How Africa is harnessing tech to deliver healthcare
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I started my career, I was the only medical doctor for 250,000 people. What do you think one medical doctor can do for 250,000 people? Welcome to Radio Davos, the podcast from the World Economic Forum that looks at the biggest challenges and how we might solve them. This week, we're looking at global health with one of the most senior health officials in Africa. If I have to close my eyes and to think about Africa the next five years, it will be another continent because we're leveraging the power of

AI and digital transformation agenda. It's a positive message from the head of the Centers for Disease Control and Prevention in Africa, a continent facing the impact of massive cuts to health spending from overseas. 30% of Africa's health expenditure comes from ODA. So it's having a massive impact in some countries more than others. In combination with that, Africa's escalating debt crisis is dovetailing with that.

The head of global health at the World Economic Forum sets out the challenges of this new reality. And the head of Africa's CDC explains why Africa is a huge opportunity. Many people are asking if we have a market. I'm laughing because I see we have 1.4 billion people. This is the market we need. The issue is how to open this market.

Follow Radio Davos wherever you get your podcasts or visit wef.ch slash podcasts, where you'll also find our sister programmes, Meet the Leader and Agenda Dialogues. I'm Robin Pomeroy at the World Economic Forum. And with this look at how healthcare can transform Africa. I have to call local manufacturing the second independence of Africa. This is Radio Davos.

Welcome to Radio Davos and this week we are looking at health with a focus on Africa and I'm joined by my colleague Laura Dumoulin, Lead for Global Health and Security at the World Economic Forum. Hi Laura, how are you? Hi, good thank you. Lovely to be here. Great to have you here. What is it you do at the World Economic Forum?

So I oversee our efforts that are related to global health and security, which includes pandemic preparedness, efforts related to vaccine manufacturing, disease monitoring, and related efforts. So you're based in the World Economic Forum's office in New York, but I'm talking to you in person here in the World Economic Forum's office in Geneva. How come you're over here? It's not just for Radio Davos, is it? No, no. This was actually quite a big week within global health.

It was the World Health Assembly this week here in Geneva. And there's quite a few notable events that took place. For example, the pandemic accord was approved here in Geneva and a draft will be moving forward to ratification. The pandemic accord, it was a set of how can countries come together in terms of how to better respond in the future to future pandemics and outbreaks.

and how can there be a more collective response moving forward. Right. This is what the lessons we've learned from COVID and how to do it better next time. Exactly. Hopefully have them more institutionalized moving forward. And there was an event here at the World Economic Forum as well. Yeah, we had two events, one related to regionalized vaccine manufacturing collaborative. So that's an effort that the forum incubated and has since spun out. It's an independent initiative that's hosted at CEPI. CEPI is the?

Coalition for Epidemic Preparedness and Innovations, really dedicated to ensuring that there's vaccines, especially within 100 days of an outbreak. That's one of its main missions it's taken on.

And the Regionalized Vaccine Manufacturing Collaborative, now as an independent, it has the vision of ensuring vaccine equity and health security are created for all countries in all regions of the world. And that there's establishment of regional vaccine manufacturing and supply chain networks, as we saw during COVID-19.

It was really the countries that had the vaccine manufacturing capacity within their borders that were the ones that had that first access to vaccines, regardless of their ability to pay. So even countries that were willing to pay, able to pay, because they didn't have that manufacturing capacity on shore, then they were unable to secure that supply. And there's also vaccine embargoes, for example, in terms of not exporting those vaccines.

And so the ideal that you can imagine is there's more around the world, more places that are able to produce vaccines. Yeah. And I think it's not to necessarily produce more vaccine, but it's to ensure that all regions and all countries have that access and access.

that not every country necessarily needs their own vaccine manufacturing plant, and it doesn't make any economic sense. But if you think about regional networks, so how can countries come together and ensure that within their region, not necessarily even a region defined by geography, but maybe geopolitical alliances, for example, how can they have a distributed network that will be able to produce the vaccines themselves

that they would need during a pandemic or an outbreak. Laura, it's an interesting time for global health right now at this World Health Organization, the Health Assembly and the meetings you've had here in Geneva. This is at a time when the US administration has pulled out of the World Health Organization and also cut aid budgets. What was the feeling you're getting from people you're speaking to and where do you think things go from here?

