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‘AHA is finalizing a health financing solution to meet medication needs’

Abimbola Adebakin is the Chief Executive Officer of Advantage Health Africa (AHA), a health solution company rendering technology, products and services to promote access to affordable and quality healthcare. In this interview with BusinessDay’s Endurance Okafor, the founder of the pharmaceutical tech start-up shares insight on how Nigerians are willing to pay for healthcare service that delivers value and how AHA is contributing its quota. Excerpts:

Tell us about yourself

I am Abimbola Adebakin, founder and Chief Executive Officer of Advantage Health Africa. I live in and work out of Lagos, Nigeria. Following my secondary school education at the Federal Government Girls’ College, Sagamu, I studied pharmacy at the undergraduate level and then business administration at the Master’s level at the University of Lagos. In addition, I am a Certified Performance Technologist (CPT) meaning I approach issues with a keen eye for systematic and systemic performance improvement at organizational, functional, individual, and societal levels. This is reflected in my work experience as a management consultant with Accenture and FITC, until my most recent role leading operations in the Tony Elumelu Foundation as COO. Thereafter, I founded AHA.

What was the inspiration behind you setting up Advantage Health Africa?

Advantage Health Africa is a vehicle to address gaps I initially observed in the health sector. Our initiatives address issues in three broad areas of poor access challenges with affordability and uncertainty in the quality of medication and overall healthcare. Too many times, the challenges people go through with access to affordable quality healthcare emanate from systemic issues that can be traced to supply and demand imbalances. We have 200 million people served by less than 5000 licensed pharmacies. We have fewer than 200 local government areas having licensed pharmacies. We have a large exodus of health workers from Nigeria. All these pointed to me that technology must play a key role in enabling us to address the current needs, the future health needs, and leapfrog where possible to meet the demands for better services by an increasingly perceptive consumer base.

In 2017 when we launched our first venture, myMedicines – which is the first online medication ordering platform (ePharmacy) in Nigeria operating with an aggregated network of almost 1000 pharmacies across Nigeria – we saw that more Nigerians were accepting eCommerce as a way of making retail purchases. Most innovators want to play as business to business (B2B) model, which is fine really. But we have to impact healthcare delivery at the last mile to address many of the ills of access, affordability, and quality and we utilize a B2B2C model to ensure we connect demand-side needs with supply-side needs, while we are the platform creator and manager. Our people suffer when they make poor health-seeking decisions and I wanted to strike out a few of these ‘sufferings’ with the solutions we put out there. So, we started to meet these needs and knew we would operate across different verticals and along different points in the value chain as we built our operations and networks.

How is Advantage Health Africa contributing its quota in enabling Nigerians to have access to affordable and quality healthcare?

With myMedicines, we meet the medication needs of thousands of Nigerians every year. Our footprint is impressive and I am just grateful the vision I had to create access is happening.

First, we have fulfillment pharmacies in 33 of the 36 states and the FCT. This is the largest network of credible licensed pharmacies you can find in Nigeria, committed to working together to serve the fulfillment end of access to affordable and quality healthcare, in this case, genuine medication whose prices are not inflated or tampered with. Soon after, we saw a need to look into strengthening the operation of community pharmacies, with curated and intentional access to skills and resources to make them deliver quality all the way. We launched the first franchise pharmacy chain in February 2020 (called myPharmacy), just before COVID hit our shores, with over 50 pharmacies. We enabled better services from several of these pharmacies, and now, our services have evolved to include projects that enable pharmacies to thrive in a harsh economy. They not only have new skills and capacity development from several of our programs, but we partner with credible organizations to bring them opportunities to serve their communities better.

Now our bespoke technology solution for pharmacy management (Advantage PMS) is to be launched as the first, specially developed for pharmacy operation in Nigeria. Most solutions are adapted from basic retail or sales functions, but we have crafted a tech solution that helps each community pharmacy operate across their various processes, from product procurement to dispensing to patient management in our continent.

Read also: Buhari approves Nigeria’s hosting of int’l summit on primary health care

What distinguishes Advantage Health Africa from every other company is the healthcare service industry?

AHA is deliberate and intentional in bringing access to healthcare for the bottom of the pyramid clients in urban, semi-urban, and rural areas. The challenges Nigerians are grappling with are many, so, where we can address the health-related ones, it brings us the utmost sense of accomplishment. We have partnered with HMOs, physicians, insurance companies, health innovators, and others to fulfill the portion of their initiatives that require medication fulfillment. I reckon that one of our biggest achievements so far is that we are THE COLLABORATOR many seek to work with when they need safe, honorable health services in medication provision.

Let me also mention that we saw opportunities to operate further up in the value chain by assuring Nigerians of access to genuine medicines that are locally produced here in the country. My discomfort with our over-reliance on imported medication is well known. Nigeria must urgently build capacity in local production, but if you produce and do not have dedicated and effective marketers, you have an inefficiency that cannot augur well. So, we have a strategic business focused on pharma distribution of over 40 products that meet the healthcare needs of Nigerians with chronic illnesses and those requiring lifestyle improvements.

