HealthCare Middle East & Africa - March/April 2023

HealthCare

MIDDLE EAST & AFRICA

TOSEEF DIN

MP Shah CEO on how the hospital alleviates human suffering through compassionate care

KISUMU SPECIALISTS HOSPITAL: Leading the way in specialized healthcare in Western Kenya

BRIGHT MEDICALS: Leveraging Artificial Intelligence to help doctors with precision diagnosis

KENYA ASSOCIATION OF PHARMACEUTICAL INDUSTRIES : Elevating Healthcare ethics & innovation in Kenya’s pharma industry

COUNTRY FOCUS : Tanzania Healthcare System

DISEASE FOCUS : Cholera

AFRICA

BUSINESS SUMMIT

MARCH 13-15, 2024

Nairobi, Kenya

INCORPORATING:

The Africa Business Summit is the ground-breaking conference and exhibition that brings together the key decision makers to define the future of business innovation, strategic leadership and the transformation of Africa, as we approach 2030 and beyond.

The program at the 3-day Summit will comprise of high-level keynote speeches and panel discussions plus sponsored industry and country-focused sessions. It will also feature fireside chats with influential people and change makers who are making waves – and inspiring the next phase of leaders in Africa

www.africabusinesssummit.biz

The Africa CEO & Leadership Forum

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ASSOCIATION FOCUS: KENYA ASSOCIATION OF PHARMACEUTICAL INDUSTRIES

Elevating Healthcare ethics & innovation in Kenya pharma industry

COUNTRY FOCUS: TANZANIA 54

Tanzania makes strides toward improving its healthcare system but a huge funding gap stands in the way between its goal to achieve universal health coverage

48

COMPANY FEATURE: BRIGHT MEDICALS

Leveraging Artificial Intelligence to help doctors with precision diagnosis

DISEASE FOCUS: CHOLERA 64

Cholera strikes again; Response strategies take center stage

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HealthCare

MIDDLE EAST & AFRICA

Year 2 | Issue2 | No.5

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Benjamin Opuko

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Lorraine A. Wangui EDITOR

Jackie Mbithe

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Clare Ngode

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Despite being traditionally male-dominated, the healthcare sector in Kenya is currently experiencing a shift in leadership, thanks to the efforts of three exceptional women. These women are breaking the ceiling by leading their respective institutions to provide high-quality healthcare services with compassion, specialized care, and promoting a counterfeit-free drug market.

At the forefront of this change is Mrs. Toseef Din, who is heading MP-Shah, a leading hospital in Kenya. Under her leadership, the hospital has continued to provide exceptional healthcare services and invest in state-of-the-art medical equipment. She is also focused on improving the patient experience through patient-centered care approaches.

Dr. Judith Getugi is another remarkable woman who is making significant strides in the healthcare sector. As the CEO of Kisumu Specialists Hospital, she has transformed the institution into a leading level 4 hospital known for providing specialized care to patients with complex medical needs. Her investment in modern equipment and highly trained medical professionals has enabled the hospital to provide world-class healthcare services.

counterfeit-free drug market in Kenya.

The impact of these women's leadership in the healthcare sector is enormous. Their achievements inspire other women to aspire to leadership roles in traditionally maledominated sectors. They also bring diversity in leadership, which results in better decision-making, ultimately leading to better outcomes for patients.

In addition to our focus on women leaders in the healthcare sector, this edition of the premium healthcare magazine highlights several other exciting developments in the sector. We feature Gael Kamdem De Teyou, Chief Technology Officer of Bright Medicals, who is using Artificial Intelligence to extract valuable insights from medical images. We also turn our attention to Tanzania's healthcare system, which is making significant strides towards achieving universal health coverage, but still faces funding gaps. Finally, we delve into the disease focus of this edition, which is cholera, highlighting the strategies being employed to combat the disease and the role of public education in preventing its spread.

HealthCare Africa (ISSN 2307-3535) is published 6 times a year by FW Africa. Reproduction of the whole or any part of the contents without written permission from the editor is prohibited. All information is published in good faith. While care is taken to prevent inaccuracies, the publishers accept no liability for any errors or omissions or for the consequences of any action taken on the basis of information published.

Food Africa Business

Dr. Winnie Ng'ang'a is leading the fight against counterfeit drugs in Kenya. As the head of Kenya Association of Pharmaceutical Industries (KAPI), she is working with government agencies to promote policies that ensure only genuine drugs are sold in the market. Her leadership has made KAPI a crucial player in the promotion of a

Overall, this edition of the premium healthcare magazine provides an insightful perspective into Kenya's healthcare sector and the challenges, opportunities, and developments shaping it. We hope our readers will find it both informative and inspiring, and we look forward to continuing to bring you the latest insights and perspectives on important health topics.

Benjamin Opuko

Senior Editor - HCMEA, FW Africa

Breaking the glass ceiling: Women leading the way in Kenya's healthcare sector

ACIBADEM OFFERS:

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 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 patient’s return to their home country within 20 different languages.

HOLISTIC APPROACH TO ONCOLOGY PATIENTS

Acıbadem Oncology Centers has been designed specifically for the needs of patients undergoing oncology treatments; they are served by a team of experienced specialists using a multidisciplinary approach.

Acıbadem Radiation Oncology Department removes cancer treatment limits by applying novel strategies. Today, it is possible to get better results in cancer treatment thanks to advanced health technologies. Our institution offers a variety of radiation therapy options and develops treatment plans to best address the type and stage of cancer. In conventional radiation treatment, radiation is given to the patients each day in the precisely the same amount regardless of the patient's changes over the course of therapy. At Acıbadem, MRIdian therapy allows us to see and track soft tissues and tumors in real-time. This enables re-planning of the treatment course on the table if it is needed.

Professor Ufuk Abacıoğlu is a renowned specialist in radiotherapy in Turkiye with more than 25 years of experience in cancer treatment. He states, "In Acıbadem Radiation Oncology Department we diagnose and treat all forms of cancer, from more common

conditions like lung, prostate and breast cancer to rarer throat cancer and brain cancer. We not only treat adult patients but also treat pediatric patients when necessary. Compared to 20 years ago, we have a lot of new technologies today. As a result, there are significant advances in radiation oncology. Also, image-guidance during radiation therapy helps us tremendously before and during the treatment. It provides myriad opportunities to treat cancer types we could not treat before."

Acıbadem uses the latest healthcare technologies to provide the best treatment for patients. MRI-guided radiation therapy is one of them. This technology is shortly called as MRIdian. It is especially beneficial for the locations where the body has some degree of motion: the tumors located in the abdomen, the thoracic regions, etc. Tumors in these regions are in motion even during normal breathing patterns. Therefore, the tumor area and surrounding healthy tissues can be visualized clearly with the aid of the MRIdian. Real-time imaging helps physicians to control the treatment process during irradiation. In the case of detecting a clinically significant movement of targets

or healthy tissues, physicians can adjust the target and re-plan the treatment while the patient is still on the table. A new MRI scan is performed before each treatment session. It allows a tailored treatment in accordance with the patient's daily anatomy.

Acıbadem began treatments with the MRIdian system in 2018, marking Turkiye's first MRI-guided radiotherapy treatments. In the last four years, after seeing the importance of real-time MRI visualization, automatic beam gating, and on-table adaptive therapy in cancer treatment, Acıbadem has purchased a second MRIdian device in 2022.

"In MRIdian therapy, we track the tumor and give the treatment at the right time and position. It allows treatment of hard-toreach tumors, tumors located close to critical structures, or tumors that can move during normal bodily functions such as breathing. This makes MRI-Guided Radiation Therapy different and more effective than other technologies. Moreover, MRIdian therapy offers better results with little to no side effects and complications." says Professor Dr. Meriç Şengöz. He is a highly respected radiotherapy specialist who has 30-years of extensive experience in this fast-evolving medical field.

Acıbadem is one of the few cancer centers in the world that utilizes the power of MRIdian in treating pancreatic, prostate, liver, and other cancer types. If you'd like to learn more, you are encouraged to contact Acıbadem Group at: apply@acibadem.com

Precise and personalized cancer treatment with cutting-edge new technology

First modular mRNA vaccine labs arrive in Rwanda

the production of vaccines.

Developed by German pharmaceutical company BioNTech, the six mobile vaccine-production units are expected to start manufacturing vaccines approximately 12 to 18 months after their installation and are capable of producing up to 100 million mRNA vaccines per year.

pioneer treatments in the development phase against diseases like malaria, tuberculosis, and HIV.

RWANDA — Rwanda has received its first modular container prototype known as which utilizes mRNA technology for

One of the recycled shipping containers will produce mRNA vaccines while the other will produce formulated bulk drug products. Rwanda plans to use the same facility to manufacture malaria and tuberculosis vaccines, as well as

This is the first shipment of its kind to Africa as the continent seeks to boost local production of mRNA vaccines. The Kigali plant is the first mRNA technology manufacturing hub, with similar facilities to be set up in Senegal and South Africa. Egypt, Kenya, Nigeria, and Tunisia will receive technology from the hub to produce their own mRNA vaccines. The vaccines produced will be distributed to the 55-member African Union bloc.

Pfizer, and Biovac launch freezer farm facility for vaccine storage and supply

SOUTH AFRICA— Pfizer and Biovac have inaugurated a freezer farm facility in South Africa that can store vaccine products at ultra-low temperatures, including the locally manufactured Pfizer/BioNTech Covid-19 vaccine.

The two-storey building houses 135 ultra-low temperature freezers, allowing for the storage of vaccines up to minus 70 degrees Celsius. Biovac is a South African public-private partnership

MANUFACTURING

focused on improving vaccine access and promoting local manufacturing of vaccines.

The partnership between Pfizer and Biovac dates back to 2015 and aims to establish a sustainable supply of Pfizer's pneumococcal vaccine. To date, Pfizer has invested over R855 million ($47.09m) in Biovac to improve infrastructure and skills development.

Moderna looks to expand its manufacturing footprint globally

USA — Moderna plans to expand its operations globally over the next few years, building on the exponential growth it experienced during the Covid-19 pandemic.

The US-based biotech rose to prominence as one of the first to develop Covid-19 vaccines using its mRNA technology, with net income of US$12.2bn in 2021 and US$18.4bn in Covid-19 vaccine sales in 2022.

Moderna is confident that its mRNA vaccine, Spikevax, can be modified to combat new SARS-CoV-2 strains, including the XBB.1.5 variant. The company is expanding its manufacturing capacity for pandemic prevention, with new facilities planned in the UK, Canada, Australia, and Kenya, and partnerships in Switzerland and the US. In addition, the company has acquired Japanese biotech OriCiro Genomics to speed up the development of its products.

Experts in Kano find unusual manifestation of diphtheria in a baby and teenager

NIGERIA — Diphtheria, a deadly throat disease, has been found in the vagina of a baby and a 17-year-old girl teenager in Kano, according to experts at the Aminu Kano Teaching Hospital.

The outbreak has claimed 61 lives in Kano State as of March 2, 2023, with a total of 783 admissions, out of which 360 were females and 423 were males. The majority of confirmed cases in Nigeria occurred in children aged two to

14 years.

The Nigeria Centre for Disease Control and Prevention (NCDC) has declared the situation as an outbreak of diphtheria cases in Lagos and Kano States. The National technical working group multi-partner, multi-sectoral Emergency Operations Centre (EOC) was activated to coordinate the response activities at all levels.

WHO, CDC to establish local vaccine manufacturing plant to fight future pandemics

AFRICA — Medical experts and leaders in Africa have agreed to establish a local vaccine manufacturing plant in order to fight future pandemics.

The World Health Organization (WHO) is partnering with the Africa Center for Disease Control (Africa CDC) to identify six countries for vaccine production, including Rwanda, Nigeria, Ethiopia, Ghana, Kenya, and Algeria.

The manufacture of vaccines will enable Africa to become self-sufficient in the fight against diseases, rather

PARTNERSHIP

than relying on donor supplies. WHO is working to improve regulatory capacities for the countries through the Africa Medicines Agency, which was established in 2020.

The agency aims to harmonize the regulatory system for medical products in the African continent and enable smoother approval processes to improve pharmaceutical production. Africa CDC also has plans to establish diagnostic laboratories and therapeutic services.

Pfizer partners with Samsung Bio for drug substance manufacturing until 2029

SOUTH KOREA — Samsung Biologics, a South Korean contract development and manufacturing organization (CDMO), has signed a biologics supply contract with Pfizer worth US$183m that runs through 2029.

This is the second CMO agreement Samsung Biologics has signed this year, having secured a US$27m CDMO agreement with GlaxoSmithKline in

February. Samsung Biologics has been expanding its capabilities and facilities to meet demand, with plans to enter the manufacture of antibody-drug conjugates in the near future.

The recent Pfizer contract marks the seventh top 10 pharma firm to collaborate with Samsung Biologics, indicating an aggressive expansion strategy.

Pfizer and GSK on track to release highly anticipated RSV vaccines this year

The US Food and Drug Administration is expected to approve both Pfizer and GlaxoSmithKline's RSV vaccines for use in people aged 60 and above by May 2023, and Pfizer's vaccine may also be approved for use in pregnant women by August 2023.

GE HealthCare and Sinopharm enter longterm joint venture to grow in China’s medical device market

USA — Pfizer has reportedly developed a vaccine for respiratory syncytial virus (RSV), a respiratory illness that affects millions of people globally and causes severe inflammation of the small airways in the lungs, particularly dangerous for infants.

The European Union is expected to make a decision on the vaccines in the second half of the year, which could pave the way for their introduction in the UK and other countries. The vaccines are designed to provide protection against RSV and reduce the severity of illness in those who do become infected, potentially reducing the number of hospitalizations and deaths related to RSV infections. Other pharmaceutical companies are also developing treatments and vaccines for RSV, including Sanofi, AstraZeneca, Johnson & Johnson, Merck, and Bavarian Nordic.

Saudi firm Attieh Medico and Augnito ally on AI-powered medical documentation

SAUDI ARABIA — Attieh Medico, a supplier of medical equipment based in Jeddah, has partnered with Augnito, an Indian-based AI-powered clinical speech recognition provider, to improve medical documentation in the Kingdom of Saudi Arabia.

Under the partnership, Augnito will deploy its cloud-based AI speech recognition technology for clinical documentation via electronic health records and systems across the country.

The solution will enable ergonomic data entry with 99% accuracy and streamline clinical workflows, freeing up more time for physicians to focus on patient care. The partnership aligns with Saudi Arabia’s Vision 2030, which aims to invest heavily in healthcare AI

and modernize the country's healthcare infrastructure.

CHINA — GE HealthCare has announced a long-term joint venture with Sinopharm, one of the largest life science products companies in the world, to expand its presence in the Chinese medical device market.

Sinopharm is ranked second in the Pharma 50 report of the world's largest pharma companies, while GE HealthCare is ranked sixth in the Medtech Big 100 report of the largest medical device companies.

The joint venture involves providing non-premium CT and general imaging ultrasound solutions for primary care and rural health, with the product scope potentially expanding as the venture develops. The formation of the joint venture is pending regulatory approvals from the Chinese government.

Temasek invests US$2B in Manipal Hospitals, raises stake to 59%

INDIA — Singapore-based sovereign wealth fund Temasek has increased its stake in India's largest hospital chain, Manipal Health Enterprises (MHE), by 41%, becoming its majority shareholder.

Temasek acquired the shares from several parties in a buyout deal valued at US$2 billion. Manipal Founder Ranjan Pai’s family shareholding will reduce from 50% to 30% while private equity firm TPG will fully exit Manipal but hold an 11% stake in the hospital chain. Following Temasek’s share purchase, Manipal Health Enterprises has a current valuation of about $2.99bn, making it the largest deal in the Indian healthcare sector.

HEALTHCARE DELIVERY

confirmed cases and 38 deaths reported from May 2022 through January 2023.

NIGERIA — The Nigeria Centre for Disease Control and Prevention (NCDC) has opened its first-ever Zonal Reference Laboratory in collaboration with the Ekiti Government, with funding from the World Bank’s Pandemic Emergency Financing facility.

The laboratory will contribute to national health security and strengthen diagnosis and surveillance of infectious

Stellenbosch University launches US$66M future-proof Biomedical Research Institute

SOUTH AFRICA — Stellenbosch University (SU) has launched its Biomedical Research Institute (BMRI) on its Tygerberg campus in Cape Town, South Africa.

diseases, with a focus on the six states in the South-West, namely Ekiti, Ondo, Oyo, Osun, Lagos and Ogun, and the whole of southern Nigeria.

