HealthCare Africa - Sept/Oct 2022

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HealthCare AFRICA

PROF. MIRIAM WERE:

Community Health Champion and 2022 Nobel Peace Prize Nominee THE KENYA DENTAL ASSOCIATION : Dr. Tim Theuri: KDA President on shaping the dentistry landscape in Kenya COUNTRY FOCUS : Rwanda DISEASE FOCUS : Mental Health WWW.HEALTHCAREAFRICA.INFO

Qaizer Manji HealthX Africa CEO on leveraging the power of digital technologies to enhance access to quality healthcare YEAR 1 | ISSUE NO. 3 SEP/OCT 2022


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EDITORIAL

Africa has made progress in advancing mental health but more needs to be done to enhance access

A

s recently as a decade ago, mental health services were unheard of in many parts of the continent. Where they were available, they were so scarce in supply and acutely underserved that their existence did not even make much of an impact. A case in point is Sierra Leone, where only one mental health facility serves a nation of about 8 million people. Until its upgrade into a modern psychiatric hospital, the Kissy National Referral Psychiatric Hospital served as a detention center in every sense of the word, as it neither had trained psychiatrists nor the required medicine. Patients were mostly held in shackles and chains and left to their own devices. That is behind us now. Most governments are waking up to the reality that mental health is indeed as important as physical health and are starting to put aside budgets for the development of new health facilities or upgrading existing ones to the required standards. New technologies

and disruptive ways of tackling mental health problems are also cropping up from every corner of the continent, from Zimbabwe in the South to Egypt in the North. Being Mental Health Awareness month, we explore the progress made in advancing Mental Health in Africa and the challenges that lie ahead on page 60. HealthX, our feature company on page 32, is a story of a company that leverages technology to enhance access to healthcare in Kenya and hopefully in the African region. Qaizer Manji,

the CEO of HealthX Africa, compares HealthX services to cab-hailing services such as Uber, where clients are offered on-demand services at the click of a button. "We have our doctors who are trained by us to operate based on our guidelines, so we can control the service delivery, quality, and safety," Manji explains. Our Country Focus on this issue explores Rwanda, a country of 13 million people that is punching above its weight when it comes to improving access to healthcare. Read the informative article on page 52 to find out how far Rwanda has come healthcare-wise 28 years after an economy- damaging civil unrest led to one of the worst health emergencies that the country has ever faced in living memory. As with other regular issues, this one is also packed with deeply informative articles and inspiring interviews with notable medical practitioners that will make every page worth your read. I can only wish you a wonderful read. Paul Ongeto Editorial Lead, FW Africa

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SEP/OCT 2022 | HEALTHCARE AFRICA

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Contents

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YEAR 1 | ISSUE NO. 3 SEP/OCT 2022

HealthX Africa Leveraging the power of digital technologies to enhance access to quality healthcare

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Editorial 8 News Updates 22 Medical Devices & Innovations 26 Appointments Updates 28 Events Review 2

SEP/OCT 2022 | HEALTHCARE AFRICA

MR. QAIZER MANJI - CEO, HealthX Africa

HEALTHCAREAFRICA.INFO


EXECUTIVE INTERVIEWS

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46

PROF. MIRIAM KHAMADI WERE Public and Community Health Champion and the 2022 Nobel Peace Prize Nominee

THE KENYA DENTAL ASSOCIATION Dr. Tim Theuri: A passionate dentist and KDA president on shaping the dentistry landscape in Kenya

HEALTHCAREAFRICA.INFO

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60

COUNTRY FOCUS: RWANDA From ashes to setting the trends In Africa’s healthcare system

DISEASE FOCUS: MENTAL HEALTH An emerging public health issue in Africa

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SPONSORED CONTENT

Acıbadem Healthcare Group's 10th Hospital in Istanbul and 24th in the world!

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cıbadem Healthcare Group began its journey into healthcare services as a small neighborhood hospital in a district of Istanbul/ Turkiye. Today, Acıbadem is a global chain operating in 5 countries including Turkiye, Bulgaria, Macedonia, Serbia, and the Netherlands with its 24 hospitals and 14 outpatient clinics. Today, Acıbadem Healthcare Group is a global brand in medical tourism by providing the highest quality of services using advanced technologies and expert teams meeting the international quality standards like Joint Commission International (JCI) and ISO 15189 Clinical Laboratory Accreditation Certificate. Every year, many patients from different parts of the world travel to Turkiye to receive treatment, and they 4

SEP/OCT 2022 | HEALTHCARE AFRICA

prefer Acıbadem. In order to provide comfort, trust and stability, Acıbadem offers to international patients a comprehensive range of services including consultations, diagnostic procedures, billing and insurance, travel and accommodation arrangements and translation services. Acibadem International Patient Service Center has been designed as a “one-stop center” and offers healthcare services from the day of the request until the time patients return to their home country within 20 different languages. As a globally renowned chain in the medical field and Turkiye’s leading Healthcare Group, Acıbadem continues to grow rapidly. The group launched its newest hospital - Acıbadem Ataşehir - as their 10th hospital in Istanbul and their 24th in the world. Acıbadem Ataşehir is recognized for its unique architecture,

advanced medical technology, and digital systems exclusively developed by the Group in the field of health management. It has been built with an indoor area of 65,000 sqm. and is certified by LEED Gold for its 'EcoFriendly' and 'Smart Building' features. Acıbadem Ataşehir provides treatments in all branches of medicine, yet it serves particular care to Oncology, Gynecology, Brain Surgery, Orthopedics, IVF and pediatric patients thanks to the hospital’s unique design and features that accommodate for their every need, thus ensuring patient safety and satisfaction. The hospital has 153 patient rooms, 298 patient beds, 10 operating theatres, 1 IVF operating room, and endoscopy/colonoscopy and angiography intervention rooms. In Acıbadem Ataşehir Hospital there is a separate building which provides a child-friendly environment, an environment that keeps child patients entertained with activities in order to distract them from the hospital atmosphere. The Pediatrics Department operates 24 hours with physicians from all branches and sub-branches. Observation rooms are located near the entrance of the clinic with direct separate access for children with fever and infection. For blood tests and vaccination, children and their families can visit the dedicated unit without entering the clinic. Also there is another separate entrance where the oncology clinic is providing multidisciplinary service to oncology patients by a team of experienced specialists. The team is highly experienced on conducting the Truebeam and Ethos radiation oncology devices located in Ataşehir Hospital. In addition to radiation oncology technology, there is a Pet CT for diagnosis and there are a total of 34 chemotherapy treatment units in the clinic, 30 of which are outpatients and 4 inpatients for treatment. HEALTHCAREAFRICA.INFO



JUNE 15-17, 2023 Sarit Expo Centre, Nairobi, Kenya

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Hospitals & Care Expo

Devices Expo

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Medilab & Diagnostics

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Health & Wellness

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Africa Health

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Health & Care Expo

Africa

Africa Health

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Financing & Insurance Expo

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HealthTech Expo HEALTHCAREAFRICA.INFO

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EDITORIAL

HealthCare AFRICA

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HEALTHCARE UPCOMING EVENTS

Medic West Africa October 11-13, 2022 Landmark Centre, Lagos, Nigeria www.medicwestafrica.com

Medica 2022 - World Forum For Medicine November 14 - 17, 2022 Duesseldorf, Germany www.medica-Tradefair.com

International Conference On Medical, Biological And Pharmaceutical Sciences October 11, 2022 Cape Town, South Africa www.researchfoundation.net/Event

Compamed 2022 November 14-17, 2022 Dusseldorf, Germany www.compamed-Tradefair.com

International Conference on Medical Ethics and Professionalism October 11, 2022 Bamako, Mali www.sairap.org/Conf The Pharmacy Show October 16-17, 2022 National Exhibition Centre, United Kingdon www.thepharmacyshow.co.uk

Re-Work Enterprise Aisummit November 22 - 23, 2022 Johannesburg, South Africa www.re-Work.co/Events/Enterprise-AiSummit-South-Africa-2022 Africa Men’s Health November 24, 2022 Nairobi, Kenya www.ahb.co.ke

www.mthafrica.com Africa Health Agenda March 6-8, 2023 Kigali Convention Centre, Kigali, Rwanda www.ahaic.org Austropharm 2023 April 13 - 15, 2023 Vienna, Austria www.austropharm.at/en-gb.html American Dental Conference April 27 - 29, 2023 Orlando, FL, USA www.magnusconferences.com/dental Simem International Health Exihibition May 3-6, 2023 Oran, Algeria www.eventseye.com

Medexpo Ethiopia October 18-20, 2022 Millenium Hall, Addis Ababa, Ethiopia www.expogr.com/Ethiopia/Medexpo/

Child and Adolescent Mental Health (IACAPAP) December 5-9, 2022 Dubai World Trade Center, UAE www.iacapap2022.com

International Conference on Medical, Biological and Pharmaceutical Sciences October 24, 2022 Bulawayo, Zimbabwe www.researchfoundation.net/Event

Second International Conference on Public Health in Africa December 13-15, 2022 Kigali, Rwanda www.afenet.net

Africa Health/Medilab Africa October 26-28, 2022 Gallagher Convention Centre, Johannesburg, South Africa www.africahealthexhibition.com/MedlabAfrica

Ethio Health February 3-5, 2023 Hotel- Addis Ababa, Ethiopia www.ethio-health.com

Amsterdam Health Tourism Expo June 2 - 3, 2023 Postillion Hotel & Convention Center, Amsterdam, Netherlands www.amsterdamhealthtourism.com

Medlab-Middle East February 6-7, 2023 Dubai World Trade Centre, Uae Www.medlabme.com

Africa Health Excon June 7- 8, 2023 Iiec Centre, Cairo, Egypt www.africahealthexcon.com

Medexpo Tanzania February 16-18, 2023 Diamond Jubilee Hall, Dar Es Salaam, Tanzania www.expogr.com/tanzania/medexpo

Africa Health & Wellness Expo June 15-17, 2023 Sarit Expo Centre, Nairobi, Kenya www.expo.healthcareafrica.info

11th Annual Africa Health Exhibition & Congress – October 2022 October 26-28, 2022 Gallagher Convention Centre 19 Richards Drive Midrand, Gp 1685 South Africa www.africahealthexhibition.com International Health Insurance Conferece November 10-12, 2022 Accra, Ghana

Meditech Africa February 23-25, 2023 Nairobi, Kenya

Precisionmed Expo & Summit 2023 May 23 - 24, 2023 Conrad Hotel Dubai, UAE www.precisionmedexpo.com

Innopack Pharma Confex 2023 June 8 - 9, 2023 Sahara Star Hotel, Mumbai, India www.innopack-india.com

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Ablitech 2023 May 16-17, 2023 Tlv Convention Centre, Tel Aviv, Israel www.stier.co.il/abilitech/en

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NEWS UPDATES REGULATORY AFFAIRS

South Africa’s SAHPRA approves Novavax COVID-19 Vaccine for adults

SOUTH AFRICA – The South African Health Products Regulatory Authority (SAHPRA) has authorized the use of Novavax’ protein-based vaccine as a

two-dose primary series for active immunization to prevent COVID-19 in adults aged 18 and older. SAHPRA said that the product registration of Novavax’ protein-based vaccine dubbed NVX-CoV2373 was based on the totality of preclinical, manufacturing, and clinical trial data submitted for review. The product registration involves two pivotal Phase 3 clinical trials namely PREVENT-19 in the United States and Mexico as well as a United Kingdom-based trial with almost 15,000 adult participants.

Biotechnology company Novavax Inc., and Serum Institute of India Pvt. Ltd. (SII) announced that the Novavax vaccine is marketed in South Africa under the brand name Covovax™. “We are pleased to work with the Serum Institute to offer our proteinbased vaccine to the people of South Africa and to support expanded access to an area of the world where vaccination rates are well below public health targets,” said Stanley C. Erck, President and Chief Executive Officer, Novavax.

INVESTMENT

Biological E to amplify vaccine production with US$226M investment INDIA – Vaccine maker Biological E has

revealed plans to invest Rs 1,800 crore, (approximately US$226M) in their three facilities in Genome Valley. According to the company, the expansion projects will ramp up the manufacturing of vaccines along with generic injectables and R&D. Biological E anticipates the project to generate employment for more than 2500 people. Hyderabad city accounts for onethird of global vaccine production with a capacity of about 9 billion doses per annum. This investment from Biological E

will enhance the capacity by 5 billion doses, increasing the cumulative capacity to about 14 billion doses each year.

The investment will be focused on manufacturing of Janssen Covid vaccine, MR Vaccine, PCV Vaccine, Typhoid Vaccine, Covid Vaccine, Tetanus Toxide Ampoules, IPV Vaccine, and Pertussis Vaccine. Furthermore, BE has secured funding from US International Development Finance Corporation (DFC) to the tune of US$50 million to expand the company’s capacity to produce COVID-19 vaccines. Further, it has developed one of the indigenous vaccines for Covid-19 in the country – “Corbevax.”

Universal Corporation nabs WHO approval for novel antimalarial drug KENYA – The World Health Organization (WHO) has approved sulfadoxine-pyrimethamine (SP) by Kenyan manufacturer Universal Corporation Ltd (UCL) for the prevention of malaria infections in pregnant women and infants. Universal Corporation’s sulfadoxinepyrimethamine (SP) is a generally well-tolerated, effective, and affordable medicine used to prevent malaria in 10

SEP/OCT 2022 | HEALTHCARE AFRICA

pregnant women and infants; hence, the approval will improve the local supply. UCL becomes the first African manufacturer of a key antimalarial drug to be issued with a quality certificate from the World Health Organization, according to Medicine for Malaria Ventures. Malaria Venture said the WHO pre-qualification will enable Universal Corporation to support regional efforts to combat malaria through local

production.

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PHARMACEUTICALS

AbbVie on course to become the biggest of pharma by 2028, narrowly edging out Roche — report

USA – Despite facing one of the industry’s steepest patent cliffs, Abbvie is expected to leapfrog Roche to become the largest pharma company by prescription sales in 2028, according to extended consensus forecasts from Evaluate Pharma. Pfizer currently holds the top spot in Evaluate Pharma’s ranking of pharma companies by sales, thanks to the success of its Covid-19 vaccine

HEALTHCAREAFRICA.INFO

Comirnaty. Ranking AbbVie first is a significant shift for some analysts who have warned of dire consequences for the company as Humira approaches the patent cliff. So far, the adaptable autoimmune therapy has survived biosimilar competition in Europe and is expected to generate US$20.8 billion in global sales by 2021. However, the company expects newer autoimmune drugs Skyrizi and Rinvoq to generate US$15 billion in combined revenue by 2025, allowing it to absorb the hit. While Abbvie will no longer enjoy US$20 billion-plus sales a year from Humira after 2023, a fairly long tail of demand is expected for the anti-TNF rheumatoid arthritis drug. These sales, combined with increasing contributions from the Jak inhibitor Rinvoq, the psoriasis product Skyrizi, and the cancer

drug Venclexta, are enough to give the company a razor-thin lead over secondplace rival Roche. Analysts polled by Evaluate Pharma, expect AbbVie's US$65.7 billion in sales in 2028 to be closely followed by Roche's US$65 billion. Johnson & Johnson (US$62.3 billion), Merck (US$59.7 billion), and Pfizer (US$57.1 billion) round out the top five in terms of projected revenue.