Apart from market acceptance and support, we have received some validating awards and recognitions, mostly international, and more are coming! We are grateful for all these achievements in the few years AHA has spent to become a platform business that takes its ability to build aggregation very seriously.

Many say we are non-conformists. I will say we only set out to ask questions – how else, what else, who else, and when else – in order to explore how to serve Nigerians better with healthcare. You see, if you can answer some of these questions and implement in a way that provides viable and sustainable solutions successfully in Nigeria, you can scale across Africa. We have set our eyes on the African healthcare space, even our core values form the acronym AFRICA.

Tell me more of the gap myMedicines is trying to bridge in Nigeria’s healthcare system

Typically, if you have a prescription to fill, you will walk into a pharmacy and hope to be served. However, you may meet that the medication is not available or only partially available. You will agree with me this has happened to you before or to someone you know. We have our mothers and fathers looking here and there for their prescriptions to be filled. Sometimes, it is not and they conclude the medication cannot be found in the country. Many rush to call their children in diaspora and it becomes a worry to get the medication down here. This gap is what we are filling.

You don’t have to be frustrated when you need your medication filled. Just reach out to us through the most convenient channel – from simple tech such as SMS or text on our WhatsApp messaging app, to email or calls, or even via our website or mobile app that is to be launched soon. Just connect and we search our carefully curated network. It is amazing how we have brought peace of mind to many families across Nigeria. Daily we are receiving orders from all six geopolitical zones. So far, we have filled orders in 27 out of our 36 states and FCT. That is no mean feat. Imagine, your mum lives in Yenagoa, and we find her medication in Port Harcourt or Lagos, ship it to her and she gets it in the same day or the very next morning. And then you assure her that every month, she can rest, a team will sort her out and you just pay us. She has one major issue to stop worrying about. This is what thousands of mothers, fathers, and individuals are deriving from myMedicines.

Telemedicine providers, health insurance providers, homecare physicians, and other prescribers now call on us immediately when they are unable to get medication for their patients. COVID lockdown and associated challenges in the supply of medicines validated our business model! Yes, something we had initiated bravely in 2017 and sustained every day with no break got validated three years after. Now, we are increasing our capacity to meet growing demand. We are also enhancing our service offerings to keep adding value.

As a health professional and entrepreneur, what is your take on Nigeria’s health sector?

Several of our challenges are low service coverage, poor financing models and quantum, inadequate infrastructure, weak distribution systems and linkages, and disconnected incentives. So many of these and the resultant effects can be addressed if we choose to work with one another, adopt new paradigms and models as well as leverage resources that are now readily available such as technology and platforms. You see, each problem in our healthcare sector appears to me like a piece of a jigsaw puzzle that needs to be repaired and placed in its right place. The skills to repair can be bought, acquired, borrowed, or copied – not much is new and unique to our clime. It’s been done elsewhere and we can borrow models. Oddly, we do this in telco, finance, logistics, housing, and other aspects of our economy, but we want to resist it in healthcare. We will get to the desired state better if we open our sector to models that work in other sectors and other climes. The task is to adapt to contextual differences.

I also think we are hesitant to change due to tradition, and I get it. We are used to one way of doing things and our human brain prefers to conform. But you see, we cannot and will not solve for the existing realities with solutions that worked in a world of several decades ago. Too many things have changed – the people we are serving have moved on, solutions have been built to shorten the learning curve for several things, supply systems have changed. We cannot thrive in such a situation where we hold on to tradition at all cost.

Let me give you an example – shared services. Back in the 90s and early 2000s, the financial services sector embraced shared services and leapfrogged. Today we are reaping huge benefits from their willingness to break tradition – banking operations were revolutionized, switching technology was brought in, hardware such as ATMs and POS devices were introduced, banks collaborated to compete as businesses that needed to make a profit. They had investors that made the demand for healthy returns. They woke up each day testing the solutions, developing new ones, discarding what did not work but learning from them, opening up to international standards of practice, and cultivating new governance codes to address institutionalization needs that you cannot shy away from if you want to scale. Capacity development stopped being a nice-to-have but a must-have. Rewards and incentives for performance were deployed, some worked, some did not, but you see, the institutions that rose to innovate thrived and where it was needed, they formed alliances, some merged or were acquired into larger thriving entities. I consulted in the thick of some of these changes and this has given me a unique perspective to change that can and should happen in the Nigerian health sector.

Our health sector must wake up to understand it cannot and will not thrive if it continues to hold onto systems and structures that can no longer deliver results. We are losing talent, we are dissatisfying our clients, we are under-employing the young ones, we are returning nil or negative financial returns, overdependent on aid and interventions and we are frustrated that the ecosystem is not conducive for professional practice. Change must come and it will take us 5 – 10 years of deliberate renewal to address the needs in a significant manner. The challenges are surmountable. I have seen change at the industry level in other sectors and I remain hopeful it can happen in healthcare.

