In Conversation With Abbott

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Collaboration – the key to sustainable rural healthcare

In September, the SVAI connected with Monica Sanders, Director of Global Citizenship & Shared Impact at Abbott, to learn more about the organisation’s work in Africa, the new normal of COVID-19 and what it takes to make sustainable rural healthcare an affordable reality for all.

Rwanda Abbott

Abbott’s Monica Sanders (right), visits with mothers and newborns receiving care at a Second-Generation Health Post in Bugesera District, Rwanda.

Q1. Looking back on Abbott’s Shared Value Journey in Africa, what are some of your most memorable milestones?

One of our efforts that we’re most proud of – and a key milestone on our Shared Value journey – is the Second-Generation Health Post initiative in Rwanda. Through a collaboration between Abbott, the Rwandan Ministry of Health and the non-profit organisation the Society for Family Health Rwanda (SFH Rwanda), this programme is a great example of what a business can accomplish by applying its core expertise and resources, while working with others.

These health posts in Bugesera District have enabled over 200,000 Rwandans to receive care in their communities within a 30minute walk from home. We have helped to address various conditions from malaria to intestinal parasites and respiratory infections. It has also helped Rwandans with everyday health matters, such as managing their glucose on a more frequent basis, urinary tract infections, everyday health concerns, and especially supporting pregnant mothers as they make their journey through the delivery of life and ensuring that mother and child are healthy.

Another key milestone in Africa centers around our work in Tanzania, where we have worked with the government to establish the first Emergency Department in the country and the first medical residency program in East Africa. In fact, since its inception more than 10 years ago, this initiative has grown to include four regional hospital sites, with more than a million patients treated to date. This partnership has also trained 56 emergency specialist doctors and more than 2,500 nurses and support staff to help ensure that the services will continue to be expanded throughout Tanzania.

Then there are also our partnerships with leading institutions in Senegal and South Africa as part of the Abbott Pandemic Defence Coalition – a global network of expert collaborators dedicated to the early detection of, and rapid response to, future pandemic threats. We are, for example, working with the Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formations in Dakar, Senegal and the KRISP, Genomic Centre of the University of KwaZulu-Natal, in Durban, South Africa. We also have additional partnerships in Uganda to address malaria and in the Democratic Republic of Congo (DRC) to advance research on HIV, among others.

Q2: On the subject of COVID-19, what lessons have you learnt and what are you doing differently?

Of course, by virtue of our core business, Abbott has been closely involved in addressing the COVID-19 pandemic through our testing solutions and services over the past year.

One of the key developments we have seen has been the evolution of how care is delivered, in particular decentralised care, which is a health delivery model that we invested in before the pandemic. In fact, we’ve long believed in democratised and decentralised testing as an important way to reach more people, when and where they need it. 

We also knew that testing would be needed at an unprecedented scale quickly, and to make this happen, we shifted how we were working. For example, processes and developments that usually took over a year were completed in weeks and months, and we quickly ramped up our capacity to produce tests to meet the surge in demand.

This approach enabled us to launch 12 COVID-19 tests globally since the start of the pandemic, on a significantly bigger scale than anything we’ve done in the past – including our Panbio rapid antigen test for COVID-19. To date, nearly 30 million Panbio tests have been shipped to Africa. 

Other trends we’ve seen is the need for greater collaboration to expand access to healthcare, as well as continued partnerships to ensure we are better prepared for the next pandemic. A case in point is the Abbott Pandemic Defense Coalition, which I mentioned earlier, where we have partnered with global centers of excellence to identify, analyse and test new viral threats quickly to help stop emerging pandemics in their tracks.

Q3. Would you say that collaboration has been a key success factor in Abbott’s model for sustainable rural healthcare in Rwanda? 

Definitely. The partnership model has been instrumental in all our engagements across Africa, and Rwanda in particular. We listened to the key stakeholders and constituents. Once we engaged with the Rwandan people, we quickly realised that the existing facilities were not meeting the healthcare needs of the rural population. We went into remote areas where we spoke to nurses, people in local villages and government officials, and we gathered information about what they collectively believed should be the purpose of the health posts and the services that should be rendered.

The net result has been an expanded service offering and new design footprint for the health post itself, as well as embedding a fully functional diagnostic lab, which has the ability to deliver point of care testing.

This design enabled us to achieve the milestone of reaching 200,000 patients in the last 18 months, with an average of just over 1,300 patients a month in the past year, which translates into 40-50 patients a day. In the context of primary healthcare in rural areas, this represents a huge milestone – to attract and treat that many patients on a monthly basis – and the numbers keep rising every month.

In June, 25% of the population in the service area visited the health post. Rwanda had a very cold, heavy rainy season which, combined with COVID-19, saw a considerable rise in respiratory infections. With the health post embedded within the community, we were able to quickly diagnose, treat, and get people home.

