Health
The Concept of Health ICT Must be Elevated in Nigeria -Dr Folarin Olasogba
Dr Folarin Olasogba is the Chief Project Officer of PreDiagnosis Telehealth Consult.
The organization is responsible for driving the initiative of PreDiagnosis International to deliver affordable basic healthcare services to 20 million poor and vulnerable Nigerians between 2020 and 2030.
In this chat, he spoke on the challenges of public health management in the country as well as PDI’s efforts at delivering healthcare to the grassroots.
With the ravaging COVID 19 putting all nations of the world on their toes, do you think we are doing enough, as a country, to curtail the pandemic?
My personal assessment of the country’s emergency response to this current health crisis is very positive. To the extent that the COVID-19 pandemic is a novel experience that caught the whole world unawares and to the extent that even the world’s best, in terms of health management systems, have been struggling with the pandemic, Nigeria, through the National Centre for Disease Control, has provided a mature, organised and commendable plan for managing the pandemic in the country. I am sure that our experience, knowledge, and systems will improve tremendously from this turn of events.
Are there lessons learnt by Nigeria at all from this pandemic? If yes, what do you think can be done to institutionalize and domesticate them as policies for better preparedness for medical situations and emergencies now and in the future?
It is not an exaggeration to say that the novel Coronavirus pandemic otherwise called COVID-19 has exposed the soft underbelly of our country’s health care system no thanks to our ill-preparedness for outbreaks of such magnitude.
More than anything else, the deadly disease has practically shown the necessity for greater collaboration on health issues as well as the power of data and digital tools to combat the outbreak of pandemics or even some opportunistic infections.
It has also reinforced the need for targeted digital health strategies to help countries like Nigeria get the most out of digital technology tools. Without the right strategies and technical and resource support, it is now increasingly clear that the gap in the digital divide will produce nothing but failing health outcomes.
Across the world, digital health is fast becoming the fad especially among low and medium-income countries with the huge responsibility to overcome traditional barriers to better health care, which includes the dearth of medical staff and professionals and other physical resource constraints.
Whether as electronic health (eHealth), mobile health (mHealth) and other emerging areas such as the use of artificial intelligence (AI), big health data and genomics, digital health now holds a lot of promise as it is making health information, care and diagnosis more accessible to health seekers.
Nigeria must urgently intensify efforts along these lines from now on.
Considering the growing relevance of technology in health care, what important role do you see medical intelligence and surveillance playing in the public health space, particularly the prevention and management of deadly infections and diseases in the country?
Sadly, despite Nigeria’s strategic position in Africa, it is highly under-served in the health care delivery sphere. Health resources such as facilities, personnel and medical equipment are inadequate, especially in rural areas.
Significantly, public healthcare delivery is hampered more by the inadequacy of healthcare resources particularly personnel, drugs and other medical equipment needed for holistic patient treatment. For instance, the doctor to patient ratio is currently 1:6000. Most of the available qualified doctors are concentrated in urban cities and towns while the rural areas have next to nothing, thereby leaving room for self-medication and also for quacks and other unqualified hands to tend citizens’ health needs. As at today, most PHCs, especially in rural areas, rot away due to lack of capable personnel to man them.
Given the above scenario, the primary challenge confronting the country’s public health system today is how to create and sustain an information-rich and patient-focused health care system that reliably delivers high-quality, affordable and accessible healthcare services that can ride on strong deployment of technology to strengthen healthcare accessibility at the grassroots.
You believe the current model of public healthcare delivery in the country is not working?
Healthcare services delivery must undergo a transmutation from the physical, brick and mortar format to a more tech-driven approach. This means the concept of tech-for-health or Health ICT must be elevated and Nigeria, now more than ever before, must confront using technology to transform her healthcare delivery system in a way that ensures a win-win for all.
It is also important to point out that the growth and the sophistication of Nigeria’s telecommunications and ICT sectors in the last two decades as well as the increasing global tilt towards greater deployment of ICT for health (Health ICT) have continued to point health service providers in the country in the direction of embracing innovative new thinking required to strengthen and revolutionize the health system. The time is now.
