Health Care Supply Chain Start-ups in sub-Saharan Africa are Transforming the Distribution Ecosystem
Across sub-Saharan Africa, supply chain constraints often cause bottlenecks in the movement of essential medicines from manufacturer to end users. In response to the COVID-19 pandemic, health start-ups across the continent are developing innovative, commercial models to transform health product distribution for consumers and providers alike, which holds tremendous promise to improve the supply chain for medicines. These innovations among supply chain start-ups are presented in a new report funded by the Bill & Melinda Gates foundation and prepared by the health care consulting firm Salient Advisory with a focus on Nigeria, Ghana, Kenya, and Uganda. The report also includes recommendations for global health actors to accelerate the impact and scale of African health tech innovators including investing in African founders and prioritizing those that serve rural populations.
Top Findings from the Innovations in Health Product Distribution report
The ecosystem of organizations working in health product distribution has grown more than 100% since 2018, from 28 to more than 60 companies currently working to improve how health care products are distributed. Nigeria, Ghana, and Kenya are key hubs of activity.
While most are in the early stages of growth, 18 companies (30%) are primed to scale their reach and impact. While more than half of the companies operate in a single country, over a third operate regionally or internationally.
A majority of companies serve both rural and urban areas. Innovators report starting in urban areas and gradually moving into rural communities due to having to adapt their business model to move away from a reliance on internet or smartphone access in favor of hybrid approaches that leverage both in-person and offline technologies. As a result, most rural operations are still nascent.
The COVID-19 pandemic has driven consumer-facing companies to expand their services by partnering with other entities. This includes telemedicine paired with product delivery and offering voice or chat-based consultation that allows patients to interact with doctors without internet connectivity.
Funding in this ecosystem remains very limited and highly concentrated. Also, only a small portion of companies are led solely by a female founder while 61% have a male founder. Moreover, African innovators who lack ties to high-income countries raise considerably less money than those with non-African founders or co-founders.
Implications for Contraceptive R&D
While Salient’s report does not specifically address contraceptive research and development, it is a great example of how health tech innovators can “begin with the end in mind.” By doing so, African health start-ups can play a crucial role in ensuring the acceptability, affordability, accessibility, and equity in health care products and services, including contraception, in the region.
The increase in health tech innovators in Africa has the potential to benefit the contraceptive supply chain, service delivery, and research and development in the region. According to Guttmacher Institute, 218 million women in low-and-middle-income countries have an unmet need for modern contraceptive methods, with many African countries facing the greatest need. Reasons for this include limited choice of methods, poor quality of available services, fear of side effects, and limiting societal norms. African health start-ups have the potential to help close this gap by providing easy access to contraception via telemedicine or chat-based consultations, the latter being particularly important for those living in rural areas who often face barriers to health care. These companies have the opportunity to better integrate user preferences, which can be achieved successfully when a company’s leadership represents the community it serves. Thus, it is important to support companies whose founders are African and either female-led or have mixed-gender leadership since they will likely best understand the cultural nuances and barriers the community faces to accessing modern contraceptive methods.