Digital health tools closing HIV prevention and control gaps in Africa

Digital health solutions are proving effective in supporting the vision for an HIV-free Africa in the future.

Out of the over 35 million people globally that are living with HIV, more than 70% are in Africa according to amfAR. Africa also accounts for 91% of the total number of children in the world that are living with the dreaded virus—most of whom were born with the virus via transmission from mother to child. Last year alone, there were about 1.5 million newly diagnosed cases of HIV; the continent also recorded over 70% (about 1.1 million) of the world’s total number of deaths resulting from the retroviral infection. But not everything about HIV in Africa is gloomy—thanks to several interventions—including digital health.

UNAIDS’ AIDS by Numbers for 2013 revealed there has been a 33% reduction in the number of new cases of HIV infection since 2001, and it acknowledged that AIDS-related deaths among adults and children have decreased by 29% since 2005. Among children, new infections have been reduced by 51% since 2001, and there has been a 40-fold increase in access to antiretroviral therapy since 2002.

Before the reemergence of the Ebola virus, HIV was probably the most feared, and continues to attract global attention—especially in the area of funding. UNAIDS said donor disbursements in 2012 alone totaled US$ 7.86 billion. A good proportion of this sum was provided by donors—including the Bill & Melinda Gates Foundation—to close the treatment gap by reducing the cost and improving the quality of essential anti-retroviral (ARV) medications. This approach, along with other HIV prevention and treatment programs, helped to significantly increase access to treatment around the world.

South Africa, Nigeria, Kenya and several other African countries have initiatives that provide free HIV treatment with varying degrees of successes. None have been able to reach 100% of the individuals living with HIV/AIDS—a challenge that some African countries are trying to address using digital health solutions.

mHealth Promoting Self-Care in Kenya

In Kenya, an mhealth patient engagement service called WelTel is boosting antiretroviral treatment in East Africa by supporting compliance with medication regimens. With WelTel, providers are able to effectively use text messaging to improve outcomes through weekly interactive check-ins to ask patients how they were doing. Those who report problems receive follow-up phone calls.

According to the New England Journal of Medicine, the model involves a weekly text message to patients with a single word — “Mambo?” (“How are you?”). The intention is to promote self-care, rather than just issuing timed medication reminders. Patients have reported that this approach made them feel cared for and supported. In its mHealth report, the World Bank affirmed that the solution has been effective in improving ARV patients’ adherence to their treatment regimens, which in turned has lowered total health system costs.

In partnership with the African Medical Research Foundation (AMREF), WelTel has been awarded $1 million to expand its mHealth program across rural Kenya. WelTel also announced the award has been matched by $1 million from AMREF through USAID.

Social Media Crowding Out AIDS

Social media is popular in Africa, especially among the youth. A 2014 Pew Research Global Attitudes Project report entitled, “Emerging Nations Embrace Internet, Mobile Technology,” revealed that about 78% of internet usage in Africa is focused on social media. Targeting this dynamic should therefore be effective in promoting and improving access to information on HIV/AIDS. Realizing the potential of social media and mobile technology as tools for HIV prevention, treatment, and control, UNAIDS launched CrowdOutAIDS.

The initiative is an online collaborative project to crowdsource UNAIDS’ strategy to educate young people about HIV/AIDS. CrowdOutAIDS hosted eight forums on social networking sites—drawing over 3,500 participants that shared experiences and perspectives. Its blog also featured professionals—including myself—who advocated for decorum on HIV and AIDS discussions on social media; I also described youths as the key to ending AIDS and securing the future.

mHealth Supporting Treatment in South Africa

In South Africa, Cell-Life—a company that provides technology-based solutions for the management of health in developing countries—is helping to address the challenge of distribution of anti-retroviral treatments, continuous patient monitoring and evaluation, and collection and communication of information.

It recently developed its iDART software solution to support the dispensing of ARV drugs in the public health care sector. It also designed and implemented a Mobile Monitoring and Reporting system for South Africa’s National HIV Counseling and Testing campaign, as well as the country’s national Anti-retroviral Treatment expansion program. It has several other impactful projects in the works to fight against HIV/AIDS.

mHealth Improving Information-Sharing in Rwanda

In Rwanda, TRACnet is providing healthcare professionals with an easier medium through which they can input, access and share health information. The success of the innovation in the francophone African country’s fight against HIV has been commended by the United Nations.

Healthcare professionals that are involved in ARV treatment programs can submit their reports electronically and have timely access to vital information. By dialing a toll free number or logging onto a bilingual website (English and French), providers can submit or receive program results on HIV/AIDS patients as soon as they are processed. The service also can be used in rural areas, since it uses mobile phones that are recharged using solar energy.

Telecom Companies Join the Fight in Nigeria

There are also partnerships in Nigeria involving the National Agency for the Prevention and Control of HIV/AIDS (NACA) and telecoms companies operating in the country to provide toll free call centers that offer citizens access to information on the virus and disease. One such center is the National HIV Call Center that was commissioned by Nigeria’s First Lady Dame Patience Jonathan; Etisalat Nigeria is also providing a similar service.

As Africa joins the rest of the world to celebrate World AIDS Day this month, digital health solutions are proving effective in addressing specific challenges and closing the gaps in HIV/AIDS prevention and treatment throughout the continent.

It has become much easier to accurately measure successes and analyze the impacts of both new and perennial challenges such as drug resistance and stigmatization (both of which are still issues being faced in Africa), with the goal of developing relevant and inexpensive solutions that support the vision for an HIV-free Africa in the future.

Paul Adepoju is an award-winning Nigeria-based freelance journalist. He is the managing editor of HealthNewsNG.com Africa’s leading health news platform, and is a correspondent for several international media organisations. He holds a master’s degree in cell biology and genetics, a diploma in legal studies, and is currently studying the dynamics of latent and active tuberculosis genetics for PhD. He speaks regularly at major African health and technology events including NigeriaCom and Nigeria eHealth Forum.

Visit his personal website for more information; he could also be reached on Facebook, Instagram, and Twitter: @pauladepoju.