The laboratory is equipped to diagnose priority diseases as part of the Centre’s Integrated Disease Surveillance and Response (IDSR) system. The NCDC has also reported a diphtheria outbreak with 523 suspected cases and 216

PARTNERSHIP

THE LABORATORY WILL CONTRIBUTE TO NATIONAL HEALTH SECURITY AND STRENGTHEN DIAGNOSIS AND SURVEILLANCE OF INFECTIOUS DISEASES, WITH A FOCUS ON THE SIX STATES IN THE SOUTH-WEST

Major drug manufacturers partner with Amazon to integrate coupons for their products

USA — Amazon Pharmacy has announced partnerships with drug manufacturers GlaxoSmithKline (GSK), Kaléo, Novo Nordisk and Dexcom to offer discounts on certain brand-name drugs with integrated coupons.

Amazon Pharmacy users will be able to automatically apply eligible coupons to orders at checkout. While this initiative aims to provide greater automatic savings for Amazon Pharmacy users, insurers and employers argue that such assistance enables pharmaceutical companies to increase drug prices, passing the burden of financial responsibility to payers.

Amazon Pharmacy is pitching its pharmacy services as a low-cost and convenient means of obtaining

medication delivered directly to customers' homes. Amazon has also been expanding its presence in the healthcare sector, with investments in telehealth, wearable devices, clinical research, and nutrition.

Marburg Virus Disease (MVD) outbreak hits East Africa’s Republic of Tanzania

and the WHO is providing support to strengthen contact tracing, case management, infection prevention and control, laboratory services, risk communication, and community engagement. The Africa CDC is deploying a team of experts to assist with response efforts in Tanzania and to guide regional surveillance strategies for containing the outbreak.

TANZANIA — The Ministry of Health (MoH) of the Republic of Tanzania has declared an outbreak of Marburg virus disease (MVD) in Bukoba district.

Eight confirmed cases and five deaths have been reported, including a healthcare worker, with a case fatality rate of 63%. Active case search, case management, and risk communication are ongoing in affected communities. The high population mobility within the region poses a risk of cross-border

Takeda acquires Nimbus Therapeutics’ subsidiary for US$6B

JAPAN — Takeda has completed its acquisition of Nimbus Therapeutics' Lakshmi program in a deal worth up to US$6bn.

Takeda has added a highly selective oral TYK2 inhibitor, known as TAK-279 and formerly known as NDI-034858, to its psoriasis treatment portfolio, with phase III clinical trials set to start later this year. Takeda will pay Nimbus US$4bn upfront and has agreed to make two further milestone payments of US$1bn each.

The Japanese pharmaceutical company also announced that the government of Japan has canceled an order for the remaining 141.76 million doses of the Novavax COVID-19 vaccine.

spread. Marburg virus disease (MVD) is a highly fatal, zoonotic hemorrhagic disease caused by the Marburg virus.

In addition, Equatorial Guinea reported the deaths of individuals with suspected hemorrhagic fever, and one sample was confirmed positive for Marburg virus by real-time polymerase chain reaction (RT-PCR) at the Institute Pasteur in Dakar, Senegal.

Ongoing investigations are being conducted to identify additional cases,

Vitality Health International enters the Kenyan insurance market with cutting-edge product

physical activity and better nutrition.

The program aims to reduce the incidence of chronic lifestyle diseases and offer comprehensive health insurance for employers operating in Africa, while also providing a seamless and intuitive experience for employees, employers, and financial advisers.

KENYA — Vitality Health International has launched a new health insurance program in Kenya that prioritizes prevention and incentivizes healthy behaviors, offering members rewards and discounts from its partners for healthy choices such as increased

The program utilizes data from wearable health devices to track important health metrics, which are then used to create a reward system that incentivizes healthy behavior, offering a unique solution for the country's shifting socio-economic landscape.

ONGOING INVESTIGATIONS ARE BEING CONDUCTED TO IDENTIFY ADDITIONAL CASES, AND THE WHO IS PROVIDING SUPPORT TO STRENGTHEN CONTACT TRACING.

KENYA — The Kenya Medical Research Institute (KEMRI) and the Gates Medical Research Institute are collaborating on a vaccine to prevent active tuberculosis (TB) in adults and adolescents.

and adolescents

The vaccine is in Phase III clinical trials, having undergone successful Phase II trials in Kenya, South Africa, and Zambia. At least 54% of those who received the vaccine were protected from active TB for three years, surpassing the threshold set by the World Health Organization.

KEMRI is also investigating the best method for diagnosing TB in children and is working on improving diagnosis and treatment for TB to reduce the number of annual cases and deaths in Kenya. Additionally, the government plans to hire at least 90,000 community health workers to improve access to healthcare and reduce the burden of TB.

RUPHA launches drug agency to provide affordable medicines to healthcare providers in Kenya

KENYA — The Rural Private Hospitals Association of Kenya (RUPHA) has launched the RUPHA Drug Agency, a Medical Group Purchasing Organization to improve access to quality and costeffective medicines for healthcare providers in underserved populations across Kenya.

RUPHA aims to leverage its purchasing power to negotiate better prices with pharmaceutical manufacturers and distributors and pass on those savings to its members, thereby enabling healthcare providers to offer better healthcare services to their patients and improving their own financial sustainability.

With a membership representing 367 healthcare centers in both rural and urban areas, RUPHA invites healthcare providers and stakeholders in Kenya to join its mission of improving healthcare services and financial sustainability for healthcare providers in the country.

Despite Kenya’s policy decision to increase primary healthcare services and the rollout of the Primary Health Care Network (PCN), the country still faces challenges around improving the quality of care, optimizing the health workforce, and sustainably funding primary healthcare for all.

Boston Scientific seals the deal on Apollo Endosurgery acquisition

USA — Boston Scientific has completed its acquisition of Apollo Endosurgery, a company specializing in developing gastrointestinal medical devices that facilitate less invasive treatments, for approximately US$615m.

The deal will enable Boston Scientific to enter the endobariatric market, which covers bariatric weight-loss procedures, as well as expand its scope in technology for the closure and suturing of incisions. The integration of Apollo Endosurgery’s product portfolio with Boston Scientific’s existing capabilities in endoscopic suturing and closure technology will enable the development of innovative, minimally invasive solutions for a range of gastrointestinal conditions, beyond just obesity.

Intesa gets full control of health insurance business with US$382 million investment

ITALY— Intesa Sanpaolo, Italy’s largest bank, is set to acquire the remaining 26.2% stake of healthcare insurer Intesa Sanpaolo RBM Salute for €360m (US$382 million) in cash.

The bank's insurance unit, Intesa Sanpaolo Vita, purchased 50% plus one share of RBM from the Favaretto family’s holding company for €325million (US$346 million) in 2020. The bank further infused capital into the business in 2021, resulting in the Favaretto family’s stake reducing to 26.2%.

With this new acquisition, Intesa aims to take full control of RBM before the two call options set for 2026 and 2029. The acquisition is intended to drive growth synergies between Intesa Sanpaolo RBM Salute and the rest of the group.

RUPHA AIMS TO LEVERAGE ITS PURCHASING POWER TO NEGOTIATE BETTER PRICES WITH PHARMACEUTICAL MANUFACTURERS AND DISTRIBUTORS.

KEMRI develops first vaccine to prevent active tuberculosis in adults

HMG invests US$1.73B to build six new hospitals in Saudi Arabia

SAUDI ARABIA — Dr. Sulaiman AlHabib Medical Group (HMG) is investing SAR 6.5 billion (US$1.73B) to build six hospitals in Saudi Arabia, which are expected to be operational by the end of 2025.

The aim is to improve healthcare accessibility by building top-tier hospitals in different geographical areas of Riyadh and Jeddah. Construction is already underway on a number of hospitals, including the Shamal Al Riyadh Hospital and the Gharb Jeddah Hospital. The infrastructure development project is set to be delivered ahead of schedule and will further cement HMG's position as one of the leading private medical services providers in the Middle East.

ACQUISITION

CVS completes US$8B acquisition of Signify to enhance value-based care in the home

providers, plans, and employers. The retail pharmacy giant plans to work with Signify to focus on care delivery and engagement, particularly for Medicare Advantage customers.

Signify’s network of clinicians assesses patients’ medical and social needs, then connects them with necessary follow-up services. The company currently has more than 50 health plan clients and will continue operating as a payer-agnostic business within CVS.

USA — CVS Health has completed its US$8bn acquisition of home healthcare provider Signify, bolstering its valuebased care strategy and making it a fullservice healthcare provider.

The deal adds 10,000 clinicians to CVS’s umbrella and new technology to improve care coordination for

The acquisition of Signify followed a bidding war for the home healthcare firm, with Amazon and UnitedHealth among the other interested buyers. CVS has been actively building out its primary care capabilities, including through its proposed acquisition of value-based primary care provider Oak Street Health, which was announced last month.

KENYA — IBL Group, a Mauritian investment company, has acquired a majority stake in Harley's, a Nairobibased pharmaceuticals distributor, as part of a consortium.

The acquisition is in line with IBL's 'IBL Beyond Borders' strategy and is subject to certain conditions including receipt of regulatory approvals. Harley's is a leading medical and pharmaceutical import-distributor in East Africa with offices and stock points in five locations.

Its products include drugs, hospital beds, intravenous poles, bedside cabinets, examination beds, delivery beds and stainless-steel buckets. The company's suppliers include Bayer, GlaxoSmithKline, Merck and Roche. Harley's managing director, Dr. Rupen Haria, said the partnership will propel the company to the next phase of growth.

Metropolis Healthcare introduces its novel stem cell transplant match testing tool

INDIA — Metropolis Healthcare has launched a diagnostic test called NextGen HLA Typing Test, powered by Next Generation Sequencing, to identify a suitable donor for bone marrow, cord blood or organ transplant.

The highly specialised testing method is designed to support physicians in pointing out the human leukocyte antigen (HLA) allelic genetic variants, which is clinically essential for matching donors and recipients for hematopoietic stem cell transplants and organ transplantation. This breakthrough marks a step forward in the treatment of hematological malignancies. Metropolis Healthcare’s test aims to reduce the risk of immune complications such as graft

rejection and Graft vs Host Disease and improve the survival rate of patients undergoing HSCT (Hematopoietic Stem Cell Transplant).

IBL Group acquires controlling stake in Kenyan pharma distributor Harley’s

Pfizer to acquire Seagen for US$43B in

long-awaited M&A deal

Adcetris.

Seagen's expertise in antibodydrug conjugate technology has yielded three new drug approvals in the past three years, and its pipeline of cancer treatments includes the top-selling lymphoma medicine Adcetris.

USA —Pfizer has agreed to acquire Seagen, a Seattle-based biotechnology company that specializes in developing tumor-killing medicine, for a sum of US$43 billion.

Marion Biotech loses manufacturing license over cough syrup deaths in Uzbekistan

INDIA – Marion Biotech has lost its licenses to manufacture and sell Dok-1 MAX, which is suspected to have led to the death of 18 children who consumed it in Uzbekistan.

In January 2023, the World Health Organization (WHO) issued an international medical product alert for batches of two contaminated cough syrups blamed for the deaths of at least 20 children in Uzbekistan.

The contaminated products, Ambronol syrup, and DOK-1 Max syrup were identified in Uzbekistan and reported to the WHO on Dec. 22 of last year.

Marion Biotech’s licence was under suspension since January 2023 and a detailed inquiry was initiated under three articles of the Criminal Code.

Uttar Pradesh Drug Controller Authority cancelled the manufacturing licence of the firm after highly toxic substances were found in the preparations DOK-1 MAX and Ambronol produced by Marion Biotech.

This deal marks one of the biggest in the biotech industry in recent years, and it will provide Pfizer with control over Seagen's cancer treatments, including its top-selling lymphoma medicine

This acquisition is Pfizer's largest since buying Wyeth in 2009 and the biggest in the drug industry since AbbVie's US$63 billion buyout of Allergan in 2019. This acquisition highlights the ongoing trend of M&A activity within the biotech industry as companies seek to expand their portfolios and stay competitive in a rapidly evolving landscape.

UAE-based AstraGene and Mylab form joint venture to commercialize automated diagnostics

manufacturer and marketer of invitro diagnostic reagents, kits, and instruments nationally and internationally.

The partnership will pave the way for the upgrading of laboratory infrastructure in the UAE and Kuwait, enabling laboratories in the region to drive better health outcomes.

UAE — Dubai-based molecular diagnostics manufacturing company AstraGene has formed a joint venture with Indian diagnostic company Mylab to design, develop and commercialise fully-automated molecular diagnostics in the Middle East.

The partnership will see both companies jointly market automated molecular diagnostics across Kuwait and the UAE in the coming months, with AstraGene becoming a leading

THE PARTNERSHIP WILL SEE BOTH COMPANIES JOINTLY MARKET AUTOMATED MOLECULAR DIAGNOSTICS ACROSS KUWAIT AND THE UAE

J&J to pay US$8.9 billion to settle legal claims regarding talcum powder

USA — Johnson & Johnson has proposed a settlement of nearly US$9 billion to resolve allegations that its baby powder containing talc has caused cancer, marking a significant turning point in the legal battle it has been fighting for years.

The proposed amount is more than four times what the company had previously set aside for this purpose. The plan includes a transfer of US$8.9 billion

to the subsidiary, LTL Management, payable over the next 25 years. This amount is being backed by more than 60,000 parties that have filed lawsuits alleging harm from J&J talcum powder. Despite the proposed settlement, J&J is not admitting any wrongdoing. The company has denied the allegations and defended the safety of its products. However, the legal battle has taken a toll on the company, with the lawsuits

resulting in significant legal expenses and tarnishing the company’s reputation.

Healthtech startup Envisionit Deep AI raises US$1.65m for its expansion plans

powered diagnostic imaging in African and emerging markets.

SOUTH AFRICA — South African healthtech startup Envisionit Deep AI has secured US$1.65million in funding

FUNDING FUNDING

from New GX Ventures and an additional undisclosed sum from the GIIG Africa Fund to help it democratize access to AI-

The funding will be used to finance research and development into new solutions for early diagnosis and support the company's expansion into Europe and the US following the attainment of the necessary regulatory authorisations. Founded in 2019, the company harnesses AI to transform how healthcare professionals diagnose and treat patients and helps to solve critical staffing and resource shortages mainly in public healthcare systems and underserved communities across Africa.

Hewatele secures US$10M loan from DFC to expand production and distribution of oxygen

KENYA — Hewatele, a Kenyan oxygen production firm, has secured a US$10 million loan from the US International Development Finance Corporation (DFC) to expand production and distribution of affordable medical oxygen for hospitals and clinics across Kenya.

The loan is part of the DFC’s COVID-19 Response, which is working to mitigate the economic and health impacts of the

pandemic, and its Global Health and Prosperity Initiative. Hewatele operates oxygen plants in Siaya, Nakuru, Kisumu, and Nairobi and produces oxygen by using a naturally occurring salt to separate nitrogen from the air. The loan is expected to help address the steep shortage of medical oxygen caused by the COVID-19 pandemic.

Dr. Moopen’s family invests US$56M in Aster DM Healthcare, raises stake to 41.88%

over the next three years to meet the growing demand for high-quality health care services.

THE PARTNERSHIP WILL SEE BOTH COMPANIES JOINTLY MARKET AUTOMATED MOLECULAR DIAGNOSTICS

INDIA – Hospital chain Kauvery Hospital Group has snapped up US$70 million in an investment funding round from a private equity fund managed by IIFL AMC allowing for its expansion across India.

Backed by reputed Indian and global investors Lightrock and Dr. GSK Velu’s family office, the Kauvery Hospital Group plans to increase its footprint

across India to help consolidate its current scale and market positioning.

Kauvery is currently in the midst of a fast-paced expansion programme, as it plans to reach 1,000 beds each by 2025 in Chennai, Bengaluru, and Tamil Nadu clusters.

The multi-speciality hospital will use the funds from the IIFL AMC’s private equity fund to expand its bed capacity

ACROSS KUWAIT AND VITRO DIAGNOSTIC INSTRUMENTS

It also plans to extend its offerings, with a focus on mother, child care, and pre and postoperative patient engagement areas, among others.

Ghana, Nigeria approve Oxford University’s new malaria vaccine

GHANA/NIGERIA — Ghana has become the first country in the world to approve a new malaria vaccine from Oxford University, R21//Matrix-M, with children under the age of three in line to benefit.

Ghana’s drug regulators have assessed the final trial data on the vaccine’s safety and effectiveness, which is not yet public, and have decided to use it, although it is unclear when the rollout will begin.

Ghana’s Food and Drugs Authority has approved the vaccine’s use in children aged between five months to three years as the West African country strengthens its efforts to control malaria-related child mortality. Around 20,000 children die of malaria every

year in Ghana, 25% of whom are aged under five.

India’s Serum Institute, which is partnering with Oxford University, plans to build a vaccine factory in the country’s capital Accra to produce up to 200 million doses a year.

“While the vaccine might be heralded as a huge win in the fight against malaria, it is no silver bullet,” Javier Guzman, the director of global health policy at the Center for Global Development, said. “There are important points to consider before the R21 vaccine is rolled out for wider use.”

