Waking the sleeping giant

Africa has been known as the ‘Dark Continent’, but not for much longer.

While it is true that less than 50% of Africans enjoy access to modern healthcare facilities at present, and that Africa suffers from one-quarter of the world’s disease burden, you can’t deny the potential that is inherent in the region.

In 2015, a World Economic Forum report noted that seven of the world’s ten fastest-growing economies are in Africa, a ‘result of governments being able to successfully implement far-reaching economic and political reforms, thus creating more conducive business and investment climates’. Economically, we’re on our way.

Home to some 1.25 billion people - almost 20% of the world’s total population - Africa has seen greater urban development and increased wealth, coupled with greater access to mobile phones and the internet. These changes could all help to awaken the sleeping giant that is healthcare delivery on the continent and, more than that, alter and improve the healthcare landscape in future.

It seems the lights are coming on, and the great giant is stirring.

There are five important indicators of growth that excite me - particularly in my role as CEO of F/NE, which has served as a trusted partner to large multinational healthcare clients in South Africa, Africa and many emerging markets for almost two decades.

1. Rising levels of economic growth

The African Development Bank Group points out that Africa’s economic outlook improved in 2017 compared with 2016, and is expected to gain further momentum in 2018. GDP growth in 2017, at around 3.0%, is up from 2.2% in 2016 and is projected to hit 3.7% in 2018. Overall GDP growth, at 3.7%, exceeds the global rate, 3.1%.

Having said this, Africa’s share of global economic output remains low, at around 3%. I agree with the Institute for Security Studies (ISS) perspective on this, that increasing trade between African countries and regions may be the most promising route to economic growth and human development.

2. Significant mobile penetration

There were 960 million mobile subscriptions across Africa in 2017, translating into an 80% penetration rate among the continent’s population. This bodes extremely well for better healthcare delivery going forward - provided that mobile is properly leveraged.

So far, it is. Mobile devices already support some community nurses in decision-making and connecting with community healthcare workers and physicians. In addition, SMS and voice messaging are being used for patient education, reducing risk factors for heart disease, supporting adherence to therapy and testing hearing, which can be done via mobile in three minutes.

In Kenya, an online medical service allows patients to access doctors via video applications (like Skype) on their computers, tablets or smartphones. A mobile app created by a Nigerian doctor offers a platform for patients in that country to type in medical questions. These are answered by qualified medical staff, or the patient is referred to an appropriate specialist.

In Uganda, a malaria-specific app provides questions and answers relating to that disease, while in Mozambique another app greatly increases the efficacy of immunisation programmes by reminding users via text message when they are due to return to the clinic.

3. Leading-edge technologies

Technology is currently leapfrogging traditional healthcare delivery methods and systems here in Africa. For instance, both Rwanda and Tanzania have now incorporated drone technology into their healthcare systems to deliver much-needed blood for transfusions. In Botswana, Africa’s first telemedicine service emerged in 2015; medical workers are able to employ the unused frequencies of TV white spaces to send high-res images of patients for diagnosis.

My belief is that, as a result of scarce skills and access to healthcare on the continent, we must bring the doctor ‘into’ the room and the pharmacist ‘closer’ to the patient, by leveraging the massive potential of augmented reality, virtual reality, drone technology and other elements of the dynamic Internet of Things.

The World Health Organization’s Director for Africa, Dr Matshidiso Moeti, believes that Africa’s healthcare systems need technology to be integrated into them, to make them accessible to society’s poorest and most vulnerable. Relevant and innovative solutions are needed that will enhance training, data management and healthcare delivery, while meeting the continent’s growing need for quality healthcare services.

Virtual reality could be one such solution. In addition to helping pain sufferers or injured patients with therapy exercises, virtual reality can serve as a useful tool for practitioners who are learning anatomy, practising operations or even teaching infection control.

4. Abundant human capital

The ISS has said that ‘Africa’s population will grow rapidly and remain chronically young’, pointing out that Africa’s growing working-age population is one of its most important assets.

A Lancet Commission, to complement this, has pointed out that ‘the rapid expansion of new, African-bred approaches to people-centred health systems, focused on prevention, primary care and public health, can go a long way to…take healthcare delivery to the next stage’.

But, while many African governments are aiming for universal health coverage based on an efficient, equitable and innovative primary healthcare system, the fact remains that progress is slow, service delivery models are out-dated and population health is poor.

Only if sufficiently leveraged and optimised can Africa-centric human resources and healthcare solutions strongly propel the region economically and socially.

5. Cooperation and collaboration

In an attempt to stretch their healthcare funding and resources, and to produce better results, African healthcare authorities are increasingly turning to partnerships with the private sector (PPPs). In fact, a number of international healthcare companies have already successfully implemented PPPs on the continent - clearly seeing both the great untapped potential and the lucrative areas for investment that exist throughout Africa.

These include the construction of health facilities; outsourcing non-clinical services, including catering and cleaning; and arranging with private laboratories for the provision of capital-intensive equipment or the outsourcing of hospital management.

There are also incredible inter-industry innovations. Take, for instance, the recent South African PPP that enabled non-hazardous intravenous infusion (IV) drip bags and tubing made of polyvinyl chloride (PVC) to be recycled into soles for school shoes. Roughly 1,000 new school shoes were then handed over to learners at a rural primary school.

Pooling resources, innovation and expertise, combined with working together, is the answer.

Waking the giant

In my opinion, there is a combination of factors with the collective potential for the most meaningful change. There’s technology, yes, but skills development and access to information are equally important, because these are the pillars on which innovation is built.

Then, there’s the opportunity that accompanies promising economic growth, positive political and social development and exciting investment opportunities.

Nearly 15 years ago, F/NE decided to become intimately involved in healthcare communications in Africa, because we knew that we were in a unique position as communicators to help deliver access to information for diverse audiences across the continent. We know that Africa’s healthcare challenges are greater than those of developed countries, and we recognise an opportunity to learn from as well as educate those developed countries. And we know that, while the role we can play may be small, it is a crucial one as we work towards finally waking our sleeping giant.