In this month’s podcast, QuickNews looks at a new Lancet study, “Non-autoimmune, insulin-deficient diabetes in children and young adults in Africa.” In this study, researchers report that a significant subset of what has previously been classified as Type 1 diabetes in sub-Saharan Africa may in fact be a distinct, novel form of the disease.
The individuals in this subset did not exhibit the typical autoimmune markers (islet autoantibodies) usually found in classic Type 1 diabetes in other parts of the world. The researchers instead identified a novel, non-autoimmune, insulin-deficient subtype of diabetes that is also distinct from Type 2 diabetes.
Further evidence of this new subtype was found in Black individuals in the USA, albeit less frequently, but not in White individuals. The discovery throws a spotlight on the heterogeneity of diabetes diagnoses in sub-Saharan Africa, and points to the need to consider alternative causes and explore new prevention and treatment strategies for this distinct form of the disease.
Supported by robust advocacy initiatives to achieve policy reform, AHF ensures equitable access to HIV and public health services globally
Dr Penninah Iutung, Executive Vice President of AHF
The AIDS Healthcare Foundation (AHF) (www.AIDSHealth.org) proudly announces a transformative milestone: delivering life-saving HIV prevention, care, and treatment to 2.5 million people across 49 countries, with 1.3 million in 15 African nations (https://apo-opa.co/45zIVFg). This achievement transcends numbers, embodying restored hope, preserved families, and a bold vision for a healthier, equitable world.
AHF’s contribution to the HIV response that has enabled countries like Malawi to see a remarkable increase in life expectancy from 46 to 67 years over a 25-year period is profound. Children who may have been orphaned due to HIV can now grow up with their parents present, and communities are thriving through access to quality care. This story can be told in several countries, and it reflects AHF’s unwavering commitment to transforming lives and achieving global HIV control.
Founded in 1987 in Los Angeles as the AIDS Hospice Foundation, AHF has grown into the world’s largest HIV/AIDS service organisation. With over 8000 dedicated staff, AHF delivers expert, compassionate, and non-judgmental care to all, regardless of ability to pay. Supported by robust advocacy initiatives to achieve policy reform, AHF ensures equitable access to HIV and public health services globally.
AHF President Michael Weinstein shared, “When we began, I never imagined we’d touch 2.5 million lives. This milestone, born of our staff’s courage and our patients’ trust, demands recognition. As George Bernard Shaw said, ‘You see things; and say, Why? But I dream of things that never were and I say, Why not?’ Our dream – delivering exceptional care to all – has become reality. We’ve stayed true to our principles, proving hope can shine in a challenging world. Yet, our journey continues. AHF is tackling STIs, hunger, homelessness, and the global HIV epidemic with relentless resolve. I’m deeply honoured to serve alongside our extraordinary team.”
“When we launched our first global programs in South Africa and Uganda in 2002, serving 100 clients in each country, we could never have fathomed expanding to 13 more African countries and caring for 1.3 million lives across the continent,” said Dr Penninah Iutung, AHF’s Executive Vice President . “Building on years of advocacy and innovation, AHF Africa now delivers programs that go beyond clinical care to include community-led prevention, equitable access strategies, and pandemic preparedness. These successes reflect the deep collaboration with government and civil society partners that has enabled us to reach the most marginalized, advance equity, and ensure no one is left behind.”
Dr. Nombuso Madonsela, who leads AHF’s largest country program as AHF South Africa Country Program Director, adds, “Being part of this historic milestone is a privilege. AHF South Africa remains steadfast in championing combination prevention, reducing new infections, and ensuring quality service delivery and support for all in our care. Through our Community Power Voices (CPV), we amplify the stories and triumphs of those living with HIV. Ending HIV is not just a dream, it’s a promise we are determined to keep.”
Looking forward, AHF is resolute in expanding access, dismantling barriers, and ensuring no one is left behind in the global fight against HIV. This milestone fuels AHF’s mission to push boundaries, innovate solutions, and build a future where HIV is no longer a threat.
Distributed by APO Group on behalf of AIDS Healthcare Foundation.
African countries face a major challenge of dealing with high rates of communicable diseases, such as malaria and HIV/Aids, and rising levels of non-communicable diseases. But the continent’s health systems don’t have the resources to provide accessible and affordable healthcare to address these challenges.
Historically, aid has played a critical role in supporting African health systems. It has funded key areas, including medical research, treatment programmes, healthcare infrastructure and workforce salaries. In 2021, half of sub-Saharan Africa’s countries relied on external financing for more than one-third of their health expenditures.