PFIZER CURRENTLY HOLDS THE TOP SPOT IN EVALUATE PHARMA’S RANKING OF PHARMA COMPANIES BY SALES.

SEP/OCT 2022 | HEALTHCARE AFRICA

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NEWS UPDATES

Ethiopian National Influenza Lab joins the WHO global influenza surveillance network ETHIOPIA – The National Influenza Laboratory of the Ethiopian Public Health Institute (EPHI) has been recognized as a World Health Organization (WHO) National Influenza Centre (NIC) following on-sight assessment by a team of WHO experts.

With the recognition, the lab is now full member of the WHO Global Influenza Surveillance and Response System (GISRS) which is currently made of 155 institutions spread across 125 countries globally. The team recommended Ethiopia to continue to contribute to regional and global influenza surveillance particularly enhancing its involvement in GISRS by increasing shipping of influenza positive specimens to a WHO collaborating Centre for candidate influenza vaccine selection four times a year, WHO reports. The assessment mission also urged Ethiopia to continue regular reporting of influenza surveillance data to WHO and to maintain participation in the annual WHO GISRS external quality assurance programme. Established in 1952, GISRS is a global network of laboratories that monitor the spread of influenza with the aim to provide the World Health Organization with influenza control information. More than two million respiratory specimens are tested by GISRS annually through its extensive network of laboratories that combined represent 91% of the world's population. 12

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ACQUISITION

Medtronic completes Affera acquisition for US$1B, expanding its cardiac portfolio IRELAND – Medtronic has completed its US$1 billion acquisition of cardiac mapping and ablation technology developer Affera, a medtech company based in Newton, Massachusetts. The transaction expands the company's cardiac ablation portfolio to include its first-ever cardiac mapping and navigation platform that encompasses a differentiated, fully integrated diagnostic, focal pulsed field, and radiofrequency ablation solution. The company had been a strategic investor in Affera through its minority investment portfolio. Prior to the acquisition, Medtronic held a 3% stake in the company. The investigational Affera technology is designed to provide solutions for patients with cardiac arrhythmias (irregular heartbeats) such as atrial fibrillation (AF). Through this acquisition, Medtronic gains the Affera

Prism-1 cardiac mapping and navigation platform, which will be compatible with Medtronic and multiple competitive therapeutic catheters and technologies. The company also adds the Sphere-9 cardiac diagnostic and ablation catheter that enables the rapid creation of detailed electro-anatomical maps and delivers radio frequency (RF) and pulsed-field (PF) cardiac ablation therapies.

THE INVESTIGATIONAL AFFERA TECHNOLOGY IS DESIGNED TO PROVIDE SOLUTIONS FOR PATIENTS WITH CARDIAC ARRHYTHMIAS (IRREGULAR HEARTBEATS) SUCH AS ATRIAL FIBRILLATION (AF).

GOVERNMENT

Rwanda lands landmark deal to host HQ of African Medicines Agency

RWANDA – Rwanda has landed a major deal to host the headquarters of the African Medicines Agency (AMA), trouncing eight candidates including Uganda, Algeria, Egypt, Morocco, Rwanda, Tanzania, Tunisia and Zimbabwe. AMA, which was formed recently, will work enhance capacity of

state parties and regional economic communities (REC) to regulate medical products with an aim to improve Africa’s access to quality medical products. Rwanda’s win was announced during the 41st Ordinary Session of the Executive Council of the African Union held in Lusaka, Zambia in July this year. Once fully operational, AMA will become the second specialized health agency of the African Union after the Africa Centres for Disease Control and Prevention (Africa CDC). It will work to encourage pharmaceutical knowledge sharing between African countries as well as expand access to effective, safe and quality medicines for patients in the region to support the continent’s fight against health crises. HEALTHCAREAFRICA.INFO


DISEASE MANAGEMENT

WHO unveils new US$1.5B roadmap for managing bacterial meningitis outbreaks in Africa

AFRICA – The World Health Organization (WHO) and partners have endorsed the new US$1.5B regional strategy that sets out a roadmap for African countries to shore up diagnosis, surveillance, care, advocacy and vaccination against meningitis. The roadmap is aimed at stopping bacterial meningitis outbreaks by 2030, urging countries to implement it rapidly before the start of the meningitis season in January 2023. WHO estimates that US$1.5 billion

will be required between now and 2030 to implement the plan, which if fully adopted will save more than 140,000 lives every year in the African region and significantly reduce disability. Despite the enormous challenges triggered by the COVID-19 pandemic, the drive to eliminate meningitis type A has been immensely successful since no new cases have been reported since 2017. “With WHO and partners’ support, more than 350 million people in 24 highrisk African countries have received the MenAfriVac vaccine since 2010,” the agency outlined. WHO further said that historically, meningitis type A was the highest cause of meningitis outbreaks in Africa while noting that controlling this lethal form of meningitis has led to fewer deaths from meningitis type A and other types of the disease.

WHO reports 50,000 World Monkeypox outbreak cases SWITZERLAND – The Monkeypox outbreak has resulted in 50,496 cases worldwide, according to recent statistics from the World health organization (WHO). Deemed a global public health emergency in July, has also resulted in 16 fatalities, the World Health Organization this year, the Geneva, Switzerlandbased agency revealed.. Encouraging reports from the global health body, however, show that in the virus's hotspots of Europe and the United States, transmission is slowing. WHO chief Tedros Adhanom Ghebreyesus said the decline in new infections proved that the outbreak could be brought to a halt. He noted that some European countries, including Germany and the Netherlands, are also seeing a clear

HEALTH STRATEGY

Ethiopia adopts new National Health Equity Strategy for the period 2022-2026 ETHIOPIA – The Ministry of Health (MoH) of Ethiopia has unveiled the National Health Equity Strategy for the period 2022-2026 that seeks to reduce inequity at zonal and district levels. The Strategy is an integral part of the Ethiopian Health Sector Transformation Plan that articulates nine strategic directions to help reduce the health equity gradient. It has so far received endorsement from World Health Organization (WHO) in Ethiopia, the Ethiopian Government at national and regional levels as well as development partners. The five-year strategy focuses on enhancing provision of equitable and quality comprehensive health service delivery along with improving accessibility of health facilities in all regions. HEALTHCAREAFRICA.INFO

It also aims to ensure the integration of health equity in all policies, strategies and program, improving public-private partnership and enhancing health financing. The new strategy also supports community engagement and empowerment as well as improving health commodity supply chain and logistics management to strengthen the Ethiopian health system.

THE FIVE-YEAR STRATEGY FOCUSES ON ENHANCING PROVISION OF EQUITABLE AND QUALITY COMPREHENSIVE HEALTH SERVICE DELIVERY.

slowing of the outbreak, demonstrating the effectiveness of public health interventions and community engagement to track infections and prevent transmission. Since early May, there has been an increase in monkeypox infections outside of the African nations where it has long been common. The head of WHO was however pleased to report that there were "encouraging" signals that the outbreak was slowing down and moving "in the correct direction" on the continent.

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NEWS UPDATES MARKET EXPANSION

Dialysis care leader Africa Healthcare Network eyes expansion into Ghana managing diabetic and hypertensive patients to chronic kidney disease patients, managing and delaying the progression of disease, renal replacement therapy and transplantation,” Nikhil noted. In addition to providing dialysis, AHN has led campaigns to spread awareness about kidney disease and has created a registry of patients in East Africa with chronic kidney disease to better prevent and manage the disease progression. GHANA –

Africa’s leading patientcentered technExecutive Chairperson of Africa Healthcare Network (AHN) Nikhil Pereira-Kamath has announced that AHN has recently expanded into Ghana and expects its first dialysis center by the end of 2022 with intentions to bring kidney care to as many regions in Africa as possible. During an interview with Healio, Pereira-Kamath explained that the dialysis centers are built within AHN’s partner hospitals and that AHN has contributed to the care of about 5,000

patients while noting that the clinics are led by independent local teams with a focus on gender equity and capacity building. The Executive Chairperson of Africa Healthcare Network reaffirmed that the Africa Healthcare Network is committed to bringing high quality kidney care at an affordable cost in sub-Saharan Africa, adding that AHN is focused on bringing access to patients. “AHN should be the provider of choice for patients requiring renal care including the continuum of care from

THE AFRICA HEALTHCARE NETWORK IS COMMITTED TO BRINGING HIGH QUALITY KIDNEY CARE AT AN AFFORDABLE COST IN SUB-SAHARAN AFRICA.

Bayer Pharma announces medication to halt the progression of chronic kidney disease among diabetic patients

INDIA – Pharmaceutical company Bayer has introduced Finerenone under the brand name Kerendia, as a drug for 14

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the treatment of chronic kidney damage (CKD) brought on by type 2 diabetes (T2D). Finerenone is described as a first-in-class non-steroidal, selective mineralocorticoid receptor antagonist recommended for those with type 2 diabetes and chronic kidney disease. Kerendia is reported to be the only drug of its kind that prevents mineralocorticoid receptor (MR) overactivation in the kidneys, heart, and blood vessels. This is even while drugs for diabetes and high blood pressure may help one control their glucose and blood pressure. The inflammation and scarring caused by MR overactivation may accelerate the onset of kidney disease and could also

worsen heart disease. The progression of CKD in T2D is hypothesized to be slowed by blocking MRs. Therefore, there may be more to be done to delay the kidney damage caused by CKD, even if one is currently taking drugs for diabetes and high blood pressure. According to several studies, there are 74 million diabetics in India, and that number is expected to rise to 93 million by 2030, making the disease an epidemic. After China, India has the second-highest global prevalence of diabetes. The US Food and Drug Administration authorized Finerenone in July of this year based on the findings of the clinical trials investigations. HEALTHCAREAFRICA.INFO


DISEASE MANAGEMENT

Rockefeller Foundation inaugurates US$7.4M vaccination network for Africa

AFRICA – The Rockefeller Foundation has initiated a US$7.4M health initiative dubbed Vaccination Action Network (VAN) that is focused on engaging public health decision-makers across SubSaharan Africa and building resilient health systems in Africa beyond the COVID-19 pandemic response. As part of the initiative, VAN will support Amref Health Africa with a US$5 million grant to design and implement tailored strategies that better reflect local needs and address demand barriers for increased vaccine uptake.

In addition, Sabin Vaccine Institute and Dalberg will host the Secretariat of the new VAN while Amref Health Africa will administer subgrants to local organizations in participating countries to support the implementation of vaccine demand generation strategies discussed during the learning sessions. The Rockefeller Foundation announced that the Vaccination Action Network’s objective is to help decisionmakers understand the drivers behind vaccination and support initiatives that will increase COVID-19 vaccine uptake. The network aims to strengthen routine immunization as well as ensure health systems are better equipped to respond to emergencies in line with the Foundation’s regional commitment to support localized solutions, empower community representatives and create more resilient health systems.

Cameroon attracts US$12M grant from SFD for hospital construction project CAMEROON – The Cameroonian Government has secured a US$12M grant from the Saudi Fund for Development (SFD) to finance the construction of the Mbalmayo Regional Hospital Project, the Saudi Arabian government agency has said. SFD Chief Executive Officer Mr. Sultan bin Abdulrahman Al-Marshad said that the hospital construction project will provide the necessary support for basic infrastructure services thus enabling society members to access all their daily needs to improve their social and economic living conditions.

DISEASE MANAGEMENT

Africa CDC issues guidelines to contain monkeypox ETHIOPIA – The Africa Centres for Disease Control and Prevention (Africa CDC) has published key recommendations for Africa Union Member States (AU MS) to curb the spread of monkeypox cases in the African continent amid outbreaks. Africa CDC has encouraged AU Member States to establish and strengthen laboratory diagnostic and genomic sequencing capacity for orthopoxviruses including monkeypox as well as introduce and beef up surveillance and contact tracing capacities. AU member have been urged to develop and widely distribute both general and tailored risk communication messages for the community at large as well as any specific populations currently impacted and at risk. The specialized agency further advised AU MSs to expand knowledge HEALTHCAREAFRICA.INFO

of monkeypox clinical management and infection prevention control measures as well as secure adequate test kits, therapeutics and vaccines as needed at country level. AFRICA CDC HAS ENCOURAGED AU MEMBER STATES TO ESTABLISH AND STRENGTHEN LABORATORY DIAGNOSTIC AND GENOMIC SEQUENCING CAPACITY FOR ORTHOPOXVIRUSES.

In addition, the public health agency revealed that the Africa CDC Emergency Operations Centre has moved to response mode to support preparedness and response efforts of African Union Member States in close collaboration with relevant partners.

Funds from SFD will go towards building and equipping the new Cameroonian hospital with a capacity of 200 medical beds and development of specialized medical departments, centers and buildings spanning a total area of 14,000 m2. The hospital construction project will also include an area for operational services covering up to 8,500 m2 and a helicopter landing pad for medical emergencies along with the rehabilitation of the road that connects the hospital to the national road to ensure easy accessl. Under the deal, the healthcare facility will be fully furnished and equipped with electricity, water and sewage facilities in a bid to support ongoing government efforts to alleviate overcrowding in Yaoundé and Douala hospitals.

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NEWS UPDATES

Takeda invests US$299m for plasma-derived therapies production in Belgium

BELGIUM – Japanese pharma major Takeda is set to invest close to 300 million euros (US$299 million) in a new state-of-the-art production facility for the manufacturing of plasma-derived therapies for people with rare and complex chronic diseases. Takeda also said that this is the largest investment the company had made in Belgium. As part of Takeda's commitment to have net zero carbon emissions by 2030, the new facility will be self-sufficient in electricity. It will also feature a water recycling system that will cut freshwater consumption by 90% by 2023. The new warehouse will itself have net zero greenhouse gas emissions. Earlier in February, Bob Nelsenbacked Resilience established a partnership with Takeda's plasmaderived therapies business unit to develop and manufacture several products in its portfolio out of its site in Mississauga, Ontario, Canada. Takeda has also been expanding its footprint in the US. Last year, the company broke ground on a 15,000-square-foot, US$126 million manufacturing facility in Thousand Oaks, CA. In June, Takeda also inked a 15-year lease to establish a 600,000-square-foot R&D and office HQ in Kendall Square in Cambridge, Massachusetts.

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SEP/OCT 2022 | HEALTHCARE AFRICA

HEALTHCARE DELIVERY

Philips Foundation, RAD-AID International ink 10-yr deal to advance ultrasound care in Africa AFRICA – Philips Foundation and RAD-AID International have entered into a multi-year cross-continental partnership to promote access to diagnostic ultrasound services in Ethiopia, Ghana, Kenya, Malawi and Tanzania. Under the collaboration with RADAID International, Philips Foundation will offer equipment and enable remote training in ten underserved areas, with a clear focus on increasing the number of patients who benefit from remote access to professional radiologists. With Philips ultrasound solutions, ultrasound experts will be able to communicate with training program participants miles away via voice, video

and text messages, view the ultrasound images taken in real time, and remotely demonstrate equipment settings during guided ultrasound exams if necessary. Meanwhile, RAD-AID International will leverage the virtual care capabilities of Philips ultrasound solutions to provide a highly scalable, remote ‘trainthe-trainer’ model to improve access to diagnostic and point-of-care ultrasound through curriculum-based education and clinical hands-on teaching. The partnership will greatly boost Philips Foundation’s mission to provide access to quality healthcare for 100 million people a year in underserved communities by 2030.