Meanwhile, the National Agency for Food and Drug Administration and Control (NAFDAC) has granted registration approval for the Malaria

Vaccine, while communicating the need for expansion of the clinical trial conducted to include a phase 4 clinical trial/Pharmacovigilance study to be carried out in Nigeria.

Director General of NAFDAC, Prof Mojisola Christianah Adeyeye said that the Marketing Authorization Holder is Fidson Healthcare Ltd in line with the Agency’s Drug and Related Products Registration Regulation 2021.

The R21 Malaria vaccine is an Adjuvanted protein vaccine presented as a sterile solution. A dose which is 0.5ml is composed of R21 Malaria antigen 5µg and Matrix-M1 50µg as an adjuvant filled in a vial as ready-to-use liquid formulation for intramuscular injection.

Julphar taps Basel Ziyadeh as new CEO to support its growth journey

UAE – Gulf Pharmaceutical Industries (JULPHAR) has appointed Mr. Basel Ziyadeh as the new Chief Executive Officer (CEO) of its manufacturing business.

In a press release, Julphar said: “Basel Ziyadeh will succeed Essam Mohamed as CEO, who has stepped down from the senior role after joining in 2020.”

With over 25 years of experience in the healthcare sector, he will be leading Julphar to achieve its ambitious goal to deliver greater impact across all the markets the manufacturer serves.

Ziyadeh brings a deep understanding of pharmaceutical marketing and multisite manufacturing, as well as strategy development in the field of vaccines and biological medicines.

“He served as an advisor and board member for several pharmaceutical entities across Saudi Arabia, Egypt, Jordan, Sudan, Iraq, and Lebanon,” outlined Julphar.

The Emirati pharmaceutical manufacturer has selected Mr. Ziyadeh as the ideal candidate to drive strategic growth and scale its operations in the MENA region and beyond.

India’s apex body NATHEALTH picks Dr. Ashutosh Raghuvanshi as its new President

INDIA – NATHEALTH has hired Dr. Ashutosh Raghuvanshi as the company’s new President following the exit of Dr. Shravan Subramanyam.

Dr. Ashutosh Raghuvanshi brings a wealth of expertise and experience in the company’s operations, serving previously as NATHEALTH Senior Vice President (SVP) since April 2022.

His appointment comes amid senior leadership changes at NATHEALTH, an apex body representing the entire ecosystem of the Indian healthcare industry.

Prof. Stanley Khainga appointed as chairperson for KMPDU

KENYA — Kenyan President William Ruto has appointed Prof. Stanley Khainga as the chairperson of the Kenya Medical Practitioners and Dentists Council (KMPDU) for a three-year term.

Other members of the newly elected NATHEALTH leadership team are Ameera Shah as SVP, Abhay Soi as Vice President, Shishir Agarwal as Secretary, and Visalakshi Chandramouli as Treasurer.

At the same time, NATHEALTH has selected Sunil Thakur, Partner at Quadria Capital Investment Management, to lead a special task force in setting up a separate NATHEALTH foundation.

Siddhartha Bhattacharya, Secretary General of NATHEALTH, will continue to lead and head the NATHEALTH secretariat. Moreover, he has led the operational arm since 2018.

The KMPDU is a workers’ union for all doctors in Kenya, with over 8,000 members in both public and private sectors. The appointment is part of a series of recent changes in the country’s healthcare sector, including the appointments of Dr. Abdullahi Ali as chairman of the board for the Kenya Medical Research Institute and Dr. Samier Muravvej as chairperson of the Kenyatta National Hospital.

Amid calls for a Health Service Commission, the unions argue that public health facilities have become less predictable since devolution began a decade ago, and that the country’s health services should be returned to the national government due to a lack of proper resources.

King’s College Hospital taps Dr. Mohaymen Abdelghany as CEO for Saudi branch

SAUDI ARABIA – King’s College Hospital London (King’s) has appointed Dr. Mohaymen Abdelghany as the new Chief Executive Officer (CEO) for its branch in the Kingdom of Saudi Arabia. With over 25 years of experience in global health, Dr. Mohaymen Abdelghany is well-suited to lead the expansion of King’s College Hospital London’s platform in Saudi Arabia.

He is an accomplished physician consultant and healthcare leader who will oversee Ashmore’s ambitious expansion plan across Saudi Arabia and the Middle East region.

Dr. Daniel Ngamije Madandi appointed WHO’ s Director of Global Malaria Program

RWANDA — Dr. Daniel Ngamije Madandi has been appointed as Director of the Global Malaria Programme by the World Health Organization, effective 8 April 2023.

Prof Jesse Otegbayo reappointed as CMD of University College Hospital of Ibadan

NIGERIA — The Federal Government of Nigeria has reappointed Professor Jesse Otegbayo as the Chief Medical Director of the University College Hospital (UCH), Ibadan, Oyo State, for another four-year term.

The Minister of Health, Dr. Osagie Ehanire, announced the reappointment while inaugurating seven projects in the hospital in Ibadan. The minister praised Otegbayo’s leadership and called on the hospital to recapture its past reputation, not just as the premier hospital in Ibadan, but as a leading destination for cuttingedge healthcare in Africa.

In his new role, Dr. Abdelghany will oversee the construction programme of King’s hospital in Jeddah, which is scheduled to open at the beginning of 2024.

KCHJ will be the country’s first truly integrated hospital bringing the full benefits of King’s College Hospital London to Saudi Arabia.

In addition, Dr. Mohaymen is expected to cement King’s position as the highest-quality provider in the Kingdom of Saudi Arabia.

Previously, Dr. Ngamije was the Rwandan Minister of Health, during which he led the development and implementation of the Health Sector Strategic Plan and the COVID-19 comprehensive response plan. He also served as the National Programme Officer for Malaria and Neglected Tropical Diseases in the WHO Rwanda country office, and coordinated Rwanda’s National Malaria Control Program between 2005 and 2007.

In addition, WHO Director General Tedros Ghebreyesus congratulated Rwanda for acquiring the first BioNTainer, a facility that is equipped to manufacture a range of mRNA-based vaccines, and commended the country for its commitment to vaccine equity in Africa.

Otegbayo, in his remarks, expressed optimism that the projects would help to stem the tide of health tourism and brain drain in the health sector due to poor working conditions.

National Cancer Summit

African Medical Equipment Facility (AMEF)

The Kenya Healthcare Federation (KHF) and the International Finance Corporation (IFC) successfully hosted an Outreach Meeting at the Pride Inn Paradise Beach Resort in Mombasa on February 23rd, 2023. The event was aimed at introducing the African Medical Equipment Facility (AMEF) to the coastal region and providing Health Small and Medium Enterprises (HSMEs) with insights on medical equipment procurement and financing. The meeting was well-attended, and the speakers provided valuable information to the attendees. The presentations covered various topics, including an overview of the Kenya Baseline Survey and the AMEF, financing options available for medical equipment, financial management toolkit, and medical equipment procurement, quality control, and maintenance. The training provided by Joseph E. Williamson R.D.M.S. was interactive and well-received by the attendees. The event concluded with closing remarks by Bas Rozemuller, who encouraged the attendees to take advantage of the resources provided by the AMEF.

February 23, 2023 – Mombasa, Kenya

2-4 February, 2023 – Nairobi, Kenya

THEME

PARTNERING WITH ORIGINAL EQUIPMENT

MANUFACTURERS TO SUPPORT SME

HEALTH FACILITIES

MP SHAH HOSPITAL

Alleviating human suffering through compassionate care

By BENJAMIN OPUKO

Named after one of its founders Meghji Pethraj, MP Shah Hospital has grown into one of the leading multispecialty Hospitals in Kenya. Starting out as a nursing home in the early 1930s MP Shah Hospital today offers a range of specialty medical services including renal services, total hip and joint replacements, and cancer treatment. Toseef Din, Chief Executive Officer, is among the few women leading hospital institutions across Africa. 2023 marks her 5th year as CEO, but she has served the hospital for more than 11 years now, first as Head of Finance and then later as Chief Operating Officer.

As CEO, Toseef is still guided by the spirit of the hospital's founders which aimed to alleviate human suffering through the provision of compassionate care. This has seen her midwife the hospital’s growth from a humble 70-bed facility into a magnificent 217-bed hospital that boasts state-of-the-art equipment and amenities. In addition to the children's hospital and the ICU tower, the hospital has recently inaugurated

the KPG Medical Center, with an additional 66bed capacity, a physiotherapy unit, medical and surgical wards, operating theaters, and a pediatric oncology ward, which is a much-needed service in Kenya. Under her leadership, the hospital has also demonstrated a commitment to improving healthcare service provision through the opening of two satellite centers and the establishment of the Cochlear Implant Program, restoring hearing to children born without hearing capabilities. Her work as the CEO of MP Shah Hospital is already bringing her unprecedented acclaim. She has been recognized as one of the Top 40 under 40 personalities in Africa for 2022 and also won the Influential Muslim CEO award and also feted as one of the most influential persons in Kenya.

LEADING WITH COMPASSIONATE CARE

In her role as CEO, Toseef oversees a team of 1,000 staff members. As a leader, Toseef recognizes the importance of using her power to influence others in a positive way. She believes that leadership is not just about climbing the career ladder, but about being a ladder for

FRONT VIEW OF MP SHAH HOSPITAL IN PARKLANDS

COMPANY FEATURE: MP Shah Hospital

others. Her leadership style is characterized by compassion, and she is known for her ability to inspire and motivate others through her words of love, comfort, and compassion. She is often described as a soft leader by her colleagues. “I'm often told, Toseef you are a very soft leader. But I feel that you don't need weapons, to make people listen to you. Your words of love, comfort, and compassion are enough to drive results,” she says. Even more, she believes that compassion and empathy are powerful tools that can drive results and create a positive impact in the lives of patients and staff members alike.

Even with her great set of leadership skills, the Hospital just like many others in Kenya, faces a challenge in retaining top medical talent particularly nurses and doctors who opt to leave the country for better opportunities abroad. To address this issue, the hospital has focused on capacity building its College of Healthcare Sciences. Through this initiative, the hospital is training nurses to ensure a constant stream of skilled nurses who can be absorbed in various nursing leadership roles within the hospital.

In addition, the hospital has a robust training and growth program in which it sponsors doctors and nurses to remain current with global trends. Growth and career progression are critical to retaining employees, and the hospital strives to provide opportunities for growth to its staff. The hospital’s CEO firmly believes that “growth and career progression is something that is very important to not only our doctors and to our nurses but for anyone in an institution.”

The hospital has also developed close affiliations with organizations like the College of Surgeons of East, Central, and Southern Africa (COSECSA) and runs internship programs to retain skilled staff. However, the hospital recognizes that engagement is crucial to retaining employees, and it has implemented various innovative employee engagement programs. These programs include Zumba sessions, potluck sessions, and social outings with the CEO.

Through these initiatives, the hospital aims to create a sense of family among its employees, strengthening social ties and fostering a sense of belonging. Overall, MP Shah Hospital recognizes that employee engagement and retention are critical to its long-term sustainability and is committed to investing in its staff to ensure their growth and success within the organization.

CHAMPIONING WOMEN EMPLOYMENT

MP Shah Hospital is leading the way in

championing women's employment in the healthcare industry. With a strong commitment to this course, the organization boasts a workforce where 64% of its employees are women.

Women employees also comprise a majority of the senior management at 84%. Additionally, 63% of the Heads of Departments (HODs) are women, a clear demonstration that women can also successfully lead hospitals. The organization

TOSEEF DIN, CHIEF EXECUTIVE OFFICER, MP SHAH HOSPITAL

is also proud to have all its nurse managers being women, another win for the women in science. Being a majority women-led organization, MP Shah also stands out as an inspiration and motivation for other women to pursue leadership roles.

While the hospital’s workforce is typically female-dominated, Mrs. Din acknowledges that there is still work to be done in promoting gender equity. “We have compelling recruitment programs in place that prioritize fairness and inclusivity,” Mrs. Din states. The organization runs a College of Health Sciences to encourage more male nursing students to enter the healthcare industry. By promoting gender diversity, the organization aims to create a level playing field where all genders have equal opportunities for growth and development.

CREATING AN AFFORDABLE, PATIENT FOCUSED HEALTHCARE SYSTEM

Despite challenges with retaining top talent, MP Shah is committed to its goal compassionate care. The high cost of healthcare is however a major impediment to this goal. At MP Shah hospital, the management has recognized this challenge and taken steps to address it. One of the ways in which the hospital has helped to minimize the burden of high healthcare costs is through

the establishment of the Dinshaw Byramjee Dispensary in Nairobi City. The dispensary provides affordable healthcare services such as pharmacy, casualty, dental, and ophthalmology services to the local population. “The Dinshaw Byramjee Dispensary is part of our commitment to making healthcare more accessible and affordable to the local population,” says Toseef.

The hospital recognizes that it is in a unique position to create accessible and affordable healthcare models, and the dispensary is a step towards achieving this goal.

Despite coming at a high cost, MP Shah Hospital places a strong emphasis on the quality of healthcare it delivers, and has implemented various measures to ensure the utmost quality care. One of the key programs in place is the AMUA program, which stands for "Always Maintaining Uniformity of Awesome Care". Under this program, the hospital has embarked on a journey towards achieving accreditation from the Joint Commission International (JCI) and the ISO 9001 certification.

To ensure clinical governance and adherence to ethical standards, the hospital has established several oversight committees, including the Medical and Therapeutics Committee, Standards and Ethics Committee, and Admissions and Privileges Committee. These committees ensure

that the hospital uses the right medication, follows ethical guidelines, and vets doctors who come to operate in the hospital.

To further its goal of delivering quality care, MP Shah hospital unveiled a five-year strategic plan in 2021 which is primarily centered around patient-focused care. The hospital aims to bring the patient at the center of all the decisions they make as a healthcare institution. This means ensuring that policies, procedures, and patient charters are designed with the patient's rights and responsibilities in mind.

The five main pillars of the hospital's strategic plan are financial sustainability, sustainable growth, operational excellence, highly engaged patient-centric teams, and patient-focused care. The hospital believes that focusing on these pillars will enable them to remain patient-centric while delivering excellent healthcare daily.

NAVIGATING THE COVID-19 PANDEMIC

The COVID-19 pandemic presented a unique challenge to the hospital, particularly in terms of staff well-being. The hospital had to deal with financial, mental, and physical stress and had to establish a mental health and well-being program for its staff. The hospital lost doctors and nurses to the pandemic, further straining the mental well-being for its healthcare workers. The only silver lining to one of the greatest medical tests in our time is that the MP Shah Hospital was presented with an opportunity to fast-track its digital journey, offering patients better access to

healthcare services.

The journey to digital health started with the adoption of telemedicine to address the challenges posed by the pandemic. This was followed by teleradiology, where radiologists could report on diagnostics from the comfort of their homes. The hospital also introduced an online booking system where patients could easily book appointments in any of their specialty clinics or other services provided by the hospital. This new approach has made access to healthcare more efficient and convenient for patients.

MP Shah is currently undergoing a major upgrade of its hospital management information system (HMIS), thanks to the COVID-19 pandemic. The upgrade is expected to include more features in terms of clinical governance protocols, and the hospital's IT department is working on a digital

UNDER THE AMUA PROGRAM, THE HOSPITAL HAS EMBARKED ON A JOURNEY TOWARDS ACHIEVING ACCREDITATION FROM THE JCI AND THE ISO 9001 CERTIFICATION.

transformation plan to keep the institution at the forefront of technology advancements. This digital transformation plan will help the hospital to offer better services, manage patient data more effectively, and remain competitive in the healthcare industry.

As technology advances, it is important to remember that the patient should always be at the center of healthcare. MP Shah Hospital understands this and is committed to using technology to bring patients together, not apart. The hospital remains steadfast in its commitment to patient care, and it strives to maintain the compassionate, one-on-one conversations that have always been part of the healing process.

A CORPORATE BODY THAT PROMOTES CARE FOR ENVIRONMENT

MP-Shah Hospital is not only concerned with the well-being of its employees but also with the environment. The hospital has launched a program called Green 365, which aims to reduce the hospital's carbon footprint and be more environmentally conscious. The program includes developing a green policy, hiring green champions, and setting green Key Performance Indicators (KPIs) to monitor and evaluate the hospital's progress towards becoming more ecofriendly.

Some of the activities that have been implemented as part of the Green 365 program

include installing LED lighting systems and planting trees around the hospital to create a more pleasant environment for patients. The hospital also involves its staff in the program through induction and orientation programs, recognizing that going green is a behavioral change that requires commitment and action from everyone.

The Green 365 program has gained global attention, with MP Shah Hospital being invited to share its journey towards environmental stewardship on international platforms. To take its green journey further, MP Shah Hospital is now aiming to become the first hospital in Kenya to fully go green. To achieve this goal, the hospital is considering introducing green buildings, which will significantly reduce the hospital's carbon footprint and promote sustainability.