As aid dwindles, a stark reality emerges: many African governments are unable to achieve universal health coverage or address rising healthcare costs.
The reduction in aid restricts healthcare services and threatens to reverse decades of health progress on the continent. A fundamental shift in healthcare strategy is necessary to address this crisis.
The well-known maxim that “prevention is better than cure” holds not just for health outcomes but also for economic efficiency. It’s much more affordable to prevent diseases than it is to treat them.
As an infectious diseases specialist, I have seen how preventable diseases can put a financial burden on health systems and households.
For instance, each year, there are global economic losses of over US$33 billion due to neglected tropical diseases. Many conditions, such as lymphatic filariasis, often require lifelong care. This places a heavy burden on families and stretches national healthcare systems to their limits.
African nations can cut healthcare costs through disease prevention. This often requires fewer specialist health workers and less expensive interventions.
To navigate financial constraints, African nations must rethink and redesign their healthcare systems.
Three key areas where cost-effective, preventive strategies can work are: improving water, sanitation, and hygiene; expanding vaccination programmes; and making non-communicable disease prevention part of community health services.
A shift in healthcare delivery
Improving water, sanitation, and hygiene infrastructure
Many diseases prevalent in Africa are transmitted through contact with contaminated water and soil. Investing in safe water, sanitation, and hygiene (WASH) infrastructure is an opportunity. This alone can prevent a host of illnesses such as parasitic worms and diarrhoeal diseases. It can also improve infection control and strengthen epidemic and pandemic disease control.
Currently, WASH coverage in Africa remains inadequate. Millions are vulnerable to preventable illnesses. According to the World Health Organization (WHO), in 2020 alone, about 510 000 deaths in Africa could have been prevented with improved water and sanitation. Of these, 377 000 deaths were caused by diarrhoeal diseases.
Unsafe WASH conditions also contribute to secondary health issues, such as under-nutrition and parasitic infections. Around 14% of acute respiratory infections and 10% of the undernutrition disease burden – such as stunting – are linked to unsafe WASH conditions.
By investing in functional WASH infrastructure, African governments can significantly reduce the incidence of these diseases. This will lead to lower healthcare costs and improved public health outcomes.
Local production of relevant vaccines
Vaccination is one of the most cost-effective health interventions available for preventing infection. Immunisation efforts save over four million lives every year across the continent.
There is an urgent need for vaccines against diseases prevalent in Africa whose current control is heavily reliant on aid. Neglected tropical diseases are among them.
Vaccines can also prevent some non-communicable diseases. A prime example is the human papillomavirus (HPV) vaccine, which can prevent up to 85% of cervical cancer cases in Africa.
HPV vaccination is also more cost-effective than treating cervical cancer. In some African countries, the cost per vaccine dose averages just under US$20. Treatment costs can reach up to US$2,500 per patient, as seen in Tanzania.
It is vital to invest in a comprehensive vaccine ecosystem. This includes strengthening local research and building innovation hubs. Regulatory bodies across the continent must also be harmonised and markets created to attract vaccine investment.
Integrating disease prevention into community healthcare services
Historically, African healthcare systems were designed to address communicable diseases, such as tuberculosis and HIV. This left them ill-equipped to handle the rising burden of non-communicable diseases, such as type 2 diabetes and cardiovascular diseases. One cost-effective approach is to integrate the prevention and management of these diseases into existing community health programmes.
Community health workers currently provide low-cost interventions for health issues such as pneumonia and malaria. They can be trained to address non-communicable diseases as well.
In some countries, community health workers are already filling the service gap. Getting them more involved in prevention strategies will strengthen primary healthcare services in Africa. This investment will ultimately reduce the long-term financial burden of treating chronic diseases.
A treatment-over-prevention approach will not be affordable
Current estimates suggest that by 2030, an additional US$371 billion per year – roughly US$58 per person – will be required to provide basic primary healthcare services across Africa.
Adding to the challenge is the rising global cost of healthcare, projected to increase by 10.4% this year alone. This marks the third consecutive year of escalating costs. For Africa, costs also come from population growth and the rising burden of non-communicable diseases.
By shifting focus from treatment to prevention, African nations can make healthcare accessible, equitable and financially sustainable despite the decline in foreign aid.
