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Public Private Partnerships Driving Cold Chain Innovation for COVID Vaccine Transport in Africa

African woman giving man a vaccine

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Public Private Partnerships Driving Cold Chain Innovation for COVID Vaccine Transport in Africa

By: Leah Ngari 

Estimated Reading Time: 3 minutes 

According to the World Health Organization, Africa is far from ready for the continent’s largest immunization drive. Data collected by the WHO on immunization readiness from 40 countries revealed only a 33% readiness to roll out the vaccines, a figure that is well below the recommended 80%. In many of the continent’s countries, the complex task of acquiring, distributing, and administering the vaccines is made more difficult by the lack of infrastructure, including electricity and good road networks.

Despite increasing urbanization, more than half the population on the continent lives in rural areas. Governments alone do not have the tools or resources needed to transport, store, or track the vaccines during their journey to remote villages and once they arrive at off-grid clinics. Getting the currently available COVID vaccines to Africa’s rural populations will require cooperation between the public and private sectors.

Ideal Transportation of the Vaccine

Most currently available vaccines require maintaining a cold chain during transportation and storage. The Pfitzer vaccine needs to be stored at -70°C, while the Moderna Vaccine needs to be stored at -20 °C. Regular refrigerators, however, do not typically cool below 2°C. The two vaccines would be viable for a much shorter time at that temperature, which risks causing massive wastage from the lack of proper infrastructure to keep them viable enough time until they reach their destination. 

infographic showing the transport of vaccines

What’s working for the continent?

While the Covid vaccine rollout has highlighted the need for effective cold-chain infrastructure on the continent, establishing cold storage and transport solutions across the continent will have a lasting positive impact on food security, farmer income, and public health beyond the current crisis

Below are some of the private-public collaborations working on mapping out and implementing cold-chain logistics in the upcoming vaccination drive:

The Africa Center of Excellence for Sustainable Cooling and Cold chain (ACES)

Operating out of the University of Rwanda, the ACES is a new project to establish and maintain a suitable cold-chain that will link the continent’s logistics providers and farmers with experts and investors. ACES aims to minimize post-harvest food loss and medicine wastage on the continent, improve urban diets, and increase food exports. Researchers are currently identifying Rwanda and Africa’s cold needs to understand how to design the most efficient cold chain solutions.

Arktek Cold Storage Device

The current pandemic is not the first time the continent required cold storage for a vaccine. During the 2014-2016 Ebola outbreak, a vaccine developed by Merck also needed to be stored at around -70°C. The Arktek Cold Storage Device was introduced to Sierra Leone in 2014 and helped transport vaccines that immunized hundreds of thousands of Africans. 

Global Good, now part of the Bill & Melinda Gates Foundation, developed the device in partnership with Acuma, a Chinese refrigeration company. The device acts like a super-thermos that can maintain temperatures of up to -80°C without using any batteries, electricity, or solar panels. Arktek’s devices are small enough to transport easily and strong enough to withstand harsh transit conditions, making them ideal for transporting vaccines to hard-to-reach places on vehicles, motorbikes, and boats. Countries could use the device to deliver Covid vaccines to people in remote areas without equipped hospitals. 

Use of Solar Technology for Transportation

Electricity on the continent is not widespread, but sunlight in most Sub-Saharan African countries is abundant and cheap. As a result, public bodies and startups have started working together to develop a solar-powered refrigeration device to keep the vaccines cold during storage and transport.

PEG Africa, a for-profit solar energy company operating in West Africa, builds solar-powered off-grid solutions for the rural West African market. Some of its products include and pay-as-you-go solar-powered freezers for fishermen and women and solar-powered water pumps for small-holder farmers. Now, the company is collaborating with Power Africa, a public-private partnership facilitated by USAID, to provide solar-powered systems to off-grid clinics in Africa

Another company driving cold-storage innovation on the continent is Gricd, a Nigerian startup that has designed solar-powered smart cold boxes. Gricd’s goal is to minimize waste of food, medicine, and medical supplies such as blood and plasma and solve the “last mile” problem in rural and remote areas. Since Covid started, the company has been helping transport Coronavirus test samples from remote locations, and its cold boxes are in the process of acquiring PQS certification from the WHO

Private-public partnerships driving innovation in cold-chain infrastructure  

Private-public partnerships are leading the way for cold-chain innovation on the continent. These types of partnerships will grow as African countries continue their race against time to deliver vaccines to their populations. The cold storage solutions designed for Covid vaccine transport will continue to serve the continent long after the pandemic is managed. 