HEALING LITTLE HEARTS IN A BIG WAY

As a corporate body, it also strives to give back to the community through various initiatives. The Healing Little Hearts program is MP Shah's flagship program on corporate social responsibility. The program creates affordable models for children who cannot lead normal lives due to heart conditions. Started in 2017, the program has left an indelible mark in the lives of many children who heretofore did not have access to this kind of care.

MP SHAH NURSE DURING BLOOD DONATION DRIVE COUNDUCTED BY THE HOSPITAL

“When the children come to the hospital, they are often malnourished, weak, and unable to engage in normal activities such as playing sports or attending school. However, after undergoing surgery, the transformation is remarkable. The children are running around the hospital corridors, able to breastfeed and enjoy their meals and have a new lease on life,” Toseef narrates.

The program's success is a testament to the hospital's commitment to making a positive difference in the community.

“I would encourage everyone to have such kind of formidable

partnerships and friendships with these organizations where we can touch the hearts literally of these young children who really need our assistance,” adds Toseef.

FUTURE PLANS

MP Shah is a healthcare organization that prides itself on being committed to growth and expansion. With a current workforce of 1000 employees, the organization recognizes that there is always room for improvement and expansion. Recently, the organization has signed many Memoranda of Understanding (MOUs) with leading institutions to facilitate capacity building and enhance the quality of healthcare services offered.

In line with its growth and expansion programs, MP Shah is open to partnerships with other institutions. These partnerships are expected to play a critical role in enhancing the quality of healthcare services offered by the organization. The organization has also developed new programs to train its nurses and doctors, and it welcomes partnerships that will contribute to the development of its healthcare services.

The organization's goal is to open more satellite clinics in the next couple of years to increase access to affordable healthcare services. The organization is also looking forward to establishing a robust pediatric oncology program and developing a Pediatric Neuro Diagnostic Center. The launch of a bariatric program and weight loss clinic programs is expected in the next couple of months, which will enhance the quality of healthcare services offered to the Kenyan population

THE DINSHAW BYRAMJEE DISPENSARY IS PART OF OUR COMMITMENT TO MAKING HEALTHCARE MORE ACCESSIBLE AND AFFORDABLE TO THE LOCAL POPULATION.

THE HOSPITAL'S TOP MANAGEMENT AT THE OPENING OF THE DINSHAW BYRAMJEE DISPENSARY

KISUMU SPECIALISTS HOSPITAL

Leading the way in specialized healthcare

By BENJAMIN OPUKO

Nestled in the serene hills of Riat, the Kisumu Specialists Hospital stands tall, providing a haven of care and healing for patients in the Lake region and beyond. With a current capacity of 50 beds, the hospital offers comprehensive medical services to its patients. Under the leadership of Dr. Judith Getugi, the Chief Executive Officer, the hospital has been taking steps to ensure that it is well-equipped to fulfill its mandate of providing quality healthcare services to the community.

MEDICAL SPECIALISTS WITH EXPERTISE

One of the hallmarks of KSH's quality care provision is the expertise of its medical specialists. With a total of 29 highly trained specialists, KSH offers patients access to a level of medical care that is simply unmatched in the region. The specialists are drawn from various fields of medicine including anesthetics, orthopedics, obstetrics and gynecology, radiology, and urology among others. Pediatricians, general surgeons, and endoscopists are also within the hospital premises for an all-round care to patients. "Our specialists are doctors with many years of experience in their particular field of medicine," explains Dr. Judith, the hospital’s CEO. “They are usually able to perform more detailed tests and administer more direct treatments than a general physician.”

Dr. Judith further emphasizes that the hospital has an excellent team of healthcare professionals dedicated to providing quality healthcare services to their patients. "With over 100 employees, both full-time and part-time, we have a team of healthcare professionals who are passionate about delivering the best possible care to our patients," says Dr. Judith.

When it comes to healthcare, staying current with the latest medical techniques and practices is crucial. That's why the medical practitioners at KSH stand out from the crowd - they are not only dedicated to providing excellent care to their patients, but they are also active faculty members at the top medical schools in the Lake Basin region.

When it comes to healthcare, the skills and knowledge of medical professionals are undoubtedly important. But at KSH, it's not just expertise that sets their medical practitioners apart - it's also their unwavering commitment to compassion and personalized care. "At KSH, patients are treated with the utmost care and respect, and their individual needs and concerns are always taken into consideration," explains the CEO. "In healthcare, we should always remember our humanity and treat our patients as part of our family."

Kisumu Specialist Hospital has also invested heavily in the latest medical equipment to ensure that its patients receive the best possible care. The hospital has newer generation equipment

such as a digitalized X-ray machine, CT scan, biochemistry analyzer, baby resuscitares, and modern delivery beds. The hospital is also equipped with 6 operation theatres and 5 endoscopy suites for advanced medical procedures. In addition, the hospital has a number of clinics including Cardiology, Chest, Neurosurgery, Oncology, and Neurology clinics which are tailored to offer patients specialized care.

IMPROVING SERVICE DELIVERY THROUGH REDUCED TURNAROUND TIMES

In the world of healthcare, time is of the essence. When patients are sick, they need care and treatment as quickly as possible. That's why Kisumu Specialists Hospital (KSH) is proud to have been recognized for its efficiency in patient care. Recently, Jubilee, one of Kenya's leading insurance companies, awarded KSH for its low length of stay. This recognition is a testament to the hospital's commitment to providing fast and efficient care to patients.

Dr. Judith explains the significance of the

A DUO OF THE KISUMU SPECIALISTS HOSPITAL MEDICAL DOCTORS AT THE FACILITY

award. "This means that when a patient is admitted, we aim to diagnose, manage, and treat them as fast and efficiently as possible." For patients, this translates to reduced wait times, quicker diagnoses, and faster access to treatment.

The low length of stay award is not just a badge of honor for KSH; it's also an indicator of the hospital's dedication to patient care. By prioritizing efficiency and streamlining its operations, KSH can deliver the best possible care to patients while also reducing the burden on the healthcare system. As things stand right now at the hospital, Dr. Judith notes that “with just a click of a button, the doctor can input whatever needs to be done, and the patient can move on to other necessary tests or treatments.”

TRANSFORMING HEALTHCARE DELIVERY THROUGH TECHNOLOGY

Technology has been a game-changer in many industries, and healthcare is no exception. At Kisumu Specialists Hospital (KSH), the adoption of cutting-edge technology has significantly transformed the way the hospital operates and delivers care to patients. “The adoption of

technology has been a game-changer for KSH," says Dr. Judith. "It has enabled us to deliver faster, more efficient, and more effective care to our patients while also minimizing waste and reducing costs.”

According to Dr. Judith, one of the most significant benefits of technology adoption at the hospital is the reduction in patient processing time. Thanks to the implementation of a stateof-the-art hospital management information system (HMIS), KSH has managed to greatly reduce patient processing times, resulting in reduced waiting times for patients. Dr. Judith notes that “the average time that patients spend in the facility as outpatients has been reduced to anywhere from 30 minutes to 45 minutes, which is much lower than the industry standard.” The HMIS system also allows doctors and nurses to access patient records quickly, enabling them to make more informed decisions and provide the best possible care.

Moreover, the hospital management information system has helped KSH predict the stocks they need to purchase, ensuring a constant supply of goods and a better relationship

NUMBER OF MEDICAL SPECIALISTS AT KISUMU SPECIALISTS HOSPITAL

RADIOLOGIST AT KISUMU SPECIALISTS HOSPITAL PERFORMING A SCAN PROCEDURE ON A PATIENT .

with vendors and suppliers. “This has allowed us to maintain a constant supply of goods and to establish a better relationship with our vendors and suppliers, as we are able to manage our inventory more effectively,” she explains.

KSH's commitment to innovation and technology is evident in its current focus on telemedicine. Dr. Judith notes that telemedicine has emerged as one of the most significant breakthroughs in healthcare delivery and is today one of the hospital’s main investment technology-wise. According to Dr. Judith, KSH's telemedicine program has been a success, with positive feedback from patients and healthcare providers alike. "We've seen a significant increase in patient satisfaction, and our physicians appreciate the convenience and flexibility that telemedicine provides," she notes. “We've also been able to reduce the burden on our physical facilities, which has been particularly helpful during the COVID-19 pandemic.”

Given the success of the program, KSH plans to expand its telemedicine offerings in the coming years. This will involve continuous investment in training, software, and hardware to ensure that the hospital remains at the forefront of telemedicine innovation. “We believe that telemedicine has the potential to transform the way healthcare is delivered, and we're committed to making it a central part of our patient care strategy,” she adds.

“We are also developing an app to support patients at home," Dr. Judith reveals. "This app is designed to provide services such as physiotherapy to patients who need them but cannot physically visit the hospital. The app can be downloaded to their phones, and patients can

continue to seek services from the comfort of their own homes,” she explains.

STRATEGIC PLANS THAT FOCUS ON GROWTH AND INNOVATION

Strategic planning is an essential aspect of any organization, and it becomes even more crucial in the healthcare sector where efficiency and effectiveness can mean the difference between

THE AVERAGE TIME THAT PATIENTS SPEND IN THE FACILITY AS OUTPATIENTS HAS BEEN REDUCED TO ANYWHERE FROM 30 MINUTES TO 45 MINUTES, WHICH IS MUCH LOWER THAN THE INDUSTRY STANDARD.

Dr. Judith Getugi - CEO, Kisumu Specialists Hospital

life and death. The Kisumu Specialists Hospital understands the significance of strategic planning and has been taking steps to ensure that it is well-equipped to fulfill its mandate of providing quality healthcare services to the community.

"We're currently in the process of establishing our new strategic plan for the next five years, which is a crucial moment for us," she reveals adding that the previous plan helped the hospital establish itself and set up efficient systems. “Now it's all about growth and innovation. We are looking for innovative solutions to the problems that we face in the healthcare industry, and we are constantly exploring new technologies that can help us achieve better results for our patients," Dr. Judith says.

A HOSPITAL WITH THE COMMUNITY AT HEART

Corporate social responsibility (CSR) is a critical aspect of any successful business. At Kisumu Specialists Hospital (KSH), CSR is not just a buzzword; it is a core value that the hospital has consistently demonstrated through its actions.

Dr. Judith emphasizes the importance of prioritizing the community in which the hospital

operates. "As a business operating within a community, it is essential that we prioritize serving the community," she says. "Our first step towards this goal is providing healthcare services to the community in which we operate."

Further KSH demonstrates its commitment to the community by hiring locally. "We hire locally and provide employment opportunities to members of the community. Our staff is mostly composed of Kenyans, which reflects our commitment to the community," explains Dr. Judith.

But KSH's commitment to the community doesn't stop there. The hospital also participates in various community projects, such as the Medical Camps tour in partnership with Ramogi TV where the hospital was able to provide support to over 1000 patients seeking medical attention.

KSH also supports local teams and participates in events that promote healthy living, such as the Dala Sevens. "We believe that de-stressing and having fun is important, especially considering the hectic nature of modern life," adds Dr. Judith.

The hospital is also big on community health awareness. "As a healthcare facility, we believe that creating awareness and educating the public about various aspects of health is an opportunity and responsibility we should take seriously," she says. “Educating the public is one of the most effective ways to improve their health and wellbeing.”

full certification for the organization, and we expect to complete the process within the next two years. We are also working on achieving other healthcare-specific certifications such as SafeCare Accreditation." Dr. Judith explains that pursuing these certifications is crucial for the hospital's success in the future. "We want to ensure that we are providing the highest quality care to our patients, and pursuing these certifications is one way we can demonstrate our commitment to that goal," she says

FUTURE PROSPECTS

As a hospital that is dedicated to providing quality healthcare services, Kisumu Specialists Hospital (KSH) is continuously exploring ways to improve and expand its operations. "We recognize that the demand for quality healthcare services is everincreasing, and we are committed to meeting this demand by expanding our operations," Dr. Judith says. "Our goal is to ensure that every patient who comes through our doors receives the best possible care, and we believe that expanding our capacity is essential to achieving that goal."

Dr. Judith also highlights the importance of benchmarking and continuous improvement through certifications. Recently, the hospital’s laboratory received accreditation from the Kenya Accreditation Service (KENAS), providing proof of the facility’s competence to carry out various

BOTH FULL-TIME AND PART-TIME, WE HAVE A TEAM OF HEALTHCARE PROFESSIONALS WHO ARE PASSIONATE ABOUT DELIVERING THE BEST POSSIBLE CARE TO OUR PATIENTS.

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KAPI:

Elevating Healthcare ethics & innovation in Kenya's pharma industry

Established in the mid-1960s, the Kenya Association of Pharmaceutical Industries (KAPI) remains committed to its mission of working towards promoting an ethical, innovative, and responsible healthcare industry

By BENJAMIN OPUKO

The Kenya Association of Pharmaceutical Industry (KAPI) is a leading voice in the pharmaceutical industry in Kenya. Established in the mid-1960s, KAPI was formed to bring about positive change in the pharmaceutical industry in Kenya.

Over the years, KAPI has grown to become a strong community that advocates for ethical and fair business practices in the pharmaceutical industry. However, after resolving the issues it was initially formed to tackle, KAPI went into hibernation mode. It was not until 2003 that the association was re-established, and it has been going strong ever since.

To ensure it discharges its mandate effectively, KAPI has put in place an elaborate leadership structure that is comprised of a Board of Directors with executing committees catering for the different areas of focus such as Trade Regulation and Policy, Compliance and Governance, Communications and Public relations, Medical Device and IVD and Pharmacovigilance and Medical Affairs committees. Holding the fort and steering the KAPI ship is Dr. Winnie Ng'ang'a, a Regulatory Affairs Director and Government

Affairs Lead at GSK. In her position as KAPI Chair, Dr. Ng'ang'a brings with her a wealth of experience in the pharmaceutical industry, particularly in the areas of regulations, thoughtleadership, strategic partnerships, and corporate governance making her a valuable asset to the association. Assisting her in this great task is KAPI Vice Chairperson Mr. Vinod Guptan, who also serves as the CEO of MedSource. In an exclusive interview with HealthCare Middle East and Africa magazine, both leaders provide insight into the association's operations and how KAPI is actively working towards creating a progressive healthcare industry that caters for the patient as the primary focus. The two note that since its resurgence, KAPI has become a powerful voice for the pharmaceutical industry in Kenya.

FIGHTING COUNTERFEITS HEAD-ON

The fight against counterfeit pharmaceuticals has long been a priority for the Kenya Association of Pharmaceutical Industry (KAPI), a membership-based organization representing research-based manufacturers and distributors of pharmaceuticals in Kenya. With a growing membership of 34-member biopharmaceutical

KAPI'S EXECUTIVE TEAM POSE FOR A PHOTO WITH MEMBERS FROM REPRESENTATIVE ORGANIZATIONS DURING AN IN-PERSON MEETING HELD AT NAIROBI CLUB,

companies, KAPI has been actively working towards creating a business environment that is ethical, fair, and free of counterfeits.

"To minimize the counterfeits, we are also working with international associations such as IFPMA to create more awareness in the markets

and bring more support in terms of developing guidelines," explains Dr. Winnie Ng'ang'a.

But it's not just counterfeits that KAPI is tackling. As Dr. Ng'ang'a notes, "Other than counterfeits, we also experience the challenge of unregulated imports." However, the association remains undeterred. Unfazed, she mentions that the association is "working with the Pharmacy and Poisons Board to streamline the imports through guidelines that are secure and that will ensure the importation of safe and quality medicine."

The fight against counterfeit drugs and unregulated imports requires a collective effort from all stakeholders in the pharmaceutical industry. As Dr. Ng'ang'a emphasizes, KAPI recognizes the importance of stakeholder engagement in this battle and has established partnerships and relationships both locally and internationally to combat this challenge.

KAPI has embarked on different strategies to combat unregulated imports and counterfeits. One of the key strategies that KAPI employs is providing training to customs officers on product evaluation and counterfeit detection.

As Mr. Guptan explains, the process of identifying counterfeits requires a range of experts, including random samplers, investigators, quality assurance pharmacists, and a well-equipped lab. With counterfeiters improving the packaging and copying batch numbers and barcodes, distinguishing real from fake is becoming increasingly challenging.

"Based on visual impact alone, it's almost impossible to differentiate genuine from copy," admits Mr. Guptan. However, to combat this

WHEN YOU BUY A FAULTY TELEVISION, YOU MAY LOSE YOUR MONEY OR BE INCONVENIENCED, BUT ULTIMATELY, IT IS NOT A MATTER OF LIFE AND DEATH. HOWEVER, WHEN IT COMES TO COUNTERFEIT MEDICINE, THE STAKES ARE MUCH HIGHER.

