Telemedicine Consultations Could Be Key to Addressing Growing Economic Cost of Treating Diabetes in the Gulf Region

"Saudi Arabia and the United Arab Emirates (UAE) are two Gulf nations witnessing an explosive growth in the prevalence and incidence of diabetes, having some of the highest rates in the world," The Economist Intelligence Unit (The EIU) explains in a briefing paper. In addition, "According to 2019 reports, prevalence is as high as nearly one in five adults (18.3%) in Saudi Arabia and about one in six adults (15.4%) in the UAE. Telemedicine has been an important part of care in these countries' evolving healthcare services to keep affected patients healthy and costs down."

Supported by Abbot Laboratories, an American company that produces health care products, Telemedicine and diabetes care in Saudi Arabia and the United Arab Emirates explores how healthcare systems in these two countries have used telemedicine to remotely monitor people living with diabetes during the pandemic. The paper suggests that the "experience and lessons may serve as a helpful guide for other countries in the Gulf."

The paper presents four "reasons why the rollout and adoption of telehealth for diabetes in Saudi Arabia and the UAE have been particularly noteworthy, and why these successes are worth continued examination:

"Diabetes care has been in dire need of enhancement: it is well known that Saudi Arabia and the UAE have a high prevalence and projected increase in diabetes among their populations. The resulting healthcare costs are significant. It has become imperative to national health, as well as healthcare budgets, that better, more innovative and sustainable management and prevention tools are explored to their fullest.

"The legal framework is expanding possibilities: telemedicine has long been on the radar as a cost-effective option, but only recently—and just prior to the covid-19 pandemic—have regulation and legal

frameworks allowed it to take shape. Leading up to the pandemic, adoption was already picking up.

"Cost models are shifting: in many ways, telemedicine has reduced costs for patients and doctors and supported social distancing during covid-19. For patients, less travel to clinics has added convenience as well. Better adherence to health recommendations can also lead to fewer costly co-morbidities and complications like stroke and amputation. For doctors, the experience has also been positive. However, some concerns have been raised regarding the increased influx of data from these apps, which requires additional time and effort for analysis, followed by explanations and tailored recommendations to patients which is more intensive, and may require updates to how providers are compensated. Going forward, advances in predictive modelling may improve the efficiency and quality of care. Clinics will also have to determine the safest and most cost-effective hybrid model of in-person and virtual clinic interactions.

"No going back: according to those interviewed and studies published, the rapid rollout and adoption of telemedicine for diabetes have been largely welcomed and deemed successful by many patients, doctors and the wider health system. Emerging evidence suggests telehealth is helping this population to achieve better self-care. More long-term studies will be needed to judge its true safety and efficacy, as well as cost-effectiveness, but doctors and patient groups we spoke to are keen to progress this care pathway based on the experience during covid-19."

The paper concludes that "The covid-19 pandemic and its lockdowns have meant a sudden change in the delivery of healthcare, with telehealth and digital solutions becoming the go-to options. In Saudi Arabia and the UAE, the transition of care to telehealth and remote services for people living with diabetes has been supported by patients and doctors alike."

"The experience has meant that patients are now more comfortable sitting in front of a screen and streaming data in real time to their doctors. In return, they have become familiar with continuous monitoring and virtually received advice on better self-care."

Importantly, "Telehealth diabetes care has been given a boost by covid-19, and it is vital that Saudi Arabia and the UAE seize it to its fullest in order to mitigate the worrying trajectory of their national diabetes trends. But indications suggest that new hybrid models of care will emerge in future involving in-person care, remote care and predictive modelling supporting real-time care."

My colleagues and I have followed the growing telemedicine sector in the Gulf region (see "Tackling Diabetes and Obesity in an Age of Digital Acceleration in the Gulf Cooperation Council," "An Analysis of 'Diagnosing Health Care in the GCC'," and "Report Explores How Digital Technologies Are Shaping the Middle East's Healthcare Ecosystems"). This paper by The EIU presents the latest evidence that telemedicine consultations could be key to addressing growing economic cost of treating diabetes and other non-communicable diseases.

What are your thoughts about the paper's findings? Do the experience and lessons serve as a helpful guide for other countries in the Gulf?

Aaron Rose is a board member, corporate advisor, and co-founder of great companies. He also serves as the editor of GT Perspectives, an online forum focused on turning perspective into opportunity.

