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February 9, 2021

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Using digital technology in health is one of the top ten ways that developing countries can progress in this technological age, according to a recent report by an influential group of entrepreneurs, academics, and policymakers. The Sidebar looks at how lower-income countries can unlock the potential of digital healthcare.

For the first time in history, more than half the world’s population uses the internet, according to the authors of a report on how technology can help transform the developing world.

But ever since the creation of the internet, there have been concerns about a “digital divide” where people living in poorer countries struggle to access the wealth of services and benefits made possible by the web.

While the latest figure could be interpreted as a good example of how the technological revolution has not served the world’s poorer countries, a group of influential leaders sees things very differently.

At a 2018 summit in Nairobi, Kenya, the Pathways for Prosperity Commission on Technology and Inclusion Development chose to highlight the opportunities for growth created by technology adoption.

The Commission ran from 2018 to 2020 and was co-chaired by Melinda Gates from the Bill & Melinda Gates Foundation, Strive Masiyiwa – founder of pan-African telecommunications, media, and technology company Econet Group, and Indonesia’s Minister of Finance Sri Mulyani Indrawati.

The concluding report and manifesto for development in lower-income countries that they oversaw were published last year and focused on the vital role that digital technology will play in healthcare.

Using digital technology to improve the cost-efficiency and reach of public services, such as health, was an essential part of its ten-point development manifesto. At the same time, the accompanying report aimed to encourage philanthropic and donor-led interventions.

It’s an idea that some forward-thinking digital health businesses are catching on to as they expand into developing countries.

Telehealth

As reported in the Financial Times, the UK-based digital health group Babylon has been operating in Rwanda since 2016.

Its telemedicine service has registered two million users across the African nation and handles 3,500 daily consultations.

Babylon is also scaling up operations in other African countries, Asia and Latin America, while rival Ada Health, based in German, is expanding in Tanzania.

In Rwanda, Babylon – rebranded as ‘Babyl’ – has a 10-year contract with the government and its local health insurance system.

It has also got around the fact that few people in the country currently have access to a smartphone, using a text-based system to arrange call-backs from nurses and arrange transfers to doctors for consultations.

Patients can receive codes for follow-up prescriptions or laboratory tests, according to Babyl’s chief executive, Shivon Byamukama.

Using artificial intelligence (AI) to improve healthcare services is one way that digital technology could begin to impact society.

But Ali Parsa, Babylon’s founder and CEO, told the FT that the technology is very much in its infancy and its potential in healthcare is largely unrealized.

“People are hyping AI often because they want to get finance. It’s really in early infancy. AI will utterly outperform our wildest imaginations in years to come and utterly disappoint us in the short term.”

Addressing unmet needs in the developing world

Sidekick Health itself has already contributed to improving lives in the developing world by linking activity in its digital care platform to supply water to children in need.

The altruistic awards element of Sidekick’s solution encourages users to donate water when they achieve their goals, increasing the motivation to adhere to treatment, exercise, keep weight down and stay healthy.

But there is still much more to do, and the challenges facing the developing world are immense as the world faces up to issues such as climate change and loss of biodiversity.

Some best practices that could allow digital health companies to scale up their operations in low- and middle-income countries were laid out in a 2018 biomedcentral article.

Based on real-life case studies, the article’s authors – led by Professor Alain Labrique, founding director of the Johns Hopkins University Global mHealth Initiative – identified five focus areas that are critical for success.

Programs must offer real benefits to address an unmet need and include input from end-users from the outset. Stakeholders must be “engaged, trained and motivated,” and the initiative’s technical profile should be “driven by simplicity, interoperability, and adaptability.”

Additionally, policies must be aligned so that digital healthcare can function, and any initiative must have the appropriate infrastructure in place to support it.

Globally, Labrique called for a “less-siloed” approach to digital health so it can be scaled up while still allowing innovative solutions to be developed.

Together with the World Health Organization (WHO) and the United Nations Foundation, Johns Hopkins University Global mHealth Initiative jointly created a scorecard system aimed at developing mobile and digital health services in the developing world.

As Labrique’s team pointed out, digital health is “like a seed planted to grow,” – but if conditions are not right, this growth will be stifled.

Many factors need to come together to make digital health projects possible, which may be “outside the influence of individual projects,” as Labrique noted.

The benefits of digital health could be immense in the developing world, and these countries have the opportunity to avoid the mistakes made in wealthier countries.

Many argue that richer countries have invested too much in health systems that treat people who have become critically ill instead of taking a more preventive approach.

But avoiding making this same mistake again will only be possible with the right leadership from both government and business.

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