Prof Abdennour Abbas, Research Associate, Department of Mechanical Engineering and Materials Science, Washington University (2012 Prize of MIT)
What are your thoughts on the current healthcare climate in the Maghreb region?
-First of all, let me thank you for your invitation to this important regional meeting. Bringing together different actors of the healthcare sector in North Africa is certainly the best way to promote regional and concerted solutions to common challenges.
To answer your question, obviously we cannot talk about the Maghreb region as a monolithic block, since some countries are now focused on rebuilding a viable government after the events of last year. For the remaining countries, as far as I know healthcare spend has never been higher and private actors are increasingly sharing the load of public healthcare services. However, progress is very slow, and there is still pressure on public infrastructure and increasing demand for improved services, mostly due to the lack of hospital/facility management companies. Despite all efforts and the good will, there is still a lot of work to do in order to build a coherent and sustainable healthcare system.
In your opinion, what are the biggest challenges the Maghreb healthcare sector is currently facing?
-The healthcare sector is part of an economic environment and currently the biggest challenges are unfortunately not specific to healthcare, which is usually a bad sign. In my opinion, the first challenge is to make the decision making process short and coordinated. A good decision and generous budget become irrelevant when you have a number of intermediate individuals and bureaus between the user or service provider and the decision makers. This ecosystem of intermediate and unnecessary actors is the reason why reform and project implementation is always lacking behind schedules. It is even at the heart of economic slowdown in general. We absolutely need to cut out the middlemen at all levels of administration.
Another major issue is the viscosity caused by the import business network on local drug and equipment production. A company like Saidal has the potential of becoming a major regional player in the pharmaceutical industry, provided a spanner is not thrown in to the works. Given its current financial capabilities and the widespread use of generics, there is no reason for Algeria to keep importing 65% of its drugs and 95% of medical equipment and devices. The solution probably lies in offering more significant regulatory and fiscal advantages that favour the emergence and relocation of private production companies, while enforcing competition rules in the import sector.
Last but not least, biomedical research is a sine qua non condition for a sustainable healthcare system. Again, the significant budget dedicated to research will not necessarily have an impact on people’s lives if it is not strategically allocated. The university must become a problem-solver for the community and industry. To that purpose, we need to promote research projects that are initiated by societal or industrial needs. In the current conditions, we cannot afford to support research that says: “I have a solution. Does anyone have a problem?” Also, creating a competitive research environment is another key factor. When it comes to public investment, those who succeed should be rewarded, and research funding must depend solely on productivity and merit. It is the only way to get the best talent in the right place.
What do you think will be the biggest developments in healthcare in the next decade and how can the Maghreb region take advantage of that?
-A decade ago, biotechnology was the big revolution in healthcare by providing affordable vaccines, antibiotics and drugs. Today, nanotechnology is radically changing the way how we detect, treat and prevent diseases. There are already companies that offer to sequence your DNA and detect your health risks for US$ 100, and others offer self-diagnostics tests that allow people to detect AIDS at home for US$ 40 or less. Even, if some of these technologies are still relatively expensive and sometimes controversial for ethical reasons, there is no doubt they are opening up new perspectives for a preventive healthcare system. Preventive care programs and technologies can save lives and billions in public spending, and thus should be a major part in any healthcare system reform or biomedical research program.
How can you or your organisation influence the progress of healthcare in the region?
-We focus our research on home diagnostics and self-testing technologies for healthcare, food safety, environmental quality control and biodefense. We are willing to work with researchers from Algeria and the Maghreb region on specific research projects and goals, and help with student training. We are also available to provide expertise on new preventive care technologies and how to set up a regulatory environment for their use and development.
What do you want to see in the Maghreb’s healthcare future?
-North Africa is a market of 166 million people, with rapid population growth and strategic access to the African and Arab markets. The Maghreb region has all the ingredients to become self-sufficient in drugs and medical devices and even become a supplier for the sub-Saharan region. From a reform standpoint, I believe many things can be learned from the Singapore model in both its healthcare system and its biomedical research strategy.
To conclude, what is your message to healthcare officials in the Maghreb?
-I have a simple one: “Keep technology in mind.” Healthcare is a technological issue before being a political one. I personally believe the ultimate solution for any problem is always a result of a technological development. Politics is mostly a time and environment management approach. In other words, when the government provides and enforces a good legal and administrative environment, scientists and entrepreneurs can solve most of the problems in a timely and cost-effective way.