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Covid’s Impact on Consumer Spending in Africa

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Covid's Impact on Consumer Spending in Africa

By: Shira Petrack 

Estimated reading time: 4 minutes

The Covid-19 pandemic has caused a recession in Africa for the first time in twenty-five years. The World Bank calculated that the considerable drop in economic activity will cost the region at least $115 billion in output losses in 2020 alone.

Some worry that the restrictions affecting entrepreneurs and small businesses will affect the trajectory of Africa’s middle class for years to come. But the middle class also includes a large share of young people age 15-24 who drive consumer trends in food, entertainment, and connectivity. In the aftermath of Covid-19, this generation will exercise an even greater influence on Africa’s consumer demand trends. 

Covid’s Economic Impact 

In a high-frequency phone survey of Malawi, Nigeria, Uganda, and Ethiopia during May-July 2020, the World Bank found that 77% of households had lost income due to the pandemic. Business income represented the most common source of lost revenue in all four countries, although there were some disparities in the findings: Ethiopians reported significantly less wage income, farm income, and remittances losses than the other three countries. In all four countries, concern about the financial threat of Covid-19 was greater than worry over the virus itself. 

An SMS poll of Kenya, South Africa, Nigeria, Côte D’Ivoire, and Mozambique conducted by GeoPoll during June-July 2020 revealed similar findings: 76% of respondents reported income losses, with almost half (49%) stating that their income decreased “a lot.” In a follow-up survey conducted in November 2020 in the same five countries plus the DRC, the percentage of respondents who told GeoPoll that their income had decreased a lot since June 2020 had increased to 52%. Another 27% stated that their income had decreased a bit. All in all, almost 4 out of every 5 people surveyed experienced a loss of income during this period. Interestingly, although more people reported income losses in the November survey, only 65% of respondents were concerned with paying their expenses, compared to 71% in June. 

Africans are Spending Less 

A majority of respondents, including those who have not experienced a recent loss of income, told GeoPoll that they expect to spend less this holiday season. This thrifty attitude should change by next year’s holidays. A September consumer sentiment survey conducted by McKinsey in South Africa, one of the hardest-hit countries, found that 69% of respondents do not expect the financial impact to last more than a year.  

The younger generation (aged 15-24) is the most optimistic both about the length of the economic impact and their future income prospects. They were also the least likely to report that their income decreased “a lot.” 

Effect on E-Commerce is Varied

The pandemic’s effect on e-commerce has been mixed. The World Bank found that sales decreased for most specialized e-commerce companies, whereas most third-party online marketplaces saw increases in sales. In South Africa, McKinsey found a 90% growth in online purchasing on average across most categories, with online purchases of alcohol, snacks, personal care products, and groceries growing over 100%. GeoPoll, on the other hand, found an overall decrease in online shopping among its respondents, perhaps due to the general decline in spending. 

Small businesses all over the continent are joining digital sales interfaces for the first time. Savvy entrepreneurs are capitalizing on the increased demand by building e-commerce platforms or integrating them into their existing offerings. In March, SafeBoda, a Ugandan rideshare app with an emphasis on safety that matches passengers with motorcycle drivers, launched a food delivery service shortly before the country went into lockdown. Several days later, the company launched a delivery service for food, groceries, and essentialsFlutterwave, a payment platform, set up an e-commerce portal that allows merchants to set up virtual shops and receive payments through Flutterwave. 

Bringing more shoppers to these new online stores depends on improving connectivity on the continent and making it more affordableGovernments can enact regulations to encourage competition in the space. Since young Africans are more likely to use the internet than their older counterparts, their online shopping habits will shape the future of e-commerce in Africa.