The issue of health financing has become so critical considering government’s revenue challenges leading to poor budget allocation for the health sector year in, year out. What do you think can be done to augment and address the situation at present?
Over the years, public health financing has been a major barrier to building a strong health care system in many countries, not just Nigeria alone.
Regarding Nigeria, at the moment, the total health expenditure is derived from the allocations for health and allocations for the Basic Health Care Provision Fund, which is put at 1% of the consolidated revenue fund.
Since the inception of BHCPF, however, its allocation has always been below the earmarked 1% of CRF; the allocation in 2020 is about 50% less than the value of the 1% of CRF.
Because of the worsening financial capability of the country, expecting additional government funding for the health sector is a mirage; and without something significantly revolutionary being done in this ugly circumstance, demand for healthcare services, especially critical care services, may become overwhelming for the public health sector. This is likely to have long-term consequences for the health sector, as well as spillover effects to the rest of the economy in many ugly forms.
Many experts have postulated that to confront the problem of dwindling economic fortunes which impacts availability of funds for developmental efforts, the best model of public health delivery the country needs to embrace is one that can deliver quality healthcare services to the remotest, undeserved villages across the length and breadth of Nigeria by leveraging technology to maximize the scarce human and operational resources for health through effective and efficient deployment.
From your experience, how possible and easy is it to deliver affordable healthcare, most especially for the poor and vulnerable people in the rural areas and rustic communities?
It is very possible and cheap, too. Remember that modern-day public healthcare is efficient only when health services can reach the hard to reach areas, when location, economic and social status do not dictate access to quality health services, when they have and have not have equal access to basic healthcare services and only when all people and communities can use the promotive, preventive, curative and rehabilitative health services they need insufficient quantity without exposing them to financial hardship as declared by the World Health Organisation.
For us at Pre Diagnosis, we have achieved remarkable progress in our burning desire to harness modern technology to effectively deliver quality healthcare to two million vulnerable Nigerians annually, in a cost-effective way that maximizes scarce human resources. It is our modest demonstration of how it is possible to deliver efficient healthcare as enunciated by WHO.
Could you be more explicit on how these efforts could benefit the poor and vulnerable in the society, given the general poverty level they face?
At the center of our commitment is the deployment of ultra-modern technology to create the PDI Telehealth Hub and the PDI Telehealth App for macro and micro-management of public health delivery.
The PDI Telehealth Hub is a Community health platform in the form of a solar-powered mobile clinic that can be placed anywhere and manned by a specially trained staff recruited from the host community. The hub is connected to the expansive PDI telehealth central control the room where doctors are available 24/7 to micromanage these hubs. The result is delivery of continuous medical services on the ground within a community (remotely) by our medical doctors, leveraging technology but totally adapted to the culture, lifestyles, and worldview of the host communities.
On the other hand, PDI has also harnessed technology to develop an app that allows individuals to consult and receive wholesale treatment for many minor and major health challenges from doctors via the cellphone without physically visiting the hospital.
The PDI App is available on Google Play for download by android phone users. It is an interactive mobile application that gives users immediate access to highly trained and experienced doctors who can assist them access free quality healthcare from any location in the country.
The best thing about the App is that it is developed for the poor and vulnerable members of the society and therefore very cheap to access by all.
Let’s talk about your company, PDI. What can you say stands PDI out among the list of health care providers in the country? What exactly is the company’s cutting edge?
Our organisation, PreDiagnosis International, is a semi-philanthropic, hybrid telehealth service provider founded in 2018 to help in bridging the dangerous and widening gap in the Nigerian healthcare delivery system. We operate as a quasi-charity entity and not strictly a business-for-profit concern. So, we are on a compassionate national rescue mission.
PreDiagnosis International’s goal is to offer cheap, affordable and innovative telehealth solutions that would be at the forefront of reducing the disparity that exists in the availability, accessibility, and affordability of quality healthcare services in the urban and rural areas on the one hand, and between the elites and the poor and most vulnerable citizens, on the other hand.