HEALTH REPORT

Healthy life expectancy in Africa increases by 10 years, new WHO study finds AFRICA – Healthy life expectancy in the African region has increased by 10 years on average per person between 2000 and 2019 due to improvements in the provision of essential health services, according to the World Health Organization (WHO) assessment reports. The report entitled ‘The Tracking Universal Health Coverage in the WHO African Region 2022’ highlights that healthy life expectancy, also the number of years an individual is in a good state of health, increased to 56 years in 2019 compared with 46 in 2000. The WHO report noted that improvements in the provision of essential health services, gains in reproductive, maternal, newborn and child health together with major progress in the fight against infectious diseases helped to extend healthy life expectancy. Essential health service coverage had for instance improved to 46% in 2019 as opposed to 24% in 2000, according to

the study conducted across 47 countries that make up the WHO African Region. Africa’s improvement was greater than in any other region of the world during the same period, according to the study which highlighted that over the same period, global healthy life expectancy increased by only five years. WHO in the report noted that high and upper middle-income countries tend to have better health service coverage and higher healthy life expectancy at birth than lower-income countries. HEALTHCAREAFRICA.INFO


INNOVATION

New ShangRing circumcision device shows promise in fight against HIV in Africa

AFRICA – A new easy-to-use device for infant circumcision device dubbed ShangRing has proved to be safe and could boost HIV (human immunodeficiency virus) prevention efforts in Africa, the highly-ranked Ivy League institution Cornell University has announced.

The device uses two concentric plastic rings to sandwich the foreskin allowing a practitioner to cut away the excess skin with minimal bleeding and without stitches. In addition, the procedure can be performed under local anesthesia and takes less than 5 minutes. With seed funding from Weill Cornell Medicine and grants from the Bill & Melinda Gates Foundation and the National Institutes of Health, Weill Cornell Medicine investigators launched a series of clinical trials of the ShangRing device in sub-Saharan Africa. The novel circumcision device was subjected to an international randomized controlled clinical trial led by Weill Cornell Medicine physician-scientists comparing the ShangRing with the current gold standard circumcision device called the Mogen clamp in infants. The study found out that the circumcision device dubbed ShangRing, invented by Jian-Zhong Shang, could boost efforts to increase circumcision

rates and prevent HIV in low-resource settings where early infant circumcision is not widespread. In addition to having minimal training requirements, the disposable ShangRing device comes pre-sterilized, reducing the time, costs and resources needed for sterilizing reusable circumcision devices such as the Mogen clamp.

THE DEVICE USES TWO CONCENTRIC PLASTIC RINGS TO SANDWICH THE FORESKIN ALLOWING A PRACTITIONER TO CUT AWAY THE EXCESS SKIN WITH MINIMAL BLEEDING AND WITHOUT STITCHES.

REGULATORY AFFAIRS

WHO international pandemic treaty to be ready in 18 months SWITZERLAND - Member states of the World Health Organization (WHO) have agreed on the availability of the draft for the global pandemic treaty. Dr. Soumya Swaminathan, Chief Scientist at The World Health Organization now predicts that the global pandemic treaty draft will be accessible in the coming 18 months. The treaty aims to promote equitable distribution of vaccinations and medications, data sharing, genome sequencing, and associated research. According to WHO, this is a chance for the globe to unite as a single, peaceful community for collaboration that goes beyond the COVID-19 crisis. In 2021, World Health Organization’s member nations came to a tentative agreement HEALTHCAREAFRICA.INFO

to discuss a future deal on preventing pandemics and on bridging the divide between the European Union (EU) and

the United States. The 25 heads of government and international agencies came together in an extraordinary joint call and expressed concerns about more development of other pandemics and other major health emergencies. The signing of a new convention would highlight the necessity for highlevel political action to safeguard the world from future health disasters. The world leaders commented that the creation of a more robust global health architecture will safeguard future generations. They also agreed that the international community should cooperate toward a new international treaty for pandemic preparedness and response.

SEP/OCT 2022 | HEALTHCARE AFRICA

17


NEWS UPDATES INVESTMENT

Moderna to invest 500 million euros in boosting vaccine production in Spain

SPAIN – Moderna plans to invest around 500 million euros (US$520.60 million)

in a new laboratory in Spain to boost its production of vaccines, Spanish Prime Minister Pedro Sanchez has said, Reuters reports. Spanish pharmaceutical group Rovi agreed early in the year to a 10-year extension to its deal with Moderna to manufacture future drugs developed with the mRNA technology used for the US company’s coronavirus vaccine. Rovi said the deal would include new

investment to expand capacity at Rovi’s plants, without disclosing the amount of investment at that moment. In a separate statement, Moderna said it plans to set up a quality testing laboratory for mRNA vaccines in Madrid, which is expected to be operational in 2023. Moderna also said the 500-million-euro (US$520.60 million) investment this year included its collaboration with Rovi.

Australia’s new digital health initiative encourages more physical activity among childhood cancer survivors AUSTRALIA - A researcher from the University of New South Wales Medicine and Health has created a digital health initiative to encourage young cancer survivors to engage in physical activity. The home-based iBounce program was developed by Dr. Lauren Ha, an exercise physiologist and post-doctoral research fellow in pediatrics at the School of Clinical Medicine of UNSW Medicine and Health. Dr. Ha modified a version of iEngage, an evidence-based health education program for school-aged children, to create the homebased iBounce.

iEngage has ten self-paced courses with themes including flexibility, aerobic fitness, and muscular strength that are presented through quick demonstration videos.

The iBounce program, which was supported by The Kids’ Cancer Project, had been tested through a 12-week pilot involving 30 patients from Sydney Children’s Hospital. According to research that was published in JMIR Cancer, participants had made “substantial” gains in their aerobic fitness by the end of the program. In Australia, an estimated 750 kids between the ages of 0 and 14 receive cancer diagnoses annually. In the G20, Australia is thought to have the fifth-highest incidence rate of child malignancies, behind Canada, the United States, South Korea, and Germany.

INVESTMENT

Gennecs to inaugurate US$150M vaccine production facility, research unit in Egypt EGYPT – Gennecs Pharmaceuticals

Ltd, a research industrial-based pharmaceutical company in Egypt, is in talks with health stakeholders to develop and inaugurate a multi-vaccine production facility and a vaccine research hub valued at about US$150 million. According to a statement from the Egyptian pharmaceutical company, the vaccine manufacturing facility will have an installed capacity of 300 million vaccines every year. The national project is expected to 18

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be the largest of its kind in the Middle East and North Africa (MENA) region with its vaccine facility anticipated to change the African market as well as position Egypt as a major player within the vaccines landscape map. Gennecs Chief Executive Officer (CEO) Adam El Daba told Enterprise that the vaccine manufacturing facility will produce jabs included in the country’s national immunization program such as shots for HPV, polio, hepatitis A and B and other pharmaceuticals. “The vaccine factory will begin producing ready-to-fill vials by 2026

and is expected to start producing antigens for the vaccines by 2029 after it has received accreditation from the World Health Organization (WHO),” said Adam El Daba. HEALTHCAREAFRICA.INFO


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NEWS UPDATES

Aspen, Serum Institute of India ink 10-year vaccine manufacturing pact for Aspen-branded jabs

SOUTH AFRICA – Aspen Pharmacare Holdings Limited, a multinational South African pharmaceutical company, has struck a 10-year vaccine manufacturing deal with the world’s largest vaccine manufacturer Serum Institute of India (SII). According to Aspen Pharmacare Holdings Limited (APN), the deal signed by its wholly owned subsidiary Aspen SA Operations covers the manufacture, marketing and distribution of four Aspen-branded routine vaccines for Communicable diseases vaccines in Africa. The vaccines in question include Pneumococcal Vaccine, Rotavirus Vaccine, Poly valent Meningococcal Vaccine and Hexavalent Vaccine. For the 10 years that the deal will be in operations, Aspen will have production and marketing rights in Africa excluding certain markets due to the Serum Institute having granted prior rights to third parties. The South African pharmaceutical company also revealed that plans exist to discuss the expansion of the Agreement to include new products or new versions of the Products. In addition to the Agreement, Aspen also anticipates receiving grant funding from the Bill & Melinda Gates Foundation and the Coalition for Epidemic Preparedness Innovations (“CEPI”) to support African regional manufacturing capacity for the affordable supply of vaccines.

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HEALTH STRATEGY

Kenya explores path to implement the three-test strategy for HIV diagnosis KENYA – Kenya’s Ministry of Health has announced plans to implement a three-test HIV testing algorithm as the country seeks to optimize ongoing efforts to deal with the virus, the ministry said on its website. Kenya’s Health Cabinet secretary Mutahi Kagwe said the field testing will be piloted in selected counties ahead of a national roll out that would be pegged on a preliminary report of a technical Task Force on the adoption of the procedure. According to the MOH, the Task Force was charged with reviewing performance reports of the current HIV testing algorithm and available evidence

to adapt the three-test algorithm as per World Health Organization (WHO) recommendation. The Ministry revealed that plans are currently underway to adopt the three-test HIV testing in the country in a bid to introduce a feasible approach without compromising the quality and readability of testing. The government department further said that the Task Force on HIV/AIDS was required to contextualize the adaptation process, implementation and feasibility of the three-test algorithm before filing its report to the Director General for Health office.

DISEASE MANAGEMENT

IAVI launches clinical trial of Lassa fever vaccine in Liberia LIBERIA – The nonprofit scientific research organization IAVI announced that volunteers at the PREVAIL clinical trial site at Redemption Hospital in Monrovia, Liberia have been vaccinated with IAVI’s novel vaccine candidate against Lassa fever virus (LASV) in a Phase I clinical trial. IAVI said on its website that the Phase I clinical trial dubbed IAVI C102 was supported by the Coalition for Epidemic Preparedness Innovations (CEPI) in ongoing global efforts to produce a licensed Lassa vaccine for routine immunization. IAVI further said that clinical evaluation of IAVI’s LASV vaccine candidate is supported by the Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), the U.S. National Institute of Allergy and Infectious Diseases (NIAID) and the Ministry of Health in Liberia. The clinical trial dubbed IAVI C102 is designed to evaluate the vaccine candidate’s safety, tolerability, and ability to elicit an immune response against

Lassa fever among approximately 100 healthy adults in the U.S. and Liberia, according to the IAVI. Following IAVI C102, a Phase II trial of the vaccine candidate is also planned to be undertaken in West Africa in partnership with CEPI, with funding already announced by CEPI and the European & Developing Countries Clinical Trials Partnership (EDCTP). HEALTHCAREAFRICA.INFO


REGULATORY AFFAIRS

Oxford University’s malaria vaccine becomes first to achieve WHO-specified 75% efficacy goal

UNITED KINGDOM –The fight against malaria has received another breakthrough after scientists at Oxford University developed a cheaper vaccine that can be manufactured at a greater scale.

The vaccine, known as R21, was shown to have efficacy as high as 80% one year after a fourth dose was administered to some 400 infants aged 5 to 17 months in Burkina Faso, according to a study published by the peer-reviewed medical journal Lancet Infectious Diseases. Oxford's R21/Matrix-M vaccine meanwhile is 77 percent effective at preventing malaria– the first time the WHO's roadmap goal of 75 percent had been met. Oxford has partnered with the world’s largest vaccine manufacturer, the Serum Institute of India, which is reportedly willing and able to manufacture 200 million doses a year HEALTHCAREAFRICA.INFO

starting next year. The new vaccine can offer protection for two years and has been referred to as a ‘game changer in the fight against the disease.’ The international research team suggested the vaccine, developed by Oxford University, could represent a turning point in the fight against the mosquito-borne parasitic disease, which killed 627,000 people –– mostly African children –– in 2020 alone. The Oxford team will start getting approvals for the vaccine, with the final decision pegged on the results of a larger trial sampling 4,800 children planned before the end of the year.

OXFORD'S R21/ MATRIX-M VACCINE IS 77 PERCENT EFFECTIVE AT PREVENTING MALARIA – THE FIRST TIME WHO'S ROADMAP GOAL OF 75 PERCENT HAD BEEN MET.

Grace Health, Penda Health team up to advance women’s digital health access KENYA – Grace Health, a leading women’s digital health platform, has entered into a strategic partnership deal with telemedicine company Penda Health to enhance access to affordable, high-quality healthcare for women in emerging markets. The Grace Health app is a women’s health companion that combines worldclass technology with a carefully tailored user experience, trusted by over a million women in four African key markets namely Kenya, Nigeria, South Africa and Ghana. Grace Health and Penda Health have agreed on a strategic pact to offer Kenyan users 24/7 telemedicine and medical services in physical clinics at a lower cost which will see the digital

platform add even more value to its users. Under the deal, integrating Penda Health in the Grace Health light-weight app will ensure that Kenyan women can access highly trusted medical services including advanced diagnostic, imaging, gynecology consultations among other services. Women can track their cycles, learn about family planning and access clear advice and comprehensive information on sexual and reproductive health through the Grace Health App as well as access Penda’s low-cost telemedicine services at a further 10% discount when they need to speak to a clinician.

SEP/OCT 2022 | HEALTHCARE AFRICA

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MEDICAL DEVICES & INNOVATIONS

Roche South Africa unveils the VENTANA DP 600 slide scanner for digital pathology

SOUTH AFRICA – Roche Pharmaceuticals South Africa has launched its next-generation VENTANA

DP 600 slide scanners for digital pathology to enhance patient care through precision diagnostics. The pharmaceutical firm revealed that the new scanner features innovative optics and dynamic focus technology for high-resolution, high-quality color images that accurately reproduce the image quality that pathologists see under microscopes. “The Roche Digital Pathology solution is an integrated solution that combines innovative slide scanners, patient-centric pathology workflow software and image analysis algorithms, working in integrated harmony with the full Roche tissue diagnostics portfolio,”

Roche said. According to the South Africa based pharmaceutical firm, the highquality images provide ease-of-use and workflow flexibility for the pathology lab while at the same time helping to accurately diagnose cancer for effective treatment. In addition, the VENTANA DP 600 slide scanner will empower pathologists to provide faster and more comprehensive diagnostic results to healthcare providers and their patients as well as help anatomic pathology laboratories accelerate the digitalization of their pathology workflow.

Becton, Dickinson launches next-gen pre-fillable vaccine syringe USA – Becton, Dickinson (BD &Co.) has launched its next-generation glass prefillable syringe (PFS) for vaccine delivery, the Effivax syringe featuring tightened specifications for processability, cosmetics, contamination, and integrity. The company designed it in collaboration with top pharmaceutical firms to meet the evolving needs of

vaccine manufacturing. With a prefillable syringe system, the very nature of its design eliminates the withdrawal step and delivers the drug product directly to the patient, which can result in a more accurate dose of the drug with less exposure to needles. In addition, prefilled syringes, with their pre-measured dosage, can reduce

dosing errors and increase patient compliance. Effivax glass PFS offers design enhancements focused on fill/ finish and container reliability. The company designed it to reduce the risk of line stoppage. It also improves the total cost of ownership, manufacturing capacity, and supply availability.