April 2nd, 2025, Nairobi, Kenya – Africa stands at the forefront of a revolutionary shift in global health, driven by artificial intelligence (AI) and data science, according to a report released today from the Science for Africa Foundation (SFA Foundation), African institutions and research councils. The report is a first of its kind to comprehensively examine national-level perspectives across Africa on AI and data science for global health. The landscape presents an unprecedented view into the potential to improve AI governance in Africa to reduce the risk and stop the perpetuation of inequity.
Titled “Governance of Artificial Intelligence for Global Health in Africa”, the report is produced through the SFA Foundation’s Science Policy Engagement with Africa’s Research (SPEAR) programme as a culmination of a year-long effort involving convenings across Africa’s five regions, policy analysis and extensive surveys to identify policy gaps and opportunities in AI and data science for global health. Grounded in consultations across 43 African countries, the report incorporates insights from over 300 stakeholders, ensuring a comprehensive and inclusive approach to its findings.
“The global AI governance framework remains ill-suited to Africa’s unique needs and priorities,” said Prof. Tom Kariuki, Chief Executive Officer of the SFA Foundation. “Our report on AI in global health and data sciences champions a shift towards frameworks that reflect Africa’s context, ensuring ethical, equitable, and impactful applications of AI not only for our continent’s health challenges, but also to advance global health.”
Key findings and opportunities
The report identifies key trends, gaps, and opportunities in AI and data science for health across Africa:
Increasing national investments: Countries including Mauritius, Nigeria, Malawi, Ethiopia, Ghana, Rwanda, Senegal, and Tunisia have launched national AI programmes, while at least 39 African countries are actively pursuing AI R&D. Initiatives such as Rwanda’s Seed Investment Fund and Nigeria’s National Centre for AI and Robotics illustrate promising investments in AI startups.
Need for health-specific AI governance: Despite growing interest, there is a critical gap in governance frameworks tailored to health AI across Africa. While health is prioritised in AI discussions, specific frameworks for responsible deployment in health are still underdeveloped.
Inclusive AI policy development: Many existing AI policies lack gender and equity considerations. Closing these gaps is essential to prevent inequalities in access to AI advancements and health outcomes.
“Incorporating AI into healthcare is not just about technology—it is about enhancing our policy frameworks to ensure these advancements lead to better health outcomes for all Africans,” added Dr Uzma Alam, Programme Lead of the Science Policy Engagement with Africa’s Research (SPEAR) programme.
There are existing policy frameworks on which to build and/or consolidate governing of responsible AI and data science: At least 35 African countries have national STI and ICT as well as health research and innovation policy frameworks that contain policies applicable to the development and deployment of AI and data science.
There is a surge in African research on health AI and data science (big data): raising the need for equitable North-South R&D partnerships.
Recommendations and way forward
The report is expected to act as a catalyst for integrating AI into health strategies across the continent, marking a significant step forward in Africa’s journey toward leadership in global health innovation by calling for:
Adaptive and Inclusive AI Governance: The report calls for the integration of diverse perspectives spanning gender, urban-rural dynamics, and indigenous knowledge into AI health governance frameworks. It highlights the need for adaptive policies that balance innovation with equitable access, while leveraging regional collaboration and supporting the informal sector.
Innovative Funding and African Representation: Recognising the potential of local knowledge and practices, the report advocates for creative funding models to bolster AI research and development. It emphasises connecting the informal sector to markets and infrastructure to encourage grassroots innovation.
The Reinforcement of Science Diplomacy: To position Africa as a key player in global AI governance, the report recommends investing in programmes that align AI technologies with Africa’s health priorities. It also stresses the importance of amplifying Africa’s voice in shaping international standards and agreements through robust science-policy collaboration.
The Bridging of Gendered digital divide: To bridge the gendered digital divide in Africa. targeted initiatives are needed to address regional disparities and ensure gender inclusivity in the AI ecosystem. It’s essential to focus on programs that build capacity and improve access to resources.
“The report clearly outlines pathways for leveraging AI to bridge gaps and overcome current capacity constraints, while strengthening Africa’s role as a leader in shaping global health policy,” said Dr Evelyn Gitau, Chief Scientific Officer at the SFA Foundation. “This initiative showcases Africa’s potential to lead, innovate, and influence the global health ecosystem through AI.”
“We envision a world where AI advances health outcomes equitably, benefiting communities around the world. The Science for Africa Foundation’s report brings this vision to life by providing clarity on policy frameworks of AI and data science in global health. This empowers African voices to shape AI policy – not only directing healthcare innovation but setting a precedent for inclusive AI governance across sectors.” – Vilas Dhar, President of the Patrick J. McGovern Foundation.