What are PDI’s target projections for the health sector in its bid to contribute to the realization of the country’s and United Nations’ goal of better health for the people?
The Vision, Mission, and Target of the PDI initiative is encapsulated in the PDI RRF 20-2030 brand Mantra. Under our Reach, Rescue and Fortify Mission, PDI has the target of helping Nigeria to deliver qualitative healthcare services to, at least, two million Nigerians annually between year 2020 and 2030 using technology-driven but largely grassroots focused platforms and model. This, in a nutshell, is what we have termed Project RRF 20-2030.
This Project RRF 20-2030, which is the core of our mandate, aims to deliver quality healthcare services to the remotest, under-served areas across the length and breadth of Nigeria by leveraging technology to maximize the scarce human resource for health (HRH) through effective and efficient use.
At PDI, we believe that our mission would not be fulfilled until when quality health services have reached the hard to reach areas; when location, economic and social status do not dictate access to quality health services; when the have and have not’s have equal access to basic healthcare services, and when all citizens and communities can enjoy the promotive, preventive, curative and rehabilitative health services they need, in sufficient quantity and without exposing them to financial hardship as spelt out in the World Health Organisation’s policy on Universal Healthcare.
Partnership, collaboration and integration are fast becoming a trend across the world for better service delivery in both private and public sectors. How best can we take advantage of this new possibility particularly in the health sector in the wake of the dreaded COVID 19 pandemic?
Stakeholders in the health sector need to collaborate on diverse levels as a way of bridging the gap in the nation’s health delivery landscape. A robust alliance between the public and private sectors for overall healthcare services development in the country should be of primary concern to all. For instance, under our Corporate Initiative, PDI has a thriving collaboration with the Project ECHO Institute of the University of New Mexico, ALBUQUEQUE, USA.
Project ECHO which stands for Extension for Community Healthcare Outcomes is a collaborative model of medical education and care management programme designed to empower local clinicians (Consultants, Doctors, Nurses, Technicians, etc) to deliver better care and treatment of chronic, common and complex diseases, especially in remote and underserved locations. PDI is the Nigerian Official Replication Partner with the Project ECHO Institute of the University of New Mexico.
This is an innovative tele-mentoring programme designed to create virtual communities of learners by bringing together healthcare providers from all over Nigeria and subject matter experts (from all over the world) using video conference technology, brief lecture presentations, and case-based learning to foster an “all learn, all teach” approach.
How does Nigeria stand to gain from projects and collaborations like this your Project ECHO?
The mission of PDI in undertaking the Project ECHO is to assist the country develop the capacity to safely and effectively treat chronic, common, and complex diseases in rural and undeserved areas across Nigeria and to monitor outcomes of this treatment while leveraging our Telehealth consult platform.
The Project not only uses innovative technology to bridge the gap between urban and rural healthcare specialists and providers in the country; it helps health services providers to undertake co-management of patients’ treatments, thereby fostering knowledge depth and technical competencies, in addition to reducing professional isolation.
By encouraging collaboration and communication between rural and urban service providers and specialists, the Project helps health professionals in the country to become highly skilled in the treatment of diverse chronic and complex diseases, thus creating a center of excellence in many remote communities.
This means with the PDI Project ECHO Initiative, we are committed to building a Clinical Knowledge Platform that combines authoritative contents and shared experiences are drawn from the expertise available in the Nigerian healthcare community and across the world so that Physicians, medical students and other healthcare workers will be able to tap into Nigeria’s largest, most powerful Continuous Professional Development (CPD) network to resolve challenging questions at the point of care for mostly lower-income patients for different diseases.
Nigeria needs more initiatives like this to truly create a modern health service sector post-COVID-19
By Modupe Gbadeyanka
An organisation known as GoMed Nigeria is offering free reproductive health services to Nigerian students through a digital self-care platform.
This is being delivered through a partnership with the United Nations Population Fund (UNFPA) and the Lagos State Government.
