24 July 2019, Cape Town, South Africa: Though the public healthcare sector in South Africa is buckling under pressure from unprecedented demand, it is faring than its peers in certain areas. However, delegates to the 20th annual BHF conference heard that the public healthcare system in the country has to leverage the power of technology to close performance gaps and facilitate universal access to healthcare.

Leading international industry players presented to delegates on the second day of the conference and shared important learnings from their countries on how universal health coverage can be obtained, and how technology can be harnessed to improve the efficiency of universal healthcare propositions such as the National Health Insurance (NHI).

Charles Dalton, Senior Health Specialist at the the International Finance Corporation (IFC), shared statistics from Healthdata which showed that South Africa was making encouraging progress in the quality healthcare table. Measured using healthcare access and quality (HAQ) metrics, South Africa is ranked 127 on the quality healthcare table and achieved a score of 50 on HAQ. The country trails Brazil, its counterpart in BRICS, which scored 64 on HAQ, and Turkey, which notched 74.

However, South Africa scored 62 HAQ on breast cancer, Brazil 63 and Turkey 70, while South Africa recorded 60 HAQ on cervical cancer, Brazil 56 and Turkey 63. On stroke and diabetes, the country notched up 53 and 24 respectively, while Brazil recorded 41 and 58 and Turkey 66 and 71 respectively.

Kenya was singled out as a country with the second-best healthcare system in sub-Saharan Africa.

“There are numerous variables that need to be considered when designing systems that allow successful universal healthcare delivery by 2030. These include understanding different country’s nuances and cultures, understanding that healthcare systems can never successfully operate in silos, and understanding the true value of collaboration between the public and private sectors,” said Dalton.

The sharing of trends and data was also highlighted as one of the most overlooked elements when it comes to developing an effective healthcare system. “There is an identified need for the smart usage of captured data; this means that neither private nor public healthcare administrators can continue functioning in silos,” Dalton added.

Recent studies have found that over the past decade there has been a significant decrease in non-communicable diseases in sub-Saharan Africa and an evident increase in communicable diseases. “The point of concern that should be currently addressed is the reality that sub-Saharan Africa currently does not have systems in place to effectively attend to and manage the rise in non-communicable diseases,” said Dalton. He further added that the value of healthcare can be measured through the quality of care over the cost of care.

Though universal access to healthcare remains an ideal that countries in the region should strive towards attaining, Dalton cautioned that the systematic trust deficiency caused by corruption with government-run programmes is one of the key concerns that should be addressed.

“What is needed to ensure that universal healthcare is attainable is creating a system where established systems and delivery of quality healthcare services are enhanced by technology. There is an evident need to embrace technology to heighten the function and delivery of healthcare professionals,” said Dalton. 

Leon Wang, Executive Vice President and International President of multinational pharmaceutical and biopharmaceutical company AstraZeneca, shared his company’s experience in China, saying that AstraZeneca optimised the usage of new generation solutions such as the internet of things (IoT), big data and data analytics to facilitate access to healthcare.

China is among the pioneers of a national healthcare system, with 95% of its healthcare funded through the public sector (government) and only 5% funded through the private healthcare sector (medical schemes).

Sharing best practice insights, Wang said AstraZeneca established one-stop centres in China that utilise smart solutions, such as artificial intelligence (AI), to increase early detection of diseases such as prostate and lung cancer.

The deployment of these smart solutions has significantly improved diagnosis and treatment. For example, diagnosis times for lung cancer have been reduced from 21 to seven days, and approximately 400 000 patients have been recorded to date having been through a lung function test.

Wang emphasised the importance of developing a patient-centric system and pointed out that the success of a universal healthcare system can only be measured through key patient outcomes. “The effective use of inexpensive technology is one of the solutions that can be utilised to create a climate where healthcare becomes a one-stop service that not only saves money, but time,” added Wang.

Citing his organisation’s successful operations in China, Wang alluded to the importance of harnessing the power of new generation solutions such as AI and robotics to facilitate access to healthcare and improve the patients’ experience.

Having developed successful smart healthcare centres in his native China, Wang alluded to the importance of marrying robotics, technology and capable healthcare professionals to enhance the patient experience.

Dr Katlego Mothudi, Managing Director of the BHF, said there is a close correlation between economic growth and quality healthcare. “Healthcare should be understood as a value, not a cost. Access to quality healthcare leads to higher productivity, more jobs and improved economic performance,” he said. He pointed out that 60% of countries still lack access to UHC, and said that South Africa has a window of opportunity to reverse the losses incurred under the current healthcare setting and draw lessons from other countries where Universal Healthcare has been implemented and adapt learnings to the South African context.

“While under the current setting there is a high administrative wastage due to lack of systems integration, operational waste accruing from inefficient processes, poor linkages, poor management of procurement, clinical waste resulting from delayed access, and poor quality and ineffective management of chronic diseases, there are also opportunities for efficiency gains under the NHI; as NHI is better placed to reduce administrative, operational and clinical waste,” explained Dr Mothudi.