World health statistics 2019 shows that 8 out of the 10 countries with the poorest healthcare in the world are from Africa with Sierra Leone being 3rd on the list and Nigerian being 5th on the list. Africans still struggle with various diseases and bad health conditions. Limited health care for a large number of the population, a lack of financial resources for patients and the challenge of distribution to rural areas all hinder the development of healthcare in Africa.
TIME TO DESPAIR?
Not if you ask impact- and business-minded entrepreneurs. While public and non-profit led initiatives like Africa Health Organisation (AHO) (ZIMBABWE), Wellbeing Foundation (NIGERIA), West Africa Health Foundation (WAHF), The Chalker Foundation and others have had some impact on key health indicators over the last decades, much still remains to be done. Recently, startups have been able to identify issues and come up with solutions not only having positive health and social impact but also taking advantage of the business opportunity.
THE PLAYERS: HEALTH INNOVATORS SOLVING PROBLEMS WITH TECH
A Rwanda/US-based startup facilitating blood deliveries via drones making waves globally. It replaces much longer and more expensive road deliveries of blood infusions. This is particularly helpful in many African countries, as the road network is not built out. The Ghana Health Service is working with Zipline hoping faster drop-offs will improve its health outcomes including reducing its maternal and infant mortality rates. Also in Rwanda, Zipline's drone blood delivery to 19 transfusing facilities has significantly reduced mortality and life-threating conditions, especially in remote Rwanda. As of April 2018, Zipline drones had made over 4,000 airborne deliveries in Rwanda covering over 300,000km and delivering over 7,000 units of blood, according to Keller Rinaudo, the firm's CEO.
Lagos-based Health technology startup that builds and operates diagnostic centers under the brand-name BeaconHealth. MDaaS was founded in 2016 by Genevieve Barnard and Oluwasoga Oni, to provide high-quality and affordable primary healthcare facilities for clinically under-served communities across Africa, starting with Nigeria. MDaas launched her first center in November 2017 in a low-income community in Ibadan, Nigeria and has since then partners with over 60 hospitals and clinics who refer patients for diagnosis, amplifying their impact and strengthening the local healthcare ecosystem. As of June 2019, MDaas has served an average of 28 patients per day in Ibadan, Nigeria with radiology, ultrasound, and diagnostic laboratory procedures starting at $4, with an average patient visit costing $20.
MPharma is a Ghana-based startup that uses a data and cost management platform to connect African consumers to accessible and affordable high-quality medication. Adulterated and low-quality drugs are still a major challenge for Healthcare in Africa. The company makes original prescription drugs in emerging markets easily accessible and affordable to underserved communities. So far, Mpharma has enlisted 208 pharmacies and serves 20,000 patients monthly.
Helium Health is the largest electronic medical records provider in West Africa. A Lagos-based technology company on a quest to make healthcare radically more efficient and affordable for Africans. Helium Health has been digitizing medical records since its release in 2016. Over 5,000 medical professionals in West Africa use their flagship electronic medical records (EMR) program to treat more than 150,000 patients a month.
Doctoora is healthcare infrastructure operating as a service company providing virtual private practice solutions to health professionals. The start-up offers a service delivery system as nine out of ten doctors can not afford to start a non-public follow-up that significantly reduces their earning potential and consequently increases the value of treatment due to a non-competitive private care sector.
LifeBank is a Lagos-based online platform that connects Nigerian hospitals with blood banks, and blood banks with donors. It uses a mobile app to create a community of voluntary blood donors, as well as a discovery platform on which hospitals can request the blood they need. LifeBank delivers requested blood in less than 45 minutes, in a WHO Blood Transfusion Safety compliant cold chain, and will soon add other essential medical products, like oxygen, vaccines, and rare drugs. In Lagos and Abuja, LifeBank currently sells to 240 public and private health centers. LifeBank received $250,000 in grant funding in November 2019 after receiving the Jack Ma Foundation's Netpreneur Award.
54Gene is an African genomics company building the world’s largest pan-African biobank. Tissue and blood banks have sprung up to catalogue human DNA’s many mysteries around the world - but that's not the case in Africa. Research has shown that 80% of the human DNA used in genetic studies comes from people of European descent. When researchers survey vast numbers of genomes to unearth a disease’s genetic causes, they use almost no African data.
Pharmaceutical companies also develop new drugs based majorly on the genomes of white people. This huge gap in genetic information has spurred the birth of 54Gene. This biobank is currently working with 17 hospitals across Nigeria to target cancer patients, cardiovascular disease, obesity, neurodegenerative disorders, and sickle cell disease, and it is on track to obtain 40,000 samples by the end of this year and 200,000 samples by the end of 2020.