The Restrictions’ Collateral Damage  

GeoPoll found that residents of countries that had enacted the most severe restrictions struggled the most financially and experienced the most emotional stress. In hindsight, the lockdowns’ economic cost may outweigh the benefits.

The region has surprised experts in its resilience to the virus. With the exception of South Africa, where over 28,000 people have died from Covid-19 to date, Africa’s average case-fatality ratio (number of deaths per diagnosed cases) is significantly lower than the global average. The continent as a whole has recorded a little under 3 million Covid cases – significantly less than the 250 million that some experts were predicting. While the lockdowns undoubtedly slowed the virus’ spread, many have attributed Africa’s success with the virus to the low median age in the region – the median age in SSA is 18.7 compared to 43.1 in Europe.

The overall public health benefits of the restrictions are also not yet known. For instance, the World Health Organization predicted that the Covid-related disruptions reducing access to treatment will lead to an estimated 20,000-100,000 increase in malaria deaths, depending on the extent of the disturbance, compared with the approximately 40,000 deaths in 2020 caused by Covid-19 in the region.

Looking forward to 2021

It is always hard to predict the future – and it seems downright impossible to do so amid a novel global pandemic. However, one thing is sure: Africa’s youth will play a key role in Africa’s post-Covid economic recovery.

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4 Healthcare Companies in Africa Leveraging Technology to Drive Innovative Solutions

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4 Healthcare Companies in Africa Leveraging Technology to Drive Innovative Solutions

By: Leah Ngari

Introduction

Africans have been living steadily longer lives over the past 20 years. Despite this progress, however, the average life expectancy at birth in Sub-Saharan Africa is only around 61 years – by far the lowest in the world, and over 10 years lower than the world average of 72.6.

Healthcare in Africa
Data source: United Nations, DESA, Population Division, World Population Prospects 2019

The increase in longevity over the past two decades are due in large part to reductions in childhood mortality, increased access to medical treatment for AIDS/HIV, and improved nutrition. But as the continent continues to tackle last century’s epidemics, new health threats are emerging. As the population on the continent gets older, the prevalence of non-communicable disease, such as cancer and heart disease, will continue to increase, taxing the already greatly overburdened healthcare system.

Healthcare in Africa is strikingly underfunded compared to the global average. Sub-Saharan African (SSA) governments spend, on average, a quarter of the global average government health expenditures in terms of relative budget share. While some of the difference in spending is offset by private and public development assistance funds, current health expenditures per capita are less than 10% of the world average. According to the World Health Organization, Africa shoulders 24% of the world’s disease burden, but only 3% of the world’s health workers working with less than 1% of world health expenditures.

Everyone should have access to basic healthcare; yet this right remains unattainable by many Africans. With an estimated population of about 1 billion people that keeps growing, most public health systems in Africa are straining to keep up. And with so many urgent demands on the national budgets, countries find that increasing government spending on health is not always feasible.

However, it’s not all gloom on this continent. Despite the challenges faced, many have found creative and innovative ways to improve different aspects of healthcare in Africa. Governments are using data and technology to improve healthcare despite the financial constraints. And by focussing on delivering specific services in an optimal way, the private sector has stepped in to deliver results where they are needed most. The following companies and projects showcase the region’s exceptional ability to solve problems by inventing and adopting new systems and technologies.

Innovative Public Health Solutions from Around the Continent

1. LifeBank – Nigeria


Patients in Nigeria, like in every other country around the world, often need a blood transfusion to stay alive. Unfortunately, not all hospitals have enough blood for all the patients. Temie Giwa-Tubosun, the company’s founder, describes LifeBank as a “technology and logistics start-up.” The company uses technology to identify available blood, communicate the whereabouts and availability of the blood to the company’s clients, and then pick up and deliver the available blood based on the client’s request. Lifebank works with motorbike riders who store the blood in cooling devices while awaiting notifications on where to transport the blood. The company’s app also helps users sign up as blood donors, further optimizing the blood supply chain.

