In a bid to address critical healthcare challenges in Nigeria and beyond, the African Export-Import Bank (Afreximbank) has partnered with King’s College Hospital London to establish the African Medical Centre of Excellence (AMCE). This state-of-the-art facility in Abuja, billed to be delivered by February 2025, aims to advance local excellence in healthcare delivery not just in Nigeria but across the West African region.
OLURANTI DOHERTY, director of export development at Afreximbank, speaks with TEMITAYO AYETOTO-OLADEHINDE, senior health correspondent, and explores the project’s goals, strategies, and potential impact.
How does the Afreximbank and King’s College Hospital partnership uniquely address specific Nigerian healthcare challenges compared to previous initiatives, and achieve its goals within the broader context of African healthcare improvement?
In 2012, the bank launched the Health and Medical Tourism Programme to support the development of health and medical facilities across the sector value chain in the continent and promote trade in services.
One of the key things that we wanted to address was outbound medical tourism and brain drain from the continent. So, our flexible medical tourism programme was a continental-wide intervention to address outbound medical tourism and to also address the issues around brain drain, with the primary focus on promoting trading services between African countries.
The programme had two key components. The first is the construction and medical tourism relief facility where the bank came up with financing facilities to support project developers, and project sponsors in developing world-class facilities and refurbishing existing hospitals, pharmaceutical companies, and manufacturing companies within the health and medical space. The instruments we deployed included the franchise financing facility for those business owners who are seeking to attract or acquire international franchises within the medical and healthcare space.
But we found out that despite these interventions, we were not able to support projects of scale. As such, we came up with a second intervention under the AMCE initiative. That initiative is primarily to develop world-class tertiary healthcare facilities across the five key regions of the continent. And we began with the first project in Abuja, Nigeria. There was a bid amongst five African countries, of which Nigeria won the bid to host the first African Medical Centre of Excellence.
It’s a 170-bed hospital currently being developed in Abuja, Nigeria, and we are developing this project in collaboration with King’s College Hospital London. We expect that the centre will be commissioned in Q1 2025.
It has a unique focus on trying to treat non-communicable diseases, focusing on three clinical areas: haematology, which is blood diseases and blood cancers; cardiovascular diseases; and oncology.
Given the critical shortage of healthcare workers across experience levels, how will the planned medical and nursing school address the brain drain and contribute to a sustainable pipeline of qualified personnel?
The World Health Organization projects that by 2030, there will likely be a shortfall of about 6.1 million healthcare workers in Africa if we do nothing. So it’s imperative that we all put in our best to address this green projection. And it’s because of this that we are partnering with King’s College London to set up this medical and nursing school. We realised that to solve this problem, you need to intervene across the healthcare ecosystem. It’s not just setting up the school, it’s also providing an outlet or a space where graduates or resources can work and be fulfilled, be trained, and progress in their careers. So for us, we see this initiative as addressing institutional capacity deficits.
It’s going to also focus on training professionals in specialities that are of the highest need to us as Africans. So you would have a situation where people who are trained can be retained within the hospital facility and they can also continue to benefit from further training and further growth in their career.
Beyond addressing rising trends in haematology and oncology, how will the AMCE’s unique infrastructure and technology integration push the boundaries of healthcare delivery in Nigeria compared to existing facilities?
Our objective for going into this area was not just accidental. We undertook a study of the African healthcare landscape to see what exactly is making our people go out of the continent to seek medical care. One of the key issues that propel medical tourism and outbound medical tourism from the continent is non-communicable diseases. When we dimension these non-communicable diseases, we found out that cardiovascular issues are predominant in West Africa and of course the rest of sub-Saharan Africa. We felt we needed to intervene by financing the development of a state-of-the-art medical centre.
And of course, we identified that you need appropriate diagnostics, labs, and equipment to be able to treat some of these non-communicable diseases holistically. Take, for instance, cancer. For you to be able to treat cancer, you need to ensure that you undertake the appropriate diagnosis and some of these diagnoses require equipment that we sometimes do not have across our medical facilities. You are talking of a PET CT scan and a cyclotron. These are some of the world-class equipment that the AMCE will be having. For instance, it will be the first institution in sub-Saharan Africa to host a cyclotron machine or equipment that manufactures radioactive isotopes, which are used by PET CT scans to diagnose cancer.
What opportunities exist for partnerships with other local and international institutions to further enhance the school’s offerings and impact?
We are currently partnering with several organisations and one of the key things that Afreximbank focused on for developing the AMCE has been partnership. We’ve partnered with King’s College Hospital London. We have also partnered with King’s College London, which is the university.
In Nigeria, we have worked very closely with the Ministry of Health. They have been a key supporter and stakeholder in this project. Most of the data resources and inputs we got were from the ministry and we carried them along in all stages of the project development.
With regards to collaborating with local organisations and healthcare institutions, we are open to partnering with them and the officials of the AMCE in Abuja have been engaging various tertiary healthcare facilities across the country. We are going to be looking at this partnership across collaboration with governments, agencies, academic institutions, healthcare institutions, non-profit organisations, and of course with private sector stakeholders.
