Tanzania is establishing itself as a regional medical hub.

Tanzania is emerging as a regional hub for the provision of specialised healthcare services. Dar es Salaam is quickly becoming a destination for patients referred from neighbouring countries.

President Samia Suluhu Hassan has set her sights on making Tanzania a medical tourist destination of choice, having inherited noteworthy achievements in healthcare provision over the past 60 years. President John Magufuli was the one who started talking about the need for Tanzania to tap into the $72 billion-a-year global medical tourism sector in February 2020.

President Hassan pushed the idea even further when she took over. Dr Dorothy Gwajima, the minister for Health, Community Development, Gender, Elderly, and Children, will unveil a medical tourism promotion team in July 2021.

Mohamed Janabi, a veteran cardiologist and executive director of the Jakaya Kikwete Cardiac Institute (JKCI), leads the team. Because JKCI already accepts patients from Comoro, Zambia, the Democratic Republic of Congo, Burundi, Rwanda, Uganda, and Kenya, the government intends to start there.

According to Dr. Gwajima, the government has submitted an application to the World Health Organization (WHO) for Tanzania to be recognised as a medical tourism hub.

More investments needed

Medical tourism’s viability will be determined by Tanzania’s investments in medical human skills development, telemedicine, the digital economy, transportation infrastructure, lodging facilities, health service price affordability, and customer service makeover, among other things.

According to analysts, there is no way around creating a favourable investment climate and a conducive business environment to facilitate the establishment of medical facilities, pharmaceutical and medical equipment manufacturing, and investments in research and development. Following the adoption of the Arusha Declaration in 1967, Tanzania passed the Private Hospitals Regulation Act in 1977, which outlawed private for-profit healthcare providers. This Act was repealed in the 1980s, but investors would need assurance that nothing similar would happen again. However, Tanzania’s medical tourism ambitions are realistic at this point, given that the government has partially reversed its policy of exporting medical tourists to India and other countries.

Dr. Gwajima said in a report on Tanzania’s health sector’s 60th anniversary, which she presented to reporters on Monday, November 8, that in the fiscal year 2020/21, only two patients were referred to hospitals outside the country, compared to 554 in the fiscal year 2015/16. Obviously, the Covid-19 pandemic, which caused global travel bans in most countries and put a significant strain on healthcare services in every country on the planet, contributed to this very small number of patients being referred to more specialised medical treatment outside the country. What is clear is that the number of patients has been declining since 2016, when the government’s efforts to purchase more specialised diagnostic machines and equipment gained traction. According to statistics provided by the then-minister for Health, Community Development, Gender, Children, and the Elderly, Ummy Mwalimu, the number of patients seeking treatment outside the country fell to 350 in 2018 from 550 in 2016.

Future plans

To strengthen Tanzania’s role as a medical hub, the government is installing software programmes in hospitals and improving performance merits through scorecards to overhaul service delivery and professionalism among the country’s healthcare professionals.

When introducing the medical tourism team, Dr. Gwajima emphasised the importance of taking customer service to the next level in order to attract as many patients from outside the country as possible.

The government is also building seven regional hospitals for the new regions (Njombe, Songwe, Simiyu, Geita, Manyara, Songwe, and Mara – Kwangwa), as well as expanding some of the existing hospitals and establishing new departments and services. The government is currently constructing medical oxygen production plants in seven regional referral hospitals (Geita, Manyara, Dodoma, Dar es Salaam-Amana, Mtwara, Ruvuma-Songea, Mbeya).

BioNTech Signs Deal with Senegal, Rwanda to Produce mRNA Vaccines

Senegal and Rwanda have agreed to build the firm’s first start-to-finish factories to create messenger RNA (mRNA) vaccines in Africa, according to the Associated Press. BioNTech is a German company that was one of the pioneers in the development of a COVID-19 vaccine (AP).

Construction will begin in mid-2022, according to BioNTech, which created the Pfizer-BioNTech COVID-19 vaccine. The company is collaborating with the Rwandan government and the Institute Pasteur in Dakar.

