By Klaus Tilmes
As Africa’s health care systems are often underfunded, ill-equipped, understaffed, or not accessible at all, Sub-Saharan Africa has become a booming arena for digital health innovation. The use of big data and artificial intelligence (AI) has demonstrated high applicability for both outbreak control and preparedness as well as to address a range of diseases and improve public health services. COVID-19 has ignited further momentum by highlighting the promise of AI in medicine and health care, with applications ranging from disease surveillance to drug discovery, clinical diagnostics, patient care, and health system management. However, this promise will not be realized without addressing persistent inequities in terms of health care access and outcomes.
The combination of rising incomes, improved health outcomes, and longer life expectancies has ignited a growing demand for medical services across Africa. At the same time, the continent continues to shoulder the world’s largest disease burden.
Despite considerable attention to efforts aimed at improving public health and reducing health disparities based on socio-economic status, race, gender, and geography, striking disparities in health status persist within and among countries. Public health challenges that disproportionately affect millions of poor Africans include lack of access to piped drinking water (approximately 495 million), basic handwashing facilities (approximately 370 million), and community health services. Communicable diseases are the first cause of death, infant mortality rates are above five percent, and at least one-sixth of the population lives more than two hours away from a public hospital. The risk of disease spreading is compounded by a humanitarian challenge, where millions of people are living in refugee camps in unhealthy conditions. During COVID-19, income-related health inequalities are estimated to have worsened six times compared to 2017.
Efforts to contain the spread of the disease and reverse Africa’s poor health outcomes will require public health interventions that take into consideration concerns about equity and justice. Drawing on examples from Africa’s rapidly evolving digital health landscape, there are lessons for building blocks and implementation steps towards a sustainable AI-enabled health ecosystem.
Recent reports1 assert that AI has the potential to revolutionize healthcare in low- and middle-income countries by improving access to services, enhancing the safety and quality of care, enabling cost savings, and serving as an educational tool. The Broadband Commission for Sustainable Development Working Group on Digital and AI in Health2, co-chaired by the Novartis Foundation and Microsoft, has zeroed in on five use cases as potentially game-changing capabilities for Africa:
There is tremendous promise in the possibilities of AI in transforming healthcare in Africa. Achieving the aspiration of an open AI-enabled health ecosystem requires strategic vision, foundational policies and regulations to guide the application of this technology and protect the users. It also requires upfront public funding in line with countries’ public health priorities, collaboration on interoperable modules, and the formation of a new workforce of African data scientists.
While AI health interventions hold definite promise, there are cross-cutting policy, regulatory, and implementation challenges that prevent their deployment from pilot to scale and prioritize AI applications for the social good. An evidence-based pathway is needed to inform key decisions and implementation of AI. To strengthen Africa’s health ecosystem, there is an overwhelming case for integrating AI applications into existing systems and institutions rather than starting from scratch or replacing an existing system.
A closer look at the building blocks of an AI-enabled healthcare ecosystem offers a holistic understanding of how these challenges could be resolved as part of an iterative innovation process:
Klaus Tilmes is a Senior ACET Fellow and former World Bank Director with experience in entrepreneurship, finance, trade, and emerging technologies.
Policy experts and researchers from the African Center for Economic Transformation (ACET) and the Development and Economic Growth Research Programme (DEGRP), in partnership with ODI, explore the critical role of innovation in Africa’s recovery from COVID-19. Essays identify areas in which innovation can contribute to effective responses and offer high-level policy recommendations.
1. Ayomide Owoyemi et.al., “Artificial Intelligence for Healthcare in Africa” (Frontiers in Digital Health, July 2020); “Building a collaborative ecosystem for AI in healthcare in Low and Middle Income Economies” (Atlantic Council, August 2020).
2. Reimagining Global Health through Artificial Intelligence: The Roadmap to AI Maturity (Broadband Commission for Sustainable Development, September 2020).
3. Michael Matheny, Sonoo Thadaney Israni, Mahnoor Ahmed, and Danielle Whicher, Editors, Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril (National Academy of Medicine, 2019).