Into Africa – is this the future of Medtech?

Medlab Middle East, one of the world’s big showcase events for the medical technology industry, returned to the United Arab Emirates earlier this month and, for me at least, it was the first opportunity since Covid to meet existing and future clients and colleagues, face-to-face in one place.

As I wandered among the 20,000 visitors and 700 exhibition stands at the Dubai World Trade Centre, it struck me how much things have changed since the global pandemic forced us all behind closed doors.

The sheer volume of people and organisations represented at the trade event – up by more than 100% on last year – demonstrated how the industry has grown since, and partly as a result of, Covid, with significant advances in telemedicine, big data analytics, wearables, and information management.

It also served as a reminder of the growing diversity of the sector and as a gauge of where future trading opportunities might lie. An admittedly unscientific, survey of delegates’ headgear confirmed the growing influence of African companies.

The wonderfully vibrant and colourful range of hats on display served as a useful guide to where in Africa many of the latest visitors hailed from, with Ghana, Kenya, South Africa, Nigeria and Rwanda all strongly represented.

Pigeon-holed thinking about African healthcare inevitably focuses on underdevelopment and lack of healthcare.

It remains the case that the continent employs just three per cent of the global health workforce, while sub-saharan Africa bears around a quarter of the global disease burden. On average, there are still only three doctors for every 10,000 patients across the region. Yet in terms of innovation and investment in Medtech, Africa is now seeing impressive levels of growth. In 2021, some 479 healthrelated start-ups received $4.77billion in investment, compared with $379.6million invested in 180 early stage companies the previous year.

Medtech companies have shown impressive versatility in using the resources available to them to the greatest benefit. While online connectivity was not widespread until relatively recently, SMS messaging has been used extensively since the mid-2000s, allowing community health workers and hospital staff to communicate with patients. Notable commercial success stories include Wisepill, a South African company founded in 2007, whose software reminds patients, via their mobile phones, when to take medication, while also alerting doctors when a pill has been taken. Ghana-based mpharma is establishing 100 virtual centres across Africa, while Digital Afrique Telecom (DAT) and Ever Medical Technologies are jointly modernising the healthcare industry through technology and improving, facilitating, and disseminating digital medical solutions across the continent. The proliferation of Infectious diseases remains one of Africa’s biggest health challenges and dealing with the effects of Covid and implementing mass inoculation programmes proved highly problematic.

However the impact of the pandemic upon the global diagnostics industry, and the way it changed popular perceptions of mass testing, has also presented the continent with new opportunities.

Better communications and travel and a general commitment to improved professional development have combined to make doing business in Africa easier and more productive. At an anecdotal level, I spoke with a Medtech professional in Dubai who had a trademark issue and the court in Nigeria solved it in a matter of weeks.

Companies seeking to sell diagnostic tests into the continent a decade ago might have struggled to find a route-to-market outside of Oxfam or Médecins Sans Frontiers. Now they are better able to deal directly with commercial actors on the ground, who will do what they promise and pay, in full and on time. These are benefits to doing business there, not yet guaranteed in some other jurisdictions and territories, notably in South Asia where some countries have not yet restored or moved to electronic visas and so, travelling to them for trade purposes still requires you to visit their embassy or consulate in your home country to get your passport stamped. The European and American delegates whom I spoke with in Dubai generally saw Africa as a more promising territory than either India or China, in whom trust appears to have regressed, although clearly their African operations are starting from a much smaller base and India and, especially, China have their own African interests. Whereas, five years ago companies regarded manufacturing in China as a no-brainer because of its low cost, they now realise there can be a heavy price to pay in other ways. Saving a couple of digits on production costs in the short term by offshoring, might count for nothing when, as during Covid or the war in Ukraine, the global supply chain breaks down.

That is not to say Africa is trouble free. Companies can face significant disruptions in supply chains and product and service delivery as well as inadequate medicine data storage and analysis, and poor financing. Corruption and lack of resources remain problematic in some African countries where inadequate and ineffective policies, lack of experienced healthcare professionals, poor access to health equipment, and bad community and user integration with technology can all act as brakes on commercial development.

And yet many more companies now see Africa as an important market, particularly for the testing and treatment of infectious diseases. They are increasingly joining stakeholders, decision-makers, and the World Health Organisation (WHO) in raising funds and working to improve Africa’s healthcare system, particularly through technology. This is not happening because the continent has a higher incidence of infectious disease – if covid taught us anything it is that every country is at the mercy of infectious disease proliferation – but rather because they are more likely to be innovative about how they test for it.

The next few years are likely to see enormous growth in the development and production of highly accurate, low-cost, high-volume tests that can be administered by nonprofessionals. This will include testing for TB which has seen a huge resurgence in recent years.

Innovation and confidence hold the key to future development of the Medtech industry in Africa. Growing investment in new medical technologies can facilitate more and better opportunities for investors, scientists, product developers and manufacturers across the continent.

By the time of the next Medlab Middle East trade event we may see an even greater and more diverse range of hats, reflecting a stronger influence of African companies in the industry.

Ivor Campbell is Chief Executive of Callander-based Snedden Campbell, a specialist recruitment consultant for the medical technology industry.

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