By Joseph Jimenez (Chief Executive Officer at Novartis)
The recent Ebola outbreak puts into focus the prevalence of infectious diseases in Africa. In sub-Saharan Africa, infectious diseases such as malaria and HIV/AIDS cause 69% of deaths. Though we can deliver short-term aid and try to develop innovative vaccines or treatments for these diseases, the real issue is the danger of a weak healthcare system. To address this, we must focus on building better healthcare infrastructure in Africa. For example, Africa bears one-quarter of the global disease burden, yet has only 2% of the world’s doctors. This is unacceptable, and we need to take steps to address inadequate healthcare infrastructure now.
We’ve learned a few important lessons on how to deal with infrastructure challenges in Africa, and have identified where sustainable investments can make a long-term difference. We need to focus on three areas: leveraging digital technologies, improving knowledge, skills and resources, and creating collaboration and consensus among key stakeholders.
Digital technologies
We’ve seen that mobile phones have been particularly beneficial where infrastructure is limited in Africa. As mobile devices become increasingly common, they become an unexpected force in delivering better healthcare. For example, previously, patients would travel to far-off health clinics only to find that the medicines they needed were no longer in stock. Today, around 27,000 government health workers in Uganda use a mobile health system called mTRAC to report on medicine stocks across the country. Novartis is also working on an mHealth pilot in Nairobi and Mombasa to better understand the supply chain cycle and build capabilities to ensure our medicines reach those patients in need. Through this initiative, pharmacists register their patients for surveys via SMS. The survey results then help us map out where patients are located in order to redistribute medicines to areas where they are most needed.
Getting the right knowledge, skills and resources where they’re needed
Secondly, we must focus on making sure all those who need them have the right knowledge, skills and resources, for example by training the next generation of scientific leaders. During a recent trip to Africa, I visited the Kombewa Clinical Research Center and the CDC-KEMRI Center in Kenya. It’s clear from these sites that sub-Saharan Africa is making strides in building up its own Research and Development capabilities. While Kombewa is remote, it is impressive that Phases II and III research is being conducted at the Kombewa Clinical Research Center on various drugs, vaccines and diagnostic tests.
We’ve seen increased commitment to training local scientists and encouraging research through programmes such as Human Health and Heredity in Africa (H3Africa), which was recently established by the NIH and Wellcome Trust. This initiative funds African scientists and local institutions to conduct basic research on the genomic and environmental bases of health issues prevalent on the continent. Additionally, Novartis is supporting scientific exchange through a partnership with H3-D, the first drug discovery and development centre in Africa. The goal of H3-D is to train local scientists from Ghana, Kenya, South Africa, Sudan and Zimbabwe to develop treatments that address widespread conditions in Africa, such as tuberculosis, malaria and cardiovascular disease.
Public-private partnerships for health
Public-private partnerships can really make a difference. For example, USAID and Orange, the global telecommunications operator, just announced a new collaboration to find innovative ways to use mobile phones to accelerate access to health information and services in Africa. At Novartis, one way we’re reaching across sectors is through building our Foundation for Chronic Disease Management (FCDM), in collaboration with IBM and Vodacom in South Africa. The FCDM links public sector community health workers and private physicians to bring high-quality, cost-effective care to people’s homes with mobile technologies. This grass-roots approach can make a big difference, as the cost of a patient spending one day in a hospital could fund two health workers for a month.
It’s clear that in sub-Saharan Africa, interventions are having an impact. I met a one-year-old boy suffering from malaria at the Ahero Sub-District Hospital in Kenya, and though he was extremely ill, his condition was improving thanks to his being able to gain access to a life-saving treatment. This drove home to me that as healthcare stakeholders, it’s our responsibility to develop new medicines to treat disease, but these medicines are useless if they can’t get to the patients who need them most. We need to commit ourselves to working together with all other healthcare players to move away from simply donating aid, to building sustainable infrastructure that can ensure needed therapies are available in even the most remote areas. Everyone should have access to good health, no matter where they live.