The pilot scheme will be available to students of the University of Lagos. They will enjoy easier and more private access to essential health products, accurate information, and professional support.
Young Nigerians face some of the highest rates of unintended pregnancy and unmet need for contraception in the world.
Cost, distance, stigma, misinformation, and fears about confidentiality routinely stop students from seeking the products and guidance they need, with consequences that include unintended pregnancy, unsafe abortion, sexually transmitted infections and interrupted education.
The self-care platform is designed to remove each of these barriers. Through the platform, students receive free contraceptives and other sexual and reproductive health commodities provided through the Lagos State Ministry of Health and UNFPA, exclusive discounts on health essentials, and fast, discreet delivery directly to campus and student hostels.
Students can also access trusted sexual and reproductive health information and services through UNFPA’s SoftLife 247 and U-Plan platforms. Through U-PLAN, they can chat directly with qualified Family Planning Service Providers to receive accurate information and address their concerns. They can also confidently engage with GoMed’s registered pharmacists for confidential, judgement-free guidance on medicines and other health products.
“Students should be able to get reliable health information and essential products without cost, distance or fear of judgement becoming barriers.
“This platform brings free sexual and reproductive health commodities, other affordable health products and professional guidance together, with discreet delivery directly to students on campus,” the chief executive of GoMed Nigeria, Mr Anthony Edeki, said.
Also speaking, UNFPA in Nigeria Resident Representative, Muriel Mafico, said, “As the UN agency mandated for “Sexual and Reproductive Health and Rights”, we are committed to reducing preventable maternal deaths and addressing the unmet need for family planning, including by providing and overseeing access to life-saving commodities worldwide.
“Working alongside our partners, we’re helping roll out the digital Self-Care Platform—so that vital, life-changing information can reach more people, more easily. Together, we want to empower Nigeria’s next generation to make informed health choices and achieve stronger health outcomes and a brighter future.”
By Modupe Gbadeyanka
A financing framework to accelerate the electrification of health facilities nationwide has been approved by the federal government.
The approval was announced at the third meeting of the Inter-Ministerial Steering Committee (IMSC) of the Nigeria Power for Health Initiative (NPHI), a presidential programme jointly coordinated by the Federal Ministries of Power and Health and Social Welfare.
The committee was constituted to ensure reliable electricity in at least 30 per cent of Nigeria’s health facilities by the end of 2027.
At the meeting, chaired by the Minister of State for Health and Social Welfare, Mr Isiaq Salako, and co-chaired by the Minister of Power, Mr Joseph Tegbe, members of the Inter-Agency Technical Committee (IATC) presented the recommendations under consideration.
Speaking at the meeting, Mr Salako said the Steering Committee approved a financing framework to mobilise investment for healthcare electrification, alongside a facility energy management framework requiring participating hospitals to build sustainable systems for managing their energy infrastructure.
He said the committee also cleared eight (8) private sector proposals for further engagement, drawn from about 70 submissions received during the National Healthcare Electrification Investor Matchmaking Week in Lagos.
The Health Minister added that Energy Management Teams are already in place at federal tertiary hospitals, with state governments being encouraged to set up similar structures. The initiative will now be institutionalised through dedicated budgetary provisions and a full-time Project Coordination Unit to oversee implementation.
On his part, Mr Tegbe declared that the initiative must now move from announcements to actual project delivery.
Describing the NPHI as one of the President Bola Tinubu administration’s flagship programmes, he said the emphasis should shift towards commissioning completed projects that Nigerians can see for themselves, rather than further groundbreaking ceremonies and public messaging.
He emphasised the need for teaching hospitals, state hospitals, and primary healthcare centres to be fully energised, noting that the Rural Electrification Agency has already energised 5 Federal Teaching Hospitals and several other health facilities nationwide.
He also tied the initiative directly to patient outcomes, arguing that dependable power would end hospitals’ reliance on emergency generators, and pledged that the Ministry would continue to prioritise the initiative’s funding needs while ensuring value for money.