By Kelly Widdop, Consumer Health Cluster Division Head for Bayer Sub-Saharan Africa
Healthcare innovation in Sub-Saharan Africa is rapidly evolving, driven by the need to address critical healthcare challenges such as limited access to healthcare services, high rates of infectious diseases, and growing non-communicable diseases (NCDs). With a population of over 1.1 billion people, many of whom live in rural and underserved areas, innovations are crucial to improving healthcare delivery, accessibility, and affordability.
What innovation in healthcare looks like
Healthcare innovation means more than introducing new medicines or medical devices; it involves creating integrated solutions that address both immediate health needs and systemic barriers to care. Globally, healthcare innovation is being driven by advances in digital technologies, personalised medicine, and artificial intelligence (AI) diagnostic tools. In developed regions, this includes the development of digital health, which provides remote consultation, diagnostic services, and treatment monitoring, helping to overcome geographical barriers for patients in underserved areas. In Sub-Saharan Africa, healthcare innovation is focused on overcoming infrastructure challenges and expanding access to self-care and wellness education. Both globally and locally, and in Sub-Saharan Africa, innovation is reshaping healthcare systems, making them more resilient, accessible, and responsive to the evolving needs of populations.
A decade of transformation – where we are as Sub-Saharan Africa
Sub-Saharan Africa presents a unique set of healthcare challenges, including limited infrastructure, a shortage of resources, and barriers related to affordability and access. Although not showing all at once, many changes are being achieved within the healthcare sector.
Kelly Widdop, Consumer Health Cluster Division Head for Bayer Sub-Saharan Africa
Over the past decade, the consumer health sector has undergone transformative growth, driven by a shift towards personalised wellness and a global demand for accessible and preventative care. Innovations in digital tools such as telemedicine and health-tracking apps, have empowered individuals to take charge of their health in real time, fostering a proactive approach to wellness. Alongside this, there has been a surge in personalised health products from targeted vitamins and mineral supplements, dry-to-sensitive skincare solutions, eco-friendly packaging and natural-based ingredients, which is gaining importance as consumers increasingly seek brands that align with their values. These changes have reshaped consumer health, making it more responsive, inclusive and environmentally conscious.
In the realm of nutritional vitamins and minerals, due to the rise in health awareness and lifestyle health management, many consumer health companies have tailored supplements to address common nutrient deficiencies such as bleeding gums, fatigue, joint pain, and delayed wound healing which are usually linked to, for example, a lack of calcium, vitamin b, vitamin c, vitamin d, and zinc. Consumer healthcare products, particularly vitamins and supplements, have empowered individuals to manage everyday health needs independently. With the availability of essential nutrients that support immunity, energy, mental clarity, and general well-being, consumers can now address minor ailments and manage everyday minor issues without needing to visit a doctor all the time, which can get expensive, especially for the low-income consumer. Instead of relying on medical help from a doctor for minor problems, consumers can now find over-the-counter solutions, saving both time and money.
The past decade has brought many changes in the dermatology space within the Sub-Saharan African market. With a focus on unique skin issues in the region, like sun damage and risks from unregulated skin-lightening products, there have been several public campaigns promoting safer skincare. Plus, with the expansion of telemedicine and digital health platforms, more and more people have access to dermatological consultations than ever before, without worrying about distance. The growing popularity of the use of natural ingredients has become super popular as consumers prefer these safer skincare options. In addition to the easily accessible dermatological products, there has been a significant increase in dermatological education and training across the region to build dermatological expertise in the region. Overall, these investments in both new product innovation and community engagement continuously empower consumers to manage their skin health.
In Sub-Saharan Africa, there have been some great advancements in allergy care, making it easier for people to find over-the-counter solutions for their allergy issues. With more people living in cities and changes in lifestyle and the environment, allergies like rhinitis, food allergies, and seasonal allergies are on the rise. To help with this, healthcare providers and companies have made antihistamines more accessible, allowing people to manage their symptoms without always needing to see a specialist. Plus, there is now a lot of useful information available on how to recognize, prevent, and treat allergic reactions, which helps consumers handle their allergies more effectively without frequent medical visits.
