Health and Healthcare Systems

How blockchain can help in Africa’s fight against COVID-19 and future disease outbreaks

A healthcare worker wearing protective gear talks on a mobile phone at a testing center for the coronavirus disease (COVID-19) of the Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), in Dakar, Senegal July 24, 2020. REUTERS/Zohra Bensemra     TPX IMAGES OF THE DAY - RC2PZH9N10BP

Healthcare worker talks on a phone at a testing centre for COVID-19 at the Institute for Health Research, in Dakar, Senegal on July 24, 2020. Image: REUTERS/Zohra Bensemra

Kayode Babarinde
Executive Director, Africa Blockchain Institute
  • The youthful populations of Africa and their embrace of the opportunities blockchain has to offer could help the continent in the fight against COVID-19 and future epidemics.
  • Blockchain’s decentralised public ledger system could allow for multiple verification of the authenticity of vaccine certificates, thus helping to curb the proliferation of fake ones.
  • Research shows that tracking systems built on blockchain are cheap, safe and ensure data integrity among stakeholders.

Compared to other continents, Africa has recorded fewer infections per million and lower mortality rates during the COVID-19 pandemic, despite having a skeletal health system and a heavier health burden from malaria, HIV/AIDS and tuberculosis, which currently take priority in budgets.

Some suggest the answer to this lies in the demography of the continent – Africa’s median age is 19-20, far lower than the aging populations of Europe and America. Africa’s youth are particularly receptive to new technologies when they can access them. Thus, embracing new technologies and the possibilities of blockchain could help in managing the COVID-19 pandemic and other pandemics that might occur in future, through the enhancement of the public health system with distributed ledger technologies.

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Faster supplies of data and material

At the heart of putting patients first in the healthcare system is making sure that there are no glitches in the exchange of patient information and supplies. The deaths recorded in India due to a lack of ventilators and vaccines in the deadly wave of the COVID-19 pandemic could have been reduced with better health information exchanges, and a health supply chain management aided by decentralised ledgers.

The tiny Baltic country of Estonia shows what is possible. Since 2012, healthcare data and transactions have been securely transmitted through blockchain. Today, most billings, prescriptions and information are digital and mostly built on the blockchain. As such, Estonia was comparatively well prepared when the COVID-19 pandemic hit.

Transparency in healthcare

In addition to social factors like Africa’s young population and its relatively wealthy travellers, there have been suggestions in some quarters that Africa’s low COVID-19 infection rates are due to an inability to trace properly, causing the under-reporting of infection rates. Blockchain’s decentralised ledger system could provide a better track-and-trace system, where data from multiple sources is aggregated to give greater confidence in the data regarding infection rates. The extant track-and-trace system is, at best, approximately right most of the time; track-and-trace systems built on blockchain would be mostly right most of the time.

Such a system could be achieved across the African continent. Dounia Marbouh and his team, in a paper published in the Arabian Journal for Science and Technology, found that tracking systems built on blockchain are affordable, safe and ensure data integrity among stakeholders.

Beyond the veracity of COVID-19 infection rates, Africa is also confronted by low COVID-19 vaccination rates that could have significant consequences for health transparency, or lack thereof. With less than 2% of people in Africa having received a COVID-19 vaccine compared with 12% of people globally, according to the World Health Organization, the inequity in the rollout of vaccines could soon lead to a situation similar to the fake vaccination certificates that have been identified in the UK.

While this has not yet happened in Africa, there are lessons to be heeded from the corruption encountered with the yellow fever certificate, which is mandatory for most travellers in Africa. Here, blockchain’s decentralised public ledger system could allow for multiple verifications of the authenticity of the certificates, thus helping to curb the proliferation of fake COVID-19 vaccine certificates. Authenticating such certificates can be done on a centralised system with replicated features, such as the e-registry introduced by the Nigerian government to prevent travel with counterfeit yellow fever certificates. However, one drawback of that is the certificates and data would not be as easily retrievable if sitting on one server. With blockchain, the certificates are distributed across several servers, providing more security while making data retrieval accurate and instantaneous.

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The case for contactless payments

One of the indirect benefits of blockchain to better public health lies in the financial applications of this technology. Financial innovations using cryptocurrencies allow for digital payments that reduce the need for contact and maintain social distancing appear ready for mass acceptance.

The continent has been particularly receptive to cryptocurrencies like Bitcoin and Ethereum. It’s important to recognize that there is a financial rationale behind the adoption of cryptocurrencies.

According to Statista, cryptocurrencies offer an alternative to the high cost of remittances carried out via traditional payment methods. Alongside mobile phone-based money transfer services like Vodacom’s M-Pesa in Kenya, the relative reduction in the cost of remittances has made Africans ready for contactless payment platforms on the blockchain, which could help facilitate financial inclusion while lowering cost of transactions.

In terms of health, digital payments, including cryptocurrencies, can help in reducing disease contagion by removing physical contact through cash, card and other means of payment that require physical contact. In addition, the ability to conduct transactions in cryptocurrency would reduce the need for congregating in physical premises to receive financial services, for example withdrawing cash from an ATM or from a bank teller.

To conclude, by combining the willingness of Africa’s youthful population to use fourth industrial revolution technologies such as blockchain and cryptocurrencies, and by deploying these in the management of the public health systems, Africa could use blockchain to better manage the present COVID-19 pandemic – and those, unfortunately, to come.

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