GE Healthcare’s deep-learning 3D imaging system gets FDA expanded approval USA - GE Healthcare has received expanded FDA 510(k) clearance for its AIR Recon DL for 3D and Propeller imaging sequences. GE says the freshly FDA-approved features are applicable to nearly all MRI clinical procedures, cover all anatomies and enable better image quality with shortened scan times. The solution’s compatibility expands from 2D to 3D imaging sequences. This allows physicians to diagnose patients with an improved signal-tonoise ratio (SNR) and sharpness. The 3D imaging provides for more clinical efficiency by eliminating the need for 22

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multiple 2D acquisitions. This potentially leads to faster diagnosis. Air Recon DL’s benefits extend to nearly all magnetic resonance imaging (MRI) clinical procedures. The platform

covers all anatomies, enabling better image quality, shorter scan times, and improved patient experience. The upgrade additionally makes AIR Recon DL compatible with the company’s Propeller imaging sequencer. This is designed to correct for patient movement during scanning. Propeller holds particular importance for anatomies susceptible to motion such as respiration during MRI exams. As a result, it is of great significance to pediatric, neurodegenerative, geriatric, and claustrophobic patients who have difficulty remaining physically still during MRI scans. HEALTHCAREAFRICA.INFO


US FDA approves Abbott’s new Proclaim Plus spinal cord stimulation system USA - The US Food and Drug Administration (FDA) has approved Abbott’s spinal cord stimulation system (SCS), which is designed to treat multisite and evolving pain. The system allows doctors to modify the programming in response to the patient's changing demands and provides pain coverage in up to six regions. SCS therapy often referred to as neurostimulation, is a form of implanted technology that modifies how the body processes pain signals by sending modest electrical pulses to the nerves that run along the spinal cord. This treatment can reduce chronic pain and enhance the quality of life. Abbott now has a new strategy to pursue after receiving FDA permission, which is to grow its market share in the spinal cord stimulation industry, where it competes with Boston Scientific, Medtronic, and Nevro. Proclaim Plus

Siemens Healthineers Symbia Pro.specta SPECT/CT Scanner receives FDA approval

expands on the elements Abbott created to set apart its spinal cord stimulator. The device employs FlexBurst360, an upgraded form of Abbott’s BurstDR stimulation that sends electrical energy packets at higher frequencies and smaller amplitudes than conventional tonic stimulation. It also makes use of connected care technology and a 10year, recharge-free battery

USA – Siemens Healthineers has announced the Food and Drug Administration (FDA) clearance of the Symbia Pro.specta, a single-photon emission computed tomography/ computed tomography (SPECT/CT) system with advanced CT and SPECT imaging technologies. Capabilities include a low-dose CT of up to 64 slices for impressive detail, automatic SPECT motion correction for additional image clarity, and an intuitive and automated workflow to guide the user through the entire decision-making process of the examination. Designed to replace the Symbia Intevo family of SPECT/CT scanners, the Symbia Pro.specta is an all-purpose system that can be customized to accommodate a wide range of clinical exams, patient types, and department settings.

FDA clears ABK Biomedical’s embolic microspheres for treating tumors USA – Halifax medical device maker ABK Biomedical has received approval from the United States Food and Drug Administration for its Easi-Vue embolic microspheres, which are used to treat deformed blood vessels and cancer tumors with abnormally large numbers of blood vessels. Easi-Vue is a radiopaque embolization

EASI-VUE IS A RADIOPAQUE EMBOLIZATION DEVICE ALLOWING DIRECT VISUALIZATION OF THE MICROSPHERES IMPLANT DURING THE EMBOLIZATION PROCEDURE.

HEALTHCAREAFRICA.INFO

device allowing direct visualization of the microspheres implant during the embolization procedure. Founded in 2012 by Dalhousie University researchers Bob Abraham, Daniel Boyd, and Sharon Kehoe, ABK is developing a slate of products that involve injecting tiny, mildly radioactive glass beads into a patient’s bloodstream for the purpose of blocking a blood vessel in order to starve a tumor of oxygen. Chief medical officer Dr. Aravind Arepally said that Easi-Vue microspheres offer a highly calibrated technology. They offer capabilities for visually targeted placement using conventional x-ray and fluoroscopy systems. He added that the technology, with a proprietary controlledconcentration delivery system, could potentially improve patient outcomes.

At the heart of the Symbia Pro. specta is myExam Companion, which includes an intuitive user interface that eliminates the traditional manual and user-dependent SPECT/CT imaging workflow. myExam Companion provides automated tools to guide the user through every step of the exam’s decision-making process—from system and patient preparation to image acquisition and reconstruction to evaluation and postprocessing.

SEP/OCT 2022 | HEALTHCARE AFRICA

23


MEDICAL DEVICES & INNOVATIONS

Olympus rolls out Thunderbeat energy device for open surgery

JAPAN -– Olympus, a global medtech company committed to making people’s lives healthier has released its Thunderbeat open fine jaw type X surgical energy devices for open surgery. Surgical energy devices are hand-

held devices used by doctors to seal blood vessels, cut tissue and stop bleeding. Thunderbeat features a new thermal shield designed to support safer procedures. The initial launch covers Japan. Olympus’ Thunderbeat portfolio includes hybrid energy devices that deliver both ultrasonic and bipolar energy simultaneously. Uses include tissue management, such as hemostatic cutting and dissection, in laparoscopic surgery and open surgery. The company said the devices eliminate the need for multiple instruments during the surgery. This contributes to efficiency in the operating room and reduced operation time. The new device is designed for open surgical procedures that require delicate and fine tissue dissection, such as thyroidectomy or radical neck dissection. The thermal shield improves the thermal profile on the grasping surface

to reduce the risk of unintended heat damage. Its jaw maintains a finely curved tip for precise dissection and enhanced visibility, the company said. It contributes to fast hemostatic cutting, easy dissection, and reliable vessel sealing and division. The separate bipolar function enables vessel sealing and spot coagulation without cutting when desired.

THE NEW DEVICE IS DESIGNED FOR OPEN SURGICAL PROCEDURES THAT REQUIRE DELICATE AND FINE TISSUE DISSECTION, SUCH AS THYROIDECTOMY OR RADICAL NECK DISSECTION.

Roche unveils dual antigen and antibody test for hepatitis C virus SWITZERLAND – Roche has launched a new dual antigen and antibody diagnostic test for hepatitis C, which the Swiss pharmaceuticals company says will give an earlier diagnosis of the virus. The Elecsys HCV Duo is the first commercially available immunoassay that allows the simultaneous and independent determination of the hepatitis C virus status from a single human plasma or serum sample. It enables early diagnosis of active HCV infection and helps prevent transmission of the virus to the tissue, blood components, blood, cells, or organs of the patient. It also helps individuals get appropriate treatment sooner, stopping disease progression and transmission while reducing unnecessary healthcare costs. Meanwhile, Roche has also introduced a human papillomavirus 24

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(HPV) self-sampling solution in countries accepting the CE mark to extend screening options for cervical cancer. This new solution enables a patient to privately collect her sample for HPV screening while at a healthcare facility, following instructions provided by a healthcare worker. The clinicallyvalidated vaginal sample is analyzed with the Roche Cobas HPV test on a

Roche molecular instrument. Roche’s self-sampling solution helps reduce barriers preventing women from participating in cancer screening programs by offering women an alternative to more invasive clinician collection procedures, while also providing accurate and reliable results enabling clinicians to make patient care decisions. HEALTHCAREAFRICA.INFO


Africa Health

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Supply Chain & Logistics Expo

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Sarit Expo Centre, Nairobi, Kenya

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APPOINTMENTS UPDATE Novartis hires Merck executive Fiona Marshall to head research unit SWITZERLAND - Fiona Marshall, a

Kenya Association of Manufacturers confirms Anthony Mwangi as new CEO

former Merck executive, has been named president of the Novartis Institutes for Biomedical Research (NIBR), effective November 1st. She succeeds James (Jay) E. Bradner, M.D., who will step down from the Executive Committee of Novartis (ECN), effective October 31st after seven years of leading research at Novartis. Marshall currently serves senior vice president and global leader of MSD’s (Merck & Co. Inc) discovery sciences, preclinical development, and translational medicine departments.

USA - American manufacturer and

KENYA – The Kenya Association of

Manufacturers (KAM) Board has elected Mr. Anthony Mwangi as its new Chief Executive Officer for a three-year mandate, effective 15th September 2022. With over 20 years of experience, Mr. Mwangi brings a vast wealth of industry knowledge and extensive experience in public policy, government relations, stakeholder engagement, communications and business development cutting across the transportation, ICT, aviation, and oil and gas industries to the Association, KAM said in a statement. KAM outlined that Mr Mwangi has a Masters’ Degree in Public Policy and Management from Strathmore Business School, a Bachelor’s degree from University of Nairobi and a Certificate of Public Policy from New York University (NYU). On his appointment, Mr. Anthony Mwangi said: “I’m excited to take up the new role. I shall work closely with all stakeholders to increase the efficiency and productivity of the local manufacturing sector and drive exportled growth.”

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Geoffrey Purtill to take charge of Invacare as interim CEO and President

At Novartis, she will become a member of the executive committee and will report to Vas Narasimhan, M.D., CEO of Novartis. Dr. Marshall was the founder and chief scientific officer of Heptares Therapeutics, a successful UK biotech business that was acquired by the Japanese biotech company Sosei. She is a Fellow of the Royal Society and the Academy of Medical Sciences, an Honorary Fellow of the British Pharmacological Society and an Honorary Fellow of the Royal Society of Chemistry.

distributor of non-acute medical equipment Invacare has named Geoffrey Purtill as interim President and CEO in a radical leadership restricting exercise that saw former CEO Matthew Morgan exit the company. According to a statement released by the Elyria, Ohio based company, Geoffrey Purtill, general manager for EMEA and APAC, will have the top job until a substantive office holder is appointed. Cliff Nastas, Invacare’s lead independent director, said that the board determined that now is the right time for a change in leadership to oversee the successful execution of Invacare’s business transformation. The board restructuring processing also saw the comeback of Michael Merriman, Jr. to the company’s board as the lead independent director. From 2014 to 2018, Merriman served on the Invacare board as an operating advisor for the private equity fund Resilience Capital Partners. Invacare now has seven of its eight directors who are independent.

HEALTHCAREAFRICA.INFO


UNFPA confirms Lydia Zigomo as Regional Director for East and Southern Africa

WHO appoints Dr Jane Ruth Aceng as the second VP of the Regional Committee in Africa

ZIMBABWE – The United Nations Population Fund (UNFPA) has elected Lydia Zigomo from Zimbabwe as its new Regional Director for East and Southern Africa, succeeding Dr. Bannet Ndyanabangi, the outgoing Regional Director ad interim. On her appointment, Zigomo said that UNFPA’s vision of achieving a world where every pregnancy is wanted, every childbirth is safe and every young person’s potential is fulfilled is close to her heart.

UGANDA – Uganda Minister of Health

She further said that her focus as the new Regional Director will be to intensify efforts to achieve UNFPA’s three transformative results by 2030. Ms Zigomo is expected to lead efforts to achieve the Sustainable Development Goals (SDGs) and International Conference on Population and Development (ICPD) commitments in East and Southern Africa. Ms Zigomo is also expected to lead the UNFPA’s Division in the attainment of its vision of achieving a world where every pregnancy is wanted, every childbirth is safe and every young person’s potential. HEALTHCAREAFRICA.INFO

Hon Dr Jane Ruth Aceng has been appointed the second Vice President of the World Health Organization (WHO) Regional Committee in Africa. The WHO African Regional Committee is responsible for formulating regional policies on Health to guide the participating governments and the committee comprises of Ministers of Health or their representatives from each of the 47 Member States in the Region.

Royal Philips names Roy Jakobs to succeed Frans van Houten as Philip’s CEO NETHERLANDS – Royal Philips, a global leader in health technology, has appointed Roy Jakobs to succeed Frans van Houten as President and Chief Executive Officer, effective October 15, 2022. Frans van Houten, who has served at the company’s top office for three terms, will facilitate the transition as the company’s advisor from now until April 30, 2023. Roy Jakobs brings to the Amsterdam based company a strong international, operational, and transformational track record together with a deep grasp of Philips. He has successfully turned around businesses in customer-focused growth organizations and strengthened the company’s Connected Care portfolio. Roy Jakobs expressed his pleasure in taking up the new role: “I am thrilled to have the opportunity to lead Philips to improve people’s health and well-being via innovation,” he said. He added that in order to meet the demands of patients and customers now and in the future, he will build on the company’s solid basis as a leader in purpose-driven health technology with deep innovation and clinical knowledge.

Aceng comes to the helm of the institution following her endorsement during the 72nd session of the WHO Regional Committee for Africa in Lomé, Togo. Besides her current role as the Uganda Minister of Health, Dr. Jane Ruth Aceng is a Senior Consultant Pediatrics as well as a Public Health expert. She has worked for the Ministry of Health in Uganda as a Medical Officer, Senior Medical Officer, Medical Officer Special Grade, Medical Superintendent, Consultant Pediatrician, Senior Consultant Pediatrician, Hospital Director and Director General of Health Services.

SEP/OCT 2022 | HEALTHCARE AFRICA

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EVENT REVIEW

East Africa Health Expo 2022

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K

enya Healthcare Federation (KHF), Strathmore University Business School, UN SDG Partnership Platform, and Open Phences, in collaboration with the Ministry of Health, hosted the East Africa Health Expo 2022. The event themed “East Africa as a hub for specialized Medical Care, Investments in Health and Innovative Healthcare Solutions” took place between 25th - 27th May 2022 at Strathmore University Auditorium. The 3-day event brought together various East African delegates and speakers to network and share best practices and opportunities for doing business. The delegates included government officials, private sector players from all the healthcare subsectors, academia, healthcare practitioners, NGOs and FBOs, Various East African Healthcare Federations, and Health Research and Policymakers. Exhibitors drawn from the vast East African market showcased healthcare products, services, mobile technologies, and innovative health solutions. The opening ceremony was graced by remarks from various dignitaries from across the region including, Strathmore University, the Kenya Healthcare Federation, East Africa Business Council, East Africa Chamber of Commerce, East Africa Healthcare Federation, World Health Organization, and Ministry of Industrialization,

SEP/OCT 2022 | HEALTHCARE AFRICA

HEALTHCAREAFRICA.INFO


25 - 27 May 2022 – Nairobi, Kenya

THEME EAST AFRICA AS A HUB FOR SPECIALIZED MEDICAL CARE, INVESTMENTS IN HEALTH AND INNOVATIVE HEALTHCARE SOLUTIONS Trade and Enterprise Development, Kenya. Day 2 was graced by a keynote speech from Dr. Rashid Abdi Aman, B Pharm., PhD. - Chief Administrative Secretary, Ministry of Health Kenya on Public-Private Collaborations in Health. Day 3 was heavy on Research and Education in Health led by UNICAF and Strathmore Business School. The panel conversations orbited around the concept of turning research into commercialization and were directed by Smart Vaccines Production, Konza City, Kenyatta University, Ethiopia Healthcare Federation, Private Health Sector Association, South Sudan, DEI Biopharma Tanzania, and PATH International.