Capacitybuilding – a crucial aspect of the transformation
Capacity building has been a crucial aspect of this transformation. Investments in healthcare infrastructure, training programs, and community health initiatives have strengthened the overall healthcare system. For instance, healthcare providers have been trained to use digital health tools effectively, ensuring that they can offer remote consultations and monitor patients’ health from a distance. Community health workers have been equipped with the knowledge and resources to educate people about self-care practices, preventive measures, and the importance of regular health check-ups. These efforts have not only improved healthcare delivery but also empowered individuals to take control of their health.
Access to self-care has also expanded significantly. With the availability of over-the-counter products, individuals can now manage minor health issues on their own and educational campaigns have raised awareness about the importance of self-care, encouraging people to adopt healthier lifestyles and seek medical advice when necessary. This shift towards self-care has reduced the burden on healthcare facilities and allowed individuals to take a more active role in managing their health, and these changes have reshaped consumer health in Sub-Saharan Africa, making it more responsive, inclusive, and environmentally conscious.
What Sub-Saharan Africa can continuously adopt to succeed
Global relations and intercontinental trade have uniquely provided Sub-Saharan Africa an advantage in bringing successful healthcare innovations to the region.
The adoption of digital health platforms has the potential to change healthcare delivery in rural and underserved areas. Remote monitoring systems can help close the gap in access to health services, making it easier and more convenient for people to get care—just like what has been done successfully in places such as India and Latin America. Personalised health solutions, such as vitamin supplements and skincare products, can cater to local needs and encourage people to take charge of their health and health education initiatives delivered through social media and schools can empower individuals with health literacy, creating a culture of preventive self-care and informed consumer choices.
Additionally, telemedicine and remote care technologies can also be expanded across Africa to keep track of consumers’ health, ensuring they get continuous care even when healthcare facilities are hard to reach. Healthcare in Sub-Saharan Africa should go beyond just offering new products; it should be about creating lasting solutions that truly empower people, patients, and communities. Innovations that fit local needs can make a real difference and improve lives across the continent.
Researchers at the University of Liverpool have conducted a large-scale analysis that sheds light on the critical steps needed to combat the vertical transmission of chronic hepatitis B virus (HBV) in Africa.
Almost two thirds of all new hepatitis B infections globally occur in Africa. The newly published paper in The Lancet Global Health shows the importance of giving the hepatitis B birth dose vaccine (HepB-BD) within 24 hours of birth, and the potential impact of providing antiviral therapy (antiviral prophylaxis) to mothers during pregnancy. The study estimates for the first time that hepatitis B vertical transmission (passed from mother to baby) could be eliminated in Africa, with increased coverage of these two key interventions.
Chronic hepatitis B is the leading cause of liver cancer and liver cirrhosis in Africa and deaths are rising. Most cases of liver cancer are diagnosed late and are associated with a very poor prognosis in the region. Vertical transmission is one of the commonest routes of infection and is associated with an increased lifetime risk of severe liver disease.
Dr Alexander Stockdale, Senior Clinical Lecturer at the University’s Department of Clinical Infection, Microbiology and Immunology, based at the Malawi-Liverpool-Wellcome Trust Clinical Research Programme, together with Dr Nicholas Riches at Liverpool School of Tropical Medicine, led the comprehensive analysis of more than 113 individual studies which reported on the prevalence of hepatitis B in more than 190 000 women and investigated rates of vertical transmission.
The World Health Organization (WHO) African region faces a significant burden, accounting for 63% of the global total of new infections. This amounted to 771 000 new infections and 272 000 deaths in 2022. Among children under 5 years, the prevalence of HBV stands at 2.5% in the WHO African region – the highest globally.
Dr Alexander Stockdale said: “This study makes the case for investment in birth dose vaccination and maternal antiviral prophylaxis, in view of the exciting potential for elimination of vertical transmission in the WHO African region in our lifetime. Vertical transmission is a key route of new hepatitis B infections. Due to limited implementation of interventions, elimination targets are not currently being met. We project that expanding HepB-BD vaccination coverage to 90% could reduce transmission events by 44%, and adding maternal antiviral prophylaxis for 90% of eligible women could further reduce transmission by 86% and achieve the WHO targets for elimination.”
Dr Stockdale and colleagues have also recently been awarded £3million funding from the National Institute of Health and Care Research to conduct implementation research in Malawi and The Gambia. The NIHR Global Health Research Grant will allow researchers in Malawi, led by Dr Stockdale and in The Gambia, led by Professor Maud Lemoine and Dr Gibril Ndow, to evaluate the effectiveness, safety, feasibility and cost-effectiveness of giving antiviral treatment (tenofovir) to all pregnant women living with chronic hepatitis B to prevent transmission. This study will provide vital evidence on the potential impact of this strategy to guide public health policy in Africa, which has been recognised as a key knowledge gap by the WHO in the 2024 hepatitis B guidelines.