Mr. Vinod Guptan - Vice Chairperson, KAPI

challenge, Guptan cites that “KAPI members have implemented innovative technologies such as barcodes, QR codes, 3D and 4D codes, and GS1 barcodes. They have also introduced a new scratch and text system that allows consumers to text a number to verify the authenticity of the product.”

The issue of counterfeit medicines is a significant challenge for consumers of medicines worldwide. These fake drugs pose serious risks to patients, which makes them a matter of life and death. Mr. Guptan's analogy of buying a faulty TV perfectly illustrates the gravity of the issue that consumers may face as a result of purchasing counterfeit medicines.

“When you buy a faulty television, you may lose your money or be inconvenienced, but ultimately, it is not a matter of life and death. However, when it comes to counterfeit medicine, the stakes are much higher. Patients who take these drugs may suffer severe health consequences or even lose their lives,” he explains.

KAPI recognizes the importance of creating a regulatory environment that ensures fair and legal trade while protecting patients. By working with regulators and policymakers, KAPI is helping to develop policies that promote the safety and

efficacy of the medicines in the market. This will help patients trust that the medicine they are buying is genuine and safe, ultimately leading to a healthier population.

Despite the efforts of industry players and regulators, counterfeiters are constantly finding new ways to evade these measures, which presents a significant challenge to the industry. As Mr. Guptan explains, the situation is akin to “thieves always being way smarter than cops”

To combat this challenge, KAPI members must continuously supplement their measures to stay ahead of the counterfeiters. To this end “KAPI is exploring new methods to combat counterfeiting, such as digitizing the entire supply chain,” states Mr. Guptan. By creating a track and trace system that covers the entire journey of a product from the manufacturer to the end consumer, KAPI hopes to increase transparency and make it easier to identify and prevent the entry of counterfeit medicines into the Kenyan market.

The benefits of a digitized supply chain go beyond counterfeit prevention. It also increases efficiency, reduces waste, and provides greater visibility into the supply chain, which is crucial for regulatory compliance. With the digitized supply chain, KAPI hopes to create a secure, transparent,

KAPI CHAIRPERSON AND MEMBERS POSE FOR A

PHOTO DURING ONE OF THE STAKEHOLDERS' MEETINGS

ASSOCIATION FOCUS: Kenya Association of Pharmaceutical Industries

and efficient supply chain that benefits both patients and the industry.

However, the implementation of a digitized supply chain is not without its challenges. It requires significant investment in technology and infrastructure, as well as training and education for stakeholders. KAPI acknowledges these challenges but believes that the benefits far outweigh the costs.

KAPI: ETHICS AND INTEGRITY

Additionally, KAPI is passionate about ethical practice within the healthcare industry and as such has partnered with the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), an association which Dr. Ng'ang'a cites as an example of one of the strategic partnerships that has led to successful initiatives across East Africa.

Through this collaboration, KAPI has developed training, policy frameworks, code of ethics and most recently delivered a First in Africa Multisectoral Health Consensus framework that focuses on ethical conduct and integrity in healthcare providers, this was launched with 17 other partners within the healthcare industry. The Launch of the Kenya Consensus framework for ethical collaboration was a remarkable achievement that brought diverse health stakeholders together to strengthen ethical conduct and together to save lives and strengthen our health systems in Kenya. The result is that patients will trust the healthcare system more and experience better holistic care. With this consensus commitment, we expect that Kenyans will receive the right treatment at the right time and for the right reason with the best therapeutic outcome.

"By partnering with organizations such as IFPMA, GSCF (Global Self Care Federation) we are able to create more awareness in the markets and bring more support in terms of developing internationally acceptable standards and guidelines," says Dr. Ng'ang'a. She goes on to stress that KAPI's relationships with key stakeholders enable it to leverage knowledge and resources for the greater good of the industry.

As Mr. Guptan highlights, KAPI's partnerships with key stakeholders such as the Kenya Healthcare Federation, Pharmacy and Poisons Board, Anti-Counterfeit Association, KEPSA, PSK, and others, have been crucial in ensuring the association's success in these areas. With a united effort and shared goals, KAPI and its partners are working towards a more sustainable and ethical

future for the pharmaceutical industry in Kenya and beyond.

Capacity building is a crucial area of focus for KAPI, particularly in strengthening the regulation system, according to KAPI Vice Chairperson, Mr. Guptan. The association's collaborations with various entities are aimed at promoting a better business environment while simultaneously strengthening the regulatory system in the country.

MAKING SUSTAINABILITY A PRIORITY

In today's world, sustainability has become a top priority for organizations across all industries. And KAPI, the Kenya Association of Pharmaceutical Industry, is no exception. KAPI has been leading the way in leveraging technology to achieve sustainability goals in the pharmaceutical industry. Dr. Ng'ang'a's insight into KAPI's adoption of digital technology for

sustainability is impressive. The Association is well aware that leveraging technology is a key factor in ensuring sustainability. Digitalization also brings more transparency to the landscape, which benefits all parties involved Dr. Ng’ang’a states that “There has been a positive move by the government with the creation of online platforms for transacting from regulation, registrations, importing and exporting of pharmaceutical products.” she adds that “This is a positive move and KAPI commends

DR. WINNIE NG'ANG'A REPRESENTING KAPI IN MULTI-STAKEHOLDER MEETING OF HEALTHCARE PROFESSIONALS

NUMBER OF MEDICAL SPECIALISTS AT KISUMU

the Pharmacy and Poisons Board for setting for pace for the rest of the East Africa markets in digitalizing their systems.”

“Digital Health is the future and we have to be ready to hit the ground running by working with the authorities to ensure that the proper legislations and regulations are in place and that all the appropriate policies are enforced to support this area of growth.

Hopes to make good use of data driven valuebased supply chain.

KAPI's dedication to sustainability is not just a trend but a conscious effort to make a positive impact on the environment. According to Dr. Ng'ang'a, "KAPI is committed to taking a leadership role in environmental sustainability and ensuring that its member companies do the same." This commitment to environmental protection is evident in KAPI's partnership with the Global Safe Care Federation, which is focused on developing a more environmentally friendly approach to pharmaceutical waste management.

KAPI'S SUSTAINABILITY EFFORTS EARN RECOGNITION

KAPI's dedication to sustainability has not gone unnoticed. The Association has been recognized

for its efforts, including the development of guiding documents that bring together key stakeholders. Dr. Ng'ang'a shares that KAPI's UHC report, launched in 2021, emphasizes the crucial role that entrepreneurs play in forming publicprivate partnerships to ensure sustainability efforts are successful. She adds, "We are proud to be at the forefront of sustainability efforts in our industry, and we hope to inspire others to follow our lead. The innovative biopharmaceutical industry’s holistic approaches focus on three key strategies.

These include collaborating across sectors to strengthen healthcare systems and respond to local needs, working to support national strategic priorities, and increasing access to quality healthcare and treatment. Dr. Ng’ang’a reiterates, “With our mission to discover, develop, manufacture, and distribute valuable medicines that enable people to live longer, healthier, and more productive lives, the innovative biopharmaceutical industry is a key actor in Kenya’s healthcare landscape.”

As part of its sustainability efforts, Dr. Ng’ang’a explains that “KAPI is working with Global Self Care Federation (GSCF) to Charter for Environmentally Sustainable Self-Care, with key focus on Plastics and Packaging, Pharmaceutical Waste disposal in the environment and CO2 footprint. “

Looking to the future, KAPI remains committed to continuing its efforts towards sustainability and making a positive impact on the environment. As Dr. Ng'ang'a notes, "We believe that our industry has a responsibility to protect the environment, and we are committed to doing our part. Through our partnerships, education initiatives, and continued dedication to sustainability, we aim to make a real difference in the world."

ENCOURAGING PHARMA INDUSTRY GROWTH LOCALLY THROUGH PPPS

KAPI is actively engaged in public-private partnerships (PPP) to encourage the growth of the pharmaceutical industry in Kenya. Through PPPs, KAPI is looking to partner with the government to strengthen regulation initiatives, fund projects, share resources, and transfer technology. Mr. Guptan reflects that the PPP “idea was initially proposed by the Kibaki government and is now seeing progress under the current leadership.” By incentivizing local manufacturers to revive or establish their manufacturing units in Kenya, KAPI hopes to create a more conducive

DR. WINNIE NG'ANG'A POSE FOR A PHOTO WITH ANTICOUNTERFEIT AUTHORITY OFFICIALS IN A PAST EVENT

ASSOCIATION FOCUS: Kenya Association of Pharmaceutical Industries

environment for businesses and provide employment opportunities in the country. This would also make Kenya a hub and a trendsetter in the pharmaceutical industry in East Africa and sub-Saharan Africa, he adds.

One of the major benefits of revamping local manufacturing units is that it would lead to the production of good quality products at a lower cost. Transportation costs can be expensive and time-consuming, and manufacturing products locally can reduce these costs, making it easier for Kenya to provide pharmaceutical products to other sub-Saharan African markets. The government’s efforts towards incentivizing local manufacturing not only contribute to the development of the healthcare industry in Kenya but also the region as a whole.

Overall, KAPI recognizes the need for a better-structured playing field for entities to manufacture locally in Kenya, which can potentially benefit the country's economy and its people. Through its partnerships with the government and other stakeholders, KAPI is committed to promoting sustainable growth in the pharmaceutical industry in Kenya and beyond.

SENTIENT ABOUT THE NEEDS OF THE COMMUNITY

As part of its corporate social responsibility (CSR) duties, KAPI collaborates with regulators, stakeholders, and its members to create sustainable solutions that benefit the country and its people.

While KAPI itself does not deal in products, its members have launched numerous products, including COVID vaccines such as AstraZeneca and Pfizer. KAPI members are also involved in the import and distribution of vaccines and antimalarials into the country, which plays a significant role in the healthcare sector. One example of a sustainable project that KAPI members were involved in is the Affordable Medicines Facility-malaria (AMFM) project aimed at eradicating malaria in Africa.

The association's dedication to CSR is further demonstrated through its engagement in various activities that benefit the country and its systems. KAPI members have donated instruments and equipment to national quality control labs, including Kenyatta and MTRH. Such donations help improve the capacity of these labs, which ultimately leads to better quality control of pharmaceutical products in the country.

FUTURE PLANS

KAPI through the leadership of Dr. Ng’ang’a has seen the association build Corporate governance structures that ensure that it has longevity in its operations. KAPI is currently revising its constitution to make it fit for the future.

KAPI is seeking to work more with the county governments to address emerging issues in healthcare as well as seek solutions in healthcare financing for the benefit of the patients and to increase access to their ever-growing portfolio from the innovator member companies.

KAPI is also looking to expand its reach by supporting other markets in Sub-Saharan Africa. The association is in the process of supporting the other East and West African markets to create strong trade association strong trade associations that can represent the pharmaceutical industry in these countries, and it is currently helping to formulate constitutions and governance structures for these new associations.

Expanding into new markets is a significant step for KAPI member companies, as it will help create a sustainable market for the pharmaceutical industry across Africa. The association's board is keen on bringing together member organizations from other African countries to strengthen the industry and create a fair business environment. KAPI's success in Kenya can be replicated in other countries, and with the collaboration of key stakeholders, it is hopeful that the pharmaceutical industry in Africa will experience tremendous growth

WE BELIEVE THAT EDUCATION IS CRUCIAL IN ENSURING THAT OUR SUSTAINABILITY EFFORTS ARE SUCCESSFUL, AND WE ARE WORKING TIRELESSLY TO ENSURE

THAT EVERYONE IN OUR COMMUNITY UNDERSTANDS THE IMPORTANCE OF SUSTAINABILITY

Dr. Winnie Ng’ang’a - Chairperson, KAPI

BRIGHT MEDICALS

Leveraging Artificial Intelligence to help doctors with precision diagnosis

By JACKIE MBITHE

Africa has the lowest density in terms of physicians, with a ratio of 1.6 health workers per 1,000 people. This is below the World Health Organization recommendation of 4.5 health workers per 1,000 who are needed to deliver essential health services and achieve universal health coverage. Hospitals and healthcare professionals are often overwhelmed. In addition, the patient’s condition might not be familiar to the physicians, or they might be dealing with a condition that has similar symptoms to another disease, causing a misdiagnosis. This results in medical errors among which are diagnostic and treatment.

Cameroonian Gael Kamdem De Teyou saw this gap and founded Bright Medicals in 2022. He developed a comprehensive web application that uses Artificial Intelligence (AI) to provide automated, fast, and repeatable analysis of medical images that are accurate as that performed by expert physicians.

“After talking with health workers, we realized that they are busy and overwhelmed. Sometimes they just want to make a quick diagnosis and go

to the next patient. For sure this can bring errors in the diagnosis or treatment. We noticed that sometimes they are not familiar with the pattern of the disease so they can also go wrong. Our idea is to enable them to work more efficiently by building tools that can analyze medical images and give them some insight,” says Gael who studied science and technology at Telecom ParisTech.

The company develops visual recognition technology that extracts actionable insights from medical images to add clinical value, and improve diagnostic decision-making, efficiency and productivity.

He highlights that the healthcare system in Cameroon is very bad. They are overcrowded and a lot of people are dying. In some hospitals, patients have to wait a long time to see a physician. Optimization is minimal, especially from the labs that do the medical exams then doctors use the result of those medical exams to make a diagnosis and order a specific treatment. “We see it as a supply chain, we have to optimize every point of the supply chain. I know just in the beginning and as we are going to work with

every entity on the supply chain, we will have a better understanding of what to do and we will bring technologies that enable them to work efficiently so that the patient will have the best experience possible,” Gael adds.

A TEAM OF 4 PROFESSIONALS

With field expertise in machine learning, signal processing and computer vision, Gael works as the Chief Technology Officer at the company with Gloria, a medical degree holder and currently completing her residency training in paediatrics at the University of Yaounde 1, as the CEO.

Jordan is the head of software engineering. “He holds almost all what we are doing,” Gael adds. Raissa Mbeng is the Chief Health Scientist. She's in charge of the company’s health policy and designs the guidelines that they have to follow to make sure that what they do is in accordance with policies.

The company is currently building a network of medical facilities consisting of hospitals, clinics, university health centers, imaging and radiology centers. “We are currently building a network of medical facilities to test our prototype. It will help us to have some feedback from healthcare professionals. After that, we will deploy our minimum viable product (MVP),” Gael says adding that the DNA of the company is to ensure the health and well-being of Africa’s

population by making clinical diagnosis datadriven, intelligent and patient-focused. “We want to revolutionize medicine in Africa by automating medical diagnosis and making it more precise and more accurate.”

Gael highlights that in general, medical equipment vendors have software that can deliver a quick analysis of medical images. However, this software uses AI models that are trained on datasets that misrepresent the African population. As a result, these models are prone to variability and biases. “We work with local clinics and local imaging labs to collect our own data on the field that truly represent the population a healthcare professional meets day to day,” he clarifies.

Bright Medicals is the first of its kind in Cameroon and its mission is to transform medicines, to make them more precise and faster in general. “We do not really have competitors, because we have talked with a lot of physicians, and they really need help. They are hoping that we will come up with solutions very soon. Every means that can make the medicine faster and more accurate we will use it to help the doctors,” Gael boasts.

He adds that since the company is made up of people from different industries, they have computer and health backgrounds, which helps them understand the problem in some way and

A THERAPIST DISCUSSING SICKNESS SYMPTOMS WITH SICK PATIENT DURING CLINICAL APPOINTMENT

build the most efficient solution. They do research constantly to make sure that they are building the latest cutting-edge technology to help doctors. They partner with universities and engage in research with students to find new ways to help doctors.

The company values transparency since they explain what they are doing to physicians and patients with confidentiality being the core rule because we are using medical data. “We preserve the medical secrets. Our data are encrypted, end to end with our tools and we do two-step authentication to make sure that no one has access to the data. We do not collect the personal information of a patient like their name, address and things like that. We do not share our data with other parties,” Gael affirms.

AN ONLINE PLATFORM

Bright Medicals operates as a cloud platform, its tools are available online. The platform uses visual recognition technologies to analyze medical images and send back reports with insight. The doctor can then use that report to make his diagnosis. In the report, the doctor will find image classification which identifies a disease and image segmentation to identify the region of interest of some tumours or some organs. They

work with medical geometrical images such as Xray, MRIs and ultrasounds.

“It is available online everywhere anywhere and you just need an internet connection. Whether you are on a laptop, on the desktop or

on the phone the platforms are available to you,” Gael says.

The company doesn’t have a factory since their work is computer-based, however, they are raising a network of physicians, hospitals and clinics that we use their solution.

At the moment, it is finalizing a prototype which they will deploy once it is ready. They are developing deep learning algorithms that can analyze the visual content of a medical image and extract regions of interest (ROIs) for different organs such as Lung, Heart, Brain and Breast. The algorithm can group medical images into categories of diseases and optimizes the next step of the diagnosis.

