Nowhere is better positioned to benefit from the digital revolution in healthcare than Africa, where technology can help tackle the rising burden of disease and major obstacles in infrastructure and the environment. However, realizing the promise of digital healthcare technology, while avoiding its potential pitfalls, will require a comprehensive, systematic approach based on the principles of sustainability, equity and inclusion.
Africa’s public health challenges are well known. While recent decades have seen major progress in the treatment of diseases such as HIV/AIDS and malaria, the continent suffers from a disproportionate disease burden and rising incidence of chronic diseases such as diabetes, heart disease, and sickle cell anemia. Infrastructure presents its own problems: less than half the population of sub-Saharan Africa has access to electricity, and road density in the region has actually declined over the last two decades.
Digital technology holds enormous potential to bridge the gaps in healthcare provision by directing limited medical resources where they are most needed. To this end, global, national and local stakeholders should focus on six interconnected solutions, which together will help ensure equitable access to medical innovation throughout Africa.
First, we must strengthen capacity for conducting basic research and clinical trials in Africa. Outside expertise only goes so far, and African policymakers would benefit from more locally derived evidence that helps them better understand which health interventions would be most cost-effective within their country contexts.
Second, the insights gained from these and other initiatives can be translated into effective interventions more quickly through the creation of centers of excellence at the national and regional levels, which can save time and money by propagating the best access solutions and providing guidance on implementation.
Third, we can streamline approval and procurement of new medicines through secure regulatory harmonization. Developing the regulatory systems needed to ensure access to affordable, quality medicines and other products can be costly and time-consuming, presenting a significant challenge for many African governments. Regulatory harmonization would allow health authorities to validate and make new medicines and health products available across multiple countries using standardized authorization and evaluation criteria.
Fourth, new technologies ranging from data analytics to drones can help tackle supply chain challenges, improving logistical efficiency and eliminating barriers that have historically prevented medicines from reaching remote, underserved populations. New distribution systems, like the partnership Novartis has with Zipline to deliver sickle-cell medicines by drone to rural populations in Ghana, can also bolster security to address the threat of counterfeit medicines – the cause of over 170,000 deaths a year, mostly in Africa.
Fifth, stakeholders must come together to formulate high-level strategies to guide investments in digital technology. A national digital health strategy should set a clear vision for how digital technology will improve healthcare access in a given country; provide clear direction for stakeholders across the health system; and establish a supportive, predictable operating environment for solution providers. A 2017 report from the Broadband Commission provides useful guidance on the cross-sector collaboration essential for effective national digital health strategies.
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Finally, suppliers of drugs and medical equipment can incorporate these measures to widen access into their own programmes, for which the Novartis Access Principles may provide a useful model. All too often public health initiatives have underestimated the powerful role the private sector can play in making access more equitable. Manufacturers of medicines and health products can do their part by systematically integrating access strategies into how they research, develop and deliver new innovations that can help reduce disease burden and improve health across Africa, incorporating perspectives from Africa’s national and local institutions.
The rapid rise of digital health technology promises to change the face of medicine across Africa, leveraging everything from AI and analytics to drones and telemedicine to expand access and make the provision of healthcare more equitable.
Africans have already eagerly embraced new technologies for applications like digital cash, banking, e-commerce and governance. This shows that there is both appetite and aptitude that can be leveraged, with the same potential to create a ‘leapfrog’ moment that positions Africa at the forefront of health systems transformation. However, it will take focused leadership, talent and creativity on the part of stakeholders throughout the private sector, government and civil society to realize the promise of these new capabilities.
Fifty years ago men went to the moon with the help of a computer considerably less powerful than today’s cheapest mobile handset. With digital networks quickly extending to every corner of the continent in the early years of the new millennium, surely Africa can solve the problem of equitable access to healthcare, yielding longer, more productive lives for the continent’s billion inhabitants.