One in eight patients in hospitals in Africa is critically ill, and one in five of the critically ill die within a week, according to a new study in The Lancet.The researchers behind the largest study of critical illness in Africa to date conclude that many of these lives could have been saved with access to cheap life-saving treatments.
The study is the first large-scale mapping of critically ill patients in Africa. Nearly 20 000 patients in 180 hospitals in 22 African countries were surveyed in the study.
Being critically ill means having severely affected vital functions, such as extremely low blood pressure or low levels of oxygen in the blood. In the new study, researchers show that one in eight patients in African hospitals, 12.5%, is in this condition. Of these, one in five, 21%, die within a week, compared to 2.7% of those who are not critically ill.
A large proportion of critically ill patients, 69%, are treated in general wards rather than intensive care units. More than half of critically ill patients, 56%, do not receive even the basic critical care they need, such as oxygen therapy, intravenous fluids or simple airway management.
“Our study shows that there is a large and often neglected group of patients with critical illness in Africa,” says first author Tim Baker, Associate Professor at the Department of Global Public Health at Karolinska Institutet.
The researchers behind the study emphasise that these are basic but crucial health interventions that can make a big difference.
“If all patients had access to essential emergency and critical care, we could significantly reduce mortality. Moreover, these interventions are inexpensive and can be provided in general wards,” says Carl Otto Schell, researcher at the Department of Global Public Health at Karolinska Institutet and one of the initiators of the study.
Merck Foundation, the philanthropic arm of Merck KGaA Germany has been awarded as the “NGO of the Year 2024”, the Most Influential NGO Shaping Africa’s Future and Leading Community Empowerment, by Avance Media, a leading rating and voting firm in Africa.
On receiving the accolade, Senator, Dr. Rasha Kelej, CEO of Merck Foundation and One of 100 Most Influential Africans for five consecutive years – from 2019 till 2023 expressed, “I am thrilled and proud to share that Merck Foundation has been voted as the “NGO OF THE YEAR 2024”, out of the list of 10 NGOs Leading Community Empowerment in Africa, shortlisted by Avance Media, big thanks for everyone who voted for us, we would not have been able to make it without your support and trust in Merck Foundation’s significant role in shaping the future of African communities.”
Winning the “NGO of the Year 2024 ” as per people’s votes acknowledged their collective efforts in shaping Africa’s future through key sectors such as health, education, and economic empowerment.
“This recognition inspires me and my team to continue our mission to transform the patient care landscape, drive cultural change, support girls’ education, empower women, and break the stigma around infertility in Africa and beyond. We are committed to contributing to improving lives of the people.” Dr. Rasha Kelej added.
Merck Foundation was initially announced as one of 10 Most Influential NGOs Shaping Africa’s Future, along with other leading NGOs working in Africa like Save the Children, Plan International, Doctors without Borders, Africa Women’s Development Fun, African Medical & Research Foundation, and others. Merck Foundation was then voted for as the NGO of the Year 2024, out of the 10 NGOs listed.
Since 2012, Merck Foundation, together with their Ambassadors, the First Ladies of Africa, and Partners like Ministries of Health, Gender, Education, and Communication, continues to transform patient care across Africa and bring cultural shift with regards to a wide range of social and health issues, including breaking the stigma around infertility, supporting girls’ education, ending child marriage and FGM, stopping gender-based violence, and raising awareness about diabetes and hypertension.
“I am happy to share that we have provided more than 2080 scholarships to young doctors from 52 countries, in 44 underserved medical specialties. Many of our Merck Foundation Alumni are becoming the first specialists in their countries. Together, we continue to make history,” Dr. Kelej added.
The scholarships of one year, two year and three year fellowship, diploma and master course have been provided in 44 underserved medical specialties like Oncology, Diabetes, Cardiology, Endocrinology, Respiratory, Acute Medicine, Sexual and Reproductive medicine, Embryology, Respiratory, Critical care, Psychiatry, General Surgery, Dermatology, Emergency and Resuscitation Medicine, Gastroenterology, Neuroimaging for Research, Pain Management, Neonatal Medicine, Clinical Microbiology & Infectious Diseases, Advanced Surgical Practice and more.
