The great promise of digital health for Africa

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The great promise of digital health for Africa

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Drones delivering blood bags in Rwanda, an electronic vaccination record in Côte d’Ivoire, an application for eye care in Botswana… Technological innovations in the health sector are flourishing on the African continent and are meeting crying needs on the ground.

In many African countries, access to health is a real challenge: in sub-Saharan Africa, there are 2 doctors and 12 nurses per 10,000 inhabitants (compared to 32 doctors and 93 nurses in France).

At the same time, the penetration rate of mobile phones in sub-Saharan Africa today reaches 87% of the population. Digital health is the use of digital technology for all activities in the health sector. It offers great promise in terms of access to healthcare, since these solutions could enable 1.6 billion people to receive treatment throughout the world, and particularly to those living in the most remote areas. In 2017, Dr Margaret Chan, then Director General of the World Health Organization, said: “In line with the principles of universal health coverage, digital health has the potential to make health systems more efficient and responsive to the needs and expectations of their beneficiaries”.

Zipline has set up in Rwanda to develop its business: since 2016, the American drone delivery company has been sending blood bags to the most deserted areas. The time saved is considerable, in these hard-to-reach areas, and greatly contributes to saving lives. Since 2019, Zipline has also set up the world’s largest drone delivery network in Ghana with 30 drones for a population of 12 million people, distributing blood, medicines and medical equipment. These drones are a striking example of the solutions that are emerging in Africa to address the great difficulties of access to health care.

These solutions could enable 1.6 billion people to receive treatment throughout the world, and particularly to those living in the most remote areas

Some, more easily applicable in countries with fewer resources than Rwanda, which is at the forefront of digital health, are also effective. This is the case of JokkoSanté in Senegal, a digital pharmacy which enables individuals to bring back their unused medicines to health centres. These are then given to the most vulnerable. People who bring back their medicines benefit from a system of points on their mobile phones, so that they can in turn buy new medicines. Through JokkoSanté, Adama Kane, the founder, makes it possible not only to give access to treatment to the greatest number of people but also to fight against the waste and illicit sale of medicines in Senegal.

Digital health certainly has a key role to play in the area of access to primary care and medicines, but it can also improve the training of health professionals, giving them more responsibility, improving the quality of primary care, and thus helping to relieve congestion in health centres in the largest cities. With such a high penetration rate in Africa, the mobile phone is an essential tool, on which Amref Health Africa, the leading NGO in health care in Africa, has relied heavily, having already trained more than 50,000 nurses and nurses’ assistants through distance learning.

On African mobile phones (most of which are cell phones, not necessarily connected to the internet), prevention campaigns are also working quite well. Whether for epidemics such as Ebola in 2013, for the current coronavirus, or for diseases such as AIDS, which is still very prevalent in Africa, public authorities are launching SMS campaigns to raise awareness and try to slow down the spread of these contagious diseases.

Prevention is all the more important since the real scourge – which is more invisible – for these developing countries is actually non-communicable diseases such as diabetes or other cardiovascular problems. These account for more than 70% of deaths worldwide, two-thirds of them in low and middle-income countries. Since 2014, the Government of Senegal has been implementing the mDiabetes and mRamadan programme, a diabetes prevention campaign launched during the Ramadan period, which includes an important digital component, by sending SMS text messages.

Digital health, in all its forms, from the most frugal to the most technologically advanced, represents an unprecedented opportunity for the African continent, most of whose countries are still experiencing great difficulty in the area of access to health, due to a lack of human and financial resources. Foreign companies such as Zipline have decided to set up in such countries, taking advantage of less strict regulation than in Europe or the United States. Yet, today, it is these more frugal solutions that have the greatest impact, since they are both more accessible and easier to implement.

Initiatives are emerging on all sides, from startups inventing new technologies to promote better access to healthcare, detect diseases, or easily reach a doctor. But the challenge now lies in mutualizing all these solutions and bringing them to the national level. To this end, the report of the working group of the 2017 United Nations Ad Hoc Commission on Sustainable Development urges governments to make a real commitment, particularly by bringing together ministries of telecommunications and health, in order to create coherent networks and have an impact beyond simple “test” areas for pilot projects. This is what Rwanda, a true example for the continent but also for Western countries, has undertaken since the implementation of its first “e-health” strategy in 2006, and which today enables the country to have a structured and efficient digital health system.

 


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