Malaria is the 4th leading cause of death in Nigeria. Wellahealth provides malaria insurance to people who cannot afford comprehensive healthcare insurance. Its service is a monthly, quarterly, bi-annually or annual subscription providing subscribers access to malaria tests and medication. Wellahealth works with 3000 pharmacies across Nigeria and provides individual as well as family plans. Subscribers also have access to chat with doctors around the world.
THE ICING ON THE CAKE: HOW MUCH ARE THESE COMPANIES WORTH?
The largest company in the group, Zipline, received $25 million in funding in 2016 and was just launching its first program in Rwanda. In May 2019, Zipline announced $190 million in new financing, bringing the company’s valuation to $1.2 billion. This makes it one of the highest-valued startups operating exclusively on the Africa continent.
While our other examples are still much smaller, they are growing quickly and have all received support by investors.
MDaas Global raised $1 million in June 2019 in a seed round led by Consonance Investment Managers with participation from Techstars, FINCA Ventures, Future Africa Fund and Greentree Investment Company.
Mpharma has raised a total of $25.1M in funding over eight rounds. Their latest funding was raised on Apr 2, 2019, from a Grant round.
Helium Health has raised a total of $170K in funding over two rounds. Their latest publicly disclosed funding was on Nov 29, 2017, from a Non-equity Assistance round.
Doctoora raised in one round a total of $35K in support. This was an elevated seed round on May 1, 2018.
LifeBank has raised a total of $225,000 in funding over three rounds, the latest being from October 2019.
54Gene launched in January 2019 after completing its stint at Y Combinator and Google Launchpad Africa. The company secured $4.5 million in seed funding, the biggest seed round ever for a Nigerian health tech startup.
WHAT IS LEFT TO DO?
Some ideas we see as particularly worthwhile to be explored are the following:
Advanced Medical Equipment
For one, the absence of advanced medical equipment in many parts of Africa remains a major healthcare challenge. For some ailments, convalescents still have to be flown to large foreign cities - or even out of the continent - to afford them access to proper healthcare and better equipment. However, this is simply not affordable and sustainable for the vast majority of the population. A possible solution would be for a medical tech startup to make highly advanced, smaller and more inexpensive machines available to be rented by doctors and health centres to take care of their patients at a rental price. Doctors and medical practitioners could go on their apps, check out available equipment, pick a date for use and pay for it. This rental or "franchise 2.0" model has been used for everything from housing (Airbnb globally, Fibre in Nigeria) to transport (Uber and many more) - why not apply this model to healthcare?
Still, getting access to relatively simple, locally available healthcare is often too expensive for many Africans. The World Poverty Clock statistics, compiled by Brookings Institute and World Data Lab, proclaim Nigeria to be the world poverty capital, which means most Nigerians are unable to pay for healthcare services without assistance. Government-owned facilities available to them are inadequate and most times not functional. Families of the sick often turn to their relatives or friend circles to try to raise funds for better care - but they often fail, as their relatives or friends themselves are not wealthy enough.
Health Funding and Loans
Now, what if one could access a wider circle of support - using the power of the internet? Both locally and internationally.
In the micro-finance sector, individuals around the world use Kiva to provide loans to startups in the developing world. Using this as inspiration, a simple way for people in a local and/or global community to pay or give loans to Africans, who are unable to pay for their healthcare procedures, would open completely new ways of funding. Profiles could be set up describing people's ailments, and loans for medical procedures could be transferred using local and international payment gateways. Loans could also be paid back within a fixed duration with or without interest, as desired by the lender. Such a startup could charge a fee for managing the loans.
Virtual Doctors
Finally, self-medication and drug abuse are major contributors to the high mortality rate in Africa. As a result of little or no access to medical practitioners, many people try to help themselves - often with disastrous outcomes. A large number of Nigerians still can't afford to use a smartphone which frustrates the effort of the current virtual doctor innovations and the necessary access to the medical practitioner. To curb drug abuse and self-medication, virtual doctors could be made available through USSD codes that could diagnose patients virtually, by dialling a code on their mobile phones in their local languages and eventually leading to a telephone conversation with a doctor who will prescribe drugs and follow up on treatment until full recovery. This solution saves transport costs and the access a large number of patients can make for a sizeable business - both for doctors and the platform making the connection.
In the healthcare space, founders are building startups with unique solutions to Africa's challenges. We’re interested in seeing how the space matures and what companies are founded.
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