PharmAccess mobilizes public and private resources for the benefit of doctors and patients through clinical standards and quality improvements, loans for healthcare providers, health insurance, mHealth innovations and operational research.
The newly elected cabinet of Prime Minister Schoof is making significant cuts to development cooperation. A shame, says PharmAccess CEO Nicole Spieker, because the Netherlands itself could benefit from this aid.
Tanzanians, Nigerians, Ghanaians – just like Europeans, can’t live without their mobile phones. In these countries, mobile technology is a game-changer for healthcare, driving innovations that could also benefit the Netherlands.
“Almost everyone in Africa has a mobile phone,” says Nicole Spieker, CEO of PharmAccess, an organization that has been involved in development cooperation in sub-Saharan Africa for more than 20 years. “They’re not 1,000-euro smartphones but simple, Nokia-like devices, available for just 6 to 8 euros. These phones have made people much more accessible than before, and they are crucial because many people in Africa don’t have bank accounts.”
PharmAccess is a remarkable organization, not because of its size (two hundred employees), but because it has worked with commercial partners since its founding in 2001 – which is quite rare and sometimes controversial in development aid circles.
Trouw speaks to Spieker shortly after U.S. President Trump announced plans to dismantle the aid organization USAID. A saddening decision, Spieker believes. “But,” she says, “it also highlights a downside of aid: That with a single decision from a president, it can all disappear overnight. That’s different when you build something within a country itself, making it a functioning part of the economy.”
PharmAccess was founded in 2001 by Joep Lange. Lange, who died in 2014 in the attack on flight MH17, persuaded Heineken and Unilever to offer HIV testing, and treatment if needed, to their staff members in Africa.
Healthcare wallet
PharmAccess pioneered health insurance in African countries, with African governments and the Dutch Ministry of Foreign Affairs covering most of the premium while insured individuals contributed a small portion.
PharmAccess also started the Medical Credit Fund, allowing clinics, doctors and healthcare facilities to access loans. By the end of 2023, nearly 10,000 loans had been issued, totaling almost 180 million euros in outstanding credit – private capital invested in African healthcare thanks to PharmAccess. The organization also provides training for clinic staff and develops quality standards that clinics must meet.
Together with the African telecom company Safaricom, PharmAccess founded the company CarePay in Kenya. This platform connects patients, clinics and insurers, offering people a “healthcare wallet.”
That wallet sits on the mobile phone, enabling clinics to easily access a patient’s medical history, reducing unnecessary examinations and tests. Patients can settle their bills immediately after treatment, or the invoice is forwarded directly to the insurer. This ensures that insurers know when a procedure has been performed and can process payments promptly, Spieker explains.
Not only is the financial settlement much faster than before, Spieker argues, it’s also significantly cheaper. “In fact, it’s faster and cheaper than in the Netherlands.”
Another major advantage is that patients have direct access to their own medical data. “In the Netherlands, medical information is scattered across various places – the general practitioner, the hospital, the insurer – making it complicated, if not impossible, for patients to access their own records.” There’s a good reason experts in the Netherlands, including in the COVID-19 pandemic, have repeatedly advocated for a system similar to CarePay. That hasn’t happened yet. Spieker hopes that will change: “The municipality of Amsterdam is very interested.”
CarePay currently has around four million users in Kenya, with similar platforms now established in Nigeria and, more recently, the Middle East. But for Spieker, the question remains: Who owns all this medical data? And who profits from its value?
Cooperative
“A cooperative will soon be established,” says Spieker. It will be led by patient representatives. “We think it’s important that third parties don’t use all that medical data without the patient’s consent. The parties directly involved should oversee it. And why should big companies like Google and Microsoft profit from storing medical data?”
Spieker would like to see a similar solution in the Netherlands. After all, Dutch healthcare data is currently processed using technology from American companies and stored in data centers owned by commercial players like Google, Microsoft and KPN.
“Why should Google and Microsoft profit from medical data?
That remains an open question. While Trump is hacking USAID to pieces, the Netherlands is also making cuts to development cooperation spending. For now, this amounts to one billion euros, as announced by the responsible minister, Reinette Klever (PVV), late last year. Spieker hopes to convince the minister that the Netherlands should continue with its support for PharmAccess (currently 12 million euros) and, more importantly, continue investing in healthcare innovations abroad. After all, these innovations benefit the Netherlands as well. A meeting with Klever is already scheduled – soon in Kenya.
View here the original article (in Dutch).