According to the Washington Post, the innovative mRNA technique employs the genetic coding for the Coronavirus spike protein and is anticipated to elicit a stronger immune response than standard immunizations. Scientists intend to employ the technology, which is easier to scale up than traditional vaccine processes, to develop vaccines for other diseases, such as malaria.

“State-of-the-art facilities like this will be life savers and game changers for Africa,” said Matshidiso Moeti, WHO Regional Director for Africa. “They could lead to millions of cutting-edge vaccinations being created for Africans, by Africans, in Africa.” “This is also critical for the transfer of information and know-how, the creation of new jobs and skills, and, eventually, the strengthening of Africa’s health security.”

“To research vaccines in the African Union and to establish sustainable vaccine production capacities to collaboratively improve medical care in Africa,” says Ugur Sahin, BioNTech’s co-founder and CEO.

Meanwhile, the fact that Rwanda and Senegal are the only two Sub-Saharan African countries working together on this groundbreaking effort is no coincidence. For many years, Rwanda has worked to establish itself as a regional knowledge-based ICT centre, investing heavily in research and R&D capabilities.

Pfizer, the world’s largest pharmaceutical company, recently signed a memorandum of intent with the Biovac Institute for the production of 100 million doses per year. The agreement covers the bulk importation of the drug material, the filling of vials, and the product’s distribution across Africa and elsewhere. The current agreement between Senegal and Rwanda is critical for Africa’s collective fight against COVID-19 because of the small number of nations in Sub-Saharan Africa with the technological competence to make vaccines.

The BioNTech plan calls for the development of a containerized manufacturing unit in Germany, which will then be sent to Rwanda, cutting the time it takes to build a vaccination factory by at least a year and lowering the chance of delays. While BioNTech employees will initially manage and operate the facility, ownership and expertise will eventually be handed to local operations. Based on Biovac’s experience in South Africa, this type of expertise does not currently exist in Rwanda and could take up to a decade to build. The agreement between BioNTech, Senegal, and Rwanda includes critical technology transfer in the second part of the contract, as well as an intellectual property licence agreement.

The Washington Post stated on October 26 that BioNTech plans to build a plant in Africa that will be able to produce around 50 million doses of the vaccine per year, with room for expansion. BioNTech also stated that it is in talks to expand its cooperation with Biovac, a South African vaccine maker. Biovac will construct the vaccine using BioNTech’s chemicals in a process known as “fill and finish.” The first finished doses will be produced in 2022, with an aim of manufacturing more than 100 million each year.

Healthcare Projects worth $140 million on the table in West, East Africa

During a virtual investor roundtable, members of the Africa Investment Forum team showed two projects as the continent strives to enhance its healthcare industry and attract much-needed investment in the aftermath of the Covid-19 outbreak.

The projects, which are valued around $140 million and are located in East and West Africa, were showcased for possible investors.

The first chance, with a project cost of $96 million, is for the establishment of a 250-bed specialized hospital delivering world-class healthcare services in a West African country. The land has been obtained and feasibility assessments have been conducted.

The second involves the development of a $45 million WHO-prequalified vaccine manufacturing factory in East Africa, which will be capable of producing three vaccines on a regular basis, including Covid-19.

Following the talks, a panel of investors shared their perspectives on investing in Africa’s healthcare industry. The panelists included Rhulani Nhlaniki, Pfizer’s Sub-Saharan Africa Cluster Lead; Jean-Philippe Syed, Principal at private equity firm Development Partners International; Afsane Jetha, Managing Partner & CEO at private equity firm Alta Semper Capital; Stavros Nicolaou, Aspen Pharmacare’s Senior Executive – Strategic Trade; and Dr. Dumani Kula, Evercare Group’s Chief Operating Officer for Africa. Aubrey Hruby, Senior Fellow of the Atlantic Council’s Africa Center, moderated the discussion.

According to Nicolaou, the fact that Africa has the largest illness load of any continent makes preventative treatment, including vaccinations, all the more crucial for Africans. The increased demand for medicines will need the formation of partnerships capable of overcoming obstacles such as research and development.

