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Tech at the Service of the Fight Against Epidemics in West Africa

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Tech at the Service of the Fight Against Epidemics in West Africa Study report for the Pierre Fabre Foundation’s Global South eHealth Observatory Tech at the service of the fight against epidemics in West Africa Born experimentally with Ebola, the use of technology to fight epidemics for a faster, more efficient and social management of the crisis in West Africa, has now reached its full potential with Covid-19, benefitting the health of African populations. Julie LANCKRIET Under the Direction of Samir ABDELKRIM StartupBRICS 1 CONTENTS I. DATAS AGAINST Ebola, OR TECH TO SERVE CRISIS MANAGEMENT ..................................................... 4 A. In an organic and incremental way, the Tech supports the fight against the virus. ......................... 4 1) INFORM AND RAISE AWARENESS ................................................................................................. 5 2) TRACE AND LOCATE ...................................................................................................................... 6 3) DIAGNOSE, COLLECT AND REPORT DATA ..................................................................................... 7 4) TO SUPPORT PEOPLE ECONOMICALLY THROUGH ELECTRONIC TRANSFERS, A PROMISING BUT STILL PREMATURE EXPERIMENT ......................................................................................................... 10 B. Case study: Ebola management in Nigeria, an example of an immediate and controlled response by the Tech. ............................................................................................................................................. 11 II. WITH THE COVID, THE DEVELOPMENT OF A SPECIFICALLY AFRICAN CRISIS TECHNOLOGY, GENERALISED TO ALL SECTORS AND ON ALL FRONTS ................................................................................ 16 A. The importance of non-health Tech solutions in protecting societies and preserving their daily life 18 1) MAKERS: TERRITORY SOLUTIONS POWERED BY THE TECHNOLOGY .......................................... 18 2) FINTECH: ACCELERATING THE TRANSFORMATION OF SOCIETIES TOWARDS A SOCIAL AND SOLIDARITY-BASED ECONOMY ........................................................................................................... 20 3) EDUTECH: TO ALLOW CONTINUITY OF EDUCATION, TRAINING AND WORK WHILE LIMITING CONTACTS ........................................................................................................................................... 23 B. e-Health solutions: accelerating and streamlining crisis management throughout the epidemic cycle ........................................................................................................................................................ 24 1) TO INFORM, RAISE AWARENESS, DIAGNOSE AND ENABLE FOLLOW-UP OF CASES ................... 24 2) BIOTECH, A STEP BACKWARDS STILL NEEDED ............................................................................ 29 3) TO MANAGE THE CRISIS FLOWER FOR A MORE EFFICIENT HANDLING OF HEALTH LOGISTICS . 30 III. CONCLUSION AND RECOMMENDATIONS ....................................................................................... 33 IV. ANNEXES ......................................................................................................................................... 35 A. Directory of "African Tech vs Covid" initiatives .............................................................................. 35 B. BIBLIOGRAPHY (non-exhaustive) .................................................................................................... 35 2 In 2015, a visionary Bill Gates already announced the risks incurred by humanity in the face of an epidemic wave with properties close to those of Covid-19: highly contagious, with an initial phase sufficiently benign to allow the sick to circulate throughout the planet and thus transform the virus into a pandemic and, above all, disarm the public authorities in the event of unpreparedness. The billionaire deduced that this organisation of health systems in the face of the epidemics he was then calling for from the West African episode of Ebola virus disease, which decimated the populations of Liberia, Sierra Leone and Guinea while causing a severe economic recession throughout the region. As the Ebola epidemic coincided with a period of rapid expansion of mobile technologies in the African continent, the epidemic in West Africa (2014 to 2016) was one of the first manifestations of the large-scale contribution of digital technology in the management of a health crisis in this Continent. Still in its infancy at the start of the Ebola episode2014-16, the smartphone penetration rate on the continent has risen from a quarter to a third of the African population in just two years, between 2015 and 2017. The contribution of digital technology, hailed by all those involved in the crisis as largely positive, has made it possible to streamline the entire health response chain, from logistics management to raising awareness among the population, including the tracing of contact cases and the macroscopic, real-time display of health data. While the Tech used in the response to Ebola was often of foreign origin and experienced in a few pilot areas, mainly in the health sector, Covid has dedicated the advent of a local Tech, spread over all sectors of activity and adapting to the virus in an agile and reactive manner to develop solutions in the field. Similarly, the rapid increase in equipment and mobile penetration rates over the period - 45% of Africans now own a smartphone according to GSMA 2020 figures - has shifted e-health towards solutions directly aimed at the population, with a multiplier impact on awareness and resilience of populations compared to Ebola, where the latter was reserved for healthcare personnel and health authorities due to the technological limitations involved. The digital mobilization in support of the Ebola response was thus the proof of concept of an efficient technology, a factor of logistical optimization and significant time savings, when it was able to adapt to the local context and coordinate with the medical response. A postulate taken up and multiplied by an indigenous Tech facing the Coronavirus, thanks to the technological evolutions that have occurred in the meantime and directed towards African populations, with transversal solutions to the different sectors of activity, ultimately contributing to strengthening health on the Continent. 3 I. DATAS AGAINST Ebola, OR TECH TO SERVE CRISIS MANAGEMENT A. In an organic and incremental way, the Tech supports the fight against the virus. The outbreak of Ebola disease in West Africa began in December 2013 and ended in March 2016, causing more than 11,000 deaths in Liberia, Sierra Leone and Guinea, and affecting Nigeria, Mali and the United States (fewer than 10 deaths in each) and Senegal, Mali, the United Kingdom and Italy (only one death-free case in each). This crisis, unprecedented in many ways, has surprised by its ability to export to new territories and to defy borders by playing on the new channels of globalization. New paradigms also have their advantages, since this epidemic was the first to benefit on a large scale from digital tools, which have been progressively used to accelerate the health response, and on which we have a first setback today. As David Sengeh, Director of Innovation and Minister of Education of Sierra Leone, said, while his country has recorded more cases than its neighbours, the case-fatality rate has been much lower, at 28% compared to 45% in Liberia and 66% in Guinea. According to the Minister, "These figures are due to the systematic action of Public and Community Health, including the mobile solutions used to limit exchanges and ensure the tracing of contact cases". *Number of suspected, probable and confirmed cases. Source WHO 4 1) INFORM AND RAISE AWARENESS The first use of these mobile applications has been to inform and alert populations in areas where the spread of rumours and false information is a curse, and where the notions of hygiene and health prevention still need to be reinforced. The institutions at the origin of these initiatives were often the humanitarian NGOs and major groups present in these countries, primarily concerned with health issues, but also telephone operators, who had the best networks for dissemination and strategic data on the target populations. For example, Airtel was one of the first operators to broadcast clips showing its users the barrier gestures and behaviours to avoid. Orange quickly had educational web videos produced for distribution in schools and colleges, before they were picked up by local TV channels. In addition to simple video spots, the Orange Group also developed its own mobile application (Côte d'Ivoire), which was one of the very first crisis applications: it included awareness messages but their main purpose was to alert areas where the disease was spreading, with a precise count of cases and maps of the spread of the virus. Similarly, MTN's No Ebola application started to broadcast live all the #Ebola information retrieved from Twitter. On the humanitarian side, the Red Cross organization in Sierra Leone opted for SMS: with the help of Airtel and the government, the NGO was directly sensitizing the concerned populations. Called TERA (Trilogy Emergency Relief Application), this initiative sent out nearly two million monthly awareness messages during the epidemic: "If someone you know is sick with a sudden fever, diarrhoea or vomiting, you should call 117 for advice" or "People who have
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