What’s the key to affordable care in Africa?

I was thrilled to participate in the November launch of the Novartis Biome sub-Saharan Africa innovation hub and host a roundtable on “Disrupting NCDs: delivering end-to-end care for NCDs in sub-Saharan Africa.” The new hub seeks to increase affordable access to high-quality medicines and strengthen health systems in the region through innovative business models and technology-driven solutions.

Accenture Development Partnerships (ADP) has been a key partner in launching the initiative and continues to work alongside this leading pharmaceutical company as it explores the region’s affordability challenges and strives for greater innovation to increase access to care for the 1.2 billion people on the continent.

As the Global Health Lead of Accenture Development Partnerships, I’m excited to help bring the breath of Accenture’s capabilities, its resources and its people to the social, economic and environmental challenges faced across the international development sector. I’m particularly passionate about working with Novartis Biome sub-Saharan Africa because of its strategic focus on affordability of care, particularly for non-communicable diseases (NCDs).

Why we need to focus funding and attention on non-communicable diseases

When we think about the population of sub-Saharan Africa, what most often comes to mind is the communicable diseases—HIV, TB, malaria and now COVID-19—and maternal, neonatal and child nutritional diseases. But NCDs like diabetes, respiratory diseases, kidney disease, cardiovascular disease and cancers are set to overtake all of these as the leading cause of mortality by 2030.

Considering that the region’s healthcare system is already overburdened, the fact that NCDs account for 67% of deaths in low and middle-income countries but only receive about 2% of global health funding, and the lack of political will needed to ensure sufficient attention and investment, and you can see why this is a daunting challenge. And that no one pharmaceutical company can solve these issues alone. Partnerships will be essential and that’s exactly why initiatives like the Novartis Biome are needed.

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How we can accelerate the progress that’s already been made

During the roundtable, one of the things we talked about was how the tide is starting to turn. Various actors are working to reduce the costs of NCD treatments, which is already making a difference in countries like Nigeria, Ethiopia and Kenya. As a result, we’re starting to see increasing willingness to invest by Ministries of Health and Finance.

My hope is that if we're able to showcase more of these proof points and share the knowledge among a greater number of country leaders, perhaps we can build the momentum we need to significantly improve patient outcomes.

To advance these efforts, we need to look at the six building blocks of health systems, as identified by the World Health Organization (WHO)—service delivery, the health workforce, health information systems, access to essential medicines, financing, and leadership & governance. While each of these have a critical role to play, let’s examine two: the health workforce and finance.

Even though sub-Saharan Africa bears the burden of 25% of global disease, it has only 3% of the global health workforce. This workforce gap creates challenges in providing end-to-end care for NCDs in the region, from awareness and accessing care to appropriate diagnosis and appropriate treatments, to the ancillary support that's required to ensure adherence. The gap grows even larger when we talk about specialists like oncologists and endocrinologists.

To address this shortage, we need to rethink the way we deliver care. Perhaps we could empower the lower levels of the health workforce, including community health workers and nurses, and allow them to play a greater role in diagnosis and care? By investing in their skill development and mentorship, we could scale up the care we can provide to individuals and communities. The more we can empower patients too, the more sustainable the model becomes.

Finance is another important issue. 69% of domestic health spending in lower income countries comes from private sources – most of which are household out-of-pocket payments. Although out-of-pocket spending is nearly twice that of government spending, we often look solely to governments and external donors to drive solutions to the problem. Perhaps we need to consider more creative financing solutions to improve the system, and engage communities in the conversation? The burden of households in financing health care needs to be reduced, and this can only happen through innovation and new models of health financing and care delivery.

How Life Sciences and MedTech companies can be an active part of the solution

Life Sciences and MedTech companies have a critical role to play too, as leaders in health and innovation. I suggest they consider how they can participate in three key areas:

1. Awareness. There are opportunities to educate populations and communities around NCDs, address the cultural stigma that often exists around these health issues, and perhaps educate and influence policymakers, donors and funders to mobilize greater political will and financing toward improving health and wellbeing for patients with NCDs.
2. Accessibility. Organizations could also think creatively and engage more to address accessibility challenges. Perhaps invest in further education of NCD specialists, point of care diagnostics, telemedicine and virtual health platforms that can support under-resourced countries that are struggling to bring diagnosis and care to communities in a timely way.
3. Affordability. I also see a need for innovative solutions and partnerships to address the growing cost of NCD care. In these markets, the supply chain between the manufacturer and the patient is often highly fragmented with many distributors and sub-distributors, which leads to markups on top of markups and higher end costs for medicines for the consumer. If there were greater transparency around the end-to -end cost of treatment, we could find appropriate ways to address this affordability challenge.

I believe the key to accessible and affordable care in sub-Saharan Africa is to recognize that these are shared global challenges that can only be solved by bringing together a mix of not-for-profits, donors, foundations, governments, multilateral agencies, private sector individuals and entities. I firmly believe, it will be through partnerships and collaborations, and initiatives like the Novartis Biome innovation hubs, that we’ll find ways to make healthcare accessible and affordable for everyone, wherever they are in the world.

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