Read the Conversation
EF: What opportunities and challenges do you see in the healthcare and diagnostics industry for 2024?
AP: It is a busy year with up to 18 countries going through general elections this year in Africa! That means slower investments in these countries. Further, predicting outcomes and how they affect the industry is often far from being an exact science.
The world today is globalised and very interconnected; big events impact most economies including Africa, for instance, the two wars going on in Ukraine and Israel.
We also have the upcoming US elections that have stalled a lot of US investment coming into Africa until a longer mandate is given to the current or new administration.
PEPFAR is a big funder of HIV/AIDS programmes in Africa, and it was due for a five-year renewal. Congress had a rather partisan debate. In the absence of consensus, the compromise was a one-year extension pending further debate post the elections. These are the headwinds that are projecting challenges for the continent this year.
Conversely, Africa is seen as the continent to persuade to come on side. Whenever that happens, it takes us back to the Cold War years.
During the Cold War, the US was on one side, and the former USSR was on the other side – and significant amounts of money flowed into Africa because both sides were trying to position themselves on the continent.
Africa will find itself in a very interesting space in 2024. There are some clear tailwinds. The first is the adoption of Universal Health Coverage (UHC) as an ambition by many African countries. This is an important topic for us as solution providers —specifically for diagnostics. The second tailwind was the passing of the WHO Resolution on Strengthening Diagnostics Capacity last year by the World Health Assembly. Subsequent to that, countries are starting to create national diagnostic strategies based on sustainable funding models. They are beginning to write an essential diagnostics list – which should translate into increased testing to diagnose diseases early and treat them more accurately.
EF: What is the role of Diagnostics in Africa, and how can we increase its importance?
AP: Diagnostics are the cornerstone of a resilient health system and a must-have component in UHC. Early testing of an index case of COVID-19 can result in a pandemic being averted and significant savings made in human life and economics. Sadly, this is only often clear after the fact. We must support all the stakeholder groups and countries to advance diagnostic strategies.
Even after the COVID-19 pandemic, the value of diagnostics is still under-appreciated; less than 5% of health budgets in Africa go to diagnosing diseases. Over the years I worked as a physician in Africa, my observation was that most of the funding is focused on treatments. This remains true today.
With the focus on UHC and the passing of the diagnostics resolution, the big debate centres around healthcare financing. The first opportunity is to re-look at the efficient use of existing health budgets; and re-evaluate whether allocation to Diagnosis and Treatment is in the optimal proportion to deliver maximum Healthcare. Demonstrating efficient use of existing health budgets is a catalyst for attracting additional financing of health. The second opportunity is to unlock new money into health. In the public sector, we will convince the Ministry of Finance to allocate more budgets to health overall when we begin to demonstrate efficient use of existing health budgets. Underpinning health financing is universal health insurance coverage. This is the efficient way forward on the topic of health financing at scale.
As a diagnostics provider and strategic partner, we are challenged, together with all other stakeholders, to ensure that the barriers to access are removed, all the technologies are working and available when needed, supply chains are working and patients can get their diagnosis early.
EF: What initiatives have you been pursuing with the African Development Fund?
AP: The initiative we are working on is part of the “Future Proofing Africa Healthcare” initiative. This is one of the points of proof we have on the value of diagnostics. We want to look at this initiative more comprehensively and conduct a meta-analysis of the data on the cost-effectiveness of diagnostics – be it cancer diagnosis or any other key area in need of focus, such as diabetes. The driving principle of the initiative is that people who are diagnosed early will be treated early and will live longer, happier lives if we intervene at the right time.
EF: What other initiatives are you working on to prioritize the planning and delivery of healthcare in Africa?
AP: We had a bit of an inflection point two years ago. I worked with the team to develop a long-term strategy for Africa. We spent the first year understanding where we were coming from. We looked at the continent and our portfolio and designed a bold vision: to deliver 10 times as many tests into Africa over 10 years – from 2021 to 2031 -The 10X strategy.
A tenfold increase in the number of tests applied to the continent will move us from reaching 50 million people, which we estimated we were reaching in 2021, to 500 million people, which we estimate we will reach in 2031. We are currently working towards this strategy.
Looking in the rearview mirror on the topic of HIV/AIDS, Roche played a big role in testing through a partnership arrangement called the Global Access program. That program brought together partners like Global Fund, PEPFAR, and ourselves.
Over 10 years, we laid out molecular testing platforms across 33 African countries through that program. Today, this platform sustains 8 million people who are HIV positive on the continent, getting their biannual viral load testing so that they know whether their treatment is working or not. We are now responsible for more than 50% of all the high viral load testing on the continent. This is a large number, and Roche’s absence would be very noticeable. The goal of the 10X strategy is to replicate this success across a broad range of priority disease areas in Africa -spanning infectious diseases and NCDs.
EF: What kind of initiatives does Roche Diagnostics have regarding AI and digital transformation to improve regional diagnostic services?
AP: In Africa, AI's impact may not be immediate, but it's inevitable. Numerous companies are pioneering AI solutions, heralding a future without boundaries. Tools like ChatGPT are already shaping the educational landscape. The transformative potential of AI spans diverse sectors, notably healthcare, where its impact is poised to be revolutionary.
Today, Africa focuses on harnessing data to fuel the evolution of AI algorithms -partnerships with innovator companies and other stakeholder groups will make this vision a reality. For stakeholders in diagnostics, our interactions transcend mere transactions; we aspire to become strategic partners. We aim to foster mutually beneficial relationships, ensuring victories for patients, customers, and Roche. Together, we can harness Africa's data wealth to drive scientific progress and shape a future where AI serves all.
EF: You will be celebrating your third anniversary at Roche soon. What are the things that you are most proud of?
AP: Our efforts have firmly established Africa on the Roche global agenda. The overwhelming internal support of the 10X strategy for Africa reflects the resonance of our compelling vision across the organisation. We feel truly embraced and supported within the company.
Secondly, a significant milestone was achieved with the passage of the diagnostics resolution last year. This monumental advancement propelled our initiatives and stood as a triumph for patients across Africa, where diagnostic strategies were previously lacking. Embracing diagnostic technologies, which today are capable of driving 70% of clinical decision-making, is imperative for the continent's healthcare evolution.
Thirdly, we have a unique opportunity to ignite a crucial dialogue about Africa's greatest asset: its people. While often labelled a resource-rich continent, true prosperity lies in investing in human capital. Rwanda's remarkable growth, despite its mineral scarcity, underscores the transformative power of prioritising education and health. With a burgeoning population of 1.4 billion and an average age of 20, Africa's youthfulness presents unparalleled potential -we must ensure it is a demographic dividend and not a demographic disaster!
By prioritising investments in healthcare and education, we can ensure that our human capital rivals the best in the world. Our commitment extends to advocating for universal healthcare coverage and delivering tangible results to enhance the well-being of our people.
