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 This Act was repealed in the 1980s, but investors would need assurance that nothing similar would happen again.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.

Pharmaceutical Supplier Shelf Life Raises US$3.6 Million Equity In Africa

Shelf Life is a revolutionary pharmaceutical inventory management subscription service launched in Abuja in 2017 and has expanded to Kenya. Within that time, through their business model of supplying pharmaceutical products to community-based outlets, it has received widespread acceptance.

The service, provided by social enterprise Field Intelligence, is active in 50 retail locations in Kenya, with over 500 life-saving medicines and essential products being supplied on a pay-as-you-sell basis. In Kenya, there are about 5,840 privately-owned community pharmacies licensed by the Pharmacy and Poisons Board, compared to approximately 4,700 government health facilities.

With the concept gaining popularity, Field Intelligence has been seeking to raise funds to expand to more shops both in Kenya and Nigeria. To this front, the company has announced the successful closing of its Series a funding of US$3.6 million equity.

The US$3.6 million equity raise will fund the scale-up of Shelf Life, the technology-enabled supply chain finance platform for pharmacies in Africa. The Series A funding round was led by Blue Haven Initiative-early-stage private equity firm with a focus on energy, fintech, logistics and human capital ventures in Sub Saharan Africa, with a portfolio that includes CrossBoundary Energy, M-KOPA, Paystack, Shortlist and Twiga Foods.

Other investors including Newtown Partners via the Imperial Venture Fund and Accion Venture Lab.

Michael Moreland, Co-Founder, and CEO, Field Intelligence, says, “We’re delighted to welcome new investors into the business. They share our vision for catalyzing change in a huge and vitally-important sector. They bring deep fintech and logistics experience, which will be vital in helping us build a new generation of healthcare supply chains in Africa and beyond.”

Shelf Life’s pharmacy clients can subscribe to over a thousand quality-assured and price-stabilized drugs from 50 medical, health and wellness categories. Using Field Intelligence’s technology platform, Shelf Life forecasts, procures, delivers, manages, and finances each product the pharmacy has subscribed to.

Over 280 community pharmacies in Nigeria and Kenya have now subscribed to Shelf Life, making it one of the largest networks of pharmacies on the continent. It is making the business of community pharmacy less risky and lower-cost while improving access to an expanded selecion of higher-quality medicines.

Since inception, Shelf Life has maintained 96% stock availability for its clients, up from a pre-Shelf Life baseline of 60%. As an alternative to traditional inventory finance, Shelf Life costs pharmacies between 60 and 82% less than traditional loans freeing these small retailers from prohibitively expensive capital.

Advisory support to this transaction was provided by CrossBoundary through USAID’s invest program funded by the USAID Southern and East Africa Regional Missions in support of the US Government’s Prosper Africa initiative.

The annual pharmaceuticals market in Africa is valued at over $60 billion. For 80% of people in Africa, their community pharmacy is the frontline of the health system and yet they routinely stock out of essential medicines, incur significant losses to expiry and struggle with substandard and falsified drugs. These inefficiencies cost the health system millions of dollars each year and limit access to quality care.

According to the company’s research, 60% of community pharmacies frequently stock out of essential medicines and 55% are without access to stable supply and finance.

Lauren Cochran, Managing Director, Blue Haven Initiative says, “Shelf Life is a proven platform to transform access to medicines through Africa’s private community pharmacy market. The design and development have been done on the ground in Nigeria and Kenya and there’s a real experience in the team of what it takes to deliver at scale in African health systems.”

Kenya – Ministry Of Health To Host A First Of Its Kind Healthcare Convention

In efforts to promote Kenya as a regional healthcare hub and healthcare investment destination, Amref Health Africa has partnered with Express Communications Limited, publishers of the Kenya Medical Directory, and the Ministry of Health to host a first of its kind healthcare convention.

The first Kenya Healthcare Convention taking place from March 9 and March 10 in Nairobi is set to bring together more than 350 industry providers to showcase their quality health service approaches, products and technologies to potential customers. This forum offers investors an opportunity to advance medical service delivery through Kenya to the East African region.

East Africa boasts a population of over 132 million people, with a projected 5.7% growth in GDP (the highest in the African region), making it a promising investment destination. Kenya is strategically positioned and regarded as a business hub within the East African Community. The country’s growing middle class (about 45% of the total population) has brought about a rise in demand for quality health care.

Drawing on Kenya’s years of experience in developing a robust private sector in health care and other industries, coupled with a clear strategic framework within the public sector aligned to economic growth and advancing social protection through the Big Four Agenda, the Kenya Healthcare Convention will foster important partnerships for the country and the region and stimulating discussions around promoting Kenya for medical tourism.

The two-day convention seeks to highlight achievements from the counties since the devolution of health services and showcase leading companies, institutions and organisations successfully providing services in this industry, drive engagement on the milestones, achievements and challenges in health service delivery and showcase collaborative achievements between government and private sector and how this has helped position Kenya as the health care hub in the region.

