Access to healthcare in Africa: challenges and innovations
On the occasion of World Africa Day on May 25, Alcimed, a consulting firm specializing in innovation and the development of new markets, is revisiting the issue of access to healthcare in Africa. Access to treatments for infectious diseases (HIV, hepatitis B and C, malaria, tuberculosis, etc.) remains a challenge in Africa. Awareness of non-communicable diseases (heart attacks, stroke, cancer, COPD, etc.) is on the rise, and represents a novel challenge.
The health systems in Africa are diverse and are best approached on a country-by-country basis or by the grouping of similar countries together: some countries have universal health coverage; others are performing well in specific therapeutic areas, while some have no capacity to provide public funding or support in the midst of outbreaks of very severe diseases. The needs and challenges are very different depending on whether we consider cities or remote rural areas. Access models and solutions must be adjusted as much as possible, both regionally and locally.
Beyond the remarkable philanthropic work done by some governments, NGOs, foundations and private actors (such as the Global Fund to Fight AIDS, the Orange, Coca-Cola or Bill & Melinda Gates foundations, the 100 NGOs dedicated to improving health systems and energy access in Africa, etc.), the long-term improvement in treatment access requires the design of balanced business models. The private sector has the opportunity to develop new practices and business models, as the purchasing power of the African middle class is growing considerably; potentially fueling some developments that complement not-for-profit programs. The topic at the heart of most issues is the pricing policy. Simply lowering prices has dangerous and counterproductive effects (counterfeit medicines, poor quality generics with dramatic health consequences in East and North Africa, unauthorized generics tolerated alongside licensed generics or branded medicines, etc.).
The current structure of the supply and distribution chain has a direct impact on accessibility: there are wide variations between prices paid by patients within the same country and between neighboring countries, and wide variations between the factory gate price and the price paid by the patient. It is possible to re-imagine profitable business models to lower the patient’s bill while reinvesting the profits into new technologies that can improve physical access to medicines.
Existing technologies – including those based on mobile phones and SMS – as well as emerging technologies – such as drones, mobile stores and units, etc. – are used to improve physical access to remote areas and to facilitate communication with healthcare and education professionals. These solutions are used by private actors and in the context of public-private partnerships. However, they are not always sustainable or profitable.
Beyond financing and the creation of new infrastructures, training, education and sustainable and localized investments are the major challenges to be addressed. Partnerships (public-private, private-private) and the pooling of resources and skills between industries are key to tackling these challenges.