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RULES AND REGULATIONS

African telemedicine startups need regulation to reach more patients

A man on a motorcycle with equipment for a telemedicine service called Rocket Health.
Rocket Health
African health tech is flourishing.
  • Carlos Mureithi
By Carlos Mureithi

East Africa correspondent

Published

A greater number of startups in sub-Saharan Africa are offering telemedicine services, spurred on by the Covid-19 pandemic and increasing digital adoption across the continent. But a lack of “clear and harmonized” regulation is preventing the industry from taking off, according to a new report on health innovation in the region.

Telemedicine, combined with direct-to-consumer distribution, is the most common type of service offered by health innovators founded in the last five years, says the report by Salient Advisory, a global healthcare consulting firm.

The researchers surveyed 61 companies in sub-Saharan African, focusing on Ghana, Nigeria, Kenya, and Uganda. The companies are all using tech-enabled solutions to change how health products are distributed. This is more than twice the number of companies Salient Advisory tracked for its last report in 2019.

The study defines telemedicine as remote medical consultation between consumers and health professionals. It excludes provider-to-provider telemedicine services and telemedicine without delivery of medicine to patients.”If I provide you remote services, but you have to go in person, to get your pharmaceutical product, it may not be the best user experience,” Malyse Uwase, senior consultant at Salient Advisory in east Africa, tells Quartz Africa.

The African health tech sector is thriving, with the number of startups in the space and the amount of funding they have received increasing significantly. The Covid-19 pandemic has forced traditional healthcare providers to change their models and adopt new tech products, creating opportunities in the industry as a result.

The research found that increased competition in the space has prompted consumer-facing companies to partner with other innovators to increase their service offerings by combining telemedicine with product-delivery services. Companies that offer telemedicine services are adding product distribution, while direct-to-consumer distributors are adding telemedicine channels. It gives the example of Kenyan online pharmacy MYDAWA, which is now offering telemedicine services powered by SASAdoctor, a provider of virtual medical services.

The research also found that e-commerce giants operating in Africa are showing a significant strategic interest in distributing health products. Since the 2019 report, Jumia, Konga and Copia have all started selling over-the-counter health products. Jumia operates in more than 13 African countries, Konga in Nigeria, and Copia in Kenya. With their reach and infrastructure—together they have at least 25 times the user base of health-focused direct-to-consumer delivery start-ups tracked by Salient—this could accelerate access to medicine in the continent.

But the lack of consistent rules across countries is problematic and constraining geographic growth, the report states. “In each new country of operations, a regulatory assessment needs to be conducted, and without clear guidelines it is costly and time-consuming,” the authors write.

That creates a high level of uncertainty for a business which faces being potentially “wiped out by a government policy that either doesn’t exist yet, or is being put together,” says Yomi Kazeem, senior consultant for west Africa at Salient Advisory. “You’ll live on a day-to-day basis of being uncertain of the future.” (Kazeem is a former Quartz Africa reporter.)

The absence of consistent guidelines could put off investors, says Dr John Bwanika, co-founder of Rocket Health, a Ugandan telemedicine service. In order to attract investment and grow, early innovators like Rocket Health need to generate as much local evidence and content to inform the development of locally appropriate policies or guidelines, he says.

The pandemic has increased uptake in Rocket Health’s services and helped the industry show its prospects. “A lot of our investors did not have a good appreciation of the business and the potential for it in the country,” says Dr Mwanika. “What has happened in the last 12 or so months is that Covid has shone more light on the value of these kinds of businesses—remote consultations and the likes—so there’s been quite a bit of traction.”

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