LifeBank has been quick to mobilize In the face of the coronavirus pandemic: the company has diverted resources to create a national register of hospitals with working and broken ventilators, respirators, and ICU beds to prepare the country for the treatment of future COVID-19 patients.

2. Zipline – Rwanda


This California-based company partnered up with the Rwandan government to kickstart the use of drones in the health sector. Rwanda’s very hilly terrain and lack of extensive road networks makes it hard to transport goods and provide services to areas far from the capital city, Kigali. Patients in such remote areas are vulnerable to succumb to an array of treatable illnesses just because they couldn’t get a blood transfusion or medical supplies on time.

Zipline solves this problem by using drones instead of traditional trucks to transport vital health products across the country. Since 2016, Zipline has transported blood and medical supplies to some of the most remote parts of Rwanda, sometimes cutting delivery time from over three hours to fifteen minutes.

In 2019, Zipline expanded to Ghana, delivering much-needed vaccines, blood, and other health products on demand. It continues to scale its operations, and has plans to expand further within and outside of Africa.

3. Praekelt.org – South Africa


In 2019, around 22 million people, or one-third of the population, used smartphones in South Africa – and this number is steadily rising. Increased smartphone penetration makes it easier for the government to communicate efficiently with its citizens and relay critical public health information.

South Africa has the largest number of coronavirus cases in SSA to date, but the government reacted quickly and efficiently using the means at its disposal. A strict lockdown has proved effective in slowing the spread of the virus. And thanks to the rise in smartphone use, the South African government has been able to save lives by delivering urgent information concerning the Coronavirus to its citizens.

The South African government has partnered with Praekelt.org, a local non-profit, to develop a Whatsapp bot that would reply to South Africans’ questions on the pandemic. The service answers questions on a variety of topics related to the pandemic including symptoms, available treatments, and debunking myths.

In late March, after 2.6 million South Africans successfully used the platform to receive accurate and potentially life-saving information about the virus, the World Health Organization (WHO) adopted the technology. The WHO Health Alerts launched on March 20, and surpassed 10 million users in just three days.

4. diaTROPIX – Senegal


The diaTROPiX initiative was launched in 2018 as a collaboration between Institut Pasteur of Dakar, the French National Research Institute for Development (IRD), and the Mérieux Foundation with the purpose of producing fast diagnostic tests that would facilitate the control of tropical diseases in Senegal. The initiative grew out of a collaborative work on creating a field diagnostic test for the Zika virus.

Now, thanks to a grant from UK AID, diaTROPIX scientists are teaming up with UK-based diagnostic specialist Mologic to design and manufacture testing kits for the Coronavirus that will allow health officials to test individuals for the virus at home and receive the results in ten minutes, eliminating the need for laboratories or electricity. In a continent where laboratories are few and have limited capacity, and where access to electricity is still too often unreliable, these ten minute kits will be of immense help to the African population. Individuals will be able to test themselves at home and proceed to self-isolation if necessary, thereby flattening the curve.

Mologic is currently concluding an initial assessment of the diagnostic test prototypes before shipping them to its international partners, including diaTROPIX-affiliated Institut Pasteur of Dakar, for validation and manufacturing. If everything continues smoothly, diaTROPIX will begin manufacturing the testing kits – which will be sold at cost – as early as June.

The Mologic-diaTROPIX collaboration is expected to continue once the Coronavirus pandemic has subsided: the partnership is working on developing an early-detection Ebola test, which could help prevent the next Ebola outbreak on the continent.

Conclusion

Good health and well-being is among the UN’s seventeen Sustainable Development Goals (SDGs) that guide international efforts to achieving global peace and prosperity. Now, as the international community continues to battle COVID-19, the critical importance of a functional and resilient public health system is more apparent than ever.

On a continent where the ever increasing population with its demand for health services and products already strains the available financial resources, numerous creative healthcare solutions have helped the continent deal with personal and public health issues. Innovation and technology can help health officials and private companies collect and store critical patient and public health information, provide telehealth services, and more. Significant gaps continue to exist that must be filled to increase Africa’s healthcare capacity.

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