Dr. Ann Aerts, head of the Novartis Foundation and co-chair of the Broadband Commission Working Group on Digital and AI in Health, shed light on its report “Reimagining Global Health through Artificial Intelligence: The Roadmap to AI Maturity”, while tasking other Sub Sahara countries to exploit ways of creating a standard universal coverage of internet and improve its population digital skill, to enjoy the opportunities in AI Digital Health Technology.
What is AI technology all about?
The goal of this report is the result that we say of a very large partnership. This report was a working group and the working group consisted of 40 representatives from different organisations ranging from the International telecommunication union to WHO, the world bank, the big 5 companies in telecommunication, Microsoft and many other companies contributing.
A lot of external experts also came from NGO’s, the academic sector etc, we joined all these brilliant minds together to look at what we can learn.
We learnt that there are 5 main ways that AI is already making impact, and in Africa, and one that is really important is that, you have a number of tremendous expertise to contain epidemics.
So, there is examples of how AI can strengthen the tracking, tracing, and predicting of transfer of diseases in case of an outbreak, and it has proven to be very valid in the case of Covid, and this program is to bring data from different sources, from meteorological services, social media, local government UHO, all together they predict where outbreaks is going to first, and give automatic information to the policy makers or the government to choose which kind of public health, and there is magic books developed by UNICEF was used in the Ebola, and has proven again to be very useful in the Covid situation where the other examples is in Asia.
The other case is basically in research and development that is accelerating the drug discovery and drug development, new cases in clinical medicine where we know that in many ways we can use images to diagnose than the doctors or the healthcare workers diagnose dysfunctional systems.
So, the AI is the combination of human expertise and machine expertise that is better than only one of those alone. A beautiful example of that is in Rwanda.
Do you partner with other organisations?
We partner obviously, all our doctors are partners, and our other partners are the local authorities that we sit with to discuss the issues and priorities that the local government wants to address, then we see the things we can offer to help them do that, and then we bring in other partners we need to address the problems in question.
Looking at the gloomy picture painted in the report “Reimagining Global Health through Artificial Intelligence: The Roadmap to AI Maturity”, it is stated that Sub-Saharan Africa currently represents 12% of the global population but faces 25% of the world’s disease burden, while housing only 3% of the world’s health workers, do you think AI Digital Health Solution can do much in this case?
There is a really urgent need for us in the continent to match human resource capability with machine capability of a high intelligence tools that can complement health workers. And an example is the Artificial Intelligence is a fantastic example of how you can reach many people who doesn’t have access to health facility because there is not enough infrastructure and we cannot think we can build far enough infrastructure that would cater for this vast number on time in Sub Sahara Africa and train enough doctors to address these needs, but we have to reemerging on these things where we deliver health and care and Africa can really take a leading role there by leapfrogging or jumping over the mistakes other countries have made and be a bit of the solution from other countries into the African context.
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Then you can build a new world of health system which the rest of the world can look at. Yes! Innovations are needed but you also have to innovate the way that health systems are organized. And daily health is just one mature model that is proven to work, that is proven to enable access to people where there no enough doctors and nurses, because you centralized your doctors and nurses into a daily consultation center and they can guide patients or health workers for their patients care through the telephone, or WhatsApp or Artificial intelligence guiding through better decision support. So, it’s really a fantastic opportunity, but we need to rethink the way our system is fashioned and that we make a lot of difference.
Do you think Nigeria can solve the huge vacuum created by brain drain and exodus of doctors by adopting AI Digital Health Technology?
My explanation above also answers the question on shortage of doctors in Nigeria given the brain drain syndrome and mass exodus. I think we should do something in that area.
Obviously it would be nice to keep the expertise in our country, but Artificial Intelligence can also do so much as I said. It can accelerate diagnoses, it can improve quality of care with a decision support based on all the medical knowledge that this machine can digest and translate into action, but at the same time, it still needs some kind of patient contact that would have to be guaranteed. The strategy for health and care in Africa would has to be looked at very comprehensively and not only from the technology angle because technology can only be a means or an enabler towards the goal of getting a better population in good health in Africa. It is not an end in itself. We estimate the fact that it can help us to look at a tool that can help out but it cannot replace the fact that they still have to make the right choice and the right investment in their health system.
