Digitizing healthcare: a key pillar for a sustainable healthcare system in Africa?

The global pharmaceutical industry is experiencing a revolution, how is Africa affected by this new dynamic?

ECONOMIC STRONG DYNAMIC

Despite a modest growth in mature markets, the worldwide pharmaceutical market reached €1.1 trillion in 2016 and are expected to grow and hit €1.3 trillion by 2020 due to 4 drivers: Emerging Countries, Drug Price and Generics. In other words, African countries will be also responsible of this strong dynamic of the pharmaceutical landscape.

From 1995 to 2010, African countries have consistently recorded strong growth. Africa economic growth rate will continue to growth at a CAGR of 5-6% in the next 25 years with an important increase of population, Nigeria for example will double the size of his population in less than 20 years. To sustain this development Africa needs to have a healthy population. The optimism resulting from this positive economic situation has led to the emergence of clusters in different African countries. For example, Kenya Eastlands is a cluster which specializes in clothing. This cluster targets the domestic market, mainly the rural areas.

HEALTH SYSTEM CHALLENGES

During years, African countries have improved the health outcomes of the population.  Nevertheless, health systems suffer from lack of financial resources or infrastructure. Digitalization of healthcare, is a fantastic opportunity to address some of those African Health System challenges.

Global life expectancy at birth in 2015 was 71.4 years, ranging from 60 years in African Region to 76.8 years in European Region. From 2000 to 2015, life expectancy increase was greatest in African Region, where life expectancy increased by 9.4 years, driven mainly by cheaper generic drugs, often sourced from low-cost countries such as India, improvements in preventive medicine, such as measures to reduce the incidence of malaria.  But also improvements in child survival, and expanded access to antiretrovirals treatment of HIV. The HIV/Aids epidemic was a major killer, efforts to prevent infection and prolong the lives of those infected have played a part in the subsequent rebound in longevity since 2000. Africa has a one of the lowest average life expectancy but we saw an important increase due to African countries effort to bring better health to their population. Since the increase in life expectancy is correlated to increase of GDP per capita, based on a GDP grew rate of 3.3 percent a year during the last 5 years (2010 to 2015), it is expected that Africa average’s a life expectancy grows to reach 80 years in 2060.

African Health context is characterized by the predominance of communicable diseases. Communicable, or infectious diseases, are caused by microorganisms such as bacteria, viruses, parasites and fungi that can be spread, directly or indirectly, from one person to another. Some are transmitted through bites from insects while others are caused by ingesting contaminated food or water.

Communicable diseases still represent the major public health problems leading to high morbidity and mortality rates among the population, particularly among children under 5 years old. Natural disasters often faced by the country turn the population vulnerable to water borne and drought related disease outbreaks such as cholera, dysentery, and meningococcal meningitis. Sporadic outbreaks of plague have occurred in the country. The major causes of morbidity and mortality are AIDS, malaria, tuberculosis, respiratory infections, diarrhoea, and meningitis.

This situation is due to 4 main factors:

• Weak epidemiological surveillance system lacking infrastructure and appropriate intra and inter-sectoral coordination
• Poor healthcare services, the impact of HIV, Ebola and economic migration weakening the health systems
• Shortage of human resources to implement activities at all levels
• Lack of radio-communication to liaise remote districts

A BETTER HEALTH SYSTEM

 Information and communication technologies (ICT) can be defined as technologies that provide access to information through telecommunications, and includes networks, the Internet, wireless, mobile devices and other communications-related technology. Information and communication technologies (ICT) can help Africa face those challenges. The past years have seen the emergence of ICT as a drive of African countries development. The impact has been both on economic growth and social transformation. For example, M‑Pesa help the Kenyan population send money to their relatives, help them to be integrated in the financial ecosystem and not to be marginalized.

Information and Communication Technologies (ICTs) have the potential to transform the way in which health services are accessed and delivered. African Health systems are taking advantage of ICT success story. For example, remote diagnostics are expanding medical services to rural areas that have few healthcare professionals. The added value of ICTs in African Health systems relies on they contribution to significantly improve the exchange of reliable information.

Information and communication technologies can contribute in 5 way to help Africa improve his health system:

• Prevention level – The need of information is crucial at prevention level to inform population about the risks; communicate about vaccination campaign or control the authenticity of drugs. Current African eHealth ecosystem addresses this issue by using SMS to alert, prevent and inform the population.
• Diagnostic level – ICT can help identify and track patients with infectious diseases. Furthermore, accessing reliable information and providing remote diagnostic in isolated areas is an important challenge.
• Treatment level – Following up pharmacovigilance, checking the efficiency of the prescription, controlling the authenticity of drugs, can be possible with ICT.
• Patient level – The follow up of population in isolated areas is possible through ICT. Example: follow pregnant women, follow the progress of the patients on their recovery process or assist patient suffering from chronic diseases.
• Learning level – One of the biggest issues for Africa is to increase the number of his healthcare professional and this will help Africa to improve his Health systems. ICT can also help Africa to improve inter-professional exchanges and connecting isolated medical centers with cities hospitals which are generally more equipped.

CASE STUDY

World Health Organization

The World Health Organization launched a partnership with the International Telecommunication Union, called the ‘mHealth’ Initiative to use mobile technology, in particular text messaging and apps, to help combat noncommunicable diseases (NCDs) such as diabetes, cancer, cardiovascular diseases and chronic respiratory diseases. The World Health Organization used information and communication technology during the Ebola crisis to strengthen workforce capacity, enhance real-time data for surveillance, expediting case management and improve community engagement.

MTN Y’ello Health

MTN in Nigeria initiated a program together with Nigeria’s National Health Insurance Scheme (NHIS) to provide affordable healthcare to its subscribers in the country.

Called MTN Y’ello Health, the mobile service provider created an all-inclusive health insurance scheme that will allow subscribers to gain access to pre-defined treatments as well as selecting their own Health Maintenance Organisation (HMO) and healthcare provider.

mPedigree

mPedigree is a phone-based anti-counterfeit ICT software application which allows pharmaceutical retailers and users verify the authenticity of a drug. This is done for free by text-messaging a unique code found on the product to a universal number.

mPedigree is not only helping poor people who are vulnerable to purchasing fake drugs, it is also helping to restore confidence to the healthcare system.

 

All these examples show the importance of digitalization; Africa needs to use new tools as a critical pillar to strengthen his health system and to face traditional challenges. this will support African countries in their efforts to develop a healthcare system by reducing cost and increasing availability and innovation. As the demand for healthcare in Africa will more than double in the coming years due to the increase of the population, systematically digitizing countries healthcare system could not only create a more sustainable cost trajectory, but improve the quality of care.

 

Source: WHO, EU, FDA