Read the Conversation
EF: If you had the opportunity to pick two questions that are not being asked to healthcare CEOs, what would those questions be?
RN: Two critical questions are often overlooked. Firstly, the importance of our workforce and their well-being in navigating the structural and policy changes in healthcare across Africa. The brilliance of health workers and their pivotal role in the functioning of health systems should be recognized and discussed more extensively.
Secondly, the discussion surrounding social determinants of health is not adequately addressed, although it has gained attention in the U.S. context. Understanding the social impact and undertaking socially relevant initiatives is crucial for shaping future health outcomes. COVID-19 highlighted the significance of social determinants of health, particularly in relation to disparities among different racial groups. It is essential to give more attention to social determinants of health, especially in the African context.
EF: What are the current priorities for Africa that you are focusing on?
RN: South Africa and Africa present different health challenges. In Africa as a whole, health outcomes are far from satisfactory, with higher rates of infant and maternal mortality and lower life expectancy compared to the rest of the world. To address this, a more radical approach to public health initiatives is needed. In our African business, we have partnered with Goodbye Malaria to mitigate the spread of malaria, while the Bill and Melinda Gates Foundation has made significant investments and led initiatives to reduce malaria-related deaths across Africa. Simple interventions can have a broad impact.
In the South African context, the health policy debate revolves around the deep inequality present in the country, stemming from its political history. South Africa has one of the highest levels of inequality in the world, which leads to disparities in health outcomes and access to healthcare among different population groups. Resolving these issues of affordability and access to quality healthcare is a significant focus. By improving access, affordability, and narrowing the quality gap, meaningful progress can be achieved in healthcare as leaders in the field.
EF: How do you perceive the evolution of digital healthcare access in terms of affordability and its pace of development?
RN: Digital healthcare experienced a surge during the COVID-19 pandemic, presenting some positive outcomes amid the tragic circumstances. The structural changes in healthcare systems, driven by the pandemic, have been favourable for digital healthcare, as it provided an alternative to face-to-face services and reduced the risk of COVID-19 transmission. Although the initial spike in digital healthcare usage has stabilized since the pandemic subsided, it remains significantly higher than pre-COVID levels, indicating a growing trend in adoption.
Virtual consultations now account for approximately 50% of doctor visits, and remote monitoring enables hospital care to be delivered at home. However, when it comes to access and affordability, digital healthcare has faced challenges in Africa. While there are success stories from other parts of the world, such as Bangladesh, where virtual consultations have greatly improved access to quality healthcare, Africa still needs to address issues such as affordable broadband, high internet adoption rates, and widespread availability of internet-capable smartphones to fully leverage the potential of digital healthcare.
EF: What are one or two lessons learned from outside Africa that you believe can be implemented in Africa? Conversely, what valuable knowledge or practices can Africa share with the rest of the world?
RN: In our continuous journey, we prioritize learning and view it as a crucial aspect of effective leadership and business success. We actively study evidence, explore various care models, and stay updated on healthcare innovations. The extent of our learning efforts is extensive and too vast to detail here. Importantly, we believe that Africa has much to offer and can export valuable knowledge. Within Discovery, we excel in data analytics and the use of artificial intelligence to analyze claims data and gain insights into the healthcare system.
Our well-structured and sophisticated data allowed us to quickly generate valuable papers and provide support to governments, including those in developed countries, during the COVID-19 pandemic. This data advantage gives us a competitive edge. Additionally, our wellness programme, recognized by the World Economic Forum, and known as Vitality, stands as a leading global programme for behaviour change, incentivizing and rewarding individuals to prioritize their health. By exporting this model to over 40 global markets, we demonstrate an African company's ability to share intellectual property and make an impact worldwide.
EF: How do you ensure a seamless customer experience with your background in finance and passion for integrating systems like Discovery Health and Discovery Banking?
RN: We have observed a growing trend in healthcare where integration between healthcare and payment systems is taking place. In our market, we have made significant progress in this area. Traditionally, healthcare journeys have been fragmented and complex for customers, with unclear cost structures and payment processes, which are prevalent in various healthcare systems, including the United States and South Africa.
To address this, we have integrated Discovery Bank's payment environment with Discovery Health's claims management system. By merging the healthcare and payment systems, we can streamline the customer's healthcare experience. When a health claim arises, we can consolidate the various sources of funding and provide a unified transaction through our product called Health Pay. This solution not only simplifies the payment process but also provides customers with a comprehensive overview of the associated costs. We are thrilled about this development, although it is still in its early stages, and we are actively working to expand and enhance this product offering.
EF: What key message would you like to convey to the healthcare industry audience from a Discovery perspective, considering the current concerns and the topics?
RN: I want to convey a message of optimism. We are highly enthusiastic about the current opportunities and the forthcoming challenges within the South African healthcare system. We are not unaware of the potential contentious health policy discussions that may arise, but we firmly believe that the existing healthcare environment is unjust.
Therefore, we are advocating for change. We believe that simultaneous regulatory changes are needed in both the private and public sectors to ensure the availability of high-quality healthcare that is more accessible and affordable in our country. We are prepared to embrace change and actively contribute to it. My plea is for collaborative efforts and working together towards this goal.
I acknowledge that there will be differences of opinion and tension, which is healthy and essential in reaching the right solutions. Despite this, I maintain a strong sense of optimism, and here at Discovery, we continue to invest and hold a positive outlook for the future. There is no doubt that we face challenges that must be addressed, but I am confident that we will find the right solutions.