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EVENT REVIEW

International Health Insurance Forum 2022 Southern Africa edition

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he IHIF series of events began in 2018 and after a pandemic-induced break in 2020 resumed in-person events in late 2021. The 2022 Southern Africa was the first in the region and the fifth event on the African continent after previous events in Ghana, Nairobi, and Rwanda. The event was graced with 14 high-profile speakers from different participants in the health financing ecosystem. The event theme was "Partnerships, products, and technology - three essentials for sustainable healthcare financing systems". Support was robust and included players like the Board of Health Funders of South Africa, Financial Intermediaries Association of South Africa, African Healthcare Federation, American Chamber of South

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Africa, and this magazine. The event organizers were particularly pleased to have on one panel Vishal Brijlal and Christopher Raath alongside Prof Van den Heever, all of whom have in one capacity or another been involved in the development of the NHI Bill or its critique. The audience received superb presentations from Dr. Ron Whelan and Emma Knox, CEO of Vitality Africa. Other speakers included Waqas Ahmad, Executive Director, Strategy & Planning, Salaam Takaful Limited from Pakistan who spoke about how that country rapidly rolled out Universal Health Coverage (UHC) to its population, and from Dr. Egbe Osifo-Dawodu, Founding Partner, Anadach Group LLC with operations in United States of America and Nigeria who spoke about telemedicine across the continent. HEALTHCAREAFRICA.INFO


20-22 July 2022 - Johannesburg, SA

THEME PARTNERSHIPS, PRODUCTS, AND TECHNOLOGY THREE ESSENTIALS FOR SUSTAINABLE HEALTHCARE FINANCING SYSTEMS In addition to the technical sessions, there were opening keynote addresses from Dr. Ron Whelan, CCO, Discovery Health, and Professor Alex van den Heever, Adjunct Professor at the University of Witwatersrand. There were three powerful panel sessions discussing topics such as how Private Health Insurance (PHI) can live alongside and indeed support National Health Insurance (NHI) schemes, a topic of particular relevance in view of the currently tabled NHI Bill in South Africa. The organizers look forward to producing the second edition in June 2023. Meanwhile, readers may like to consider the forthcoming West Africa event in Lagos in November. www.ihif.global for details.

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HealthX Leveraging the power of digital technologies to enhance access to quality healthcare 32

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COMPANY FEATURE: HealthX

By Benjamin Opuko

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igital technologies are now ubiquitous, and the world's population has never been more connected. Innovation is occurring at an unprecedented scale, particularly in the digital sphere. The application of digital technologies to improving population health has, however, remained untapped despite their enormous potential to revolutionize healthcare delivery, especially in emerging markets, Africa included. HealthX Africa, a healthcare provider expanding health services through virtual and digital means in Kenya, is one of the private sector companies in the country that has set out to address the disparity in access in low-income and underserved communities by leveraging the power of digital technologies and health. LIKE UBER (BUT NOT QUITE!), FOR HEALTHCARE DELIVERY Manji describes some similarities between HealthX Africa services to cab-hailing services such as Uber, offering clients-on-demand services at the click of a button. Instead of a cab

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pulling up at your doorstep, you get linked to healthcare professionals via video, voice, or live chat based on your preference, from wherever you are, and whenever you need. With HealthX, Manji reveals that patients could be located in regions as far-flung as Turkana, some 530 kilometers away, and still get to talk to doctors in Nairobi, as if they were in the same examination room. How effective is this mode of healthcare delivery? Manji cites a report by McKinsey that suggests two thirds of primary health care visits could be virtualized, freeing up human resources, expertise, time, and finances for those who really need it. He further points out that a large part of doctors' diagnoses are based on taking a thorough and detailed medical history, which can be done through telemedicine – supplemented by tools to gather vital signs or do virtual examinations of a patient. At HealthX Africa, medical consultations are guided by detailed medical algorithms and guidelines, developed specifically for telemedicine and in accordance with national and internal guidelines, with clear thresholds for what cases can and

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cannot receive care. According to him, it is thus safe to say that virtual health delivery is just as effective as physical consultations for most basic health needs. In some ways, it is a notch better as the distance between the doctor and the patient becomes inconsequential, important factors as distance, travel and cost are well known barriers to patients engaging with the health system in a timely manner. To ensure high standards of care, HealthX deviates from the driver-partner model synonymous with Uber and instead employed its own, full time, licensed medical doctors. "We have our doctors who are trained by us to operate based on our guidelines, so we can control the service delivery quality and safety,” Manji explains. Each of their patients has a medical record, so, if a patient calls today and they are connected to any of HealthX’s doctors on duty, the doctor will be able to make his/her recommendations, accordingly, depending on the details already in the patient’s medical history. This ensures continuity of care for the patient even if they do not speak with the same HealthX doctor every time. VIRTUAL CLINICS BOOST ACCESS TO CARE HealthX’s phone conversations and live chats are supported by a virtual clinic model that is equipped with Bluetooth-enabled medical devices such as a blood pressure machine, stethoscope,

weighing scale, glucometer, pulse oximeter, and thermometer, all fully integrated with the HealthX electronic medical records system. The virtual clinic is particularly well suited for corporate buildings, factories, academic institutions, residential compounds, pharmacies, commercial locations, construction sites, and underserved communities, says Manji. Nearly a year after launch, it is already generated interest from many users. "We've seen a lot of demand from corporates, schools as well as those who want this at their premises," Manji reveals. According to him, the facility is particularly handy if a corporate entity has a clinic and a nurse onsite. “This is a great thing to supplement because the nurse can only handle up to a certain level.” HealthX's virtual clinic not only supplements the nurses' effort when the number of patients is overwhelming or for more complicated cases, but it also significantly reduces time wastage, he adds. This kind of clinic would save people from traveling to hospitals and taking many hours back. After triaging, if there is a need to consult a doctor, "that employee or student doesn't have to take time off and spend money to travel five kilometers to see a doctor. They just go into the next room. They hit a button and they connect straight to the doctor." To align with Kenya regulations and standards, HealthX is a licensed level II medical clinic in Kenya and maintains an active Virtual Medical

HealthX's virtual clinic not only supplements the nurses' effort when the number of patients is overwhelming or for more complicated cases, but it also significantly reduces time wastage.

RADHA KARNAD, THE CHIEF MEDICAL OFFICER OF HEALTHX AFRICA, MR. ONESIMUS KAMAU, THE HEAD OF HEALTH INFORMATICS DIVISION IN THE MINISTRY OF HEALTH AND MS. CAROLINE MUTOKO DURING HEALTHX LAUNCH IN KENYA

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COMPANY FEATURE: HealthX

With its vision of "A Doctor for Every Kenyan," it also reaches out to individual members who wish to cut the long waiting lines typical of many public hospital consultation rooms and have a doctor available to them whenever they want

Services Provider license from the Kenya Medical Practitioners and Dentists Council. Patients can therefore be assured of high-quality primary care from a licensed and registered practice. Should there be need, they can visit HealthX’s physical clinic in Gigiri on an appointment basis if “deemed necessary by the doctors.” PARTNERSHIPS ENHANCE MARKET PENETRATION Just like in any sector, partnerships are key to market success. “We work with a lot of corporates, schools, and universities that come to us,” Manji says. “These entities can get subscriptions for their members on retail subscriptions as low as KSh. 495 a month." An annual subscription for less than KSh. 290 a month also exists, guaranteeing unlimited access to the full team of Medical Doctors, Clinical Psychologists, and Clinical Nutritionists that work at HealthX Africa. For this fee, patients may consult with the HealthX Africa clinical teams as many times as they want during the subscription period, and receive prescriptions, laboratory requests, and referrals (where needed), at no additional charge.

HEALTHX'S STAFF DEMONSTRATING HOW THE HEALTHX EQUIPMENT WORKS

For a small, fixed additional fee, corporates can also implement the virtual clinic on their premises. HealthX is, however, not a corporate leaning startup. With its vision of "A Doctor for Every Kenyan," it also reaches out to individual members who wish to cut the long waiting lines typical of many public hospital consultation rooms and have a doctor available to them whenever they want, wherever they are. Where laboratory tests are required, HealthX Africa has partnered with diagnostic companies like PathCare and Ilara Health to conduct at-home/ at-office lab testing in line with its core pillar of maintaining quality service provision. The digital health service provider has also joined forces with pharmaceutical retailers like GoodLife, MyDawa and Livia to enable delivery of high-quality medicine to its clients at a time and place that is convenient to them. CEO Manji says his company sought these partners out of the conviction that its partner organizations are "delivering highquality medication and the patient is still receiving the best of the best,” addressing a key patient concern about the high number of pharmacies offering counterfeit drugs in Kenya. WARM MARKET RECEPTION VALIDATES BUSINESS MODEL

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to the immense capabilities of telemedicine in bringing care to people in far-flung areas. Success in Nairobi may be good, but Manji reveals that the startup's focus is on the remote villages in counties like Turkana, where their services are urgently needed.

HEALTHX'S MEDICAL STAFF AT THEIR HEALTH CONTROL CENTRE

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Five months after its launch, HealthX celebrated its first milestone of attracting over 3000 active subscribers – a combination of individual subscribers, corporates, and insurance. This was proof that there was indeed a gap in the market that they were addressing, and a willingness to pay for and engage in a new way of health services. Emboldened by the warm market reception, the startup has since grown and today boasts a growing team that currently numbers 23. The company's employment profile is diverse, comprising doctors (including a family medicine specialist), clinical and community nutritionists as wellness advisors, and a clinical psychologist to help with stress and mental health, as well as HealthX care coordinators who support the care process. The expanded staff fully caters to the needs of patients, which are growing by the day. Manji projects that the company is well on its way to exceeding 30,000 subscribers by the end of 2022. In terms of subscribers' distribution, he reveals that a majority of the subscribers on the HealthX digital platform are based in Nairobi, with about 10% of the subscribers based in Mombasa. Others are spread as far as Lamu and Baringo. The spread across the country is a testament

COVID-19 PANDEMIC - A BLESSING IN DISGUISE The Covid-19 pandemic stretched hospitals all over the world to the limits. Most resources were shifted to battling the pandemic, leaving little capacity for routine hospital walk-ins and checkups. Many people resorted to the internet for advice on various medical conditions, a reality that inspired HealthX to successfully launch to market. "COVID helped, because before COVID, there was nothing like a virtual medical service,” Manji reflects. Covid-19 also helped HealthX score some quick wins with authorities. To best protect the safety of patients, health is a highly regulated industry; and the Kenya Medical Practitioner and Dentist’s Council moved swiftly to respond to the restrictions imposed by the COVID-19 pandemic and ensure that patients still got quality healthcare from their healthcare providers despite the prevailing circumstances by commencing the

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COMPANY FEATURE: HealthX

In the long term, Manji believes that widespread adoption will contribute to a healthier population, as patients will be more willing to engage with affordable (and particularly subscription-based) healthcare services for preventive and promotive care. Preventive and promotive care naturally get very little uptake when patients have to travel to facilities and pay a fee for service.

HEALTHX MOBILE USER INTERFACE

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issuance of approvals for various registered and licensed health institutions to offer virtual medical services. Hence HealthX Africa was registered with a virtual medical service provider license, which then set the company in motion to deliver on its primary mandate. SMARTPHONE PENETRATION DRIVES ADOPTION Kenya's smartphone penetration is among the highest in the continent, and this played well to the HealthX business model. With smartphones at the hands of most Kenyans, the virtual health network could be easily deployed, allowing many to meet their doctor or other medical professionals without having to physically visit health facilities. Manji is cognizant of the fact that the idea of telemedicine is yet to be fully embraced by all Kenyans. He is, however, confident that this form of hesitation will gradually erode over time as telemedicine becomes an accepted – indeed, expected – component of a normal healthcare journey for patients in developing nations. He reckons that faster adoption will help to reduce congestion in healthcare facilities, lower costs for patients, and give users access to useful healthcare content that will help prevent diseases.

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A DOCTOR FOR EVERY KENYAN Having been warmly accepted into the Kenyan market, Manji and his team now has their eyes set on ensuring every Kenyan has access to a doctor. He is already spearheading plans to expand HealthX Africa services in Kenya and the East African region. The need is clear: despite considerable investment and planning at both national and county level across the country, health infrastructure and resources lag the health needs of the population. The Kenya Master Health Facility List identifies 13,517 public and private health facilities in Kenya, an insufficient number to serve the population of 50 million and growing. As of 2019, Kenya had 12,090 registered medical doctors, resulting in a ratio of 25 doctors per 100,000 population, leaving the country a long way from the World Health Organization’s recommended ratio of 1 doctor to 1,000 population. And the distribution of that existing health workforce is inequitable, with 80% of clinicians serving 20% of the population . The inequity in healthcare infrastructure and access between urban and rural Kenya is striking, and the cost of accessing healthcare is rising, with much of the burden carried by individuals and families paying out-of-pocket. In its expansion, the company is mainly targeting regions that are marginalized in terms of accessing quality and affordable healthcare services. He is hopeful that in the next five years, the company will be “at least 75% of the way there.” 75% from Manji’s perspective includes “having at least a thousand virtual clinics across Kenya.” It also involves increasing the number of doctors and other healthcare workers that the company employs to meet the demand in the virtual healthcare space. The company intends to grow its financial muscle by seeking partnerships with "external strategic investors to help us achieve our vision and our mission." Ultimately, Manji believes that hospitals should be decongested and exist to serve those who need in-person care the most, for examinations, emergencies and operations, and for him, telemedicine is the only way to make this a realityHCA HEALTHCAREAFRICA.INFO


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DISCOVER THE A-Z OF MEDICAL LAB & DIAGNOSTICS SOLUTIONS & SERVICES

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www.expo.healthcareafrica.info


PROF. MIRIAM

KHAMADI WERE Public and Community Health Champion and the 2022 Nobel Peace Prize Nominee By Achieng' Odundo

NAME: Prof. Miriam Were COUNTRY: Kenya

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he 2022 Nobel Peace Prize Nominee Prof. Miriam Khamadi is a kindhearted and vastly intelligent woman who has dedicated her entire life to advocating for Public and Community Health in Africa. At 80, Prof. Khamadi has won numerous awards, the latest one being the Lifetime Achievement Award at the recently held Quality Healthcare Kenyan Awards 2022. Her achievements notwithstanding, she still feels she has a lot to do to impact the health sector before she retires. The first thing you notice when you engage her is her promptness and efficiency in communication and decision-making. She categorically picked the midmorning for this interview, quoting that this is the time she is most spirited, prolific, and has her memory in check. As we sat under the mid-morning East African sun, we listened raptly as she took us through the journey to becoming one of the most respected medical doctors in Africa and beyond. MEDICINE; A DELAYED DREAM Prof. Were is among the few girls who had the privilege of attending school during colonial times. Inspiration from her elder siblings who were progressing well in school and sound advice from her mum to avoid boys, however, saw her complete her high school education at Butere Girls and later pursue A-Levels at the Royal Technical College, the current University of Nairobi. Prof. Were had always harbored a dream of becoming a doctor one day. Her high school struck a heavy blow to this dream, as it was not offering

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Chemistry and Physics at the time. Without these necessary prerequisites, she resigned herself to studying literature, history, and scripture on her A-levels. An opportunity to study Bachelor's Degree in Sciences at the Liberal Arts College in the United States in 1961 revived her long-held dream. Upon graduation in 1964, she got admission to a medical school in the US to start immediately. A homesick Khamadi, however, opted to come back home. She tried registering for the Medicine school at the Makerere University in Uganda but was not successful. With her dream paused for the second time, she took up an offer from Kenya’s Ministry of Education to teach Chemistry and Biology. She took another Diploma in Teaching High School Sciences and later on enjoyed teaching Chemistry and Physics for another 2 years (1966–1968), teaching at Lugulu Girls, Kaimosi Girls, and Eastleigh Secondary School. Her stint at Eastleigh Secondary School brought to the fore the enormous gap in the health of the African child, stirring up once again the desire for medicine. “I could take some to the hospital in my car in the afternoons but even the care they were given was not enough,” she recalls. Jolted with a burning desire to help, she left the teaching profession in 1968 and enrolled at the Medical School of the University of Nairobi (UON), choosing to specialize in Community Health rather than surgery. For 5 years, she juggled between raising a family and school. In 1973, she graduated, finally realizing a long-held dream.

