The World Health Organization (WHO) in 2020 acknowledged that the COVID-19 pandemic has spurred development of various health technology innovations. The global health institution identified more than 120 health innovations and over 1,000 disruptive and non-disruptive technologies developed to increase performance in some target areas—such as community engagement, contact tracing, treatment, surveillance, lab systems, and infection control/prevention. But despite the improvement in technology adoption, Africa accounts for less than 13% of global innovations. Further analysis from WHO showed that innovation in Africa is driven by ICT (57.8%), 3D printing (25%) and robotics (10.9%). Some major country-specific technologies are contact-tracing apps (Ghana), WhatsApp chatbots (South Africa), health information systems (Nigeria), and self-diagnostic tools (Angola). Countries with highest technology adoption rates are South Africa, Kenya, Nigeria and Rwanda. Remarkably, the COVID-19 pandemic posed a serious health challenge in Africa, but it also opened an opportunity for creativity, entrepreneurship and innovation. For example, development of solar powered handwashing machines and mobile apps that serve health purposes show that home-grown innovations can improve health care delivery in the Africa. But whether and when the continent can fully leverage innovative health management strategies to change health outcomes is up for debate (Awosika., 2014; Aransi., 2019).
Background to innovation barriers in Africa
The World Intellectual Property Organization (WIPO) asserts that the level of development in global economies determines the perception and practice of innovative culture. Similarly, an empirical study by the World Bank group reports that most countries in Africa are around 0.01% per capita, adding that budgetary allocations for health care is decreasing in the region whereas developed countries are investing more in R&D. Both global organizations conclude that Africa is not living up to its potential. But there is a possibility that even the less-developed countries can negate this evidence-based statement by performing better in creative thinking and innovative practices—beyond economic predictions. For example, many countries in Sub-Saharan Africa are performing above expectations in various industries, including the health sector, notwithstanding results of studies reporting and predicting low performance for the region. However, the research outcomes highlight the importance of government intervention in healthcare innovation (Gupta et al., 2015; Oshin-Martin., 2017).
The impressive adoption of ICTs in some African countries is yielding dividends. As changing innovations in health care delivery solve most of the continent’s health problems—to a greater extent, it is important to add that the poor infrastructure base of health systems, including lack of well-trained personnel, and unfavourable government policies have continuously increased cases of preventable diseases and maternal/child mortality deaths. This does not imply lack of innovation; advancements in healthcare management now permit use of apps connected to phone cameras to interpret test results, as well as systems that connect health workers and patients in rural communities. Diagnostic systems for identifying and managing or treating health problems (such as pneumonia, high blood pressure and cholesterol levels) are available in some health centres. In addition, health providers are using drones to deliver drugs to hospitals in hinterlands thereby saving lives. And social media engagement has improved coverage of health campaigns. The main obstacle to attaining SDGs in Africa is centred on incompetent, corrupt and visionless leadership (Erin & Bamigboye., 2021).
Public health in Africa is saddled with the responsibility of catering for about 80% of the population who can hardly afford FFS care nor the expensive private-sector services. But even in resource-rich countries, corrupt leadership has brazenly robbed care users of a non-negotiable human right: free access to medical care. A study by the Global Fund to Fight Aids, Tuberculosis & Malaria found there are cases of misused public funds, bribery, and theft of medical supplies in almost every African country. According to the organization, over $2.5 million worth of drugs and medical equipment were stolen in 13 countries between 2009 and 2011 (Hope., 2021).
Situation analysis of healthcare innovation in Africa
African countries are making serious efforts to integrate innovation in healthcare management. In recent years, governments have built relationships and shown commitment at the policy level and towards resource mobilization. COVID-19 realities have therefore increased the drive to invest in indigenous health innovations. Some of the government-level arrangements include the Consolidated S&T Action Plan & New Economic Partnership for African Development (NEPAD). Whereas the first institution has outlined and is implementing innovative strategies in key technology areas, NEPAD—in partnership with the African Union (AU)—reported during a meeting held on Science, Technology and Innovation for Public Health in Africa that Africa has growing need for change management and technology adoption. The organization extensive collaborations that support manufacturing and adoption of health innovation systems needed to attain SDGs. NEPAD also reiterated the relevance of health systems to African economies (Ajakaiye & Jerome., 2019).
Furthermore, a report from the high-level panel on Modern Biotechnology delivered at an AU Summit with the title ‘Freedom to Innovate’ asserts that health biotechnology is one of the core areas of innovation. The committee recommended a more integrated approach to regulation, R&D investment, and protection of intellectual property rights in every African country (Gupta et al., 2015).
In similar vein, the African Network for Drugs & Diagnostics Innovation (ANDI) which coordinates existing R&D across Africa towards addressing public health issues, shows political will on the part of governments and industry stakeholders to unanimously improve capacity-building measures. The purpose is to manage health systems on the principles of accountability and equity and strengthen health development objectives (Fisher et al., 2009; Park., 2016).
Future prospects
Despite the huge expenditure on human capital development and innovation in the health sector, particularly in academic medical research and clinical trials, there is insignificant result in product development. Moreover, available technologies in the continent are far from addressing health needs of populations. Thus, collaborative efforts should be prioritized to revitalize innovation capacity, build entrepreneurial culture, and increase investment in science and technology to stimulate response towards delivery of affordable health care in Africa. But it should be noted that Africa cannot compete favourably with health systems in developed countries unless indigenous capacity in innovation is widely supported. Changes in the number of trained doctors, nurses and medical workers, including improvement in R&D and increase in budgetary allocations to the health sector will not solve the systemic problems militating against the growth of African health systems (Gupta et al., 2015; Awosika., 2014).
Furthermore, the presence of multinational corporations spearheading product development and delivery such as Tanzania’s A to Z (Africa’s largest bed-net manufacturer), Ghana’s LaGray Pharmaceuticals, South Africa’s Acorn Technologies, Nigeria’s Xechen, the Kenyan Medical Research Institute (KEMRI), and Nigeria’s National Institute for Pharmaceutical Research and Development (NIPRD), among others, will not transform African health systems and economies. Even funding from foreign investors and transfer of technology would be ineffective unless African leaders instil accountability in corporate governance together with political will and commitment to implement country-specific development agenda driven by innovation culture. In this way, Africans can improve indigenous technologies—with incentives from the governments—to foster local use thereby facilitating growth of health systems in the continent (Fisher et al., 2007; Aransi., 2019).