Other difficulties raised by attendees included overcoming cold chain and last-mile delivery issues, as well as approaches to scale up experimental technologies such as the use of drones to aid vaccination distribution.

The Africa Investment Forum’s Unified Response to Covid-19 pillars include health as one of five priority investment areas. Agribusiness, energy and climate change, ICT/Telecoms, and industrialisation and commerce are the others.

Last week, Africa Investment Forum Senior Director Chinelo Anohu mentioned the East Africa vaccine facility idea in the context of Africa’s present restricted access to Covid-19 vaccinations at a panel discussion hosted by the University of Edinburgh. Anohu believes that the continent may prevent vaccination inequities through trade and investment, particularly in its pharmaceutical industry.

Kenya plans to build vaccine factory within six months

Kenya intends to establish a vaccine manufacturing factory in Embakasi, Nairobi, over the next six months.

President Uhuru Kenyatta stated that the company, known as Kenya Biovax Limited, will aid in the country’s access to vaccines.

“By Easter next year, the Ministry of Health should be operationalizing this enterprise to manufacture vaccinations in our country,” he remarked during his Mashujaa Day (heroes) address.

Kenya wants to establish full-fledged vaccine production capabilities by 2024, according to the National Covid-19 Vaccine Deployment Plan.

The Covid-19 pandemic has highlighted the inadequacy of vaccine production facilities in Kenya and other African countries, leaving the region vulnerable to vaccine shortages. So yet, just around 1% of Africa’s population has been properly immunized against coronavirus.

Kenya Biovax is anticipated to be a fill-and-finish facility, where vials with vaccinations will be filled and packed for delivery. Many pharmaceutical companies outsource this final production procedure to third parties. These facilities package and deliver ready-made vaccinations.

The Nairobi facility will be erected in the Embakasi depot of the Kenya Medical Supplies Authority (Kemsa). According to the Ministry of Health, the factory will also manufacture other vaccinations such as polio drops.

Vaccine components will be imported in large quantities. The vaccinations will be manufactured, packaged in vials, labeled, and delivered at the new facility.

In May, the Health Ministry said that negotiations with Oxford AstraZeneca manufacturers were ongoing to import substantial amounts for repackaging in vials. According to the authorities, the discussions are nearly over.

The government stated that because the region is highly inhabited, the Kemsa Kitengela depot was disregarded as a potential location for the plant.

“We have gone for what we term the APIs, which are the active pharmaceutical ingredients,” said Willis Akhwale, head of the vaccines deployment group. We’ve found a partner, and we’re now under nondisclosure, so a lot of information isn’t public. We must first sign.”

US billionaire to manufacture Covid, cancer vaccines in S. Africa

Patrick Soon-Shiong, a biotech millionaire, has announced that he will begin transferring technology to South Africa in order to manufacture Covid-19 and cancer vaccines.

In an online news conference with President Cyril Ramaphosa, the South African-born and now-US-based doctor detailed the proposal that would see coronavirus vaccine production begin next year. Within the following three months, Shiong’s business NantWorks will transfer the technology, and vaccine manufacturing is scheduled to commence in 2022.

The government’s Council for Scientific and Industrial Research, the South African Medical Research Council, and the Centre for Epidemic Response and Innovation, as well as four local institutions, according to a statement from Ramaphosa’s office.

Aside from vaccinations, the NantWorks project will focus on cell-based immunotherapies, which might lead to novel cancer treatments.

Soon-Shiong, a physician from California, described this as “a momentous event in my life; it’s been a life ambition to look at technology we can bring back home.”

“We now have the expertise and technology to manufacture vaccines in Africa,” he continued. “It is my hope and wish that Africa would benefit from this technology.”

The investment, according to Ramaphosa, is a “game changer” for South Africa.

“This collaboration will drive South Africa and Africa in general to the forefront of healthcare, research, technology, and innovation,” Ramaphosa added.