Yeah, it is a difficult time indeed. There was a lot of anticipation that there would be a lot of geopolitical changes. However, I don't believe it was on anyone's radar the extent to some of those changes that have taken place. There's been a 70% reduction in official development assistance or ODA this year from

81 billion in 2021 to 25 billion in 2025. So that's a 70% decrease. This is overall globally, you mean? To Africa. To Africa. Yeah. From the rest of the world or from the US? From the rest of the world. However, the United States does represent the vast majority of that, not only in percentage wise, but an overall dollar amount as well. And it represents the most significant kind of retrenchment of foreign health investments globally.

perhaps ever. 30% of Africa's health expenditure comes from ODA. So it's having a massive impact in some countries more than others. And in combination with that, Africa's escalating debt crisis is dovetailing with that. This is the debt crisis, and we've covered it on Radio Davos, where government debt has become so big, interest rates have gone up. Some governments are spending more just servicing, just paying the interest on their debt than they are

on government services such as and particularly healthcare. Yeah, precisely. So the obligations are projected to reach $81 billion US dollars by 2025. So that's surpassing the anticipated external financial inflows.

So that's going to further limit fiscal space and bandwidth to be able to make those critical health. So that figure you just cited, that's the cost of the debt? The obligations that countries will have to pay. Right. Because of the debt. So because of this, because of the overall impact it will have on health financing, the

there's going to be tragic consequences and impacts. The WHO, for example, that estimated cuts will lead to more than 10 million additional cases of HIV and 3 million HIV-related deaths. Because as a direct consequence of this cut,

in overseas development aid. Yeah, exactly. And that's just for HIV. So up to 4 million additional people can now die from just treatable diseases in Africa.

And that's, I mean, that's related to the just the US funding cut, according to the Africa CDC. Earlier this month, WHO reported that Kenya, Lesotho, South Sudan, Burkina Faso, and Nigeria, that they'll actually run out of the antiretroviral medicine for HIV within the next few months as a result of these at the USAID cuts. So the impact is being felt immediately and right now and when somebody is off treatment, your viral rates start to go up.

it's the impact is indeed immediate. And what can be done to counter that? Someone's got to come in and find some money for that, I suppose. There have been significant investments announced this week coming from China to the WHO, from the Gates Foundation, from Novo Nordisk Foundation. However, there's been

irreparable damage already made in terms of some of the institutions that are funded by that ODA. A lot of clinical trials, for example, have been halted. People have, as I mentioned, gone off their treatment. There are some gaps that have been filled, but not all. And a lot of the progress that has been made over the past two decades in particular, we're going to see a backtrack on that

One thing to note is that Africa CDC and Dr. Jean Kaseya, they did just announce recently a new strategy in terms of how to promote COVID.

domestic financing, using other types of innovative financing tools, blended financing and whatnot, that has received support from the African Union, from heads of state. But that's going to take time. And we don't have time. And lives are on the line. And it's going to mostly affect children.

who are most vulnerable to preventable diseases like malaria, young women and adolescent girls where we see a lot of the new infections from HIV. And those are the people that are going to be most impacted. And I suppose this makes the work you're doing, the work of the World Economic Forum more important than ever in some ways because this is an organization that brings together people who are looking for solutions, be that private sector,

academic experts, philanthropists even. I guess we have to look at the glass half full in a situation like this. Yeah. I mean, there's definitely going to be some innovative partnerships that will be catalyzed and advanced more rapidly because of this. And I mean, that's going to be fantastic actually. And I think there is...

There's absolutely more interest in engaging with private sector now than I have ever seen within this field. There's more openness and willingness for cross-sectoral collaboration. And I think that a lot of the expertise, capabilities, and capacities that exist within the private sector and the ability to scale and to ensure sustained solutions

through public-private partnerships can really address some of these changes that have taken place recently. So yes, in response to your comment, I do think that the World Economic Forum as the neutral convener and platform for public-private partnerships can play a role here. Well, let's take a listen then to Dr. Jean Cassez. Now, he spoke in Davos, the annual meeting of the World Economic Forum in January. So that was...