By Kestér Kenn Klomegâh
Health authorities in the Democratic Republic of Congo (DRC) and the Africa Centres for Disease Control and Prevention (Africa CDC) have bitterly complained over their inability to track down new cases of Ebola, which has spread into the Republic of Uganda. An estimated 1,635 Ebola cases have been confirmed, and 127 people have died from the dangerous infectious disease in the DRC.
The Ebola outbreak is increasingly impacting social interaction and people-to-people movements, as scepticism toward the disease appears to accelerate among the population, and cross-border movements are being controlled daily. Alarm was sounded last week as the virus moved into new areas of the DRC. In some instances, patient routinely escapes, and limited contact tracing undermines containment efforts. Contact tracing coverage has plummeted to 56.5 per cent, a sharp decline from the 95 per cent target, Health Ministry officials said.
“We remain committed to supporting affected countries until transmission is stopped. We call on partners and donors to urgently mobilise resources to strengthen the response and save lives,” Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, said on Sunday.
Shortage of Medical Kits
The World Health Organisation (WHO) reported that the three major laboratories, in South and North Kivu, have run out of Ebola testing kits, as infections continue to rise daily. Teams are working through a large backlog of samples from suspected Ebola patients, many of which were collected several weeks ago, to confirm or rule out the presence of the deadly virus.
In a situation report released earlier this week, the global health agency said the labs in major cities including Bukavu and Goma were awaiting the arrival of reagents–substances ​ required to run the tests–to resume work on the backlog of samples.
“Running out of Ebola testing reagents during an active outbreak is a serious setback,” Dr Krutika Kuppalli, associate professor in the division of infectious diseases at the University of Texas Southwestern and former WHO officer, told The Telegraph.
“Diagnostics are the foundation of outbreak control; if cases cannot be rapidly confirmed, this may lead to delays in isolation, treatment, and contact tracing, which can allow transmission to continue unchecked,” said Dr Kuppalli.
The Race for Vaccines
Vaccine candidates are racing to fill the gap. The Coalition for Epidemic Preparedness Innovations (CEPI)—a multinational nonprofit organisation that finances vaccine development for emerging infectious diseases—has so far prioritised several vaccine candidates for development.
Two are Ervebo-like prototypes aimed at recognising Bundibugyo’s specific blend of glycoproteins, a platform that showed experimental potential years ago. In 2013, an early version of the vaccine protected 100 per cent of monkeys infected with Bundibugyo. However, because most Ebola outbreaks didn’t involve this species, the vaccine didn’t get the investment needed to become licensed. That’s an outcome CEPI aims to remedy with its latest investment.
The International AIDS Vaccine Initiative and Public Health Vaccines are developing the vaccines, which, like Ervebo, also rely on the vesicular stomatitis virus. WHO called this technology the most promising of the candidates.
VSV-based vaccines are front-runners because the weakened version of the virus used to produce them is so good at replicating itself inside humans—including the small chunk of whatever germ it’s been hybridised with—without causing harm. As a result, a single dose typically leads to a strong immune response.
Another candidate, called ChAdOx1, operates using a similar concept: A virus shows the immune system part of a pathogen to generate a protective response. However, it uses an adenovirus that causes colds in chimpanzees—and is also harmless to humans—that University of Oxford scientists modified to keep it from replicating.
There’s also a vaccine candidate based on Moderna’s mRNA science, which was also used to produce the company’s COVID-19 vaccines. This vaccine employs tiny fat bubbles to deliver genetic instructions to cells on how to produce a small part of the Bundibugyo virus. The immune system generates a protective response, and the mRNA degrades quickly without causing lasting changes to cells’ genetic codes.
US-Backed Kenya’s Quarantine Centre
Health Cabinet Secretary Aden Duale has consistently defended the establishment of US-backed health centres in Kenya. The US says it will quarantine citizens exposed to the virus but not showing symptoms in a facility it is building in Kenya, and will not bring them home if they develop symptoms, instead sending them to a third country.