This is the third pharmaceutical manufacturing investment announced in South Africa this year, the pandemic’s worst afflicted country on the continent.

In the southern city of Gqeberha, once known as Port Elizabeth, Aspen Pharmacare is filling and packing Johnson & Johnson injections.

The World Health Organization has chosen South Africa to host an mRNA manufacturing centre, with Biovac of Cape Town completing the final “fill and finish” phase for the Pfizer/BioNTech vaccine.

Rwanda Medical Supply Ltd signs $75m contract with USAID

Rwanda Medical Supply Ltd (RMS) has secured a contract with USAID for $75 million to increase the efficiency of Rwanda’s health product supply chain.

The agreement was inked on September 3 and is scheduled to last for five years.

The “Transforming Rwanda Medical Supply Chain (TRMS)” initiative will act as the principal vehicle for procuring and delivering health commodities to end users.

The first phase will focus on providing HIV/AIDS goods, followed by Malaria, Family Planning, Maternal and Child Health items, and other health commodities.

RMS is scheduled to acquire over 350,000 multi-month supply bottles of the very effective HIV treatment medication as one of the first operations financed under this contract.

Dr. Daniel Ngamije, Minister of Health, stated that the initiative seeks to enhance RMS’s planning and management skills.

“It would boost operational efficiency, capacity to use data in decision making, and guarantee proper and timely purchase and distribution of health commodities to last mile service delivery points,” he added.

He went on to say that the first few years will be devoted to delivering HIV/AIDS goods under the President’s Emergency Plan for AIDS Relief (PEPFAR).

The effectiveness of the country’s pharmaceutical supply chain, despite the fact that it is a complicated industry, impressed the USAID Rwanda Mission Director, Jonathan Kamin.

“This is noteworthy for Rwanda, a supply chain performance leader on the continent, because it is now the beneficiary of one of the largest direct commodity procurement contracts with a local supply chain organization from USAID.”

“Direct collaboration with capable local organizations is critical to USAID’s objective of strengthening local self-sufficiency.” Kamin made a comment.

According to Pie Harerimana, CEO of RMS, this fund would address the issue of capacity building by allocating funds to teach staff to operate properly.

He went on to say that the initiatives are intended to address operational inefficiencies, long procurement procedures, inventory management gaps, and inadequate order fulfilment rates, among other things.

The formation of RMS Ltd was a government of Rwanda initiative aimed at strengthening the pharmaceutical supply chain system with the ultimate goal of ensuring the availability of quality medications in health facilities for the people.

Ethiopia gets 108,000 doses of COVID-19 vaccine from AVAT

As part of the first monthly shipment of Johnson & Johnson vaccinations, the African Vaccination Acquisition Trust (AVAT) announced the arrival in Ethiopia of 108,000 vaccine doses.

AVAT is delighted to announce that, 108,000 vaccination doses of Johnson & Johnson single-shot vaccines will be shipped to Ethiopia. This is part of a total shipment of 6.4 million vaccine doses to African Union member countries in August 2021. Members who bought vaccinations through AVAT will continue to receive shipments for the foreseeable future. UNICEF provides logistics and delivery services to Member States in conjunction with the Africa Medical Supplies Platform (AMSP).

These shipments are part of a historic COVID-19 vaccine advance procurement deal signed by AVAT on March 28, 2021 for the purchase of 220 million doses of the Johnson & Johnson single-shot COVID-19 vaccine, with the option to acquire an additional 180 million doses. The agreement and the beginning of delivery represent the first time that African Union Member States have jointly acquired vaccinations to protect the African population’s health. The 400 million vaccinations obtained by AVAT are enough to immunize one-third of Africa’s population.

The deal with Johnson & Johnson was made possible by a USD 2 billion facility granted by the African Export-Import Bank (Afreximbank), which also serves as the Financial and Transaction Advisers, Guarantors, Instalment Payment Advisers, and Payment Agents. The United Nations Economic Commission for Africa (UNECA) provided technical support with the financial arrangements and the AU Ministers of Finance’s alignment.