Africans can and will pay for healthcare if they see us in a position to deliver value, not the barest minimum we can do. We keep holding on to the belief that the average person will not pay if you try to be the best, but you are talking about the same people who are daily borrowing billions of naira worth of credit to stay in touch with family, friends and conduct business or just stay on social media! Come on!! We have grossly underestimated the demand side of healthcare in general, it has made us careless and unimaginative to a large extent and the ones who are innovating must be encouraged to thrive.

Advantage health Africa is here to innovate, test and try new models, borrow concepts and ideas, explore shared platforms, and trust that the people will reward us with their patronage when we remain consistent in delivering value. When we trust them, they will trust us. Ultimately, we will see growth. I urge fellow healthcare providers and regulators to work together to deliver the change we must bring. Otherwise, we create a vacuum that nature abhors and nature will force others from outside to fill the gaps! It is a law of this life. I have said nothing new here.

What should Nigeria/Africa expect from Advantage Health Africa in the nearest future?

So much, as we have interesting products in the pipeline. Right now, we are seeking to work with Optometrists to deploy the radical solution that DOT Glasses provides, enhancing eye care for people living at the bottom of the economic pyramid. When deployed in collaboration with community pharmacies – a trusted health facility where people go for their basic medication and even patronize when they are feeling well, you will capture more people who would otherwise not visit a clinic until their health is terrible. This is an exciting opportunity we are championing. So watch this space.

We are also finalizing a health financing solution that will enable medication and other healthcare needs to be met more conveniently. You see, convenience is what the other climes have provided for their citizens. They find ways to make you pay a fair price, from tax or credit systems or both, as long as it is a fair price. Paying at point of use has made many shy to visit our orthodox facilities and go round and round until their prognosis is poor. Too many die needlessly from diseases that could have been nipped if caught early.

Other collaborations are in the works, and we cannot wait to pilot them and deliver value in the space we have pitched our tent. I mentioned earlier our technology solutions being launched these coming months. Also, the 4th anniversary of myMedicines is Oct 1, 2021. We have come a long way, but we are not resting on our oars. It’s time to innovate further.

What are some of the key challenges industry players like yourself are facing in the healthcare sector and what do you think can be done to boost growth while also providing access to healthcare services for more Nigerians?

Slow uptake of collaborative initiatives. My team will testify that I speak about collaboration every day. Even though I have had my fingers burnt a few times, I still see more benefit from it as a fundamental implementation approach. We need to practice till we get it right. Token half-hearted attempts will not cut it. You see, when you and I choose to work together, we bring synergistic energy to a matter. One head battling alone and another on the other side battling will grow weary and give in (not necessarily give up, many of us actually give in and just can’t muster the energy again to energize our practices) – decay sets in. Instead, when we collaborate, we bring different perspectives and create something new. When one party is tired, it’s likely the other one is still energized and the idea keeps going, sustainability is better achieved. Onlookers trust that your collaboration is a risk minimization strategy and choose to back you with strategic partnerships and even more resources than you first imagined available. Some will appreciate you and join you with the unique skills and experience they have garnered from other sectors. You have something much bigger than you that is alive and rewarding!

I want to see physiotherapists and physicians work hand in hand with mutual respect as equals; I want to see pharmacists work with midwives to enable better health outcomes. You get the picture. I want to see whole verticals in the health space extend a hand of fellowship to another vertical. I want to also see interprofessional collaborations, not only intra professional ones. This is how we as Africans can leverage strength and address African problems with the African philosophy of Ubuntu.

Guess what will happen, we create NEW LAND. New opportunities and values that make the pie bigger. But if we stay insulated, the pie is stagnant or shrinks, and you find all sorts of infighting and dissatisfaction that those coming from behind see and just check out. I daresay that no one group in the health sector is well remunerated right now, from medical officers to nurses, to medical lab scientists to pharmacists. So, it’s a clear indication of poor incentive systems. Someone has the solution to this, if such a person comes from the agric or hospitality sector and shows us how it’s done, maybe one day we will listen and realize we have ignored so many aspects that could have funded our practice and were distracted by sentiments and infighting. There is no reason why we should remain small.

When reward systems are set right, when value creation and performance improvement become the drive of management of our institutions and associations, when regulators are well empowered and resources are in place for oversight, when trust thrives, I know for certain that we will create value and it is the people who will benefit. We will share data professionally, we will look out for one another’s input and output, we will measure the right indices and report outcomes that push our competitive juices to improve health index and not against one another. We will take pride in health outcomes across the sector and do less finger-pointing, respect professional boundaries while embracing role growth and task-shifting that optimize the modern tools that have simplified many things nowadays.

The people are crying and desirous of this change, so, I know they will change their spending pattern when we show promise. They currently spend billions abroad, money that could be used well here to fund our sector and create a portion for the vulnerable that are unable to pay like them.

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