Given the crippling impact of currency devaluation on Nigeria’s healthcare costs, particularly with imported drugs and supplies, what concrete strategies does Afreximbank have to reduce this dollar exposure and make essential care more affordable for the average African patient?
A lot of our member countries in the last year have faced a lot of issues with currency devaluation, not due to just internal factors. The world has tried to rebound from the impact of the COVID-19 pandemic, only for us to rush into the Russia-Ukraine crisis. And then we also now are facing the impact of the war in Gaza. How do we support our member countries in addressing the issues around access to medical drugs, and consumables, the majority of which are imported? We come up with two approaches. You would have the short-term intervention from us and then of course the long-term interventions.
The short-term interventions for the bank have been to ensure that we assist our member countries in coming up with a pooled procurement approach to acquiring medical consumables or pharmaceutical products that are not manufactured on the continent. We have worked with the Africa Center for Disease Control, and the African Union to create what we call the African Medical Supply Platform, which is an online platform that facilitates the acquisition of medical and healthcare consumables and equipment. The platform was initially designed to assist member countries during the COVID-19 pandemic to acquire personal protective equipment, consumables, vaccines, et cetera. But it’s now transforming a platform that would be available to support member countries in acquiring medical consumables, pharmaceutical equipment, or goods that they need at very competitive pricing using a pooled procurement system. So this is one of our interventions.
But for the long term, it is to get Africa to be sufficient. It is to protect Africa in terms of ensuring we have health security and to scale up our manufacturing capabilities in the area of pharmaceutical products and medical consumables. In this instance also, Afreximbank offers debt financing through the bank to support the development of pharmaceutical facilities across the continent to increase our capacity to manufacture or produce some of these required items.
But apart from the debt financing, we also have a subsidiary company called the Fund for Export Development in Africa, which can provide equity interventions to support the development of some of these facilities. We have seen the bank deploy some financing support across the continent to scale up on this. And we’ll be looking at doing more.
One of the things the AMCE will be seeking to do is also to partner with foundations and NGOs to see how we can put in mechanisms to support access to care at the AMC.
While local trust issues are a hurdle, have you observed similar high-quality projects successfully reducing or reversing the loss of skilled health workforce?
One of the things that I was able to understand with the AMCE was that a lot of Nigerians who live on the continent or who leave the country to seek greener pastures in Europe, America, and Asia, do this because they believe that there is no viable healthcare ecosystem under which they can walk and drive. And when I mean the healthcare ecosystem, just having a job is not all. People have aspirations. They want to have a job and they want to know that within that job, they can get better training; they can improve themselves; and they can be on the same level with contemporaries across the world. And where there’s a situation where you can provide this opportunity to these people, they would want to stay in their country. When we were going around talking to Nigerians in diaspora at the Medical Centre of Excellence in Abuja, there was high interest from the people we spoke to in the UK and in the US with regards to their willingness to come home and work.
And I’m pleased to let you know that we have been able to attract Nigerians in the diaspora back home to take up positions within the AMCE. I’m not talking of people who come every week and go out. I’m talking of people who resigned and took up positions within the AMCE after years of working in the US and the UK. So what I’m saying is this: with a good healthcare ecosystem that does not only have the infrastructure but has the right equipment, has the right opportunities for the resources you are attracting, provides them with the training they need, provides them with the opportunity to be at the same leading edge as their contemporaries across the world, they would stay in the country and they would work to push quality healthcare across Nigeria and even within the West African region and beyond.
We have spared no expenses to ensure that we bring in the right partners and the right personnel and give them the right enabling environment they need to try. The project, for instance, is injecting $236 million into the Nigerian healthcare ecosystem and this is just the first phase. It’s going to scale up to 500 beds in the second phase. So you can imagine the impact that this facility is going to have.
How will this project specifically address concerns about quality to win over patients previously seeking treatment abroad?
If you look at the majority of Nigerians are forced to seek medical tourism, to seek medical services outside of the continent. The ones who go because of perception are just one percent. The majority go because they don’t have choices. The majority go because they have tried to seek services or treatment in the country – which are not available, or they have been treated and they have not found the solution.
If you look at where the largest urban medical tourism from Nigeria or even from the African continent is, it is not to France or the UK. It is to India and you can’t tell me that Nigerians are going to India because they prefer India to Nigeria, or because they want to go vacation in India. It is because they don’t have a choice. And these are the people we are seeking to support and help. And that is our focus.
We want to turn around outbound medical tourism.
The bank’s head office is based in Cairo, Egypt. And a lot of medical tourism from Nigeria, particularly northern Nigeria, is to Cairo, Egypt. People come here in droves, seeking medical help and they are treated here in hospitals in Cairo, Egypt. Those are the kinds of things we are trying to see. How do we reverse this? How do we make Nigeria the medical hub for West Africa? That is the goal of our project. And those are the focus, the people we are focusing on, and those are the people we are focusing on trying to support.
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