The Federal Democratic Republic of Ethiopia’s Minister of Health, Lia Tadesse, hailed the delivery of the vaccinations, saying, “The acquisition of these vaccines would strengthen our national COVID-19 immunization program- in addition to helping the current COVID rollout.”

The African COVID-19 Vaccine Acquisition Task Team was established in November 2020 under the African Union chairmanship of HE President Cyril Ramaphosa, President of the Republic of South Africa, as part of the African Union’s COVID-19 Vaccine Development and Access Strategy, with the goal of vaccinating at least 60% of the African population with safe and effective vaccines.

This vaccine purchase and deployment is also backed by an innovative collaboration between the World Bank and the African Union, African Vaccine Acquisition Task Team, which aims to increase access to vaccinations across the continent.

UK Export Finance invests in Six Hospitals Project in Africa

The UK’s export credit agency has granted its largest-ever loan to West Africa to encourage UK exports. UK Export Finance (UKEF) has agreed to lend EUR 241 million to NMS Infrastructure, a Sub-Saharan African infrastructure project developer.

The dual-tranche facility will assist NMS Infrastructure in the development of six hospitals under an export contract with the Ministry of Health and Public Hygiene of Côte d’Ivoire. The total project, at EUR 326 million, is for the design, construction, and equipment of six hospitals in Bouaké, Boundiali, Katiola, Kouto, Minignan, and Ouangolodougou.

It is envisaged that the project would provide equipped and contemporary healthcare locations that will serve over a million local inhabitants.

The funding arrangement makes use of both buyer credit and direct loans to the government of Côte d’Ivoire.

The development of the project has already commenced, with completion expected for 2024.

GKB Ventures, a boutique consultancy firm designated consultants to the Côte d’Ivoire’s Ministry of Economy and Finance, led a tender process for the project’s funding, together with an international loan syndicate.

MUFG Bank was named preferred lender and mandated lead arranger for the project’s finance after the bidding procedure ended.

The borrower’s legal adviser on the project was KSK Société d’Avocats, a law company in Abidjan, with Ashurst acting as legal advice to the lenders.

This project is a high priority for the government of Côte d’Ivoire, and procuring a commercial credit prior to the facility granted by UKEF “allowed the project to move quickly,” UKEF noted in a news statement on 5 August.

UKEF has allocated GBP 2 billion to new business support in Côte d’Ivoire.

HM Trade Commissioner for Africa Emma Wade-Smith said in a statement, “This record-breaking UKEF facility in West Africa underlines the UK government’s strong commitment to promoting sustainable economic growth throughout the African continent.”

Wade-Smith also stated that the loan “further illustrates the positive impact that UK businesses are having in Africa, working in collaboration with governments and the private sector to foster growth, investment, and job creation.” It also highlights the tremendous range of opportunities we see for UK firms wanting to grow and expand into new African markets.”

HM Ambassador to Côte d’Ivoire, HE Catherine Brooker, added that the project is critical for modernizing the country’s healthcare facilities, saying, “Thanks to the UK government’s support, through UKEF, UK companies are ideally placed to support infrastructure development in West Africa and seize the huge export potential that brings.”

The United States Government Donates Life-Saving HIV Medicine

The distribution of life-saving HIV/AIDS prevention and treatment drugs provided by Americans began. These antiretrovirals will be distributed to 2,144 public health facilities across Kenya’s 47 counties. Following agreements between the US and Kenyan administrations, the present deliveries are doable. Antiretrovirals and other medical supplies are being imported, warehoused, and delivered in a timely manner by the two governments.

“The United States has fought HIV/AIDS with Kenyans for decades, and we are pleased of the results,” said Eric Watnik, Chargé d’Affaires, a.i., of the US Embassy in Nairobi. “Medicines, equipment, and expertise donated by Americans have improved the lives of a generation of Kenyans and helped to manage the disease. We will continue to collaborate with the Kenyan government to achieve our shared objective of eliminating HIV/AIDS in Kenya.”

