Solving the digital health divide in Africa through scaled up public-private support for digital innovation

Dr Ernest Darkoh

Digital innovation is vital for the advancement of African economies and their health services, but to make this possible certain large stumbling blocks need to be removed.

This was the consensus amongst high level global and African health experts who came together for a recent online discussion co-hosted by the Africa Health Alliance (AHA) and USA Healthcare Alliance (USAHA) on promoting healthcare infrastructure and bridging the digital divide in Africa. Major challenges discussed included lacking broadband infrastructure, a shortage of digitised data for actionable systemic insights, and inadequate long-term investing and political support for innovative health technologies from Africa.

Three of the participants, Microsoft, BroadReach Group and access.mobile International, shared their experiences in successfully partnering with each other and with other roleplayers to solve complex healthcare challenges at scale on the continent.

It was agreed that the COVID-19 pandemic presented a rare window of opportunity for Africa’s health sector to come to terms with many long-time systemic challenges and to use their newfound momentum to mobilise vital role players, technology, available funding, and improved ways of working, to solve more than just the pandemic for the long term.

“I like to use the analogy of the elephant and cheetah,” said Dr Ernest Darkoh, BroadReach Group co-founder, World Economic Forum’s Schwab Foundation board member and TIME Health Hero. “The private sector has the speed and agility of the cheetah and governments the strength of the elephant. When the road is cluttered with rocks, you need the might of the elephant to clear the way so that the cheetah can get through.” Examples of such public-private partnerships included the sourcing of broadband or laptops for rural clinic staff.

“It is time to partner the cheetah and the elephant and it is time to scale. It is time to put our money where our mouths are and invest in scalable systems – our lives literally depend on it. COVID is a watershed moment that has made us realise we need to start doing things differently. We can’t approach this in the same way that we’ve approached other things that have taken so long to gain acceptance,” said Darkoh, referring to Africa’s longtime fights against malaria, TB and HIV.

“Technology has the power to improve health outcomes, specifically access to care, quality of care, and patient and provider experience, so that you can remove waste and improve efficiency of care,” said Dr David Rhew, global chief medical officer at Microsoft.

Rhew, who is also an infectious diseases doctor, technologist and researcher on how technology can be used to improve public health outcomes, said Microsoft provided healthcare support around the globe and in Africa, both in the clinical realm of electronic health records and with digital technologies that consumers and patients used. One of its most recent innovations is an artificial intelligence (AI) powered “COVID-bot” to help triage patients. Microsoft noticed however that they always came up against the same challenges: the lack of streamlined communications and broadband access.

It was for this reason that Microsoft got involved in providing broadband access through technologies such as TV white space (unused spectrum that can be used to transmit WiFi). They have also worked with BroadReach on its AI-based health data platform Vantage, and mass mobile communications partner access.mobile to assist governments and regions with large scale interventions for more equitable healthcare provision to large, vulnerable and hard-to-reach populations.

Governments such as South Africa’s conducted extensive door-to-door screening campaigns at the beginning of the pandemic to find out people’s ages and comorbidities. In partnership with provincial governments, BroadReach also gathered screening data including valuable granular details such as the geolocation, household information and categorisation of patients. Darkoh explained that the challenge was that scalable solutions were not always in place at a broader systemic level for decision-makers to use this data effectively.

To solve such challenges, it was important to remember that you did not have to reinvent the wheel, said Darkoh. The private sector, digital innovators and different government departments already had many of the health technology solutions that governments were now seeking – the key was to open up opportunities for information sharing, collaboration, procurement and interoperability of existing systems.

“For many African innovators there is no path to market and the prospect of being contracted by the government is unrealistic – they can’t even have those conversations with their governments to support their technology. We need to elevate the conversation back to the political will level, for example to make decisions such as ‘let’s get every clinic connected to the grid for electricity and WiFi.’ There are some big rocks we need to move. Let’s run the health system the same way we do the central banks: independent of the election cycle or which political party is in power, on a ten year timeframe to get things done.”

This sentiment was echoed by Kaakpema “KP” Yelpaala, Chairman and Founder of access.mobile International, an organisation with the mission to use digital communication channels to improve access to health services and to support positive behaviour change in the healthcare space. The company has worked at scale in 13 countries across West, East and Southern Africa since being founded in 2011.

“Every African country you go to you will find incredible digital health innovation. As Ernest mentioned, the problem is they are not scaling and the barrier that is driving that digital divide is an infrastructure one,” Yelpaala said.

Yelpaala also believed another key solution for the divide was to bring on board “investors with a long-term view on returns”.

Opportunities needed to be viewed in the context of the generational shift currently happening in Africa. “The population is young and this always presented us with a bit of a conundrum. Young people were active digital innovators and consumers, but tended to be healthy and to not seek out health information. This is changing with the pandemic. We are in Generation One of digital health adoption on the continent. As Gen One ages and the generation behind them start adopting digital health, at that point we’ll see it starting to exponentiate. It’s really frankly just a matter of time.”

Yelpaala believed digital innovation was “going to be one of the key pathways to how African economies and health services are going to be transformed” and that African innovations would be used in other parts of the world. This could be made possible through strong public-private partnerships and investment in the already impressive digital innovation that existed in Africa, he said.

Source: BroadReach & APO