Through their “More Than a Mother” campaign which is a strong movement that aims to empower infertile and childless women through access to information, education and change of mindset, Merck Foundation has been building quality and equitable reproductive and fertility care capacity, breaking infertility stigma and raising awareness about Infertility Prevention and Male Infertility.
“I am happy that we are contributing to building and advancing fertility care capacity in Africa and improving better access to women’s health. I am very proud to share that we have provided till today more than 650 scholarships of Embryology, Fertility and Reproductive care to young doctors from 39 different countries. Moreover, we also support childless women by helping them start their own small businesses. It is all about giving every woman the respect and support she deserves to lead a fulfilling life, with or without a child”, Senator, Rasha Kelej explained.
Moreover, Merck Foundation strongly believe that Education is one of the most critical areas of women empowerment. Therefore, through their “Educating Linda”, Merck Foundation contributes to the future of young African girls who are brilliant but underprivileged, by providing more than 700 scholarships, to cover their school fees till they graduate, and thousands of school items to schoolgirls in many African countries including Botswana, Burundi, Malawi, Ghana, The Gambia, Nigeria, Zambia, Zimbabwe, Ghana, Namibia, Democratic Republic of the Congo, Niger and more.
I am happy that we are contributing to building and advancing fertility care capacity in Africa and improving better access to women’s health
Dr. Rasha Kelej
Additionally, Merck Foundation has been raising awareness about many critical social issues including breaking infertility stigma, supporting girl education, women empowerment, ending FGM & child marriage, stopping GBV and important health issues like Diabetes & Hypertension prevention, early detection & Management; promoting healthy lifestyle; infertility awareness & management and more. Merck Foundation has introduced many unique and innovative ways like Songs, Animation Films, Children Storybooks, Health Media Trainings, “Our Africa” TV Program, Awards for Media, Filmmakers, Fashion Designers and Musicians and more.
Sickle cell disease. Credit: National Institutes of Health
A clinical trial in Uganda has revealed that hydroxyurea significantly reduces infections in children with sickle cell anaemia. Their latest findings enhance strong evidence of hydroxyurea’s effectiveness and could ultimately reduce death in children in Africa, the continent most burdened by the disease.
The group’s research, appearing in the journal Blood, revealed that hydroxyurea treatment resulted in a remarkable 60% reduction in severe or invasive infections, including malaria, bacteraemia, respiratory tract infections and gastroenteritis, among Ugandan children with sickle cell anaemia.
“Our investigation provides powerful justifications for hydroxyurea’s use in children with sickle cell anaemia in Africa,” said Dr Chandy John, paediatrics professor at IU School of Medicine and co-lead investigator of the latest study.
“Given the high rates of infection in this region, we hope our evidence will encourage ministries of health to continue supporting and expanding access to hydroxyurea for young patients who can greatly benefit from the treatment.”
Sickle cell anaemia is a genetic blood disorder that alters the structure of red blood cells and affects oxygen distribution throughout the body, increasing susceptibility to serious health complications and life-threatening infections.
According to the World Health Organization, more than 300 000 children worldwide are born with sickle cell disease each year, with a high prevalence found in African countries.
While hydroxyurea has had U.S. Food and Drug Administration approval as a sickle cell disease treatment for children since 2017, its accessibility and acceptance in Africa have been comparatively limited.
As hydroxyurea has become more recognised in African countries for its effectiveness in treating sickle-cell-related complications, John and his colleagues noticed a knowledge gap about the treatment’s effect on infections.
This led the research group to incorporate hydroxyurea treatment and analysis into their established clinical trial, Zinc for Infection Prevention in Sickle Cell Anemia, led by Indiana University School of Medicine and collaborators in Uganda.
During the study, the researchers examined the effects of hydroxyurea on 117 children in Uganda and focused on a range of infections. After hydroxyurea treatment, results showed a substantial decrease in the incidence of these infections.
Additionally, eight of the nine deaths that occurred in the trial were children whose parents declined hydroxyurea treatment. The only death in a child on hydroxyurea treatment occurred four days after starting treatment, providing insufficient time for hydroxyurea to have an effect.
Of the five children for whom a cause of death was known, all five died of infectious causes.
The high death rate in the study, despite expert clinical care by study personnel, provides further evidence of the urgent need for additional interventions to decrease mortality in children with sickle cell disease in Africa.