Nowadays, according to Gael, artificial intelligence is a powerful technology which is being used in most sectors; transportation education and government but has not been applied in Africa yet.

AI technologies are well suited to analyze data and uncover patterns and insights that humans could not find on their own. In healthcare, AI provides many benefits, including automating tasks and analyzing big patient data sets to deliver better healthcare faster, and at a lower cost. According to Insider Intelligence, 30% of healthcare costs are associated with administrative tasks. “We plan to take advantage of these benefits to find more efficient ways to modernize our healthcare ecosystems. We believe AI will have a profound impact in creating

WE ARE SUGGESTING THAT IF WE USE THE MEDICATIONS CORRECTLY, HIRED ALL THOSE PHARMACISTS WHO ARE NOT HIRED, AND GAVE THEM POSITIONS WHERE THEY ACTUALLY EFFECT WHAT THERAPY GOES OUT.

Gael Kamdem De Teyou - CTO, Bright Medicals

more efficiencies and breakthroughs that today we can yet imagine,” says Gael.

Bright Medicals uses technologies to break down how medicine is being performed in Africa. “Even if we trust our doctors, sometimes they can be tired or overwhelmed, and sometimes also because they are human their eye may not have a good vision when they analyze an image,” Gael explains. “This is why technology is there to see beyond what the human can see. We really want to extract every detail of what is inside an image.”

He explains that they want to extract features from low levels and high levels so that the doctors can have all the information inside the image. The company wants to develop cutting-edge technologies that can optimize and revolutionize medicine in Africa. “Technological watch is important in our company to have access to the latest information related to innovations, emerging trends and developments in healthcare, the impact of new technology adoption and new market opportunities,” he reiterates.

For Gael, healthcare is human beings. It is very dependent on the human population. There are no standards or any particular protocol that everyone uses. “That is a big challenge and try to bring the technologies that can industrialize the way we work.”

NO SUCCESS WITHOUT SETBACKS

According to Gael, they have experienced 2 types of setbacks; medical and computer engineering. On the medical side was majorly

a communication problem. Sometimes they couldn’t understand what the doctor was saying; other times, the doctor could understand them. “The doctors were very sceptical about what we are doing at the beginning. Later we realized that doctors’ questions could be solved with artificial intelligence which in the end made everyone happy.”

The artificial intelligence helped Bright Medicals in a great way, like in a case where the doctor would say that the medical image was not good and they cannot use it for analysis, they would use the artificial intelligence to verify that.

Initially, the company wanted to build an MVP that can provide a diagnostic report for several organs like the breast, lungs, brain or breast. But it was complicated to collect the data for all these organs simultaneously. “Finally, we decided to start with the lungs, and considered only one-use case.” Another problem was the infrastructure needed to train and deploy the AI models. Gael says they solved this by applying to Microsoft Founder Hub and were given cloud credits and access to development tools to build their platform.

DESPITE ALL THAT

The biggest milestone that Bright Medicals has had so far is that they have built a use case for COVID-19 and pneumonia that doctors in Cameroon are currently working with. The use case was a project with students and has been very successful so far.

They have also participated in the first AI Builders Garage competition accelerator, a competition on how artificial intelligence can be used and leveraged to solve problems in emerging countries. The competition was held on December 1st, 2022 at the virtual Flapmax Artificial Intelligence Summit (FAI) organized by the Flapmax AI Institute, with a focus on digital transformation for emerging markets. Bright Medical won the second prize for the Youth Entrepreneurship track. “The program will start next year, it is the first prize that we won,” Gael adds.

In December 2022, they were among the 30 innovators in Africa selected among more than 900 applicants to join the Francophone African Incubator. They are among the 40 companies that have been pre-selected. “The final selection will be happening soon. Those are the two awards that we have won, and more achievements are coming in the future,” he says.

On giving back to the community, Bright

Medicals participates in education in Cameroon by hiring students and training them. They collaborate with university students and give them internships where in the end they can work with them.

The company is also committed to saving the planet. “We are working mainly remotely. It helps us to reduce pollution due to transportation,” Gael says when we ask him what his company is doing towards sustainability. He added that they share their information digitally, and all their reports are available on the internet, therefore, no use of paper. “You do not have to print them. It's available on the phone and the computer. When you go to some hospital you see some paper, that's not good for our planet. Our idea is to record our medical information digitally so that we can save space and paper. We believe that if people are healthy, that is also going to be good for the planet,” Gael adds.

TO IMPACT THE WHOLE OF AFRICA IN FUTURE

Bright Medicals is currently focusing on Cameroon and will soon be going to the Central African Economic and Monetary Community (CEMAC) region, then Africa at large. The CEMAC region consists of six countries: Chad, Congo, Gabon, Equatorial Guinea, and Central African Republic.

“The problem is almost the same everywhere. In Cameroon, Uganda, Tanzania, doctors have the same issues. They need technologies that can help them to work with precision. It is important

for us to make sure that every doctor in Africa can use our technology to do to work efficiently and avoid errors.”

“This year, the first one is Cameroon, year 2 is CEMAC and in year 3 we will explore more opportunities in the whole of Africa. We want to attack a large market progressively. We will start with the neighbour country of Cameroon and then go further,” Gael adds.

Because of this, Gael says that the company plans to invest mainly in technology for the next 5 years. They want to bring new features to their products, explore new markets in CEMAC and hire new people. “We plan to make our product robust and deploy it by next year. We want to improve the product to have something mature for the industry.”

The company also plans to provide analysis and diagnostic reports for other organs such as brain, breast and heart. It will do research with universities to have a better understanding of African disease. “So that is something important to us, not just providing insight but to increase the new pledge we have about local diseases and see how we can solve them with artificial Intelligence,” Gael explains.

All these needs funding and Gael says that they will consider external sources of capital to join the organization. Gael says, "We have venture capitalists showing interest in our company in exchange for equity. We will think about that in the future. We will explore those opportunities and make the best decision for the company.”

We plan to make our product robust and deploy it by next year. We want to improve the product to have something mature for the industry

Country Focus:

TANZANIA’S HEALTHCARE SYSTEM

By BENJAMIN OPUKO

Tanzania is a pre-demographic dividend country with a high population growth rate and a large number of young individuals. In 2017, the population was estimated to be 57.3 million, with women comprising 50.5% of the total population. Over the past three decades, Tanzania's population has grown steadily and is predicted to double in size by 2040. The majority of the population is under the age of 19, while the working-age population (i.e., individuals between the ages of 20 and 59) is expected to increase by 2050.

However, Tanzania faces significant health challenges, including high rates of child and maternal mortality, as well as infectious diseases such as HIV/AIDS, tuberculosis, and malaria. Despite economic growth, poverty remains widespread, particularly in rural areas, and access to healthcare is a significant barrier. The healthcare system faces numerous challenges, including underfunding, chronic staff shortages, and a lack of medical technology.

The government has made progress in improving health services, but the quality of healthcare facilities remains low by global standards. The government has a universal healthcare program, but the scarcity of facilities means that private medical insurance may be necessary for comprehensive coverage, including medical evacuation to countries with higherstandard facilities.

Overall, Tanzania's healthcare system ranks at 156th place on the WHO league table, with healthcare financing dependent on contributions from international donors. Despite the challenges, Tanzania is working towards achieving middleincome country status while continuing to improve access to quality healthcare for all its citizens.

CURRENT PUBLIC SPENDING ON HEALTH IS INSUFFICIENT TO PROVIDE ACCESS TO QUALITY SERVICES TO ALL

There is a compelling argument that the current public spending on health is insufficient to provide access to quality services to all Tanzanians. While there has been a modest increase in per capita health spending across all public sources, from US$23.6 to US$28.5 between 2010 and 2017, this increase is merely keeping pace with population growth. The funding gap that exists is preventing the provision of basic healthcare services to the whole population, which is necessary to achieve universal health coverage.

Given that Tanzania is a pre-demographic dividend country with a rapidly growing and youthful population, the current public spending on health is even more inadequate. The adolescent population is projected to grow from 12 million in 2015 to 25-33 million by 2050, putting significant pressure on the healthcare system. If this gap in funding is not addressed, it will lead to an increase in out-of-pocket expenditure for healthcare, which will drive many Tanzanians into poverty.

The World Health Organization (WHO) recommends a minimum health expenditure of 6% of GDP to provide basic health services. However, Tanzania's health expenditure accounts for just 5.6% of GDP, translating to US$51 per capita, which is significantly lower than the recommended amount. This underfunding has led to a shortage of health workers, inadequate health infrastructure, and limited access to medical technology, all of which contribute to low-quality health services and limited access to care. To address this issue, the government has implemented reforms such as decentralization and payment-for-performance policies. These efforts are likely to have a positive impact on the

Tanzania is making noteworthy strides toward improving its healthcare system but a huge funding gap stands in the way between the East African nation and goal to achieve universal health coverage

health outcomes of the population and improve the overall functioning of the healthcare system in Tanzania. However, more must be done to ensure that all citizens have access to essential health services, particularly in the areas of maternal and child health.

INCREASED PER CAPITA HEALTH EXPENDITURE STILL FALLS SHORT OF GROWING DEMAND

Tanzania is making noteworthy strides toward improving its healthcare system, as evident from the increase in health expenditure per capita. In 2019, the health expenditure per capita in Tanzania was US$40, indicating a substantial improvement from US$13 in 2000. The average annual growth rate of health expenditure per capita in Tanzania during this period was 6.91%, which is a positive sign of progress. It is crucial to continue increasing health expenditure per capita to ensure access to quality healthcare for all Tanzanians. Therefore, it is critical that the Tanzanian government increases public spending on health to provide access to quality services to all. A well-funded health system is necessary to provide pre-emptive care, treatment, and management of diseases and prevent health emergencies. This can be achieved through the implementation of sustainable health financing models and social health insurance schemes, which mobilize both public and private resources to enable equitable and sustainable health financing to achieve universal health coverage.

A study by USAID and Health Policy Plus on

the Costing of Tanzania's Health Sector Strategic Plan V (HSSP V), 2020/21-2025/26 found that the yearly costs of health services in Tanzania are expected to increase from Tsh.3.7 trillion in 2021 to Tsh.6 trillion in 2025 (US$1.6 billion to US$2.6 billion), with a total five-year cost of Tsh.24 trillion (US$10.4 billion). The study revealed that the financial resource requirements are greatest for human resources for health and for infrastructure, which comprise 81 percent

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of the total health systems costs and 40 percent of the HSSP V overall. By the end of the HSSP V, there will be an expected 117,000 health service providers, a 21 percent increase over the estimated 97,000 at baseline. The study also revealed that logistics and governance represent about 10 percent of the total HSSP V costs.

(Source: USAID and Health Policy Plus on Costing of Tanzania’s Health Sector Strategic Plan V, 2020/21–2025/26).

If effectively implemented, the HSSP V is expected to save more than 200,000 additional lives and avert over 400,000 disability-adjusted life years by expanding services beyond current levels. The plan will also avert more than 100,000 child deaths, nearly 20,000 maternal deaths, and more than 40,000 stillbirths. In addition, it would reduce the probability of dying from an NCD between the ages of 30 and 70 and achieve more than 400,000 additional healthy life years beyond what could be achieved by maintaining current coverage of NCD and mental and neurological services interventions.

UNIVERSAL HEALTH INSURANCE (UHI) BILL TO SHIELD LOW-INCOME EARNERS

The Tanzanian government is currently discussing the Universal Health Insurance (UHI) Scheme Bill, which aims to provide affordable

THE

COSTS OF

SERVICES IN

ARE EXPECTED TO INCREASE FROM TSH.3.7 TRILLION IN 2021 TO TSH.6 TRILLION IN 2025 (US$1.6 BILLION TO US$2.6 BILLION), WITH A TOTAL FIVE-YEAR COST OF TSH.24 TRILLION (US$10.4 BILLION).

healthcare to low-income earners and the elderly. The bill proposes making the scheme mandatory for all Tanzanians, with an annual fee of Tsh. 340,000 (US$146) for a standard package covering a family of four. Currently, only 14.7% of Tanzanians are registered with a health insurance scheme, leaving 85% of the population without coverage.

The government aims to enroll 15 million people in the scheme, with the cost of covering 4.5 million elderly individuals being covered by the government. The law will be rolled out in phases whereby the first one runs from 2023 to 2026. The second phase, which runs between 2026 and 2028, will also involve the informal sector through business and driving licenses while the third phase will be implemented in 2029.

The proposed health insurance plan will provide coverage for up to six family members per household, with the Tanzania Insurance Regulatory Authority (TIRA) responsible for overseeing the insurance and identifying citizens who cannot afford to pay, who will then be supported by the government. The bill makes it compulsory for citizens to have health insurance to access various services such as driving licenses, motor vehicle insurance, advanced secondary education or college admission, and

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more. As part of the plan, it is suggested that the Community Health Fund (CHF) be disbanded due to its perceived shortcomings in delivering inadequate services that do not align with the fees charged, as well as a lack of interest from the public to participate in the fund.

However, the proposal to make health insurance enrolment mandatory in Tanzania has sparked debate, particularly because it has been suggested that services may be denied to those who do not enroll. As a result, the bill has elicited opposition from some quarters, with the dissenting voices calling for more time to debate the proposed law. However, the Health Ministry argues that the increasing burden of treating non-communicable diseases in the country has necessitated the reform of the national scheme. For instance, cancer cases in Tanzania have been

rising steadily by 42,060 cases per year, resulting in higher treatment costs. In 2022, NHIF spent Tsh.35.44 billion (US$15 million) on kidney ailments and Tsh.4.33 billion (US$1.8 million) on the treatment of cardiovascular diseases.

From a financial perspective, the NHIF is by far the largest insurance scheme in Tanzania, with over Tsh.480,000 million (around US$206 million) in annual revenue. Despite having an annual revenue of over US$206 million, the scheme's surplus has decreased each year since 2014/2015, from Tsh.148,000 million (US$63.27 million) down to Tsh.32,000 million (US$13.68 million) in 2017/2018 leading to concerns about its long-term financial viability. The potential loss of cross-subsidy and the inability to extend health insurance coverage to the entire population of Tanzania will become a reality if the scheme’s annual surplus continues to decline. This could pose a major financial challenge for the future of the health insurance system in Tanzania.

INCREASING INVESTMENTS IN HEALTHCARE BRING TANZANIA CLOSER TO REALIZING UHC

Significant progress has been made in Tanzania's healthcare system. The number of health centers has increased from 8,449 in 2019 to 10,067 in 2022, and the government has invested TSh20

TANZANIA'S HEALTH EXPENDITURE ACCOUNTS FOR JUST 5.6% OF GDP, TRANSLATWING TO US$51 PER CAPITA, WHICH IS SIGNIFICANTLY LOWER THAN THE RECOMMENDED AMOUNT.

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billion per month (US$ 8,550,662) to ensure essential medicines are available in health centers, with 67 percent coverage achieved as of December 2022. The government has also upgraded medical facilities by installing modern equipment such as X-rays, CT-Scans, and MRIs, and constructing Emergency Medical Departments (EMDs) and Intensive Care Units (ICUs) to improve service delivery. These developments have brought Tanzania closer to realizing Universal Health Coverage (UHC).

The Tanzanian government has prioritized investing in health infrastructure and human resources, with a focus on rural regions. Recent budgets have allocated funds for upgrading and building health facilities. For example, in 2020/2021, the Tanzanian government earmarked US$387.9 million for its healthcare sector as it advances towards achieving universal healthcare. Out of this amount, US$155.5 million was allocated for developmental projects aimed at facilitating the implementation of health improvement initiatives. The government has further allocated Tsh. 1,109 billion (approx. US$474 million) for the sector in 2022/2023. The Government of Tanzania has identified some key issues as a priority in the 2022/23 budget, including strengthening the delivery of vaccines for children under the age of five and enhancing the quality of health services delivery in the country. Also, the 2018-19 health sector budget included provisions for upgrading and building health facilities, including the construction of 67 new district hospitals. The government's Health Sector Strategic Plan V also shows a long-term commitment to further investment in health facilities.

Though a hindrance still remains. UNICEF's Budget Issue Paper for Health in Tanzania reveals that low per capita budgetary allocation for Tanzania's health sector has become a significant hindrance to achieving universal health coverage. Between FY 2017/18 and FY 2021/22, the nominal health budget allocation decreased from 9% to 7.3% of the total government budget, falling below the 15% required by the Abuja Declaration. This has caused a reduction of 11% in per capita allocation, from TSh 38,211 (approx. US$17) to TSh. 33,873 (approx. US$15), which is far below the recommended benchmark of TSh 199,094 (approx. US$86.27) required for achieving universal health coverage. These budgetary cuts have had significant impacts on healthcare service delivery, making it difficult to provide affordable and accessible health services to Tanzanian

citizens. Without an increase in budgetary allocation, the goal of achieving universal health coverage in Tanzania may remain elusive.