The grant will be distributed by the US government’s development agency, the United States Agency for International Development (USAID), in collaboration with Kenya’s Ministry of Health. Approximately 300,000 packs of 90-day doses of Tenofovir/Lamivudine/Dolutegravir and 4,400 packs of 30-day supplies of Atazanavir/Ritonavir are included in the current donation.

The two governments are motivated to seek a long-term solution for continuous supplies of health commodities supplied by the United States, including building processes that will improve accountability. The US and Kenya will work together to improve and strengthen Kenya’s public health supply chain, as well as to adopt comprehensive internal and external controls, to ensure that all Kenyans continue to get life-saving pharmaceuticals in a reliable and transparent manner.

In the meantime, on behalf of USAID and the Kenya Medical Supplies Authority, the Mission for Essential Drugs and Supplies (MEDS), a Christian not-for-profit organisation registered as a trust of the ecumenical partnership of the Kenya Conference of Catholic Bishops and the Christian Health Association of Kenya, will facilitate distribution.

The United States is Kenya’s top donor for HIV/AIDS prevention and treatment, and it is dedicated to the health and safety of Kenya’s 1.2 million antiretroviral users.

African SMEs in the health sector to benefit from the Digital Finance Fund.

Medical Credit Fund (MCF), a non-profit fund primarily committed to funding small and medium Enterprises (SMEs) healthcare enterprises in Africa, has received a catalytic investment of Sh900 million from the Dutch Ministry of Foreign Affairs.

The Fund, according to Maarten Brouwer, the Netherlands Ambassador to Kenya, is focused at establishing new digital finance solutions to promote investments in African health infrastructure and improve access to high-quality basic healthcare.

Because health and development are inextricably linked, achieving universal health coverage will ensure that everyone, regardless of social position, has access to high-quality healthcare,” stated Amb. Brouwer.

Amb. Brouwer announced that the funds will save small and medium-sized healthcare companies that have poor infrastructure, limited means to invest in quality improvement, and difficulty accessing capital from commercial banks during the celebrations of the first loan disbursement within Medical Credit Fund 2.

Arjan Poels, Managing Director of Medical Credit Fund, noted that the infrastructure and equipment utilised in SMEs hospitals have an impact on the quality of treatment they provide to patients who visit their facilities.

“The Covid-19 pandemic has highlighted the value of well-functioning health systems. MCF2 aims to promote equitable and high-quality healthcare by assisting clinics in improving the services they provide, according to Poels.

Poels went on to say that the MCF was founded on Kenya’s advanced mobile money ecosystem, which led the launch of its cash advance, a credit product aimed at improving access to capital for the health sector.

In his remarks, PharmAccess Foundation Country Director Kenya, Isaiah Okoth, noted that achieving Universal Health Coverage necessitates striking a balance between allowing residents to receive care without financial hardship and the availability of high-quality healthcare facilities.

MCF, according to Okoth, is using the potential of the mobile phone to increase access to quality healthcare in Africa by using digital loans. “During the epidemic, digital lending has proven critical, with Covid-19 increasing mobile money use and further lowering banks’ desire for SME credit,” Okoth added.

Most health institutions were on the verge of closure because they couldn’t get bank loans to bridge cash flow gaps or buy personal protective equipment (PPEs), according to the Foundation’s Country Director, who said that Cash Advance proved to be the solution due to its convenience and flexibility.

MCF was able to release Sh2.4 billion in 2020, and has been averaging Sh433 million per month in disbursements since the start of 2021, according to him.

Millicent Olulo Orera, MCF Regional Director Advocacy and Partnerships, stated, “We believe that better functioning healthcare markets are critical in attaining Sustainable Development Goals, particularly those connected to Universal Health Coverage.”

According to Olulo, the fund would begin operations in its present nations of operation, which include Kenya, Ghana, Nigeria, Tanzania, and Uganda, before expanding to additional countries.

Sori Lakeside Hospital in Homabay County was the first recipient of MCF 2, receiving Sh4.25 million from the Medical Credit Fund.