Cofounder and managing director of Endeva, Aline Menden is an expert on business-model and system innovations that advance SDGs and achieve positive impact at scale. Her work focuses on low- and middle-income contexts, at the intersection of health and technologies on projects involving NCDs as well as primary healthcare strengthening. Since 2007, she has directed more than 50 projects with over 40 partners, including development organizations, corporations, social enterprises, and NGOs.
Aline has published extensively on topics related to inclusive business models and partnerships. She is a lead author of over 10 reports as well as over 50 in-depth case studies, with a particular focus on the health sector. A trained facilitator with experience in (online) workshop design, she has conducted over 40 multi-stakeholder workshops, trainings, design sprints, peer-to-peer exchanges, and other interactive formats.
Aline has a strong academic background, with a PhD on “Identifying Low-income Consumers as a Source of Innovation” from the TUM School of Management in Munich, Germany. She is a frequent guest lecturer at the TU Munich Business School and the TU Berlin on business models and systems change for SDGs. Aline is fluent in German (native), English, Portuguese, and Spanish.
An Ethiopian-native Canadian healthcare expert, Dr. Maraki Fikre Merid has a deep passion for the betterment of healthcare focused on women’s health and innovative models that can increase affordable, quality access to care in underserved countries. As a founding partner of CHS, a healthcare advisory firm with offices in UAE and Ethiopia, Maraki brings to DHP more than 18 years of healthcare experience, with a unique in-depth market knowledge of Ethiopia and of the challenges and opportunities faced by the Ethiopia private and public sectors. Her deep expertise in pharmaceuticals and digital health infrastructure, combined with first-hand understanding of the African education, business spaces and public-private partnerships, allows her to deliver effective advice to clients.
Bilingual in French and English, Maraki holds a PhD from the Department of Health Policy, Management and Evaluation at the University of Toronto. She also holds a Master of Science in Epidemiology and Bachelor of Science in Biochemistry from McGill University in Montreal. Maraki has published many articles in leading health journals and her research was highlighted in influential international reports.
An international consultant in public health, global health, and digital health, Dr. Ousmane Ly is currently a Digital Health Expert and Research Professional at the Interdisciplinary Center for International Health Development, CIDIS Faculty of Medicine and Health Sciences, at the University of Sherbrooke in Longueuil, Quebec.
Dr. Ly holds a University Certificate in Medical Informatics from the University of Geneva (Switzerland), a Diploma of Advanced Studies master’s degree in medical informatics from the Université Pierre et Marie Curie (Paris VI), and a Diploma in Health Informatics from the University of Sherbrooke. Dr. Ly is also an Assistant Professor/Researcher at the Faculty of Medicine, University of Sciences, Techniques and Technologies of Bamako, Mali, where he frequently lectures.
Prof. Georges Bediang is a Cameroonian Medical Doctor who obtained a PhD in Medical Informatics and a Master of Advanced Studies in Public Health at the University of Geneva. He is currently Associate Professor in Medical Informatics at the Faculty of Medicine and Biomedical Sciences, University of Yaoundé I (Cameroon), where he introduced pre-graduate training in medical informatics for medical students in medicine, pharmacy, and dentistry over the last five years.
His main research areas are the appropriate use of eLearning for the training of health professionals in Africa, the use of digital health and telemedicine tools to support healthcare and decisions for health professionals in Africa, and the use of knowledge engineering and artificial intelligence-based approaches in healthcare to improve screening, diagnostic, and management of patients in resource-limited settings.
Prof. Bediang is also involved in the coordination of telemedicine and eLearning activities of the RAFT network in Cameroon and at the international level. He has helped deploy eLearning and telemedicine activities in several French-speaking countries.
Paulo Gusmão is a visionary IT entrepreneur with over 25 years of experience, primarily in health tech. As the co-founder and CEO of OTAWA Health, he has spearheaded the development of an advanced Oncology Electronic Health Record and Clinical Decision Support system (O-EHR/CDS), utilizing individual diagnostics to inform evidence-based treatments and enhance patient outcomes through Real-World Evidence studies.
Paulo is dedicated to nurturing future tech leaders as a mentor for Bridge for Billions, particularly in the Health Tech Hub Africa program. His involvement underscores a deep commitment to leveraging technology for healthcare advancements in Africa, aiming to increase access and efficiency in the region’s healthcare services.