These low budgetary allocations have slowed healthcare service delivery, as seen in significant variations in intra-LGA per capita budget allocations in FY 2021/22, with Njombe receiving the highest per capita allocation TSh 35,292 (US$15.08) and Simiyu region receiving the lowest of TSh 8,874 (US$3.80). Curative care services received the largest proportion of the health sector budget for FY 2021/2022 (26%), followed by district hospitals (22%), preventive services (13%), and dispensaries (10%).

MIND THE GAP: TANZANIA'S HEALTH SECTOR STILL NEEDS IMPROVEMENT DESPITE GOVERNMENT EFFORTS

Despite the efforts made by the Government of Tanzania to improve the efficiency of the health sector, a gap remains. The high recurrent expenditure on salaries in Tanzania's healthcare system can be detrimental to the system's effectiveness and the provision of quality care.

IN NUMBERS

98,987 THE TOTAL NUMBER OF MEDICAL STAFF REQUIRED IN TANZANIA IN 2019/2020

NURSE INTERACTING WITH PATIENT IN PRIMARY HEALTHCARE FACILITY IN TANZANIA

The allocation of 79% of the recurrent budget to salaries between FY 2019/20 and FY 2021/22, on average, indicates that the healthcare system

has limited funds to address critical areas such as infrastructure development, medical supplies, and equipment.

The shortage of medical personnel, such as doctors, nurses, and other healthcare workers, is a significant concern for Tanzania's healthcare system. The total human resources required for health was 212,193 in 2019/2020, yet the actual number was only 98,987, indicating a 53% staff shortage. The shortage of medical personnel can lead to longer waiting times, lower quality of care, and even unnecessary deaths. For instance, in 2016, an estimated 45,000 deaths were due to poor care quality and many involved conditions that could be addressed in primary care in Tanzania.

In 2018, there was one medical doctor attending approximately 26,000 to 30,000 patients per year, which is higher than the international standard of one doctor attending a maximum of 10,000 patients per year set by the WHO. Additionally, the country has a low ratio of nurses and clinical staff with 0.39 nurses and 0.26 to 0.30 clinical staff per 1000 population. The number of hospital beds per thousand people has also decreased from 1.4 units per thousand people in 1976 to 0.7 units per thousand people in 2010, representing a 50% decline, according to data from the World Bank. As a result, the WHO recently ranked Tanzania's healthcare system 156th out of 191 countries with an overall efficiency index of 0.422, underscoring the significant gap that exists in the efficiency of the health sector in Tanzania.

It is crucial to note that a well-functioning healthcare system requires adequate funding for various areas to deliver quality care. The

high recurrent expenditure on salaries can starve other critical areas, leading to sub-optimal healthcare services. Therefore, there is a need to strike a balance between recurrent expenditure on salaries and other critical areas to ensure the efficient delivery of services and improve the quality of life of the population.

To address the shortage of healthcare workers, the ministry employed 3,347 and 9,262 staff in the 2020/21 and 2021/22 financial years, respectively. In addition, Tsh.8 billion (US$3.4 million) has been allocated for specialized training and customer care improvement during the current 2022/23 financial year. Furthermore, Tanzania’s Health Quality Assurance Division conducted a star rating assessment in 2018 aimed at improving service delivery in primary care facilities.

Despite the positive impact of the star rating assessment on the health sector in Tanzania, there are still significant gaps that need urgent attention to improve the quality of healthcare. First and foremost, access to healthcare remains a challenge for many Tanzanians, especially those in rural areas. This is due to a shortage of health facilities and trained medical personnel. As a result, many people continue to rely on traditional healers and home remedies, which

TO ADDRESS THE SHORTAGE OF HEALTHCARE WORKERS, THE MINISTRY EMPLOYED 3,347 AND 9,262 STAFF IN THE 2020/21 AND 2021/22 FINANCIAL YEARS, RESPECTIVELY.

TANZANIA MEDICINES AND MEDICAL DEVICES AUTHORITY BUILDING

may not always be effective.

Another critical issue is the quality of healthcare services provided by some facilities. Although the star rating assessment helped identify common gaps and raised awareness of performance issues, there are still facilities that do not meet the required standards. These facilities may lack adequate resources, trained staff, or appropriate equipment to provide quality care. Furthermore, there may be a lack of accountability and transparency in some facilities, which can lead to poor management and staff performance.

Additionally, there is a need to address health disparities and ensure that all Tanzanians have access to quality healthcare services, regardless of their income or location. Currently, many low-income individuals cannot afford to pay for healthcare services, which limits their access to medical care. This, in turn, perpetuates health disparities and can lead to negative health outcomes.

While the star rating assessment was a positive step towards improving healthcare services in Tanzania, there is still a long way to go. The government and stakeholders in the health sector must continue to work together to address the gaps and challenges that hinder the delivery of quality healthcare services. This includes addressing access to healthcare, improving the quality of healthcare services, promoting transparency and accountability, and addressing health disparities. By doing so, Tanzania can improve the overall health and well-being of its citizens and achieve its development goals.

VAST OPPORTUNITIES IN HEALTHCARE FOR PRIVATESECTOR PLAYERS TO TAP INTO

The United Republic of Tanzania has recently been the focus of a collaborative study between SIHI/TDR, UNICEF, and UNDP on the role of the private sector in healthcare delivery in low- and middleincome countries (LMICs). The study provides insights into how private sector engagement and interactions could be enhanced in order to improve the quality of healthcare for women

and children. The study found that private sector facilities account for 30% of the total facilities in Tanzania, and a large portion of these facilities are run by NGOs or faith-based organizations (FBOs), contributing to 22% of all healthcare provision. FBO facilities are often located in remote areas where public facilities are not available, providing access to healthcare services in underserved regions.

In addition, the study found that about half of all training institutions in Tanzania are privately owned, indicating the significant role that private sector education plays in the healthcare sector. Furthermore, the study revealed that 12% of women in Tanzania give birth at private health facilities, highlighting the

provides access to quality healthcare services for all citizens.

LOW MEDICAL INSURANCE COVERAGE PREDISPOSES TANZANIANS TO SERIOUS MEDICAL DEBT

Despite Tanzania's low share of GDP spent on healthcare and meager public expenditure of 39% of total health costs, the country has made significant progress in reducing the burden of outof-pocket healthcare expenses. In 2000, nearly half (47%) of the country's total healthcare expenditure was paid by individuals, but this has significantly reduced over the years. As of 2019, outof-pocket expenditures accounted for

importance of private sector facilities in maternal and child health services.

The findings of this study provide important insights into the role of the private sector in healthcare delivery in Tanzania and how private sector engagement could be harnessed to improve healthcare outcomes for women and children. By working collaboratively with the private sector, the government of Tanzania can create a more robust and effective healthcare system that

22.2% of current healthcare expenditure in Tanzania, indicating a remarkable improvement.

Insurance coverage in the country is however significantly low. As of 2019, only 32% of the Tanzanian population was covered by health insurance, with a mere 1% being members of private health insurance. Besides, the existing health insurance structure in Tanzania is highly fragmented, with different small schemes targeting various

32%

IN NUMBERS PROPORTION OF TANZANIANS COVERED BY HEALTH INSURANCE

population groups with the Community Health Fund (CHF), the main voluntary insurance for informal rural sector workers, only covering 25% of the population. Further to that, PharmAccess has played a significant role in improving health insurance coverage in Tanzania by working with the government and other partners to develop and implement sustainable health financing models. They have been active in Tanzania since 2006, providing technical assistance and support to improve healthcare access and quality. In collaboration with Kilimanjaro Native Cooperative Union (KNCU), PharmAccess designed and implemented a health insurance scheme for coffee farmers in the Kilimanjaro region. This scheme enrolled up to 40% of eligible members, demonstrating the potential for health insurance to expand coverage and improve equity in healthcare financing.

of how to make the premiums affordable for all socioeconomic groups while ensuring the financial stability of the national scheme.

DIRECT HEALTH FACILITY FINANCING IMPROVES PERFORMANCE OF TANZANIA’S PRIMARY HEALTHCARE SYSTEM

The provision of quality primary healthcare is essential for the economic development of a nation. In an effort to improve primary healthcare (PHC) services through fiscal decentralization, Tanzania introduced direct health facility financing (DHFF) in the 2017/18 fiscal year. The reformed Health Basket Fund in Tanzania has been a crucial program for channeling direct funds to primary health care centers, resulting in the transformation of care delivery in the country. The program has attracted investment partners and donors, including Switzerland, the Tanzanian government, and other development partners, who have strengthened the health system and improved access to quality primary healthcare services for Tanzania's 58 million inhabitants. The Direct Health Facility Financing mechanism, which was expanded through effective decentralization to both state and non-state primary healthcare providers, has accelerated Tanzania's progress towards universal health coverage and "Leaving no One Behind".

However, there is still room for further progress and improvement in the country's healthcare system. To ensure equitable access to healthcare, Tanzania can consider several strategies, such as increasing public financing for healthcare, expanding health insurance coverage, improving healthcare infrastructure, and strengthening healthcare service delivery. These steps can help to reduce out-of-pocket expenses and improve access to quality healthcare for all Tanzanians, regardless of their income level or geographic location.

Additionally, investing in preventive healthcare and health education programs can reduce the need for costly medical interventions, leading to better health outcomes and reduced healthcare costs for individuals and the government. The government aims to unify health insurance schemes into one national health insurance fund and extend coverage to the entire population, but the question remains

Initially created in 1999 as a pooling mechanism of external resources to support government efforts in strengthening primary healthcare in Tanzania, the HBF has evolved from simply financing the Sector Expenditure Frameworks at the central level to a decentralized, performance-oriented aid modality for health sector financing. One of the most impactful reforms reported by the HBF mid-term review has been the DHFF mechanism, which was piloted in 2017/18. It has enabled the direct transfer of funds from the Ministry of Finance and Planning to frontline PHC facilities, reducing leakages and enhancing the predictability and timeliness of funds received at frontline PHC facilities.

The success of the reformed Health Basket Fund is evidenced by the commitment of all eight contributing donors to continue supporting the new HBF, which focuses on expanding the Direct Health Facility Funding mechanism. The Health Facility Governing Committees have also improved community engagement in the governance of their health facilities, holding healthcare providers accountable for the quality of their services

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TANZANIA'S Pharmaceutical Industry SPOTLIGHT

There are a total of 14 registered domestic pharmaceutical industries in Tanzania, of which 11 produce human medicines, two produce veterinary medicines, and one facility manufactures health devices. However, most of these industries have a limited range of products and primarily focus on producing generics. These include Tanzania Pharmaceuticals Industries, AA Pharmaceuticals, Keko Pharmaceuticals, Mansoor Daya Chemical, Shelys Pharmaceuticals, Tanzansino United Pharmaceuticals, and Interchem Pharmaceuticals. In addition to these local manufacturers, multinational pharmaceutical companies such as GlaxoSmithKline, AstraZeneca, Sanofi, Johnson & Johnson, Boehringer Ingelheim, Bayer, Novartis, and Novo Nordisk supply the Tanzanian market through exports. According to the United Nations COMTRADE database on international trade, Tanzania imported pharmaceutical products worth US$458.77 million in 2021. The top five importers of pharmaceutical products in Tanzania during the same period were Phillips Pharmaceutical Limited, which enjoyed the highest market share at 16.2%, followed by Astra Pharma Limited at 12%, Wide spectrum Ltd at 11.7%, JD Pharmacy at 6.9%, and HEKO Pharmaceuticals at 5.2%.

The sector is also supplied by Indian drug manufacturers such as Ranbaxy, Dr. Reddy's, Cipla, Strides Arcolab, Panacea Biotech, and Piramal Healthcare, primarily through the import of generic medicines. India dominates the drugs imports market

with a 54% cumulative market share of total imports from 2013-2016, ahead of competitors such as Egypt, Switzerland, the USA, and South Africa. A systematic analysis of data for pharmaceutical imports from the Ministry of Health and data from 20132016 fiscal years accessed from the Tanzania Food and Drugs Authority (TFDA) confirms that India ranked as the first country for exporting the highest value of pharmaceuticals into Tanzania, with a total worth of US$216 million in the 2013-2014 fiscal year, followed by Egypt (11.7%), Switzerland and the USA hold 4.1% of cumulative market share.

The private sector suppliers in Tanzania imported pharmaceuticals worth US$216 million during the same fiscal year, indicating India's dominance in supplying pharmaceuticals to Tanzania. By 2020-2021 fiscal year, it was forecasted that imported pharmaceuticals for the private sector supply chain will reach a total value of US$906 million. Therefore, India's dominance in exporting pharmaceuticals to Tanzania is expected to continue, despite the competition from other countries.

According to the Tanzanian Ministry of Health, Community Development, Gender, Elderly, and Children, the pharmaceutical sector is a priority area for investment, and the government has developed several policies and strategies to promote investment in the sector. These include the National Health Policy 20172022, the Tanzania Food, Drugs, and Cosmetics Regulations 2015, and the Pharmaceutical Sector Action Plan 2014-2020.

The Tanzanian government has

recognized the importance of achieving self-sufficiency in the pharmaceutical sector, with 33% of medicines being produced locally in 2009. However, this has dropped to 10-20% in 2016 due to various challenges, including registration delays, unfavorable tax laws, labor shortages, poor infrastructure, and rising power prices. The government has encouraged investments from Indian generic drug makers to establish local production facilities and seeks collaborations with international pharmaceutical companies.

The government has tasked several public institutions to create a more conducive investment environment, including the Medical Stores Department, National Health Insurance Fund, Tanzania Investment Bank, Tanzania Food and Drugs Authority, and Tanzania Industrial Research and Development Organization. Despite this, a WHO study has highlighted that local pharmaceutical production in Tanzania may not compare with cost-effective imported drugs from India, which has over 70 U.S.-approved production plants for APIs and ARVs. Investment opportunities in the Tanzanian pharmaceutical sector include local manufacturing to reduce reliance on imported drugs, efficient distribution channels to ensure medicine and vaccines reach remote areas, research and development focused on tropical diseases prevalent in the region, and increased regulatory oversight to support the development of strong frameworks and institutions. Both local and international investors have significant opportunities to invest in these areas.

CHOLERA STRIKES AGAIN: RESPONSE STRATEGIES TAKE CENTER STAGE

In strange new patterns, cholera cases are making rounds in different parts of the world after the acute diarrheal illness was thought to be on the verge of eradication. According to the World Health Organization (WHO), Africa is currently experiencing an exponential rise in cholera cases and cholera-associated deaths. The trend is expected to continue into this year without strong interventions.

A major concern with cholera is its high rate of fatalities. The average case fatality ratio is currently almost at 3%, above the 2.3% reached in 2022, and far exceeding the acceptable level of below 1%. Since January 2023, the World Health Organization estimates that about 26,000 cases and 660 deaths were recorded in 10 African countries, including Malawi, Mozambique, Zambia, Burundi, Cameroon, the Democratic Republic of the Congo (DRC), Nigeria, Ethiopia, Kenya, and Somalia.

The resurgence of cholera is characterized by the number, size, and concurrence of multiple outbreaks around the world, the spread to areas free of cholera for decades, and alarming high mortality rates. Here's what you should know about the latest epidemic of cholera on the African continent and how health experts are trying to keep the water-borne disease under control.

AN UPTICK IN CHOLERA CASES

Cholera is easily treatable but remains an anover present risk in many developing nations. In 2022, nearly 80,000 cases and 1,863 deaths were recorded from 15 affected countries across Africa. The caseload has increased by more than 30% in the first month of 2023 compared to the whole of 2022. The United Nations (UN) attributed the sharp rise in cases to conflicts, concurrent epidemics, inadequate levels of access

to health care, poor drinking water, hygienic and sanitary conditions, and population movements between the affected areas and neighboring countries.

The ongoing armed conflict in the province of North Kivu in the Democratic Republic of the Congo is a case in point. In 2022, the UN Office for the Coordination of Humanitarian Affairs estimates that DRC reported 17,355 suspected cases including 285 deaths. It is unsettling that poor people living in disadvantaged neighborhoods, lacking adequate sanitation and

By LORRAINE ABWAO

safe drinking water are at an increased risk of becoming severely ill from diarrhoeal diseases.

Although it has sickened people from Central Africa to Eastern Africa, cholera has had particularly dramatic effects in Malawi: since

last March nearly 37,000 cholera cases and 1,210 deaths have been reported in all 29 districts. More than 600 Malawians are estimated to contract the disease, or have symptoms of cholera, daily. It is the costliest cholera outbreak in Malawi's history, with the case fatality ratio near 3.1%. The nation is experiencing an outbreak of unprecedented scale, outpacing hospitals' ability to keep up with the volume of new patients.