Q4. Do you plan to replicate the Second-Generation Health Post model elsewhere in Africa?

Yes, our broader goal is to take this approach in other countries in Africa as well. At the moment, we are working on identifying funding requirements and a standard financial model to drive broader expansion of second-generation health posts in Rwanda.

We plan to use the information gathered from all our sustainability and decentralised healthcare projects in Rwanda, to develop a toolkit that we can take to other countries in Africa.

We also believe that there is an opportunity for similar solutions outside of Africa, where the need for decentralised care is equally important, for example in South America and in some parts of Southeast Asia.

In Rwanda, the Second-Generation Health Posts are having a significant and positive impact on the health of rural Bugesera residents
Clinical Highlights through June 2021:

  • 200,000 patients served; averaging 1,100+ visitors/SGHP per month
  • Averaging 1+ diagnosis per patient
  • 63,000+ respiratory infections treated
  • 52,000 malaria tests delivered; 18,400+ positive cases treated
  • 41,000+ cases of intestinal parasites resolved
  • 5,200+ new participants in family planning
  • 1,100+ ANC visits and panels completed
  • 720+ babies safely delivered in community

Q5. How has the pandemic impacted or influenced Abbott’s social impact initiatives in Africa over the past year and more? 

As COVID-19 continues to spread across Africa, the pandemic is magnifying the limitations of African health systems and, for us, longstanding, sustainable partnerships have been critical to quickly ramping up other work to help address the pandemic.

A case in point is our partnership with the African Federation of Emergency Medicine (AFEM).

Africa only has a small number of emergency physicians. These experts were providing day-to-day patient care without access to dedicated COVID-19 training or modern equipment to address key patient needs – while often playing leading roles in developing local-country COVID-19 response plans. 

Our partnership with AFEM worked to strengthen the continent’s emergency healthcare system in several ways. For starters, we were able to support the creation of targeted guidelines for COVID-19 that emergency rooms can adapt to local needs. AFEM was able to pilot these guidelines in 10 hospitals in Sudan to generate real-world data and experience to learn and refine these recommendations.  

We were also able to host an eight-month series of virtual training sessions for healthcare providers to share best practices and information about critical COVID-related topics. We believe that these training sessions have become essential for healthcare providers across the continent to share information and bolster each other’s efforts.

Q6. Are there any new partnerships in the pipeline or planned? 

Rapid tests are an important innovation for rural care and partnerships are key to expand access to this testing. The Panbio test for COVID-19, for example, is easy to use even in the most challenging settings, since no instrumentation is required, and results are delivered in just 15 minutes.

To help advance access to this test, Abbott joined the WHO’s Access to COVID-19 Tools (ACT) Accelerator, which was established in 2020 to make affordable and high-quality rapid antigen tests available to low- and middle-income countries. 

We have also worked directly with governments, businesses and organizations to advance COVID testing across the continent.

For example, airports in Luanda, Angola, are using Panbio to screen passengers before they board planes for international travel or upon arrival from other countries, while businesses` in South Africa are using Panbio to enable a return to work. We’ll continue this important work to advance COVID testing in the months ahead.

Q7: Any closing remarks about Abbott’s social/environmental impact initiatives?

The most important effort underway at Abbott is our 2030 Sustainability Plan and how we’re planning to help address the world’s greatest health challenges over the next decade.  

The world faces immense health threats – from the devastating impacts of COVID-19 to the major barriers we face in confronting chronic conditions like diabetes, cardiovascular diseases and malnutrition. Then there are also the many complex and interconnected challenges of poverty and other social and economic factors, all of which pose significant barriers to care.  

All countries and all communities are struggling to respond to this wave of health challenges today – and the challenges only get tougher from here. Health systems and workers are overwhelmed, debt and budget issues are increasing, and healthcare costs are expected to nearly double to $16 trillion over the next decade.

Given this reality, it’s clear that the world needs new approaches to health. At Abbott, we took a step back, thought about the role of our industry, and focused on how our company specifically could create the greatest impact. We know that cutting-edge innovations alone aren’t enough.

We believe that we can play an important role in helping to close those gaps. After all, the best healthcare solution is the one that can reach the most people who need it.

Our 2030 Sustainability Plan has a clear focus on designing access and affordability into our life-changing technologies. We are working across our business and in partnership with others to remove barriers to access and design products that are affordable, will reach the most people possible and can be used in developing and emerging markets, as well as developed markets.   

The plan will help to focus our organisation on the things we need to do to help even more people live healthier lives. Our work will touch the lives of two billion people this year, and we intend to reach over one billion more in the next 10 years – improving the lives of one in every three people on the planet by 2030.