The CDC imposed temporary travel bans last month on people who have been in the DRC, Uganda, or South Sudan, including green card holders, who are typically exempt from such bans. It is also screening Americans travelling from those countries at three US airports. The strategy marks a sharp break from past practice as President Donald Trump’s administration seeks to keep all cases out of US territory.
There are 13 US treatment centres in a government-funded hospital network for severe infectious diseases ready to handle Ebola patients. Public health experts have, however, called on the government to bring any sick Americans home for treatment, and local protests at the Kenya site have led to at least two deaths. A Kenyan court has ordered a halt to the construction.
WHO Appeals for International Community Support
In a rapid and comprehensive response to WHO’s appeal to marshal resources for support of Ebola prevention, the United States has provided an additional $38 million. The additional funds brought the total amount committed by the U.S. to more than $200 million in direct funding, the State Department said in an official statement.
CDC model scenarios show that without strong public health interventions, the outbreak of the Bundibugyo strain of Ebola in the DRC could become as large as, or even larger than, the 2014-2016 West Africa outbreak, the agency said.
In modelled scenarios where the isolation of patients is limited, the outbreak could become one of the largest ever documented, said Jason Asher, director of the CDC’s Centre for Forecasting and Outbreak Analytics.
From Addis Ababa, the Africa Centres for Disease Control and Prevention (Africa CDC) also said it had received a €11.5 million renewed commitment from the European Union Commission (EU) to support a stronger preparedness and coordinated response to the Ebola outbreak. Dr Jean Kaseya, Director General, Africa CDC, described the partnership with the European Union as respectful and without any conditionality, a type of partnership the continent needs.
The package is aimed at reinforcing the EU Commission’s support through the Africa CDC emergency response to the Ebola crisis, within the long-standing and comprehensive AU-EU health partnership. This demonstrates the central role of Africa CDC in coordinating the continental response to health emergencies, as well as the EU’s action as the world’s largest humanitarian contributor.
This includes €6.5 million to strengthen the Africa Pathogen Genomics Initiative, to help equip frontline teams, train healthcare workers and improve surveillance through diagnostics and an in-kind contribution of €5 million worth of testing equipment, including rapid diagnostic devices and lab test kits, to be deployed quickly where they are needed most. The EU’s partnership with Africa CDC spanning technical expertise, capacity-building, and policy dialogue continues to play a key role in building resilient health systems.
Ebola epidemic at G7 summit
Amid the horror of the Ebola epidemic, world leaders gathered at the G7 summit in France were urged to find the “political will” to push through the final part of the Pandemic Agreement on Monday. In a joint letter, Brazil’s President Luiz Lula da Silva and WHO chief Dr Tedros Adhanom Ghebreyesus urged leaders gathered on the shores of Lake Geneva to get the “benefits sharing” annex of the deal signed with a “sense of urgency.”
The Pandemic Agreement, which seeks to ensure the world is better prepared for the next global outbreak, was agreed last year but a vital element of it was deferred because of arguments over its wording. It is unclear, and perhaps unlikely, that a truly global agreement on benefits sharing can be reached.
Nevertheless, an agreement between the remaining 192 member states of the WHO is possible and would represent a major step forward. “Every month this annex stays unfinished is a month the world is less ready than it could be, and people are less safe than they deserve to be,” say Mr Lula da Silva and Dr Tedros. “Finalising this Agreement, through a shared commitment to one another, is our collective promise to protect humanity.”
The epidemic, caused by the rare Bundibugyo strain of the virus, for which there is no approved vaccine or specific treatment, was declared on May 15. It has since spread across Ituri, North Kivu and South Kivu, regions marked by insecurity, displacement and cross-border movement.
The Democratic Republic of the Congo (DRC), also known as the DR Congo, is situated in the central African region. With a population of around 124 million people, it shares borders with the Republic of Congo and Angola to the south, the Atlantic Ocean, and the Central African Republic and South Sudan to the north, and also with Uganda, Rwanda, Burundi, and Tanzania (across Lake Tanganyika) to the east, and Zambia and Angola to the south.