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EXECUTIVE INTERVIEW: Prof. Miriam Were

When you focus on curative services, it's like wiping the floor where the taps are leaking, instead of turning off.

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17,000 START-UP CAPITAL FOR UZIMA FOUNDATION

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STEERING KENYA’S COMMUNITY HEALTH PROGRAM After graduating as a Medical Doctor from the UON, Prof. Were was posted to the Division of Communicable Disease Control at the Ministry of Health, Kenya, where she developed the framework for the Integrated TB-Leprosy Control Program in Kenya. The only way to practice Community Health was through Public Health, so after her internship as the Medical Officer, Ministry of Health in 19731974, Prof. Were grabbed yet another chance to study Public Health at the Johns Hopkins University, Department of International Health where she graduated with a Master of Public Health in 1976. A master of public health, Prof. Were pursued a research project in community health at the Ministry of Health Kenya (MOH). Her research was adopted by MOH as the National Health Pilot Programme on Community Health. Evidence from this project premiered at the 1978 International Conference on Primary Health Care (PHC). It was also honored with the 1978 Global UNICEF MAURICE PATE AWARD, the first time the award came to Africa. During this time, she was also doubling as a Senior lecturer at the Department of Community Health, Faculty of Medicine, University of Nairobi. Her project inspired the training of community health workers (CHWs) in the country for the first time with the sole agenda of introducing modern healthcare to communities still stuck in traditional healthcare. CHWs became critical drivers of health in Kenya, promoting community cohesion, preventing diseases at the community level, and eventually reducing the mortality rates. This model will, later on, be introduced in Ethiopia in 1985 while she was working with the United

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Nations. She continued working at the UON, where she went on to become the Chair of the Department of Community Health, Faculty of Medicine. During her tenure, she developed the Curriculum for classroom and fieldwork on the Basic principles of Public Health. BUILDING ETHIOPIA’S HEALTH SYSTEMS Prof. Were moved to Ethiopia in September 1985 and stayed for 15 years working with UNICEF as the Chief Health and Nutrition/Senior PHC Adviser. While in Ethiopia, she made various impactful changes to the health systems, most notably the Accelerated Child Health Development (ACHD) Programme that raised

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child immunization from 3% in 1985 to over 60% by the end of 1990. She later took up a role as the Representative and Chief of Mission for the World Health Organization to Ethiopia in 1990. In this capacity, she provided support to government planning and management of national health programs for improved delivery of medical/health services. While serving as Director, United Nations Population Fund Country Support Team Addis Ababa (UNFPA/CSTAA) between 1993 and 2000, she steered a multidisciplinary team of over 20 international and regional advisors, to provide a timely, appropriate and effective response to country requests for technical support in population and development programs. In her work both in Kenya and Ethiopia, Prof. Were came to one conclusion: community health care is much better in improving public health outcomes as it focuses on preventing disease and promoting health. Hospitals to her are an expression of failure, not an expression of success. "When you focus on curative services, it's like wiping the floor where the taps are leaking, instead of turning off," She says. EMPOWERING THE YOUTH THROUGH UZIMA FOUNDATION Apart from being an ardent champion of public health, Prof. Were also happens to be an ardent supporter of the youth. "I like seeing young

people like you do great things," she says. Her love for youth mentorship saw Prof. Were and her husband start the Uzima Foundation in 1995 to catalyze youth empowerment. According to Prof. Were, the foundation aims to stimulate young men and women to define, plan for, and act to experience improved quality of life. About KES 2 million (about US$17,000) was spent to get the foundation up and running. The initial focus was on Nairobi, Nyanza, and the Western regions, but soon afterward, activities spread to other regions where interest had picked up. With the support of donors and other NGOs, the Uzima Foundation has been able to spread its tentacles across the country. 27 years after its establishment, the foundation has grown its membership to over 20,000 across 100 Uzima youth groups. Prof. Were has also employed her prolific literature talents to help nurture the youth. Her books The Boy in Between (1969), The High School Gent (1972), The Eighth Wife (1972), and Your Heart is My Alter (1980) not only epitomize literary prowess but also highlight other issues that affect the community other than health. STEERING KENYA’S HIV/ AIDS RESPONSE In 2003, Prof. Were again found herself in public service, this time as the Chair of the National AIDS Control Council (NACC). With her leadership, NACC coordinated the work and inputs of National and International Stakeholders in Kenya’s National Response to HIV/AIDS. Under her watch, the HIV prevalence rate reduced from 14% in 2000 to 6.8% in 2003 and 5.1% in 2006. New infections also dropped from 120,000 to

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PROF. MIRIAM WERE DURING ONE OF THE YOUTH EMPOWERMENT SESSIONS

In her work both in Kenya and Ethiopia, Prof. Were came to one conclusion: community health care is much better in improving public health outcomes as it focuses on preventing disease and promoting health.

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EXECUTIVE INTERVIEW: Prof. Miriam Were

As the Chair of the International Board of Directors of the African Medical and Research Foundation (AMREF), Prof. Were championed the foundation's mission to improve the health of disadvantaged people in Africa.

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55,000 by 2006. As the Chair of the International Board of Directors of the African Medical and Research Foundation (AMREF) from February 2003, Prof. Were also championed the foundation's mission to improve the health of disadvantaged people in Africa. During her tenure, AMREF expanded its medical services. As a result, the foundation’s annual budget increased from US$19 million in 2003 to US$60 million in 2007. An astute health administrator, Prof. Were had also sat on several medical organization boards. From September 2002, she sat on the Board of Directors of MAP International, a Christian NGO with the theme of health and hope for a hurting world for over 50 years. She also sat on the Action Africa Help–International (AAH-I) Board, an international NGO focused on improving the quality of life of people through their community involvement in healthcare, food production, and good governance. To crown her boardroom prowess, Prof. Were currently sits on the COVID-19 Commission Board, an international board that has people from all over the world monitoring the development and the approaches to be used by nations on how to tame the pandemic. AN AWARD-WINNING HEALTH PROFESSIONAL Prof. Were has won outstanding International Awards for her role in health and other sectors. In 1978, she received the UNICEF Maurice Pate Award. This was followed by the George P. Tolbert Health Award of the National Council of International Health of the USA in 1980, the International Order of Merit (IOM) in 2000, and Elder of the Order of the Burning Spear (EBS)

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of the Republic of Kenya in 2005. In 2006, she received the Medal of the Italian Cabinet and The Eve Woman of Year Award in the Academia Category. Her work spanning decades also saw her receive the Queen Elizabeth II Gold Medal for Public Health in the Commonwealth in 2007, and the HIDEYO Noguchi Africa Prize in 2008 in Japan, where she was honored in the Medical Services category. In her tray of awards also sits the Order of the Rising Sun with Gold Rays and Neck Ribbon by the Emperor of Japan, which she received in 2020. Adding to the impressive list is the 2022 Lifetime Achievement Award presented to her in April 2022 during the Quality Healthcare Kenyan Awards (QHKA). To crown it all, Prof. Were was recently nominated for the 2022 Nobel Peace Prize. The professor has the opportunity to become the second woman to be the laureate after the late Prof. Wangari Maathai. She talks about it with a smile and wonders how she made it to the PROF. MIRIAM WERE DISPLAYING HIDEYO NOGUCHI AFRICA PRIZE

nomination list. The nomination is in recognition of her tireless work over the years in promoting trust between governments, health authorities, and the citizens through culturally sensitive programs. As she retires, she is still a firm believer in the community approach to healthcare. She reckons that embracing community health care is good not only for health but also for economic growth and business management. Her one wish is that the leaders of today embraced this approach and implemented programs aimed at involving the people in health management through the community approachHCA HEALTHCAREAFRICA.INFO


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THE BIGGEST PHARMA SUPPLIES & NEW TECHNOLOGIES EXPO IN EASTERN AFRICA

WHAT’S ON SHOW? • • • • • • • • •

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THE KENYA DENTAL ASSOCIATION Dr. Tim Theuri: Passionate dentist and KDA President shares his views on shaping the dentistry landscape in Kenya

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im Theuri opted for dentistry after finishing his O-levels because he believed that was where he would be able to create his own niche. Almost a decade later, the Moi University graduate, is still passionate about oral care and works with the County Government of Muranga as a Dentist. Dr. Theuri also doubles up as the 21st President of the Kenya Dental Association (KDA), after previously serving the organization as assistant secretary, assistant national secretary, and the national secretary. He no longer focuses only on restoring smiles and peace to patients with dental problems. His assignment also includes shaping the dentistry landscape in Kenya through policy, advocacy, and lobbying. As Chairman of KDA, Dr. Methu is the person mandated to enter into agreements on behalf of the association, look for partners and funding, as well as responding to member issues. HCA: Kindly introduce KDA to us in terms of membership, structure, and the association's mandates. DR. THEURI: KDA was founded just before independence on the 27th of May 1960. We've enjoyed diverse leadership in terms of our chairpersons. We have also enjoyed largely good corporate governance over the years and that has HEALTHCAREAFRICA.INFO

worked for us in terms of continuity. In terms of numbers, we don't take joy in many dentists as a country, given the nature of our training, which is about 5 to 6 years, including the internship. Currently, we have about 726 general dentists and about 172 specialists. Out of that, the KDA boasts of a membership of about 300 to 400 in any given year. On the structure front, we are organized into branches. We have a Coast branch, a South Rift branch, a North Rift branch, a Western branch, a Central branch, and on the national level, we have the National Governing council. Within the national governing council of 16 members, we have a national executive committee that comprises the president, the vice president, the national treasurer, and the secretary to the association. Any profession has a welfare bit, and that is what KDA does largely. We take care of the welfare of our members; from their professional well-being to their social well-being and once in a while we get involved in personal matters like when death or sickness is involved. When it comes to professional issues, will go all the way in terms of how you are bettering yourself as a dentist. In terms of continuous professional development, we bring key industry players to our members so that they can get the best rates in the market. For those who are

By Lorraine Wangui

COMPANY: Kenya Dental Association COUNTRY: Kenya WEBSITE: www.kda.or.ke

EMAIL: secretariat@kda. or.ke TELEPHONE: +254 710 856 304

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EXECUTIVE INTERVIEW: Dr. Tim Theuri

support from partners. We have donations and grants that flow into the association, and we also do endorsements. If you have a product that you’d wish for us to endorse, you will present the same to us. The product has to be duly registered and be in conformance with local standards and with what is internationally accepted as well. We also do tests to ascertain quality before endorsing the product.

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interested in purchasing a dental product, we pull together our numbers so that we give them more purchasing power where certain things are involved. The mandate of the association is widening now as the years move from what it was in 1960 to what it currently is. It takes my mind back to when the COVID-19 pandemic struck, and the association was involved in helping members evolve into that new space. We didn't practice for a few months back and had to figure out how doctors will take care of themselves. We were able to hold their hands and now we've been able to walk with our dentists out of that and into the space where we are now. HCA: How is the Association funded? DR. THEURI: How we sustain the association is basically through a membership subscription, that’s our biggest source of funding. Other sources include the events that we hold and

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HCA: How many dentists are trained every year? Is there a structured curriculum by the government and are there any private universities that train dentists? DR. THEURI: Currently, only 2 universities offer the bachelor of dental sciences or dental surgery, in Kenya, namely The University of Nairobi (UON) and The Moi University. They each train about 20 students annually, thus the country annually releases about 40 graduates into the market and another 20 - 30 graduates coming from overseas. We don't have any private universities training dentists. However, we hope that in the next one or two years we should be able to see an institution that can be able to take up a role. In terms of the curriculum, the cocurriculum is domiciled within the Kenya medical practitioners and dentist council, that's our regulator. The universities pick the cocurriculum and add units that are perhaps peculiar to each of the universities, such as behavioral science courses and communication skills courses, among other relevant courses. HCA: Does the KDA lobby for the dentists to the government and is there any significant one that has happened that you can share? DR. THEURI: We’ve been involved in various legislative efforts, the latest being the national hospital insurance fund (NHIF bill) that was trying to reconstitute the fund so that it's able to deliver UHC. In 2021, the health committee in the national assembly sought to find out why we have a rising cost of health care. We submitted to them our findings that doctor charges were incredibly high and recommended that doctors’ fees should be less than 12% of the total bill. Another key recommendation we gave was for the government to reduce taxation on medical equipment, instruments, and drugs to ease the cost of care. We noted that our medical products HEALTHCAREAFRICA.INFO


are attracting 16 percent VAT and some levies such as the railway development levy which, if removed, would result in an instant 16 percent reduction in health at the point of care. We have also done various projects with various partners in terms of taking dental care of the general mass and the largely unreached people. In 2012, we partnered with the American Dental Association to deliver dental services in Kayole, Nairobi. For the 2017-2019 period, we did a project with the Mass Rebuild Foundation where we reached 20,000 children in 6 Kenyan counties namely Nairobi, Murang'a, Nakuru, Meru, Machakos, and Kajiado. To the public, we also conduct various dental camps in unreached areas. We have already done two dental medical camps in Lamu County involving different parts of the archipelago of Lamu islands. HCA: What is the dentist-to-patient ratio in Kenya? DR. THEURI: The last population census that was conducted put the national population at about 50-52 million people. You're easily looking at a ratio of about 1 dentist to about 50000 people. On average, out of those who are retained to practice, about 800, half of the dentists are in public service. Overall, we can easily say that we have less than 10 dentists on average per county. In employability, there is a huge need for

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dentists, and we are not training enough despite the disease burden rising. We are having cancers of the head and neck coming up. The mouth is affected by cancer because of lifestyle choices like smoking and drinking and habits like the use of 'betel' and ‘kuber’, especially among the Asian population. The most prevalent form of oral cancer is oral carcinoma affecting the tongue, the flow of the mouth, the lips, and the cheek area. The thing is that cancer spreads quickly and before you know you can't eat and need to have surgery. Sadly, we lose 50% of the people who come and get treated after five years. HCA: Do dentists have any policy that's coming up? DR. THEURI: We've been able to release the national oral health strategic plan (2022-2026) which is the second of its kind. The association was heavily involved in its development, and we are urging the Ministry of Health to look into operationalizing this policy. It requires about KES 1.5 billion to operationalize. Our current Health Permanent Secretary Madam Susan Mochache was gracious enough to say that she will look for those funds. The other thing that we've been able to do is lobby for the adoption of the AMINAMATA Convention. Kenya is now a signatory to the

The most prevalent form of oral cancer is oral carcinoma affecting the tongue, the flow of the mouth, the lips, and the cheek area. The thing is that cancer spreads quickly and before you know you can't eat and need to have surgery.