His entrepreneurial background also includes co-founding FROTANET Tecnologia, a fintech firm specializing in solutions for the roadside cargo transportation market, and OnixCann, a platform enhancing connectivity within Brazil’s medical cannabis ecosystem. His early ventures in multimedia and interactive technologies with Studio Interativo and collaboration with IBM’s Ultimedia Team have cemented his reputation as a pioneer in integrating technology with user-centric solutions.
Paulo’s career is distinguished by a consistent theme of using technology to solve complex problems, enhance healthcare delivery, and mentor the next generation of health tech innovators. His work reflects a robust blend of technical acumen, strategic thinking, and a passion for impactful healthcare innovations.
In lower- and middle-income countries (LMICs), access to health remains an important issue to solve.
Shortage of healthworkers is one challenge among others: according to the World Bank, there is only 1.2 doctor in LMICs (versus 2.9 in high income countries) and 2.1 nurses or midwives per 1,000 people (versus 8.7 in high income countries). At the same time, 90% of smartphones users will be located in LMICs in 2020. The promise of digital health to address some of the underlying health systems challenges is undeniable. Digital health can significantly support the achievement of Universal Health Coverage (UHC), one of the targets of the third Sustainable Development Goal (SDG). A recent report estimated for example that 1.6 billion people could benefit from quality medical services through digital health solutions. Beyond access, digital health can also play an important role in terms of cost reduction and health systems efficiency and quality. Although not many countries have yet analysed the impact of digital health on their systems, it is notable that Canada estimated that their investments in digital health (implementation of electronic medical records (EMR), telehealth and district information systems) generated savings of CAN$16 billion since 2007.
Many challenges remain to fully leverage the tool of digital health. Fragmentation, data interoperability and lack of appropriate legislation and laws are still prevalent. The Ebola crisis was one of the wake-up calls to the growing realisation that data fragmentation needs to be addressed if ICT tools are to be used for effective data collection and analytics. Data needs to be integrated to make it useful in real-time to healthcare professionals or public health authorities.
A striking example of what we mean by fragmentation is Mali where there are 11 different mobile health initiatives for maternal and child health funded by different institutions. Moreover, most of these institutions use their own tools and systems which are not interoperable with systems used by the national eHealth agency. In LMICs, the number of digital health projects had increased by more than 30% between 2005 and 2011 but two thirds were still in pilot or informal stages. Although this statistic is a bit dated, “pilotitis” has been a common word used in the field of digital health for many years and is still prevalent.
Many countries still do not have the appropriate data security and data privacy regulations in place and this is a current hot topic that hinders the trust of any user. A lack of proper legislation to govern mHealth Apps or connected devices and sensors can also undermine investments in countries.
Beyond these obstacles, other barriers still need to be tackled: insufficient human and technical capacity to analyse health data and meet patients’ needs, resistance to technology, unsustainable financing, lack of coordination between national ICT plans and national digital health strategies, connectivity gaps, quality and performance issues of networks, and lack of reimbursement schemes.
As the cycle of digital health evolves, there is a growing realisation on the fundamental role governments have to play in advancing the use of technology for health by developing the right policies and infrastructure as well as building capacity for digital health. In February 2017, the Broadband Commission Digital Health Working Group (co-chaired by Novartis Foundation and Nokia) published a report called: “Digital Health: A Call for Government Leadership and Cooperation between ICT and Health”. It advocates for governments to take action on national digital health strategies to solve the fragmentation dilemma and help tackle the challenges mentioned above.
As of 2016, 58% of WHO’s member states had developed national digital health strategies. This does not translate in the fact that countries have implemented these and there is therefore still a lot of work ahead. Implementing a strategy is no minor task and represents a significant investment: the Government of Rwanda committed US$32 million for its first 5-year eHealth plan for example. Tanzania’s more recent digital health road map calls for overall investment of approximately $74 million. The above-mentioned report looked into 8 countries that managed to advance effectively the digital health agenda (Canada, Estonia, Malaysia, Mali, Nigeria, Norway, the Philippines and Rwanda) and provides key insights and lessons which other countries can leverage from.
A key finding was that countries achieving success in implementing strategies shared responsibility and investment between the Health and the ICT authorities (typically between Ministry of Health, Ministry of Communication and the eGovernment agency).
Perhaps the most important learning from the global scan that was done, is the utmost importance of having the appropriate leadership and governance in place to enable the effective implementation of a national digital health strategy. Many stakeholders saw this as the most challenging first brick to attain in order to robustly build around the other essential components of a strategy: Strategy & Investment, Standards and Interoperability, Infrastructure, Legislation & Policy & Workforce. Government leadership is vital in fostering an enabling environment for digital health policies and an effective cross-sectorial governance mechanism, the basis for facilitating alignment and cooperation between health and ICT sectors.