In a disheartening twist, countries that share land borders with cholera-affected countries are at risk. The epidemic has spread to neighboring South Africa, Botswana, Mozambique, and Zambia. Grappling with severe storms brought on by Tropical Cyclone Freddy, Mozambique too is facing a multi-layer crisis, with a cumulative total of 5,237 suspected cases and 37 deaths reported in 29 districts from six out of 11 provinces in the country. All six cholera-affected provinces are flood-prone areas, and WHO anticipates that more areas will be affected as the rainy season continues.

In Zimbabwe, the dreaded disease has killed 783 people and more than 16,000 people have been affected by the latest outbreak of cholera. Since the beginning of the year, up to 15 March, cholera has claimed the lives of nearly 818 people and more than 40,563 have been affected by the disease outbreaks in 13 African countries. Other countries facing cholera outbreaks include South Africa, Haiti, Lebanon, India, Pakistan, the Philippines, Turkey, and Syria.

HUMANITARIAN CRISES HINDER ACCESS TO CARE

In some parts of the African continent, the cholera outbreak is being driven by civil unrest, mass displacement, the collapse of essential public health services, and malnutrition. Caused by comma-shaped bacteria known as Vibrio or Spirillum cholerae, which dwell in sewagecontaminated water, cholera causes a particular type of acute watery diarrhoea that leads to rapid loss of fluids. Flooding and heavy rainfalls can spread the bacteria and contaminate water sources. For instance, Nigeria is experiencing an uptick in cholera infections following extensive flooding amid the Boko Haram insurgency.

Notably, heavy flooding due to seasonal rains and tropical cyclones in Southern Africa has led to a spike in malaria cases and increased the risk of cholera outbreaks. New United Nations Children's Fund estimates show that millions of children are at risk in the face of a potential increase in cholera cases in Malawi and Mozambique in the aftermath of Tropical Cyclone Freddy. Across Malawi, an estimated 4.8 million children – "one in two children in the country" –need humanitarian assistance.

Because the incubation period of cholera

AFRICAN LEADERS HAVE BEEN URGED TO ADDRESS WATER AND HYGIENE

INFRASTRUCTURE, ALONGSIDE COMMUNITY ENGAGEMENT IN CONCERTED EFFORTS TO ATTAIN THE LONG-TERM GOAL OF ENDING CHOLERA BY 2030.

is short (2 hours to 5 days), the number of cases can rise quickly and multiple deaths can occur, creating an acute public health problem. The disease risk is considerably heightened in humanitarian emergencies-

large-scale displacement is often accompanied by a deterioration in hygiene and sanitation. Unsurprisingly, a combination of water scarcity and food crisis leads to the proliferation of severe malnutrition and a high risk of serious waterborne diseases.

An estimated more than 16.2 million people cannot access enough water for drinking, cooking, and cleaning across the Horn of Africa, including 8.2 million in Ethiopia, 3.9 million in Somalia, and 4.1 million in Kenya. Drought decreases the available amount of clean water, forcing people to use contaminated water. Water vulnerability makes children 11 times more likely to die from water-borne diseases than those who are well nourished, according to the current publicly available data from UNICEF. The worst drought in the region in 60 years has spurred the spread of cholera and made stopping it substantially harder. The frequent disruption of access to healthcare services and unequal distribution of health resources across impoverished areas makes access to treatment even more challenging. Communities in these drought-affected areas are in dire need of humanitarian assistance to avert a looming crisis, threatening the lives of hundreds of thousands of adults and children.

CLIMATE CHANGE WORSENS THE SPREAD OF CHOLERA

Outbreaks of water-borne disease surge globally amid climate change chaos. Shifts in climate patterns can lead to variations in water

A CHILD RECEIVING ORAL CHOLERA VACCINE

availability, rainfall, and temperature, which can create conditions favorable for the growth and spread of Vibrio cholerae. While the host for the agent of cholera is an integral part of the environment, the consequences of Vibrio-related diseases due to climate change are worsening, hampering efforts to eliminate the silent illness.

Between 1970 and 2011, African countries reported 3,221,050 suspected cholera cases to the World Health Organization, representing 46 % of all cases reported globally. Excluding the Haitian epidemic, sub-Saharan Africa accounted for 86 % of reported cases and 99 % of deaths worldwide in 2011. In 2021, Africa experienced

its highest-ever reported numbers – more than 137,000 cases and 4,062 deaths in 19 countries. The global disease prevalence is now higher than previous WHO estimates, nearly 1 billion people in 43 countries face the threat of cholera infections.

Extreme weather events, including heatwaves, hurricanes, and floods, fuelled by climate change have resulted in a higher incidence of waterborne infections like cholera. These climate-related events are critical contributing factors to the breakdown of an already limited healthcare infrastructure, compromised sanitation systems and access to clean water, and ultimately, increasing vulnerability to cholera epidemics in low-resource environments.

The State of the Climate 2021 Report, a multiagency publication coordinated by the UN World Meteorological Organization (WMO), reveals that high water stress is estimated to affect about 250 million people in Africa and displace up to 700 million individuals by 2030. What's worse, four out of five African countries are unlikely to have sustainably managed water resources by 2030. Africa, despite its low contribution to greenhouse gas emissions, remains the most vulnerable continent. Climate-related hazards continue to be a major driver of new displacement in the continent, the UN agency warns.

Population density is also a critical driver of cholera spread. With hundreds of people from Somalia arriving each week in Kenya's Dadaab

TO INCREASE VACCINE ACCESS, THE AFRICA CENTERS FOR DISEASE CONTROL AND PREVENTION CHIEF IS IN ADVANCED TALKS WITH LOCAL MANUFACTURERS TO EXPLORE OPPORTUNITIES FOR COLLABORATION.

DISEASE FOCUS: Cholera

Refugee Complex, living conditions in camps hosting over 233,000 refugees and thousands of new arrivals since January are worsening, according to the latest Médecins Sans Frontières (MSF) analysis. 1,875 cholera cases have so far been recorded in Dadaab camp which is hosting hundreds of thousands of refugees and asylum seekers in three camps: Dagahaley, Ifo, and Hagadera.

The number of cholera cases is rising at an alarming rate in these overcrowded camps in the context of inadequate access to clean water, waste collection, and proper toilets. In response, MSF called on relevant health stakeholders to enhance cholera prevention measures, including vaccination campaigns, to prevent large-scale outbreaks and save lives. The call to action comes after Kenya issued a cholera alert following confirmation of 61 cases reported across six counties in October 2022.

CHANGES IN VACCINE STRATEGIES

The oral cholera vaccine (OCV) has been recommended as an additional public health tool in conjunction with the safe Water, Sanitation, and Hygiene (WASH) technique as a measure to eliminate the preventable disease. Following the explosion of cholera outbreaks worldwide, WHO and its partners recommended in October 2022 that countries temporarily switch to using a single dose of the cholera vaccine instead of two to "counter" the ongoing supply shortage. The three WHO pre-qualified oral cholera vaccines, Dukoral, Shanchol, and Euvichol-Plus, have proven to be effective in controlling cholera during outbreaks by targeting critical populations in hotspots. Although the single-dose approach offers shortterm protection, the new strategy will ensure a more proactive response in containing the deadly outbreaks in endemic areas and humanitarian crises.

As attested by WHO, the pivot in strategy will allow for the doses to be used in more countries, at a time of an unprecedented rise in cholera outbreaks worldwide. The suspension of the two-dose regime is a timely response to help prevent active transmission of cholera infections as many African countries lack immediate access to vaccines. Of the total 36 million doses forecast to be produced in 2022, 24 million have already been shipped for preventive (17%) and reactive (83%) campaigns and an additional 8 million doses were approved by the International Coordinating Group for the second round for emergency vaccination in 4 countries. Illustrating

the short supply of the vaccines, only 37 million doses are available in 2023.

A number of vaccines, funded by Gavi, the Vaccine Alliance, were sourced from the global stockpile and are being used to carry out major campaigns in Zambia, Nigeria, Malawi, Mozambique, and Kenya. As of February 2023, Kenya's Ministry of Health rolled out the first-ever cholera vaccination campaign in the country, targeting 2.2 million people in affected counties. MSF collaborated with the Ministry of Health and its partners to coordinate the cholera vaccination campaign reaching 122,832 people in the Dagahaley camp. Also, Malawi has conducted two oral cholera vaccination campaigns in 21

IN NUMBERS

37M

NUMBER OF CHOLERA VACCINE DOSES AVAILABLE IN 2023

affected districts while Mozambique has kicked off a cholera vaccination drive targeting around 720,000 people in eight districts. WHO also disbursed US$6 million to kick-start emergency cholera response in Malawi, Kenya, and Mozambique, through the ICG.

To increase vaccine access, the Africa Centers for Disease Control and Prevention chief is in advanced talks with local manufacturers to explore opportunities for collaboration, particularly repurposing their facilities to meet the growing local demand for cholera vaccines. In November 2022, South Africa-based Biovac Institute inked a licensing and technology transfer

UNICEF STEPPING UP HUMANITARIAN AID TO MANAGE CHOLERA OUTBREAK

pact with the International Vaccine Institute (IVI) to develop, manufacture, and deploy oral cholera vaccine doses for the African and global markets. According to Gavi, the burden of cholera could get worse unless governments put measures in place to control and prevent outbreaks. In 2015, it was estimated that over one million cases in 44 African countries resulted in an economic burden of US$130 million from cholera-related illness and its treatment. African leaders have been urged to address water and hygiene infrastructure, alongside community engagement in concerted efforts to attain the long-term goal of ending Cholera by 2030.

INTENSIFIED HYGIENE AND ANTICHOLERA CAMPAIGNS

Apart from concerted vaccination campaigns in cholera-affected areas, the spread of the disease can be checked by educating communities about sanitation, hygiene, and food preparation. According to the Centers for Disease Control and Prevention, sustainable WASH solutions is a critical step to reducing Africa's cholera burden. The WASH strategy has been adopted in some countries of Africa, which are making up the bulk of the new cholera cases on the continent. This strategy will contribute to improvements in water supply, sanitation, food safety, and community awareness of preventive measures before outbreaks occur.

A shining example is Malawi which has launched the Malawi Cholera Flash Appeal which aims to address the most immediate needs of people impacted by the current outbreak through an integrated response that brings together

health and water, sanitation and hygiene. These campaigns are usually effective particularly in mild cholera cases where victims are treated with an oral or intravenous solution of fluids and electrolytes - to replace those violently expelled by cholera's main symptom, diarrhoea. The survival rate is usually 99%.

A CONCERTED EFFORT NEEDED

Besides addressing the near-term risk of cholera, there is a dire need for a greater supply of vaccines and rapid progress in developing safely managed water and sanitation services to achieve the targets of the Sustainable Development Goals. More investments in socioeconomic conditions are critical to curbing the growing incidences of cholera, acute watery diarrhoea, dysentery, and other diarrheal diseases. Prevention is key at a time when nearly half the world lacks access to safely managed sanitation. Efforts for an integrated approach to cholera control are vital to tackle cross-border transmission and persistence of cholera outbreaks.

According to WHO, cholera surveillance should be part of an integrated disease surveillance system that includes feedback at the local level and information-sharing at the global level. A concerted action of all relevant government ministries is needed to realize access to safe drinking water and sanitation, which are internationally recognized human rights. To successfully eliminate cholera by 2030, national, regional, and international bodies should also be empowered to coordinate the implementation of joint interventions addressing health inequities and human-related determinants

DISEASE FOCUS: Cholera

Stryker introduces upgraded Mako Total Knee System for improved surgical precision

USA — Medical technology company Stryker has launched Mako Total Knee 2.0, the latest advancement in its Mako SmartRobotics system at the AAOS 2023 Annual Meeting.

Leveraging the strengths of the Mako SmartRobotics system, including 3D CT-based planning, AccuStop haptic technology, and insightful data analytics, the new system promises better patient outcomes compared to manual surgery for total knee, total hip,

and partial knee procedures.

Mako Total Knee 2.0 includes a new, intuitive design with customizable workflows and other features, such as a digital tensioner for assessing knee stability during total knee arthroplasty. The system began a limited release in August 2022 and will roll out in phases in 2023. Stryker also plans to launch two additional Mako systems, Mako Spine and Mako Shoulder, in the near future.

Bruker introduces advanced diagnostic solutions for clinical microbiology and infection diagnostics labs

USA — Bruker, a leading life science research and diagnostics solutions provider headquartered in the US, has unveiled a range of cuttingedge diagnostic solutions specifically designed for routine clinical microbiology and infection diagnostics laboratories.

These solutions include the nextgeneration MALDI Biotyper IVD Software, MBT Mycobacteria IVD Kit, MBT HT Filamentous Fungi IVD Module, and LiquidArray Gastrointestinal PCR Assay.

Bruker’s innovative MALDI Biotyper (MBT) platform employs a molecular approach based on proteomic fingerprinting to enable

swift identification and classification of bacteria, yeasts, and fungi.

According to the company, the platform delivers rapid and reliable results, thus facilitating timely decisionmaking for better patient outcomes.

The MALDI Biotyper (MBT) system, offers rapid sample target exchange and can analyze up to 600 samples per hour.

Moreover, this system covers over 4,600 species in the reference library, making it a versatile and reliable tool for microbial identification.

The MBT system now comes equipped with the new IDealTune, which offers fully automated tuning of MALDI-TOF parameters within a sample run, delivering consistent data

quality without requiring any user intervention.

Wolfgang Pusch, the President of Bruker’s Microbiology and Infection Diagnostics Division, stated that the company’s new diagnostic solutions, such as IVD workflows, kits, software, and reference libraries for mycobacteria and fungi, are expanding the applications of their established MALDI Biotyper platform.

Pusch also highlighted that the new LiquidArray Gastrointestinal is a nextgeneration syndromic panel that offers amazing pathogen coverage and is ideal for laboratories that require a broad screening approach to detect most pathogens in one run.

Cardiawave granted 3 new U.S. patents for ultrasound aortic stenosis treatment

USA — Cardiawave, a medical device manufacturer, has been granted three US patents for its Valvosoft ultrasound device used in treating aortic stenosis, the most common heart valve disease in adults.

The patents cover the device's ultrasound imaging and therapy system, detection and monitoring of cavitation bubbles that create the therapeutic effect generated by the focused

ultrasound, and the entire apparatus for treating deep vein thrombosis.

Cardiawave's device aims to provide a safe and effective non-invasive alternative to surgical interventions, such as transcatheter aortic valve replacement, and address the unmet medical need in treating severe symptomatic aortic stenosis in patients, particularly those who do not undergo treatment.

Medtronic pioneers new MRI scan solution for patients with

cardiac devices

IRELAND — Medtronic has launched its MRI Care Pathway, a technology designed to streamline the process of MRI scanning for patients with MRIcompatible cardiac devices.

Revolutionary concussion detection blood test from Abbott receives FDA approval

USA — Abbott has received clearance from the US FDA for its Alinity i TBI test, the first commercially available laboratory test for traumatic brain injury.

The Alinity i TBI test measures two biomarkers in the blood that are correlated with brain injury and takes 18 minutes to provide clinicians with an objective way to assess individuals with mild TBIs or concussions. The test could reduce the need for CT scans by up to 40%, offering potential cost savings to the healthcare system and patients.

Abbott's i-STAT TBI Plasma test was already cleared by the FDA as the first rapid blood test for concussion. Abbott has been leading the way in TBI testing technology for over a decade and this clearance complements their efforts to broaden the availability of the TBI blood test for use on lab-based instruments.

This is significant as up to 70% of patients with implanted cardiac devices will require an MRI at some point in their lifetime, and cardiac disease is one of the leading causes of death worldwide. However, patients with implanted

cardiac devices have traditionally been excluded from MRI scans due to potential risks. Medtronic's MRI Care Pathway addresses these challenges by providing a user-friendly platform that can help healthcare providers safely conduct MRI scans on patients with MRI-compatible cardiac devices.

The system includes a website and tablet-based application that allows clinicians to independently verify whether a patient's cardiac device is MRIcompatible. Meanwhile, Applied Medical Resources has filed an antitrust lawsuit against Medtronic over the alleged use of its size to eliminate competition in the US market for advanced bipolar surgical devices.

South Africa’s first Covid-19 antigen selftest launched by Medical Diagnostech

SOUTH AFRICA — Medical Diagnostech, a manufacturer of rapid diagnostic test kits, has launched South Africa's first Covid-19 antigen selftest with a companion mobile phone application called HealthPulse TestNow.

The application provides detailed instructions on how to perform the self-test and assists in interpreting the results through image capture of the rapid test device. HealthPulse TestNow also helps ensure the accurate use of

rapid diagnostic tests through easyto-follow instructions, process control timers, and guided result interpretation.

The solution integrates with public health reporting systems and ensures that self-testing data is reported. The rapid test and companion application were subject to rigorous evaluations by the National Reference Laboratory (NRL) of South Africa, the National Health Laboratory Service (NHLS).