DELEGATES DURING 37TH KENYA DENTAL ASSOCIATION'S SCIENTIFIC CONFERENCE

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EXECUTIVE INTERVIEW: Dr. Tim Theuri

We believe that dentistry is that field of medicine that sits in the middle of preventive and curative care as the procedures that we do are both preventive and curative. convention, which is about the safe disposal of material used at the point of care by dentists.

DELEGATES DURING 38TH KENYA DENTAL ASSOCIATION'S CONFERENCE

HCA: What's the health care financing framework in dental care to UHC? DR. THEURI: We believe that dentistry is that field of medicine that sits in the middle of preventive and curative care as the procedures that we do are both preventive and curative. If I'm giving you a filling, I'm not only curing a dental cavity, but I'm also preventing others from forming. Providers of healthcare financing,

however, don't look at dentistry this way and this explains why oral health care has not enjoyed good financing. If you even look at third-party players, mainly insurance firms, dental care and optical will be an add-on as opposed to being the main feature in it. The National Hospital Insurance Fund (NHIF) has two types of schemes: we have the national scheme, and we have the managed scheme. Under the managed schemes, we have the civil servant schemes as well as the discipline forces, i.e. the police and the military who enjoy a good dental cover of about 50,000. In the national scheme, however, dental services are not strictly included, as we just have basic things like extractions and surgical services. Also, what worries them is that if we say we are giving fillings to anyone, everyone will walk in and say they want a filling. We need to ask ourselves, what is the health-seeking behavior of Kenyans? Do we have data on that? Because if you have the data on the health-seeking behavior of Kenyans, then it will be possible to guide the providers. HCA: What would you tell young people aspiring to take up a career in dentistry? DR. THEURI: To anyone who would like to do dentistry, it's an excellent profession. It has provided me with experiences that I don't think I’d have ever got elsewhere. I've been able to interact with people from all walks of life. I’ve been able to understand privilege and lack. I've been able to see people who are content with the little they have because they just enjoy good health, and that's an experience that you can't pick from anywhere else. For me, it has inspired and motivated me to be a good citizen because we don't enjoy many of those in our countryHCA

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COUNTRY

FOCUS:

Rwanda From ashes to setting the trends In Africa’s healthcare system By HealthCare Africa Team

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t is otherwise known as the land of a thousand hills. Stretching over an area covering 26,333 square kilometers, Rwanda is one of the smallest nations in Africa. With an economy estimated to grow at 10.9% in 2021, the East African nation punches above its weight on many fronts. One of the areas that has recorded tremendous growth is the Healthcare sector. Dusting itself from the 1994 internal conflict, Rwanda, with a population of 12.9 million people, is a shining example of the potential that the continent’s healthcare system holds. Today, the country enjoys improved healthcare services under the Universal Health Coverage (UHC) program and boasts of strengthened and wellstructured Primary Health Care (PHC) systems funded by the Government in collaboration with development partners. USAID, a key partner, has been particularly resourceful in the country's

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fight against malaria and HIV/AIDS. The role of the private players in the country’s health sector can also not be understated. Its network of hospitals and clinics helps release pressure from publicly funded institutions, further driving universal access to healthcare in the country. What does the health landscape in Rwanda look like in 2022? What prospects, if any, does the country’s health sector hold in the near future? This article seeks answers to these and many more questions about Rwanda’s budding health sector. A ROBUST NETWORK OF HEALTHCARE FACILITIES The Rwandan system is a referral system. The burden of the disease is treated at the bottom of the pyramid by the Community Health Worker (CHW). From the CHWs, the case can be scaled up to a Health Post. Over 850 Health Posts exist SEP/OCT 2022 | HEALTHCARE AFRICA

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COUNTRY FOCUS: Rwanda

FRONT VIEW OF NYARUGENGE DISTRICT HOSPITAL IN RWANDA

In a move to enhance the capacity to train new healthcare workers, the Ministry of Health has upgraded nine hospitals to the level of university teaching hospitals to increase the workforce in the health sector.

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in the country. Then, the beneficiary will be sent to a Health Center (600), from Health Centers the patient can be referred to a District Hospital (37 in the country). At the top of the pyramid are four Provincial Hospitals and seven Referral Hospitals. This is how Rwanda implemented its vision of geographical accessibility. Private Health care facilities such as the Baho International Hospital, Kigali are also scattered across the country to support the public-run hospitals in offering care. Manning these network hospitals is a contingent of healthcare workers who are estimated to number about 60,000 in 2022. Nurses and Midwives account for the second highest number of HCWs at 10,758. General physicians (786), specialist physicians (567), dentists (228), pharmacists and technicians (167), laboratory personnel (1,990), community health workers: 45,000, and other health workers (506) complete the list of the country’s healthcare team. Although impressive, the country’s workforce of 11 health workers per 10,000 population density in 2018 is still far below the World Health Organization (WHO) recommended critical minimum of 44.5 per 10,000 people. Several initiatives by President Paul Kagame-led government have however tried to boost these numbers up to enhance access to healthcare for Rwandans. In 2011, the country introduced the Rwanda Human Resources for Health (HRH) to increase the quantity and quality of health care workers needed to ensure the sustainability of

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the health system. The initiative has greatly raised the number of qualified HCWs in the country. Data from the Ministry of Health (MOH) indicates specialist physicians in Rwanda increased from 197 in 2015 to 567 in 2018. Between 2011 and 2017, the country was also able to add about 111 specialist nurses to its workforce thanks to the HRH program. The government also shifted many clinical decisions and activities to nurses and community health workers (CHWs) in 2009, including in the delivery of HIV care, under a strategy called Task Shifting. With a deficit of physicians, task shifting leveraged the relatively large pool of Nurses and CHWs to increase the ability to care for patients. Through further task shifting and a reformation of the national community health system, care for 80 percent of the disease burden was offloaded to CHWs at the village level through health promotion activities as well as preventive, diagnostic, and curative care. A 2015 study revealed that the program coupled with upskilling of nurses has achieved high levels of retention and improved patient health outcomes. In a move to enhance the capacity to train new healthcare workers, the Ministry of Health has upgraded nine hospitals to the level of university teaching hospitals to increase the workforce in the health sector. The hospitals include Ruhengeri, Kibungo, Rwamagana, Kabgayi, Butaro, Kibogora, Kibagabaga, Nyamata, and HEALTHCAREAFRICA.INFO


Byumba. The new university teaching hospitals will support five existing ones including the University Teaching Hospital of Kigali (CHUK), Rwanda Military Hospital, University Teaching Hospital of Butare (CHUB), King Faisal Hospital, and Neuro-Psychiatric Hospital Caraes Ndera. To ensure a smooth running of the Healthcare sector, the Rwanda Government has established several agencies to oversee the sector. The Rwanda Allied Health Professionals Council was established in 2013 to promote, support, and regulate allied health professionals in the Country. Established by law in 2013, The Rwanda National Pharmacy Council serves as an interlocutor with the public and the private organs in matters relating to the pharmacy profession. The Rwanda Nursing Council of Nurses and Midwives of Rwanda protects the public from harmful or unprofessional practices. The council ensures that the public receives medical care from competent and ethically behaved nurses and midwives. DISEASE BURDEN As in many other countries in the region, malaria, tuberculosis (TB), and HIV/AIDS are endemic in Rwanda. Malaria has remained a life-threatening disease with millions of children and pregnant women falling prey to the disease, particularly during April and May. Remarkable improvements have been realized in recent times following a government contingency plan to call on all stakeholders, including external financiers, to

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join efforts in combating the killer disease. With efforts such as Indoor Residual Spraying (IRS) and encouraging the use of treated mosquito nets, the country has seen a decline in malaria cases from 4.8 million in 2017 to 1.8 million in 2020. HIV/AIDS is also a major health concern in Rwanda, with the country ranking among the top ten African nations most affected by HIV/AIDS, according to the WHO. Rwanda is however doing the most to manage the disease and limit the number of new infections. Efforts by the authorities include accelerated scaleup of HIV testing and immediate linkage to antiretroviral treatment (ART) for those testing positive. Rwanda also actively pursues evidencebased prevention interventions such as condom availability, voluntary medical male circumcision (VMMC), and mass community education. Combined, these strategies have managed to give Rwanda a stable prevalence of 3% and a relatively low incidence of between 0.08% to 0.27% among the ages of 15-64 years, translating to between 5,400 new to 14,000 new infections per year. Rwanda has also made progress toward the Joint United Nations Programme on HIV/ AIDS (UNAIDS) 90–90–90 targets. A study by the US Centers for Disease Control in Rwanda revealed that 83.8 percent of adults living with HIV were aware of their status, of adults who knew their status, 97.5 percent were on ART, and of adults who had detectable ARVs or reported current use of ARVs, 90.1 percent had Viral Load

IN NUMBERS

60,000 ESTIMATED NUMBER OF HEALTHCARE WORKERS IN RWANDA

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COUNTRY FOCUS: Rwanda

IN NUMBERS

US$

150M DOMESTIC RESOURCES ALLOCATED TO HEALTH BUDGET IN 2021

Suppression. When it comes to TB, Rwanda has made significant progress in diagnosis, treatment, and prevention. Based on WHO Global Tuberculosis reports, the incidence of tuberculosis in Rwanda has decreased from 96 patients per 100,000 population in 2000 to 57 patients per 100,000 population in 2020. This decline in TB incidence in Rwanda represents a decrease of 41% in the last 20 years. NON-COMMUNICABLE DISEASES PRESENT NEW CHALLENGES As Rwanda makes significant strides in improving the health outcomes of her people, non-communicable diseases threaten this progress. According to the Ministry of Health, 15.9 percent of adults in Rwanda are living with hypertension while 40 percent of adults present for the first time with heart failure class III to IV. The number of Cardiovascular patients treated in the country’s health facilities has more than tripled between 2018 and 2020, from 25,353 to 88,486 cases. Similarly, the number of men and women diagnosed with cancer increased from 3,000 in 2018 to 10,400 new cases, according to current WHO estimates, indicating a high prevalence of the killer disease. While addressing a virtual World Health Summit, the Rwanda Minister of Health, Dr. Daniel Ngamije, noted that NCD had become a huge burden for the country. “Almost 59 percent of cases of death we are getting in our health facilities are as a result of NCDs and injuries,” Ngamije revealed. To address this problem, the country rolled out a 5-year National Strategy and Costed Action Plan for the Prevention and Control of NCDs in 2020. Rwanda is planning to spend some US$638 million during the 5 years when the plan is active and targets to reduce

NCD-related premature mortality by 25 percent by the time the plan matures in 2025. NEW HOSPITALS CROP UP TO MEET RISING DEMAND With an annual growth of 2.5%, Rwanda's population is projected to increase by more than 50% to 17.6 million by 2035 and double to about 22.1 million people by 2050. This influx of people coupled with an increased health burden requires investment in new health infrastructure. The government, with the support of development partners, has recently been investing in new hospitals or upgrading existing ones. In 2021, the country inaugurated the US$8 million, 120-bed

Almost 59 percent of cases of death we are getting in our health facilities are as a result of NCDs and injuries Dr. Daniel Ngamije - Minister of Health, Rwanda 56

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or more, according to Ildephonse Kambogo, the Mayor of Rubavu District. With the incidence of non-communicable diseases rising by the day, Rwanda is set to take reception of a new cardiac teaching hospital that will reportedly be the first of its kind in the Sub-Saharan region. Built by the Heart Care and Research Foundation (HCRFR), the 12,000 sq teaching hospital will provide cutting-edge, freeof-charge medical care to local communities. It is also expected to spur the creation of a biomedical and innovation knowledge base, training a generation of young Rwandan doctors, nurses, scientists, and technicians to ensure sustainability in the region.

KING FAISAL HOSPITAL THE LARGEST REFERRAL HOSPITAL IN RWANDA

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capacity Nyarugenge District Hospital in Kigali. Less than a year after commissioning, plans are already underway to expand the hospital, built with funds from the Kingdom of Belgium, to add another 180 beds and more medical facilities like pharmacies, laboratories, and operating theatres for US$11 million. King Faisal, Rwanda’s top teaching and referral hospital, secured US$14 million funding from the Trade and Development Bank (TDB) undertake towards the expansion of the hospitals outpatient facilities in a bid to boost Rwandan health system. The Butaro Hospital, which was launched less than a decade ago is also being expanded under a multi-year construction project which will increase its bed capacity from 150 to 240 beds and further establish it as a leading medical institution and teaching hospital in the region. Nyanza Hospital in the southern province of Rwanda has also benefited from an increased focus on hospital expansions. In 2019, the facility took reception of a new maternity ward, equipped with new essential medical equipment with support from UNICEF. Gisenyi Hospital is also expected to become even bigger as authorities decided to move it to a safer location after it was affected by tremors, which followed the eruption of the Nyiragongo volcano in May last year. Construction of the new hospital will cost €32 million(US$ 31.6 million) and is expected to accommodate 400-500 patients

LEVERAGING DIGIHEALTH TO DELIVER QUALITY CARE As new health challenges crop up, the need for healthcare rises even further. Although Rwanda's healthcare system is robust as discussed above, the rise of non-communicable diseases is putting new pressure on an already stretched workforce. To leverage the limited number of doctors and nurses to serve populations in the most impoverished and rural parts of the country, Rwanda has embraced digital health. The government has been at the forefront of this transition, teaming up with UKheadquartered remote consultations provider Babylon Health to create the world's first digital-focused universal primary health care service. When rolled out, the system will give everyone in Rwanda above the age of 12 access to consultations with doctors or nurses through their mobile phones within minutes. The project would be a scale-up of an existing digital health service which was launched by Babylon in 2016 and has so far gained two million registered users and delivered more than one million consultations. The government has also rolled out the “SMART Health Card” to facilitate health information exchange. Health Minister Dr. Daniel Ngamije recently said that the country planned to leverage the card to its fullest in line with the country’s universal health coverage (UHC) objectives. He further revealed that there are plans underway to ensure the SMART Health Card standard will be extended to provide individuals with additional health data, such as routine immunization records, lab results, health insurance information, and prescriptions. The transition to digihealth has been relatively easy for Rwanda as the country has a broadband infrastructure that now covers 90% SEP/OCT 2022 | HEALTHCARE AFRICA

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COUNTRY FOCUS: Rwanda

KING FAISAL'S MEDICAL PERSONNEL

By securing a chance recently to host the African Medicine Agency Headquarters (AMA), Rwanda made a statement to the effect that it is an emerging economic powerhouse in the region

