Innovations for Africa, From Africa
Instilling a culture of innovation is a promising way to propel Africa in its efforts to eradicate diseases and improve health. All of the organizations mentioned in this article are pioneering solutions customized to the unique context and culture of communities across Africa. Nevertheless, more support is needed, particularly from governments, to encourage future entrepreneurs to seek to invent new solutions with the potential to create a lasting impact on the health of hard to reach communities.