“We cannot speak of the right to health without quality care. Quality is a critical dimension of social justice and human rights principles and one of the essential pillars of universal health coverage. The overall quality of care by private and public providers in our health system is what will set Kenya apart as a regional health care destination,” said Dr Meshack Ndirangu, Country Director, Amref Health Africa in Kenya.

“Among other outcomes, the Kenya Healthcare Convention is expected to set in motion the formation of a multi-agency, government-industry partnership to promote Kenya for medical tourism, as well as kick off the process of developing a Medical and Wellness Tourism Policy for Kenya,” said Sammy Masara, CEO Express Communications Limited.

The Ministry of Health will launch two key documents at this inaugural event – the Quality of Care Certification Manual and Quality of Care Certification Framework for the Kenyan Health Sector, marking a key milestone in the nation’s quality improvement efforts.

The inaugural Kenya Healthcare Convention is also expected to catalyse the identification of a range of national government agencies and policy initiatives to stimulate and promote medical tourism in Kenya.

Tanzania Govt To Improve Healthcare In EACOP Corridor

The team visited the health facilities in Gomba, Ssembabule, Lwengo, Rakai and Kyotera districts while the health facilities in Nwoya, Buliisa, Kikuube, Hoima, Kakumiro and Mubende districts were previously assessed in May 2019. As part of wider reforms tailored to improving health service delivery in the East African Crude Oil Pipeline (EACOP) corridor, the government is planning a raft of major reforms in the health centres in the districts surrounding the oil region.

According to the Permanent Secretary Ministry of Health Dr Diana Atwine, this will be part of the government’s efforts to revamp the districts health sector and improve efficiency to meet the required standards to benefit all the relevant stakeholders who are going to work in EACOP.

Most of the health facilities will be enhanced with standby ambulances, emergency units, fridges for blood storage as well as re-modeling and refurbishment of some facilities, said Dr Diana.

“Additional equipment will also be provided especially in the operating theatres as well as recruitment of supplementary staff,” Dr Diana continued.

Dr. Joseph Kobusheshe, the Director Environment, Health, Safety and Security Management at PAU said a lot of attention has been given to the development and application of environmental and health management systems as an integral parts of the oil and gas business frameworks.

Dr. Elly Muhumuza, the Chairperson LCV Sembabule district; expressed happiness that the health facilities will be upgraded to international standards, which will be a direct benefit to the local communities.

Anti-Cervical Cancer Awareness Mission in Tanzania

Prof. Faustin Kamuzora, The Regional Administrative Secretary (RAS) has appointed for intensive efforts to ensure that no woman or girl dies from cervical cancer.

He emphasized the importance of screening for early detection of cervical cancer which can be treated and urged parents and guardians not to miss out on the great opportunity of having their children immunized.

He reassured the public that the vaccine was safe and approved by the government and WHO and would be provided free of charge at all health facilities.

Prof Kamuzora, however, noted that to date, the regional vaccination average against cervical cancer was far below the national average set at 80% with the regional average ranging between 53 -64%.

Five screening centers were set up in Bukoba Municipal Council- Buhembe, Kashai, Rwamishenye, Bukoba Referral Regional hospital, and Zamzam.

At the regional level, 64 centers would provide the service. Tanzania achieved a historical milestone to roll out a Human Papilloma Virus (HPV) vaccine against cancer of the cervix.

A safe and effective Human Papilloma Virus (HPV) vaccine when provided to young girls between 9 and 14 years old, protects them against HPV and cervical cancer.

The Vice-President, Ms. Samia Suluhu Hassan, launched the programme last year and emphasized the importance of screening for early detection of cervical cancer which can be treated.

“The first beneficiaries of this vaccine would be girls aged 14 as we prepare to extend the vaccination to the rest of the girls. In order to get the girls to return for their second dose requires new routine delivery services and a good social deployment strategy,” she said.

The government’s assurance to reach the vaccination target of 616,734 girls, she acknowledged.

She commended the government’s decision to introduce the HPV vaccine in the country aimed at reducing mortality and morbidity caused by cervical cancer.

She congratulated the government for making a high-level decision and commitment towards the reduction of preventable childhood illnesses and deaths.

“This is an important milestone in the history of Tanzania, to join the fight along with other countries in the world to prevent mortality and morbidity due to cervical cancer. To achieve the full benefit of the HPV vaccine, it must be given to all targeted children regardless of where they live or how hard they are to reach.

IAEA Assisting Ethiopia To Control Cancer With New Radiotherapy Machine

Ethiopia has only one radiotherapy machine, but the country’s new government commenced office 16 months ago and has determined plans to change that with the support of the IAEA and other development partners.