In terms of governance and government leadership, some LMICs are true models. In the Philippines, close cooperation between health and ICT ministries has been materialised in a joint MoU and governance mechanisms with clear role and responsibilities, and Rwanda’s very strong high-level commitment of broadband policies and extraordinary intersectoral governance makes it a real example for many countries around the world. It embodies the promise for these countries to leapfrog and avoid the difficulties today faced by high-income countries, often linked to legacy infrastructure and systems.
The digital health ecosystem in LMICs is entering a new phase where the focus is starting to shift to investing in “the roads” for digital applications and services to scale. In other words, a shift to a “system” thinking vs. solutions. This evolution will accelerate the scaling and development of digital health and help in achieving Universal Health Coverage.
It was so exciting to be part of the important place digital health took in May at the Transform Africa Summit in Kigali, the leading African forum organized by Smart Africa bringing together global and regional leaders from governments, business and international organizations to collaborate on new ways of shaping, accelerating and sustaining Africa’s ongoing digital revolution. With over 4,000 attendees and 90 countries represented, the fact that the Digital Health Hub comprised no less than 5 very interesting sessions and panels in the forum was a significant step in the ecosystem realizing the importance of this theme to achieve a fully digitalized Africa. I am also very grateful to the Novartis Foundation for its sponsorship in making this event happen, thereby underlining again their leadership in this space on the continent. The teamwork between the Smart Africa team, WHO and ITU was gratifying and showed the power of collective impact in bringing together some great content and speakers.
The 80.8% mobile penetration and 25.1% Internet users' penetration, against 99.7% and 47.1% at the world level (ITU source 2016) has already allowed digital health in the African Region to contribute to strengthening health systems and accelerating the attainment of the SDGs, including UHC. In the African region, 26 countries have national digital health strategies. There is no question that with the predicted exponential increase of internet usage (+20% since 2017 according to ‘Digital in 2018’ report) as well as smartphone penetration, the potential of digital health in Africa will keep growing.
I was thrilled to moderate the session entitled “Government Leadership in Digital Health-Breaking Silos and Mitigating Pilotitis”. Government leadership for digital health has become increasingly important as there is a great need to build core systems and platforms as well as create harmonization in what is still a fragmented space. The Digital Health Working Group from the Broadband Commission released last year a report entitled “Digital Health: A Call for Government Leadership and Cooperation between ICT and Health” demonstrates the importance of ICT ministries and e-Government agencies joining forces with Ministries of Health to develop and implement national digital health strategies. A warm thank-you to the following speakers for having contributed to this important conversation: Hon. Aurelie Adam Soule Zoumarou (Minister of Digital Economy and Communication, Republic of Benin), Hon. Patrick Ndimubanzi (Minister of State, Ministry of Health, Rwanda), Houlin Zhao (Secretary General, International Telecommunications Union), Olu Olushayo Oluseun (World Health Organization- Country Representative) and Ann Aerts (Head of the Novartis Foundation). Here is a video to this session.
It was also such a pleasure to be a speaker on the panel focused on Digital Health for Universal Health Coverage and NCDs. More than 75% of NCD deaths - 31 million - occur in low- and middle-income countries and if you combine this with the shortage of health workers and health infrastructure in Africa, digital tools can make a significant contribution in tackling this rising crisis in Africa. This was a lively and passionate discussion which was moderated by Hani Eskandar (ICT Applications Coordinator ITU) with the following participants: Harald Nusser (Head of Novartis Social Business), Frasia Kura (General Manager at AMREF Health Africa), Prebo Barango (Medical Officer &Expert on NCDs at WHO Africa) and Dr. Sipula (CEO of Watifhealth, South Africa). Here is a video of the panel.
This is yet another conversation that serves as a prelude to a report on digital health and NCDs from the Digital Health Working Group from the Broadband Commission (co-chaired by the Novartis Foundation and Intel) which should be released in September around the UN High-Level Summit on NCDs in NY.
Sincere congratulations also to the African Alliance for Digital Health Networks for their official launch at Smart Africa
I will conclude by giving a special thanks to Jean-Philbert Nsengimana (who served until recently as ICT Minister in Rwanda and is now Special Advisor to Smart Africa) as he played a very important role in convincing stakeholders to make digital health a significant part of this impactful summit!
