Affordable healthcare needs more than cheaper technology

While much attention is centred around making healthcare affordable, there is not enough focus on embracing appropriate health technology innovations. This is vital considering digital technologies have the potential to revolutionise how populations interact with national health services from improving its quality all the way through to coverage.

According to Dr Sudesh Sivarasu, associate professor of biomedical engineering in the department of Human Biology of the Faculty of Health Sciences at the University of Cape Town, just by making technology low-cost in terms of manufacturing does not necessarily translate into it becoming more affordable. There is certainly much innovation centred around this, but it does not account for the complexities of the healthcare industry.

He was speaking at a recent Café Scientifique event, a public science initiative hosted by Research Contracts and Innovation Department (RC&I) at the University of Cape Town and sponsored by leading international intellectual property (IP) law firm Spoor & Fisher.

His discussion, titled ‘Appropriate Health Technology Innovation through Frugal Biodesign’, examined this dilemma and highlighted just some of the issues facing healthcare on the continent.

“It is quite simplistic to say that reducing the cost of technology will see more people benefitting from affordable healthcare. The fundamental challenge revolves around fitting technology into a working environment. Just consider the donations of health technology Africa receives from first world countries. More than 70% of these donations are not compatible or operational in our healthcare environment.”

The continent receives a large donation of wheelchairs from all around the world. And yet, these are virtually unusable in the unique conditions of the continent. Something as basic as how the wheels are not designed for bumpy roads to the complexities of not having an ecosystem in place to fix and replace parts of these international products.

“Almost 90% of healthcare technology is imported. This translates to billions of Rands. Sadly, very little of this accounts for South Africa’s and largely African nuances. Aspects such as the humidity in our climate, inconsistent power supply, and the like mean very few of these imports operate as effectively as possible.”

This is where appropriate health technology comes in.

“Those stakeholders benefitting from the traditional import-based system are multinational companies. And with no proper incentives in place for local businesses to flourish in this space, more must be done to create a level playing field. Contributing to this is the mindset of people that the healthcare technologies imported are better than what we can make locally.”

Fortunately, healthcare technology will never go out of fashion and so innovations in technologies related to healthcare will be here to stay.

“Most innovative countries around appropriate health technology start with imports but then incentivises home-grown solutions. This changes the import/export balance and establishes an enabling environment for an extensive support infrastructure vital for innovation.”

And it is this support infrastructure that is vital for innovation. In some countries, there are centres for healthcare innovation and technology. While others see the private sector, government, and other stakeholders work to invest directly in the technology development phase.

“Unfortunately, the investor community in South Africa is very risk averse. And when it comes to medical devices there is a significant amount of risk involved in getting a product released into the market. It is a long-term and large investment where many do not want to participate in. For the country, it is best if government puts the emphasis on local innovation and home-grown technology as opposed to simply going the import route.”

“It is impossible to develop a self-sustainable economy without investing on local production and job creation. Healthcare is one such segment where this equation would always be relevant.”

This, he feels, is where tertiary institutions must work with the public and private sectors to give graduates opportunities in the local market.

“We need to build an ecosystem that is centred around more than just HIV and TB innovations. Appropriate health technology must revolve around all diseases instead of being neglected. This requires a balance between innovation and delivering tangible business benefits. By no means is this a quick fix but it is possible to change the system. But to do so requires a concerted effort by all role players to change the fundamental processes that have become interlinked in the local healthcare system,” he concluded.

Date published: 30 August 2019
Author: Spoor & Fisher

Tags: health technology