The government is acquiring new equipment, constructing a new, 8-floor oncology center in the capital Addis Ababa, and is assigning doctors trained through IAEA fellowships to regional hospitals, where some of the radiotherapy machines will go.

“Excessively time had been spent with little progress and we are working to change that,” said Wendmagegn Gezahegn, Head of the St Paul’s Hospital in Addis Ababa, which looks as much as a construction site in a boomtown as a functioning hospital. Founded by Emperor Haile Selassie in the 1960s to cater to the poor, it is the country’s second-largest hospital and once the current expansion project is completed in the coming years, it will be the largest, with close to 5000 beds, fit to treat half a million patients per year.

The new wing will include an oncology center with 350 beds and 5 linear accelerators (Linac) machines and brachytherapy units for cancer treatment, as well as a new cyclotron facility to produce radiopharmaceuticals for diagnosis and treatment of diseases. The construction of the bunkers that will house the radiotherapy machines for the safe operation will begin in the coming months, while the room to hold the cyclotron is already being built.

Wendmagegn Gezahegn, Head of the St Paul’s Hospital in Addis Abeba, and his colleagues reviewing the plans for a new cyclotron facility to be installed in a hospital wing currently under construction.

“The key to planning is to make sure that every machine has a maintenance plan, we need to budget more than just the purchase cost,” Gezahegn said. And indeed, one of the country’s two Cobalt-60 radiotherapy machines has been out of service since 2015 in Addis Abeba’s Black Lion Hospital due to lack of funding to repair it.

In parallel with the construction and procurement of the machines, the country also needs well-trained oncologists, medical physicists and radiology technicians and has turned to the IAEA for support.

Radiotherapy machines in two of these centers, Jimma and Harar, have been purchased and are being set up, while another three centers are under preparation.

The Government of Ethiopia plans to decrease waiting times for radiotherapy treatment by acquiring more equipment and train its staff with IAEA support.

Oncologists and public health officials are well aware that Ethiopia has a lot of catching up to do: the IAEA recommends four radiotherapy machines per one million people, a ratio that will take many expansion projects and several decades to reach. As of now, authorities hope the country will soon have nine functioning machines.

Gezahegn said that “Ethiopia is evolving rapidly and it is important that the economic growth means an improved standard of living nationwide.” “Providing access to cancer services, including radiotherapy, is a key component of that.”

A challenge that remains is the training of radiotherapy technicians. A curriculum for local training has been under approval for years, so in the meantime, technicians need to be sent abroad to be trained to operate radiotherapy machines, said Wolemariam.

“Development of local training schemes is key to the implementation of the services,” explained Kirsten Hopkins, Radiation Oncologist at the IAEA. “It is not feasible to provide expatriate training for the numbers of staff required for all the planned facilities.”

The IAEA has provided Ethiopia with training and expert advice on the new course curriculum and will continue to provide support through its technical co-operation program, she added.

The country’s radiation protection authorities are gearing up for the licensing of the new equipment, said Solomon Mekonnen, Director General of the Ethiopian Radiation Protection Authority. “We have been involved since the early stages of the radiotherapy expansion process and will do our best to authorize the equipment quickly, assuming all safety conditions are met,” he said.

Almost all of the Authority’s 40 technical staff, including those in the licensing department, have received training via IAEA fellowships and courses, Mekonnen said.

Having all stakeholders, ministries, authorities, health experts work together is key to making a difference, said Sandokan Debebe, Director General of the Technology and Innovation Institute of Ethiopia, which coordinates the IAEA’s projects in the country. “We have a holistic view to make sure that all angles are covered, and no future machine will sit idle due to lack of funds for repair or expertise to operate or license them,” he said.

Africa Cut Down TB Antibiotic Medicine Price By 66%

The price of TB antibiotic medicine – rifapentine, was cut down by 66% by its manufacturer Sanofi. When combined with another antibiotic (isoniazid), rifapentine can prevent tuberculosis (TB) disease. This good news was broadcast at the Union World Conference on Lung Health.

Talks to lower the price from US$45 to US$15 for a three-month course took more than a year to complete and involved Sanofi, Unitaid and the Global Fund to Fight Aids, Tuberculosis, and Malaria, in collaboration with the Stop TB Partnership’s Global Drug Facility and the United States PEPFAR initiative.

Advocates have been insisting on price lower the price of rifapentine medicine since the scientific effect of this medicine was proven in peer-reviewed journals. Three months of treatment with rifapentine plus isoniazid was shown to be just as effective as and less toxic than one year of therapy with isoniazid alone (the previous standard). The reduction in treatment time alone provides an obvious improvement.

The World Health Organisation (WHO) reviewed its guidelines for preventing TB disease. The guidelines now include three months of rifapentine and isoniazid taken weekly for people living in countries with a high TB burden. This routine is known as 3HP.

