FT Health: The drive for universal health coverage

When Tedros Adhanom Ghebreyesus was elected director-general of the World Health Organization last month, he did so thanks to one dominant campaign pledge: to push for universal health coverage.

Progress will not be easy given the growing demand for healthcare in a world of limited resources and disagreements about the best ways to respond.

Access to medicines and other medical commodities including vaccines and diagnostics is one barrier, sparking questions about intellectual property but also about donations and differential pricing for poorer patients.

But there are many broader issues around investment in health systems and innovation in how services are delivered — let alone the need for a far greater focus on prevention.

Our Access to Healthcare report covers handouts of free medicines for Americans, South Africa’s reliance on charities to plug gaps in public services and profiles of innovative social enterprises.

Three questions

Kees Van Lede, chief executive of Carepay, operator of mTiba – a ‘health wallet’ – one of the winners of the 2017 FT/IFC transformational business awards.

What is mTiba?

It’s a way to save, send, receive and spend money ringfenced for healthcare in Kenya by mobile phone. It gives full transparency on the patient, what they are treated for, the price and a quality check. mTiba turns the whole development debate upside down. It allows donors, insurers or others to give money straight to the end-user. It cuts overheads and gives power to the individual who decides how to spend it within limits. It turns beggars into choosers.

What is its impact?

So far we have signed up 450 hospitals and clinics, 900,000 people and processed payments totalling $1.4m for 100,000 visits. The growth suggests we are on to something really big. These are outputs and now we’re launching a project to get a sense of outcomes. But we’ve already had visitors from the US and Europe drooling. We are leapfrogging western healthcare practices. We can turn real-time data into really valuable tools to help doctors treat their patients better and help patients manage their own health better.

What help do you need?

We want to add more partners, products, and services so we can reach millions of Kenyans, then go into other markets in East and West Africa. We need clever people who are experts in patient-doctor interactions. The biggest risk as a start-up is not to focus. We think there is a business model, not to charge the patients or the provider (or very little) but the third party payers [such as insurers]. We do not look at this as a donor project but a solution that should be able to pay for itself.