The North east Nigeria is a no go area due to the terrorist activities of Boko Haram Insurgency and challenges which has made it difficult for health workers to be there. How do you think Digital Health Technology can help in crisis environment like this?
It’s really a good question because technology is a strong enabler to provide care in areas where it is too dangerous to work. In my own experience because I work a lot in conflict areas; In the beginning of my career I was an emergency physician working in the wilds of the world, I worked in Angola, Mozambique, in Rwanda when there were lots of turmoil, in Burundi and in Sudan, so it is really essential not to interrupt the care for people who need it most in such complex situations and emergencies. Because it is possible that people die in that condition because no help is available. So I fully understand where you are coming from.
You know I was dropped by a plane in the middle of a crisis area in Mozambique and I had to go with my bike from village to village to see the wounded and there were always village health workers who are there to help me taking care of those that were possible. So, today I thought about those times and if I had a phone I would have been able to communicate with health workers that on the ground regularly, we could have saved many more lives. It was such a revolution for me to stay in health services but you can actually guide someone who is not necessarily high skilled in medical term, to give emergency care through the phone and the internet. So, the possibility is there to connect village health workers who are willing to help their neighbors when they have a problem and guide them to help in emergency conditions. I don’t know how well the connection is out there in the Nigeria North East but it is feasible.
From your experience and close working with Rwanda and Kenya, what are they doing right that other countries of Sub Sahara Africa can emulate in Digital Health technology?
This is a really a good question. We only highlighted a few examples in the report. There are many more in Africa but the most impact are in Rwanda. However there is another one in Benue are of Nigeria, where there is a phone based tool that can detect from a baby who is born and is crying. It can detect asphyxia, a condition where the baby is deprived of oxygen at birth. Normally for a doctor to diagnose this condition which is a high fatality for the baby, it takes a lot of very complicated tests that can only be done in specialized laboratory, but with this phone, it can identify that the baby has a special tone of the cry when it cries and it can identify immediately by the cry that the baby needs oxygen. And that is saving so many babies lives and that is one that comes from Nigeria. So, there are fabulous innovators in Nigeria as well.
But definitely Rwanda did something right in the sense that there was from the beginning the visionary willingness to get national connectivity board into its country and 90 percent of its people has broadband connection. It gives people the opportunity to use digital services towards the health owner and education for any other sector.
It is similar in Kenya because their mobile phones went so fast there and they have a beautiful example of mobile banking that was wide spread and I would have dream that the health sector would follow that speed. The connectivity was key for the success of Rwanda and then the choice to really tap into the potential to digitize their health data and for Rwanda all of these decisions were very strategically important.
So, other government in Africa must ensure first that there is universal coverage of internet in your country and secondly to ensure that your population digital skill gets better because that is a key success factor as well to health service to the population. And also a strength to the population opportunities for the health work force in digital, data science.
Another factor I would recommend for these countries is to create a national governance and framework for regulatory standard.
What are the challenges of health system?
I think that the major challenges of the health systems around the world are very similar in all countries around the world, reading high, and low in some countries. Cost of health care is doubling really fast, and we are going to double the annual cost from ten to twenty trillion in 20years time.
Secondly, we have this enormous shortage of health workers around the world, it is true that it is more in Africa, but this face is all in other countries around the world.
Thirdly, we live with an enormous volume of diseases, and Covid is only a wakeup call of how we live with the constant threat of diseases. We also live with the threat of climate change and anti-microbial resistance.
All of these challenges together are really a precedent problem for the world. Also, we have this wave of Covid misinformation or disinformation which is putting millions of people’s lives at risk which are facing our health systems around the world, obviously, it is not going to work to address it all together, it’s specifically not in cities where many are getting together, specifically in Africa.
So we have to reengineer our health systems. And make them, instead of being disease care systems, to become broadened and predictive to be preventive and keep their population healthy, so that they don’t have to become sick, that is the role of digital technology and AI in the world, to transform all of our health systems to real health systems.