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of the country and mobile phone penetration that exceeds 75% of the population. Additionally, the Protection of Personal Data and Privacy law that was enacted in 2021 has further created an enabling environment for health information to be electronically shared among interested parties. Babylon is not the only company to exploit Rwanda’s digital health potential. Silicon Valleybased Zipline has also established a partnership with the Rwandan Government to deliver blood, vaccines, and other essential medical products to hospitals, no matter how remote. With drones, the time it takes to supply products for emergencies has reduced from hours or days to just minutes. It also means refrigerated blood or other rarer products, such as frozen plasma, which often require expensive machinery can be easily delivered to local hospitals that lack the necessary infrastructure. Eden Care Medical, another digihealth company, is also dipping its fork to get a share of the budding sector. The Rwanda-based digital health startup is focusing on insurance and recently became the first company in East and Central Africa to gain regulatory approval to offer digital health insurance following the Letter of No-Objection granted by the National Bank of Rwanda in June 2022. HEALTHCARE FINANCING With healthcare being naturally expensive globally, Rwanda has invested in health insurance to make it easier for its citizens to access quality care. Today, the country is one of the few developing countries in the world to have achieved universal health coverage (UHC); its community-based health insurance program– known as Mutuelle de Santé–reaches more than 90% of the population. The annual health budget has also been rising over the years as Rwanda ramps up its efforts to fight disease and improve healthcare delivery to

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its citizens. Domestic resources have increased in nominal terms from US$140 million in 2020/21 to US$150 million in 2021/22. Support from development partners such as the Global fund, the World Bank, COVAX, the US Government through PEPFAR, The Belgian Development Agency (Enabel), The GAVI Alliance, and The Rwanda Health Financing has also grown over the years. Data from the ministry shows that external funding grew from US$130 million in 2020/21 to US$200 million in the 2021/22 financial year. Increased funding has been particularly resourceful in helping Rwanda implement its UHC program that targets all the citizens, including the nation's poorest citizens. Higherincome earners also assist the government in realizing this program through annual premiums of up to US$8 per adult per year. AN EMERGING HEALTH HUB IN AFRICA 28 years after the country’s worst internal conflict, Rwanda is once again standing high in Africa’s health industry. The country recently outbid 8 other countries, including Algeria, Egypt, Morocco, Tanzania, Tunisia, Uganda, and Zimbabwe, to secure hosting rights to the African Medicine Agency Headquarters. AMA was the crown jewel of several big health moves that the country has been making recently. In May, the African Development Bank announced that the new African Pharmaceutical Technology Foundation will be hosted by Rwanda. At the end of June, BioNTech broke ground on the construction of a messenger RNA vaccine manufacturing facility in the country. The country had earlier, alongside Senegal, been selected by the International Finance Corporation (IFC) along Senegal and South Africa as potential regional vaccine manufacturing hubs in Africa. By securing a chance recently to host the African Medicine Agency Headquarters (AMA), the tiny but progressive East African nation made a statement to the effect that it is an emerging economic powerhouse not only in the region but on the entire continent. It has also proved that with the right policies and proper investment in healthcare, a country can make great leaps in delivering quality healthcare to its people. Challenges still exist, particularly in the human resource department and hospital infrastructure, but if the recent moves to train more people and invest in hospitals are anything to go by, Rwanda is well positioned to achieve its 2050 vision of prosperity and high-quality life for all citizensHCA HEALTHCAREAFRICA.INFO


RWANDA IN FIGURES SURFACE AREA: 26,338 Square Kilometres. POPULATION: 12.9 Million people POPULATION GROWTH: 2.5% LIFE EXPECTANCY: 69.0 years URBAN POPULATION: 17.4%.

GDP: US$37.2 billion (2022 Estimates) GDP PER CAPITA: US$2,405 (2022 Estimates) POVERTY INDEX: 38.2% NUMBER OF PHYSICIANS: 1,350 as at 2018 NUMBER OF NATIONAL REFERRAL HOSPITALS: 7 NUMBER OF UNIVERSITY TEACHING HOSPITALS: 14 NUMBER OF DISTRICT HOSPITALS: 42 NUMBER OF HEALTH CENTRES: 600 NUMBER OF NURSES & MIDWIVES: 10,758 HEALTHCAREAFRICA.INFO

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DISEASE FOCUS

MENTAL HEALTH An emerging public health issue in Africa

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he idea of health as a holistic concept is widely acknowledged. World Health Organization (WHO) defines mental health as a state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to his or her community. The slogan ‘no health without mental health’ is immensely popular, but its application in the African context leaves a lot to be desired. Facilities for mental health are scarce, with their finite resources stretched beyond capacity. Mental health specialists are equally unavailable, particularly in the publicly funded health system. It is safe to say that access to mental healthcare on the continent is almost impossible, and when available, extremely expensive, putting it out of reach for millions of people who are in need. October being a mental health month, Healthcare Africa explores the mental health situation in Africa and progress being made to enhance access to this very critical form of care. MENTAL HEALTH SERVICES ALMOST NONEXISTENT IN AFRICA Mental health services in Africa are scanty, to say the least, mainly due to the blind eye turned to the problem by African governments. Worldwide, 24% of countries that reported to the WHO's 2014 Mental Health Atlas survey did not have or had not implemented standalone mental health policies; in Africa, this proportion rose to 46%. The lack of supporting mental health policy manifests itself in the low numbers of personnel and critical infrastructure. According to the "Mental health in Africa" report by Lancet Global Health, "the region has 1.4 mental health workers per 100 000 people, compared with a global average of 9.0 per 100 000.” Lancet Global Health also notes that “Africa performs relatively poorly with regard to the number of psychiatrists, the number of hospital beds for patients with mental illness, and the coverage of outpatient facilities.” Their observation could not be far from the truth if a sample of Africa’s top economies is anything to go by. According to a 2017 United Nations report, Kenya had only about 80 psychiatrists, 30 clinical psychologists, and fewer than 500 psychiatric nurses, of which only 250 work in mental health. More prosperous South Africa boasts of 22 psychiatric hospitals and 36 psychiatric wards in general hospitals, while oil-rich Nigeria

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only had 130 psychiatrists in the country of 174 million people (now more than 200 million). This is, however, not surprising as Most African governments spend less than 1% of their allocated health budget on mental illnesses. Partly as a consequence, the proportion of Africans who receive treatment for mental health problems is extremely low. According to Lancet Global Health, the annual rate of visits to mental health outpatient facilities in Africa is 14 per 100 000 population, an extremely low figure when compared to a global annual rate of 1051 per 100 000 population. In Sierra Leone, for example, the treatment gap (that is, the proportion of those in need who go untreated) for formal mental health services has been estimated at 98.8%. In South Africa, only about 14% of the population have access to mental health services, of which one-third are afflicted with mental diseases, according to experts. MENTAL ILLNESS, A REALITY WE WISH NEVER EXISTED One would be persuaded to think Africa has no mental health problems, but statistics on the ground suggest otherwise. Between 2000 and 2015 the continent's population grew by 49%, yet the number of years lost to disability as a result of mental and substance use disorders increased by 52%, according to WHO estimates. Additionally, the world health body noted that 17.9 million years were lost to disability as a consequence of mental health problems. Such disorders were almost as important a cause of years lost to disability as were infectious and parasitic diseases, which

By Lorraine Wangui

Africa performs relatively poorly with regard to the number of psychiatrists, the number of hospital beds for patients with mental illness, and the coverage of outpatient facilities.

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DISEASE FOCUS: Mental health

Currently, an estimated 100 million people in Africa suffer from clinical depression, including 66 million women

accounted for 18.5 million years lost to disability. Depression, the most prevalent mental illness in the world, has also been on the rise in Africa. Currently, an estimated 100 million people in Africa suffer from clinical depression, including 66 million women, according to data from the World Economic Forum. Regionally, 2017 estimates show that a fourth of the Kenyan population of 44 million suffer from a range of mental diseases, including schizophrenia and other psychotic disorders, bipolar disorder, depression, and severe anxiety. WHO estimates that the number of mentally ill Nigerians ranges from 40 million to 60 million. Disorders like depression, anxiety, and schizophrenia are common in the country. The WHO estimated in 2017 that 450,000 people in Sierra Leone— which has a population of just over 7 million— suffer from depression every year and that 75,000 suffer from schizophrenia. PROHIBITIVE COSTS, STIGMA HINDER ACCESS Payment for mental healthcare is mainly out-ofpocket, putting a significant burden on individuals and families and sometimes causing severe financial strains. As a case study, the cost of treating mental illness in Kenya ranges between KES50, 000 (US$414) to KES100, 000 (US$828) before factoring in the doctor's consultation fee of KES 10, 000 (US$82). The cost of treatment in private hospitals is much higher with patients

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having to part with between KES 3000 (US$25) to KES 5000 (US$41) every time a psychiatrist attends them. In a country where a majority of the people live on less than US$2 a day, this is an impossible amount to put together. The socio-cultural bias toward mental health disorders remains an age-long barrier to seeking care in Africa. As earlier noted, mental health is such a non-issue that African languages never bothered to create a word for it. In severe cases, mental health patients are considered dangerous and until recently, several of them were forced to wear chains in hospitals such as the Kissy National Referral Psychiatric Hospital (now Sierra Leone Psychiatric Teaching Hospital). Afraid of the stigma, patients choose not to seek HEALTHCAREAFRICA.INFO


help, assuming the problem would go away on its own. Sometimes, family members decide not to seek care for the same reason. Also, help is sometimes sought from traditional and spiritual healers, as mental health is sometimes believed to be a spiritual problem. A TICKING-TIME-BOMB WAITING TO EXPLODE As Africa's population is expected to double over the next three decades, the pressures on young people in particular, who across the region are already struggling to earn a livelihood in highly competitive labor markets, are likely to ratchet up. Many will experience psychological problems as they fail to realize their ambitions, and some will turn to substance misuse as a means of alleviating their frustration, and this will create a mental health crisis that the continent has never experienced before. The problem is already brewing. The most recent systematic review focusing on sub-Saharan Africa reported that one in seven children and adolescents experiences significant psychological challenges, and almost 10% qualify for a psychiatric diagnosis. Across 37 studies published between 2008 to 2020 and spanning 97,616 adolescents, the researchers found the following prevalence: depression (26.9%); anxiety disorders (29.8%); emotional and behavioral problems (40.8%); PTSD in one study (21.5%) and suicidal thoughts (20.8%). It can only get worse from here as the population doubles in size.

of having mental illness rose from zero to 1,593. Of these, 494 went on to be clinically diagnosed with a mental health disorder. In Zimbabwe, benches have been placed outside health clinics, which people visit for treatment of all kinds of conditions, including HIV and AIDS. Lay health workers, known as Golden Ladies or "Grandmothers, " are trained to deliver low-intensity cognitive behavior therapy to anyone referred to the benches by clinicians. To date, over 15,000 people have used the Friendship bench. Given its potential, Grand Challenges Canada is funding its roll-out to 60 clinics in the 3 cities, where it's hoped up to 50,000 people will have access. Egypt, through its Ministry of Health and Population (MoHP) recently introduced the firstever free of charge national electronic platform for mental health services and addiction treatment. The platform seeks to contribute to the nation's mental health wellness by providing educational material around the issue to enhance awareness and by giving citizens access to psychological support and counseling services through virtual telemedicine clinics. Therapists on site also have permission to transfer emergency cases to the General Secretariat of Mental Health and

IN NUMBERS

US$

414

THE MINIMUM COST OF TREATING MENTAL HEALTH IN KENYA

NEWLY REFURBISHED SIERRA LEONE PSYCHIATRIC TEACHING HOSPITAL

NEW SOLUTIONS TO MENTAL HEALTH ARISE As mental health problems continue to abound and brick-and-mortar facilities remain out of reach for many, new solutions are cropping up across the continent to provide the muchneeded care. Kena Health application recently launched in South Africa to provide private, affordable, and remote care for mental health through digital solutions. The app allows mental health professionals to chat with patients via smartphones, improving access to mental health services across South Africa and helping to alleviate the lack of mental health services in rural areas. To enhance access to mental healthcare in Kenya, the Africa Mental Health Foundation started project TEAM, which enlists African traditional healers, faith healers, and community health workers to detect mental illness and refer cases to clinicians. Referrals of people suspected HEALTHCAREAFRICA.INFO

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DISEASE FOCUS: Mental health

FRIENDSHIP BENCH OUTSIDE ZIMBABWE'S PSYCHIATRIC CLINIC

The outlook of Africa's mental health landscape has a silver lining in the renewed focus by governments across the continent to alleviate the problem.

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Addiction Treatment for speedy and immediate intervention. A FRESH IMPETUS TO MENTAL HEALTH IN AFRICA Although grim, the outlook of Africa's mental health landscape has a silver lining in the renewed focus by governments across the continent to alleviate the problem. In Kenya, the Ministry of Health is operationalizing a mental health call center to improve access to mental health services for all Kenyans. The country is also bolstering its human resource capacity for mental health through the recruitment and deployment of 146 psychologists to the 47 counties. To add to these efforts, Kenya unveiled plans to relocate the Mathari National Referral Hospital, the largest facility for mental health in Kenya, from its current location on Thika Road to an 80-acre plot in Karen, one of Nairobi’s affluent suburbs. The new 600-bed capacity hospital will be the largest of its kind in East and Central Africa and will have facilities to handle 1000 walk-in patients daily. Built through a public-private partnership between the government of Kenya and Group San Donato and San Raffaele Research Hospital in Italy, the facility will be renamed National Teaching and Referral Neuropsychiatric Centre and will host a specialist university to train mental health workers. Elsewhere in the continent, Sierra Leone, in partnership with Partners in Health, opened a newly refurbished Sierra Leone Psychiatric Teaching Hospital, which years of neglect had left it in a near-derelict state. The SLPTH is today

SEP/OCT 2022 | HEALTHCARE AFRICA

a transformed, dignified, and well-resourced with a steady flow of never-before-available psychiatric medications. Not to be left behind, Nigeria has also started efforts to enhance medical care for its citizens. The Lagos state government, one of the devolved federal units in Nigeria, announced plans to construct a 500-bed Psychiatric Hospital to promote mental healthcare delivery in the country. South Africa has also invested US$120 million to build the Kimberley Mental Health Hospital. Opened in 2021, the hospital has the capacity to accommodate 287 inpatients at a time. Government efforts across Africa are being boosted by the WHO which is working to help them review mental health legislation and related policies, and to build capacities using the MHGap approach, a task-sharing strategy where primary health care workers are trained and then supervised in managing common mental disorders. The efforts by governments, although commendable, are still a drop in an ocean when compared to the problems at hand. Researchers suggest that mental health should become an integral part of programs related to community empowerment, poverty reduction, HIV/AIDS prevention, and reproductive and sexual health. African governments should also do more to increase their budgetary allocation to mental health as it is the only way they can be able to achieve their commitment to increase service coverage for severe mental health disorders by 20% and to reduce suicide rates by 10%. Without clear and concerted efforts to manage the problem, mental health may snowball into a catastrophic pandemic in the next decade, and Africa will only have itself to blameHCA

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