The WHO recommends that anyone living with HIV and those living in the same household as a person with TB disease should receive TB preventive therapy. The theme of 2019’s World AIDS Day was “Ending the HIV/AIDS epidemic: Communities make the difference”. Reaching this goal requires that preventive treatment programs engage with communities to develop, refine and bring to scale interventions designed to meet the needs of people with and vulnerable to HIV and TB.

Importantly, the 3HP regimen can be administered along with dolutegravir, a better antiretroviral drug that is now being provided in South Africa and globally. A combination is an effective tool for keeping vulnerable people as healthy as possible.

All prevention programmes must begin by finding people who need TB preventive therapy. People living with HIV can be identified through HIV clinics. Contacts of people with TB disease can be identified by investigating affected households. People must always be screened for TB before starting TB preventive therapy.

In 2018, the member states of the United Nations committed to expanding the number of people receiving preventive treatment to at least 30 million by 2022. But the world is nowhere close to meeting that goal. It will take a lot of work to achieve these targets.

As the price of Sanofi’s rifapentine product Priftin cut down, now it can be more accessible to the public. If Priftin has not been approved for use in a country that needs this treatment, national TB programmes can work with the WHO and local regulatory authorities to process waivers.

Treatment for latent TB infection has been available since the 1950s, yet very few people who could benefit from TB preventive therapy are taking it. This price break making a shorter and equally effective treatment more affordable and perfect opportunity to make a dent in these numbers.

Kenya Targets To Achieve A Free Nation Against HIV/Aids By 2030

First Lady Margret Kenyatta led the nation in marking the 31st World Aids Day in a colorful function at Gusii Stadium in Kisii County.

Speaking during the event the First Lady said the community and families need to sacrifice in the fight against the global menace noting that everybody needs to contribute towards the country’s challenge of achieving an HIV/AIDS-free nation by 2030.

She said efforts to eliminate HIV are central to the government’s health promise for Universal Health Coverage (UHC) and strengthening health systems and increasing access is essential to the government’s program.

Cabinet Secretary for Health, Cecily Kariuki said that they recognize how the HIV/AIDS epidemic in Kenyan counties has been managed with great milestones recorded by the government.

Kisii Governor James Ongwae said the county has given 50% towards the health sector in the county adding that the county is working hard to ensure there is quality health service delivery to Kisii residents.

He noted with the Sh2.5 billion funds they are soon launching the construction of a cancer center facility to help residents cut on travel expenses to Kenyatta National Hospital or the Moi Teaching and Referral Hospital.

Dr. Nduku Kilonzo, the Chief Executive Officer, National Aids Control Council (NACC) said that Kenya had taken bold steps towards tackling HIV/AIDS.

Newly Installed Cancer Treatment Equipment Saves Tanzania

Newly installed cancer treatment equipment at the Ocean Road Cancer Institute (ORCI) has for the past one year facilitated the treatment of over 200 patients whose conditions were supposed to get the service abroad.

If referred to hospitals abroad, particularly India, it could have cost the government between 50m/- and 70m/- for each patient, which implies that a considerable amount of money ranging from 10bn/- to 14bn/ was rescued.

The Executive Director of the ORCI, Dr. Julius Mwaiselage, said the facility installed the new radiation therapy machines called medical linear accelerators (LINAC), worth 9.5bn/-, which started functioning from September last year.

He was briefing the media on the achievements that the ORCI made during the four years of President John Magufuli’s regime.

With 80 percent of cancer patients in the country needing radiotherapy, the government took a bold move to strengthen the availability of the services domestically.

The capacity of the hospital has increased from serving 180 patients to 300 patients per day, he revealed, noting that the government has been increasing the allocation of the budget for purchasing medicines.

The budget for anticancer drugs shot up from 790m/- in 2015 to 10bn/- this financial year, which increased the availability of drugs by 95 percent from only 4 percent.

“This is a never-ending achievement and the institute has been an exemplar in the East and Central zone of the region,” he said.

ORCI’s financial measures have helped a steady rise in revenues collections from 569m/- in the 2014/15 fiscal year to 14.7bn/- during the 2018/19 financial year.

Such measures include new sources of revenues such as pharmacy and enhanced service delivery.

On the institute’s future plans, Dr. Mwaiselage said processes are underway to purchase a new Positron Emission Tomography – Computed Tomography (PET-CT), disclosing that the government had already disbursed 14.5bn/- for that purpose.

The PET-CT scan is a diagnostic examination that involves getting images of the body based on the detection of radiation from the emission of positrons.

It gives detailed information, including the exact representation of certain types of cancer and their metastasis. Hence, it is possible to display not only the cancer itself but also its activity.

The method fits very well by checking the effects and success of the therapy used. Through consultation, PET-CT can determine the exact position, size, activity, and development of cancer in the entire body.

The tender process to purchase the PET-CT has started and expected to complete in April next year.