Just, I remember well, the week that the Trump administration was sworn into office. So it was ahead of these cuts, although, as you say, some of them were anticipated, probably not quite to the extent that did happen in reality a few weeks after Davos.

Let's hear from Jean Cassea, the head of Africa CDC. He was speaking in Davos to my colleague, Nicola Rowe, who started by asking Dr. Cassea about the role for AI and other tech in speeding up the detection and response to infectious disease outbreaks.

You know, I have to say to people that Africa can jump and we don't have to follow all processes, all steps that other continent they took. If I give the example for the cell phone, you know, before having cell phone in Europe, you had the landline. In Africa, we didn't have landline. We crossed landline. We got the 4G and the 5G.

This is also what we are doing to support the surveillance. We need strong digital systems in place and we need also to leverage on the power of AI. When we decided to accelerate with the digital agenda,

we discovered that only 32% of our help centers are connected. People, they heard about this disease X in DRC. For two months, the national level didn't have information about what was happening at the regional level. It means before talking about the digital transformation, we need connectivity. And

It's the basis. Now we are working to connect all health centers. And when we connect them, we leverage now the power of AI because we need telemedicine. We have a shortage of medical doctors. And if we have AI that can help us to push the agenda of telemedicine, we can save the lives of so many mothers and children.

the Pathogen Genomics Initiative. Can you just tell us a little bit about that? The main issue, you will just name what you know. The laboratory issue in Africa is a male issue. When we had COVID, we discovered that we had only three countries that could conduct pathogen genetics. Now, we have almost 40 countries out of 55.

In two tiers, we made huge progress. It's based on the Pathogen Genomics Initiative 1.0. Now we are moving to Pathogen Initiative 2.0. It means we need all African countries to have capacity and capability to conduct genomic sequencing first, second, at the centralized level to have capacity to conduct appropriate testing, and also

to ensure that there is a connection because we want when there is a public threat somewhere to get information quickly. We are putting in place mechanisms with Pathogen Genomics Initiative 2.0, but we are also bringing the digital component. Africa will be a very well connected continent using the health sector approach with initiatives like Pathogen Genomics Initiative 2.0.

It might be quite an interesting angle to talk about how by installing the connectivity now, it's sort of zero to a hundred in terms of connecting the entire continent and getting every country involved. But you'll be using the latest in tech to do so. Seems like this might really, really change the face of healthcare across the continent, which is a huge task. Yes, I think...

Africa will use the opportunity of AI to change the face of morbidity and mortality in Africa. Because, as I was saying, the potential of telemedicine will change a lot. When I started my career, I was the only medical doctor for 250,000 people. What do you think one medical doctor can do for 250,000 people? But if we start today to implement the powerful

a system in Africa. This is why I'm talking about telemedicine, I'm talking about early detection, I'm talking about strengthened surveillance mechanism who can jump from zero to maybe 80 to 90. In September of last year, the Pan American Health Organization signed an agreement with the CDC to collaborate on equitable access to vaccines and medicines and other strategic tech. So

Can you tell us how the two organizations are going to strengthen this regional regulatory and production mechanisms, as well as support local manufacturing of essential medicines and vaccines? What are the major focus areas and accelerators of this agreement? I have to call local manufacturing the second independence of Africa. Why second independence of Africa? Because it's bringing a lot of areas together.

We are talking about health security. Like today, we are facing a number of outbreaks, Marburg, cholera, mpocs, and we don't have tools. Second, it's because of job creation and economic growth. We are talking about a market that is potentially around $75 billion per year.

And this 75 billion dollars per year will grow because of Plusone is growing with around 2.5 billion people in 2050. We are also talking about youth employment and that one will reduce the risk of migration of young people from Africa to other continent because we are also leveraging on the power of digital system linked to the local manufacturing. Then

To accelerate this agenda, we need two major components. The first one is regulatory process. The regulatory process, we are working on that. We are putting in place what we call the African Medicine Agency because we don't want a country that will manufacture one product to register that 54 times.