Here are videos of some of the other panels on digital health:
State of Digital Health in Africa
Investing in Digital Health: Business Models and PPPs
Innovation for Digital Health: Biotech, Drones, IoT, Mobile, Big Data, AI: Where Are the Quick Wins?
The recent 71st World Health Assembly was exciting for digital health champions like me!
First and foremost, the long-awaited and hoped-for Digital Health Resolution was approved urging Member States to prioritize the development and greater use of digital technologies in health as a means of promoting Universal Health Coverage and advancing the Sustainable Development Goals. The resolution was proposed by Algeria, Australia, Brazil, Estonia, Ethiopia, Germany, India, Indonesia, Israel, Italy, Luxembourg, Mauritius, Morocco, Panama, Philippines and South Africa. This move is significant and will hopefully mark another inflexion point in the development of digital health. India deserves special congratulations for having supported this initiative over the months.
I was also thrilled at the high attendance and success of the event that I supported the NCD Alliance, the Novartis Foundation and Intel to organize which focused on the importance of digital health for addressing the challenge of NCDs. Although there were many events on NCDs at WHA last year, we had noted little mention was made of the significant potential digital health and technology could play in this space. Several players decided to act on this gap by raising awareness to the eco-system. This has spurred one of this year’s digital health working group from the Broadband Commission (co-chaired by the Novartis Foundation and Intel) to work on a global report which is due to be released in September around the UN High-Level Summit on NCDs in NY. Below is a snapshot of its content and its 36 working group members.
The event at WHA served in some ways as a prelude to this report and aimed to start raising awareness on this important subject. Health ministers and experts from Ghana, Rwanda and India discussed how governments and policies can make a difference in using the tool of digital health for NCDs and thereby improving UHC. WHO presented the important joint WHO-ITU “Be He@lthy, Be Mobile” initiative which has already achieved quite a bit assisting 9 countries to develop programs using mobile health targeting NCDs. The George Institute for Global Health, Siemens Healthineers, the NCD Alliance, the Novartis Foundation and Intel brought their insights on the importance of partnerships. The Carlos Slim Foundation spoke of their significant CASALUD NCD project which uses digital health and has reached over 12,000 health centers in Mexico and affected over 1,5 million patients.
The event was a great reminder of how powerful the tool of digital health can be in revolutionizing how NCDs care can be delivered by expanding access, improving efficiency and training less-skilled health workers. Of significant importance is the empowerment of patients managing their illness which is supported by connected devices, apps and digital solutions at large. Thanks a million to the NCD Alliance, Intel and the Novartis Foundation for the great teamwork. Stay tuned for the upcoming report from the digital health working group from the Broadband Commission!
Special congratulations also to the Commonwealth Centre for Digital Health for its recent launch and the wonderful event they also held at WHA. Several ministers of health were present, and the expertise shown in their speeches gave a glimpse of how the cycle of digital health is maturing and becoming more widespread in high-level political circles.
Here is also a good read from Ann Aerts, Head of the Novartis Foundation on WHA and digital health: Reflections on a great week at WHA71 as the World Health Assembly acknowledges digital health to fight NCDs and accelerate universal health coverage.
A national ICT framework that facilitates alignment between health and ICT sectors supported by effective governance mechanisms – and importantly, sustained senior government leadership and committed financing – are critical for the success of digital health at national levels.
Recounting experiences and associated developments particularly in the African context, Florence Gaudry-Perkins, founder and CEO of the Paris-based Digital Health Partnerships explained in her Africa Health Management Conference presentation at Gallagher Estate, Midrand, this week that by 2017, 23 African countries had already developed digital strategies for their healthcare delivery and management systems.
Digital health stumbling blocks commonly faced by countries at the outset include lack of common standards and appropriate legislation for digital health, insufficient human and technical capacity to collect and analyse health data, and lack of co-ordination between national ICT plans and national digital health strategies.
A notable exception in Africa, said Gaudry-Perkins, has been Rwanda with a personal interest and resulting co-operation at the highest level: “They have a very efficient system already up and running as a result. I come from France where some associates who have noticed Rwanda’s progress have gone so far as to suggest it be brought to the attention of the French government!”
A significant benefit achievable with the successful implementation of these technologies is the ability to reduce costs and increase efficiencies of healthcare systems: “Here they have the ability to use real-time data to make surveillance action-orientated and as such respond to health priorities.
“The promise of digital health also includes empowering patients to take more responsibility in the management of their own health, at the same time empowering providers with support systems.
“Importantly,” Gaudry-Perkins added, “it facilitates communication between providers, patients and communities.”
