The outbreak of the novel coronavirus (COVID-19) has disrupted the ways in which we interact, operate, and do business. The pandemic’s spread has not only impacted our health, but also revealed the systemic barriers preventing a dynamic and innovative rapid response within Africa’s healthtech sector. New technologies, systems, and methods of combatting and developing a response to COVID-19 already exist, but regulatory barriers, disconnected infrastructure, outdated legislation, and stagnant bureaucracy deprive us access.
We reached out to our membership body to find out who was innovating in this space and could lend their voice to our discussion on Building Africa’s Frontline Readiness. We assembled a panel of experts from the legal, tech, and healthcare industries to evaluate Africa’s healthtech industry and discuss possible solutions to innovation barriers. Below we have summarized the four core findings from the discussion.
Today the majority of countries are guided by a five-year health sector plan, which lacks the flexibility to adapt to current events or keep pace with technological developments. Many systems are in the position where they struggle to meet immediate demand and don’t believe they can afford to deviate from the known to pursue new solutions that could potentially assist them. Even where states are making provision for Innovation and Technology within these plans, the distinct lack of leadership and budgetary allocation does not incentivize engagement or progress in these areas. It is into this space that donor-funded projects enter to supplement budgets and try and engage with new healthtech initiatives.
However, it is the substantial role that donor-funded projects play in Africa that leaves jurisdictions uniquely vulnerable. Public Health Specialist Yara Cumbi spoke about her experiences in Mozambique, where she saw most donor funding in the public sector being routed directly towards paying salaries and costs. While donor-funded partnerships with the private sector did focus on healthtech solutions and products, they more often than not involved companies coming from abroad. Many of them fail to understand the local context and are ultimately not fit for purpose. As a result, we are not seeing the same strides in adopting healthtech as we are in other sectors, such as in fintech.
Success seems to be largely dependent upon a supportive and enabling legislative, institutional, and regulatory environment. Daniel Batty, the Tech Law Advisor at South African technology law firm EndCode, hailed the environment within Rwanda as one of the best locales for healthtech and other tech startups. Rwanda’s dedication to establishing the country as an ICT-based economy has resulted in direct partnerships between government ministries and startups, as well as high levels of stakeholder engagement. Institutions and regulators are willing to evolve to support advancement and innovation. This is currently demonstrated by Rwanda’s Emergency Response Project for COVID-19 which focuses on digital-led solutions and utilizes analytical tools. The program has received approval and funding from the World Bank, demonstrating to others that this approach is viable and the way forward.
Such an enabling environment can also solve problems related to project longevity and volatility. Cynthia Antwi-Dodoo, a Senior Technology for Development Consultant at RealFin in Ghana, pointed out the fact that even if government and private sector can successfully collaborate to deliver a technology solution/product, there is the problem of who is supposed to continue to support it, and how it will be supported financially? Donor-funded projects may bring solutions to fruition, but when the money dries up the solution or project often dies leaving a critical gap in service. Wale Adeosun, CEO of the Nigerian telehealth company Wellvis, expressed his frustration when trying to work with government and they request that the startup find the funding. When it comes to government level projects, there must be government-level funding. Mr. Adeosun also cited the lack of regulation of market entrance means that local startups are forced to compete against outsiders with temporary grant money, who ultimately leave resulting in the consequences described by Ms. Antwi-Dodoo.
Rwanda’s environment enables greater flexibility with its regulators, as proven by the case of Zipline. Melissa Rusanganwa, the company’s Regulation and Aviation System Integration lead, noted that while the regulators in Rwanda were tough, the institutional and legislative environment is what permitted them to collaborate to develop new drone legislation and pioneer a medical and blood-delivery services to rural parts of the country. Not only did the environment support collaboration between regulators and the private sector, but also amongst regulators themselves – in this case bringing together the Ministry of Innovation and Technology, Ministry of Health, and the Aviation Regulator. According to Ms. Rusanganwa, without this multidisciplinary approach, the success of Zipline would not have been possible.
All of our panelists agreed that the lack of black and white legislation and regulation remains a significant barrier to any progress. Its absence forces startups to either operate in grey areas or remain severely limited in their operations under what is expressly permitted. Many jurisdictions are simply “copy and pasting” legislation from other countries, like Singapore, and therefore are not fit for context. Mr. Batty suggested that the easiest process to improve upon regulation and legislation is for industry to come together and formulate guidelines or codes of conduct, and then seek their approval by government. That way future legislation does not have to begin from scrap and a dialogue is opened between the public and private stakeholders. All panelists agreed that this must be advocated for and encouraged at the community level, rather than led by outsides. Those who are well-seasoned and experienced within the sector should be guiding the development. Mr. Batty and others on the panel discussed the need for deployment of “Regulatory Sandboxes,” which create a safe space for innovation to be displayed and tested, and regulators can assess its impact on the environment without innovators being punished for breaking regulations. The legacy command and control regulation, where people have to come in and meet that set standard, must change to allow informed industry leaders to set the standard and allow governments to then grant approval. The unification of the sector to propose guidelines, codes of conduct, or standards has the potential to carry a great deal of influence and generate reform.
According to Ridwan Oloyode, the Privacy and Data Protection leader at TechHive Advisory, “We need to be balancing the current human health crisis with our fundamental human rights.” Mr. Oloyode delivered a compelling case for increased awareness and mindfulness about the interconnected nature of data protection with human rights more widely. Our data protection and privacy are tied to our rights of freedom of association, freedom of expression, and freedom of movement. Some countries have established “state of emergency” measures, including the suspension of certain rights, in order to get a better handle on the spread of the virus and perform contact tracing. However, only seven African countries have been identified as having data protection and privacy laws. Therefore, Mr. Oloyode warns that many governments and organizations collecting health data are not following secure protocols. Anonymization is not foolproof or sufficient, and failures in this area have severe ramifications for individuals, particularly as the nature of an online data breach is not confined within a nation’s borders.
To conclude, the ALT Network joins our panelists in their resounding call for greater leadership, increased dialogue, and collective solutions amongst African nations. We thank our panelists for contributing their time and powerful insights. We hope you all join us for our second African HealthTech webinar session, on July 16th, which is entitled: “Fostering growth and inclusion in the African healthtech sectors of the future.”