This African medicine agency, like the European medicine agency, will cover the whole continent. And our countries or our partners, they will just ask and they have access to the African market. And the second one is the pool procurement mechanism. Many people are asking me if we have a market. I'm laughing because I say we have 1.4 billion people. This is the market we have.

But the issue is how to open this market. This morning I had a meeting with the Secretary General of African Free Trade Agreement. We are working together to open the market using the procurement mechanism that Africa is leading. I think we are ready for this agenda and we are accelerating the process. How do challenges like sort of cultural public skepticism around sharing your health data and

cyber issues and policy and regulation gaps. How does that challenge growth? Yes, let me first respond to some rumors I'm getting from some partners. Africa doesn't want to share data. This is not true. There are three major issues. The first one is we don't have reliable data because we don't have a strong digital system in place.

Today, anyone who can give you any figure about a disease in Africa is just a proxy because we don't know exactly what's happening at the rural area. And this is why the agenda of putting all health centers connected is critical for us. This is the first one. The second one is about what we call the trust that we have.

We saw in many countries when they are coming to share information that they have, they are punished. And the last example that we had was Marburg in Rwanda. Rwanda was declaring this Marburg quickly. And we saw a country come with travel ban. And that one, all other countries, they are watching that. We need now to rebuild trust to say, please continue to share information.

because we are also advocating for no travel ban, no punishment. And the third one is what we call data sharing agreement. To share data, I must know also you are sharing your data with me because it's not just a one-way. Then we need to have this data sharing agreement internally in Africa.

We are also talking with our partners to have this data sharing agreement with European countries, American countries and others. That one will help us to have a common platform where we can say we are all dealing with the same issue timely. In terms of opportunities and innovations, what is next for the African CDC in terms of mobile health?

We have countries in Africa where the mobile phone penetration is more than 80%. We see in many countries it's not less than 60%. But how will they reach on this power to connect the health system? For the next five years, I see each community health worker in Africa. It means people who are at community level, working with communities, each of them will have a mobile phone

connected to the health center, sending information timely because we are connecting all health centers. This information will be also shared at national and continental level at the same time. We are also thinking about how we can make opportunity of mobile phones at community level to leverage on the power to record the U report. You know, we have young people

we can be connected. We can start to talk about what to do, what not to do. It means to sensitize people, to educate people. If I have to close my eyes and to think about Africa the next five years, it will be another continent because we're leveraging the power of AI and digital transformation agenda. From a professional's perspective, did you ever anticipate that this would be in your lifetime?

that these things that you're working on now that will change the lives of millions? You know, the person who inspired me to become a medical doctor is my mother. She was a nurse, a pediatrician nurse. I was sometimes going with her to see how she was supporting children. And one day I said to my mother, I want to be like you.

She said, "No, you can be more than that. You can become a doctor." Because me, at that moment, I was not given the opportunity to do medical studies. And then when I started my career, as I told you, I was in a rural area called El Fison, Cayemba. Cayemba is bordering Angola. At that moment, Angola was a country facing civil war and health infrastructure were not in place. Human resources were not in place.

In addition to my 250,000 people, I was getting also people from Angola. I was not thinking in a very short period of time, things can change like that. This is why I'm also positive. What I did since I started my career to become Director General of Africa CDC,

I think that the next generation of the Autism of Africa CDC will not talk what I'm saying today. We'll start to talk about how Africa is influencing the global health region because we have more young people very well connected, educated, and today we are putting in place the mechanism for sustainable financing system. Africa is where people must be. If I have

To give an advice to people, make sure that you have your foot in Africa because tomorrow it will be the leader of the world. Jean Cassez, Director General of Africa CDC was speaking to my colleague Nikki Rowe. You also heard in this episode Laura Dumoulin, Lead for Global Health and Security at the World Economic Forum.

You can find out more about the work of the Forum's Centre for Health and Healthcare on our website. And please follow Radio Davos wherever you get your podcasts. Please leave us a rating or review and join the conversation on the World Economic Forum Podcast Club on Facebook. This episode of Radio Davos was written and presented by me, Robin Pomeroy, with reporting by Nikki Rowe, editing by Gerry Johansson and studio production by Taz Kelleher. We'll be back very soon. Please join us then. But for now, thanks to you for listening and goodbye.