“Infections commonly precede other complications related to sickle cell anaemia and often result in hospitalizations that can lead to death,” said Dr Ruth Namazzi, site principal investigator, first author and a lecturer in the Department of Pediatrics and Child Health at Makerere University in Uganda.
“We believe incorporating hydroxyurea treatment as the standard of care for sickle cell anaemia across Africa will not only reduce infections but will more importantly save countless lives.”
By Robert Appelbaum & Prelisha Singh, Partners at Webber Wentzel
In Africa, dysfunctional governments are often unable to allocate sufficient funds for essential aspects of healthcare. This results in a shortage of new primary and specialised hospitals, little local pharmaceutical and medical device manufacture and the inability to train doctors beyond undergraduate level, creating a shortage of medical specialists.
In a recent seminar hosted by Invest Africa and moderated by Webber Wentzel, panelists Silven Chikengezha, Liza Eustace, Jen Pedersen, Jasen Smallbone and Dr Sue Tager, shared their insights on how to tackle the problems of financing healthcare in Africa, and building a pipeline of medical professionals who remain in Africa.
Funding
From the perspective of the IFC, the obvious need for greenfield hospitals in Africa is not sufficient to attract funding. To be attractive, projects need to meet certain criteria.
The first is that it must have a sponsor with experience in construction and operations. The second is that it has to have the potential to grow. It takes at least three years for a hospital to start making returns. Primary care is an identified area of potential growth on the continent, but it offers low margins so it needs to build up volumes. If the hospital is a primary healthcare facility that addresses an identified need in the local community, it is more likely to attract reliable footfall. But there is very little revenue in basic services like treating TB, AIDS and giving vaccination, so the facility should offer a range of affordable treatments.
The third criterion for any hospital project seeking funding is that it should have, or will be able to attract suitably qualified staff. Doctors like to work in complementary practice groups, so the hospital should be able to offer an attractive environment for medical professionals.
The next important issue is the certainty of cash flow. Although government-sourced revenue for the hospital can provide a steady income stream, governments can be slow payers. It is important to look at each government’s history of making timely payments. Commercial banks will also consider the affordability of the hospital’s services, given that a very small proportion of Africa’s population has medical insurance. In some countries, governments require employers to pay their employees’ medical bills, which provides a level of comfort to the banks. Technology can help to improve affordability, for example, innovations such as monitors that track the temperature of heat-sensitive medicines in transit, which reduces wastage.
A fifth critical issue for funders is the way the funding is structured. If a large hospital project is structured with 60-70% debt from its initial stages, it is likely to struggle to meet interest payments. It is better to start with a smaller facility that is scaleable, and structure the funding so that there is more equity than debt in the early years.
ABSA noted that they would seek strong equity holders before considering debt, and they will look carefully at who the main equity funders are. This is an area where the IFC and other Development Finance Institutions (DFIs) can play a role because they are usually willing to take the “first loss” risk, which encourages commercial banks to extend debt. Commercial banks take comfort from developers with strong balance sheets.
An emerging source of funding for healthcare projects in Africa (as well as other projects, such as in energy, water and education) are social impact bonds, in which an institutional funder will lend money to an implementer that can correctly manage a project that meets a need – often a need identified by the government. Corporates should be pooling their available funds to create scaleable projects that will make an impact.
If healthcare financing is intended to support existing service providers in Africa, it has to adapt to the capacity of what are often very small- to medium-sized businesses. These businesses, which may be anything from manufacturers of medical devices to providers of digi-health services, need far less than USD 20 million, so they tend to be ignored. But funding is essential to help established businesses build scale. This is another area where DFIs and commercial banks working together can help, as the DFI can provide the first loss facility which allows commercial banks to take risk on smaller clients.
Public-private partnerships
The pandemic made it clear that perceived obstacles between public and private entities in providing healthcare together could be overcome if there was the right will and people in the room.
Speakers discussed the Wits Donald Gordon Medical Centre as an example of a successful PPP, which could be replicated elsewhere. The Donald Gordon offers treatment to the private sector, and the derived profits are used to train medical students from Wits University, which is the public partner. The centre also performs liver transplants for all patients, both public and private. Mediclinic has a share in Donald Gordon but does not receive dividends. All profits are recycled back into the hospital.
A PPP model for the provision of healthcare needs partners who have similar levels of sophistication and can work together. Governments have to appreciate that the role of the private sector is not merely to bring money so that the government can continue running things the way they have always done. Private sector partners should be allowed to introduce the levels of efficiency in delivery that are typically found in the private sector.
