What we learned at Africa Healthcare Week 2018
Africa’s brightest healthcare brains from the public, private and NGO sectors – and a lot of salespeople – flocked to London this week for Africa Healthcare Week, the largest healthcare event about the continent outside of the region. Healthcare Nova was there. Here are four of the things we learned from the two-day conference.
If you want UHC, you start by tackling primary and community care – and the private sector can get involved
Many African nations have a national strategic plan to achieve Universal Health Coverage by 2030, but the overarching theme from day one was the impossibility of that task without first ensuring robust and accessible primary care. The private sector has tended to leave it to NGOs and the charity sector, instead focusing on higher-end areas with better margins. And as Pape Amadou Gaye, CEO of IntraHealth International, says: “Volunteerism is nice but not fair.”
It doesn’t have to be that way. US non-profit Sanford Health has been investing significantly in primary care clinics in Ghana and seeks break-even as eagerly as a for-profit would, while GE Healthcare has announced an agreement with NGO Amref to develop primary and community health service collaborations in Ethiopia, across a range of specialities including maternity, post-natal, paediatrics, non-communicable diseases and preventive public health.
Massive opportunities lie at the other end of the care spectrum
Having said that, in some geographies, the opposite problem has also been seen. In Nigeria, for example, the private sector has shied away from entering the high-end tertiary care space, which has led to a lack of quality provision and the exodus of US$1bn in health spending from either the capital or the entire country, depending on who you ask.
Dr Olujimi Coker, medical director at Lagoon Hospitals, part of the large HMO Hygeia, says that the country has only one linear accelerator. He repeated what other local contacts tell us about an over-abundance of secondary hospitals in Lagos, and points out that it might actually be no more difficult to get larger loans from bodies like the IFC than smaller. Above a certain threshold the process stops becoming more demanding: “The same work goes into approving a US$10m loan as does a US$100m one.”
Coker quipped that capturing even 10% of that outbound market “wouldn’t be bad for you as an investor!”.
One size does not fit all.
You need to adapt your approach to working on the continent, even if you have a 100-plus-year-old modus operandi. One common theme that we hear from contacts who’ve entered Africa, and emerging markets in general, is the need to train locally to ensure there is the expertise to accompany investment. A great example came up at the conference when GE Healthcare Africa CEO Farid Fezoua told us that when selling its V-scan ultrasound technology in Ghana it trained midwives as there was often no gynaecologistist in the rural communities it was targeting.
“This [training] was never our business model originally: we sell technology. If you look at 15 years ago in GE Healthcare we sold it and if people could use it, fine, if people couldn’t, that wasn’t our problem! We completely shifted our model in Africa because we had to.”
A new friendliness to the private sector is obvious from the rhetoric – but let’s see if action follows
Ministers of health from Zimbabwe, Botswana, Zambia and Mozambique spoke in a panel session on “Investment Opportunities and Progress in African Health” where the message to the private sector was clear: come and invest your capital. The Zambian minister praised the country’s established regulatory framework around PPPs, in place since the 1990s. This builds on the message delegates received at AHBS II in November, which was “governments taking the private sector seriously” according to one delegate and hospital director.
We would welcome your thoughts on this story. Email your views to Cameron Murray or call 0207 183 3779.