Report Looks at How Digital Health Technologies Are Impacting Healthcare in the US

According to a report by The Economist Intelligence Unit (The EIU), "A fundamental question surrounding the US healthcare system is 'How do we improve overall health while reducing costs?' Health care spending in the US greatly exceeds that in other wealthy countries, but does not achieve better health outcomes. By 2030, an estimated 171m people in the US will suffer from a chronic disease. This fact, coupled with an aging population in need of greater health services signals the need for change."

Digital Health: Transformation and Innovation within the USA explains that "[a] promising response to this question has come in the form of the digital health transformation. The internet of things, artificial intelligence (AI), and wearable technology are a few examples of digital transformations that have great opportunities in healthcare, and they have already begun to disrupt the healthcare landscape."

The report encouragingly notes: "Digital innovation, though an overwhelming space and daunting to adopt, has the potential to drive significant positive changes through streamlined workflows, optimized systems, improved patient outcomes, reduced human error, increased transparency, and, of course, lowered costs." What is more, "Medical technology (medtech) companies should be prepared with the knowledge of how digital transformation may impact their business environment and the understanding of how to successfully bring new innovations to the market."

Under the title of "Modes of digital disruption: The technologies reshaping healthcare," the report "looks at how trending digital health technologies are impacting healthcare, and the outlook on the adoption of these technologies."

Medical Internet of Things (mIOT) applications to watch:

• Medical facility infrastructure and security
• Workflow tracking and optimization
• Medication compliance tracking
• Data recording (EHRs)
• Chronic condition management

"Impacted populations: Healthcare facilities and device manufacturers are already benefiting from the medical internet of things. Organizations can analyze processes at scale with mIoT to determine trends and improve efficiencies. Doctors are increasingly using mIoT to monitor patients with chronic diseases."

AI applications to watch:

• Patient diagnosis based on pattern recognition from large databases (genomic and symptom information)
• Early prediction of conditions likely to develop
• Assistance in image analysis for scans and slides (e.g. X-ray interpretation for radiologists, slide interpretation for pathologists)

"Impacted populations: AI stands to improve on how well physicians can predict health risk, come to diagnoses, and draw insights from large sets of data. Workflow optimization centered around AI is already being used to reduce inefficiencies, and the technology's predictive power may be able to speed up R&D for medtech manufacturers. AI will be a key way to analyse the massive amounts of clinical data generated by increasing use of wearable sensors. This analysis will enable deeper understanding of patients' disease states, and support physician's decision-making process when providing care. Improved outcomes for patients and reduced costs for providers will be among the largest benefits of this technology."

Wearable technology/Remote patient monitoring applications to watch:

• Activity monitors for sports and fitness
• Heart rate and diabetes monitoring
• Neurological disease monitoring to conduct large studies and track disease progression
• Post-discharge patient monitoring for treatment response
• Chronic condition management
• Patient health risk assessment from activity and biometrics monitoring
• Ingestible sensors for biomarker tracking and smart drug delivery

"Impacted populations: A component of the mIoT, wearable devices are capable of collecting and transmitting health data about the individuals wearing them. The growing elderly population will benefit heavily from this technology's adoption because physicians will be able to draw health insights from larger amounts of data than previously possible, and without the need for constant in-person visits. The same is true for people with chronic diseases. Their symptoms can vary immensely from day to day, making it difficult for doctors to make treatment decisions based off infrequent visits."

Telemedicine applications to watch:

• Medical specialties well-suited for telemedicine, e.g. radiology, psychiatry, dermatology, ophthalmology
• Follow-up doctor's visits
• Healthcare access for rural populations
• Remote chronic disease management
• Assisted living center support
• Preventative care support

"Impacted populations: Widespread adoption of telemedicine will be especially impactful for those unable to easily access a medical center. Major groups affected are those living in rural areas with a shortage of doctors, and the elderly who may be unable to travel for a clinician visit. The ease of visiting with a doctor via a phone or tablet may also lead to fewer appointments cancelled at the last minute."

Augmented reality (AR), virtual reality (VR) and mixed reality (MR) applications to watch:

• Medical practitioner training
• Remote surgery
• Diagnosis support
• Mental health support tools for patients
• 3D patient rendering for improved surgery planning

"Impacted populations: VR and AR technologies will have the greatest impact on clinicians in the coming years. VR is already being used in some settings to train doctors by allowing them to practice operations in a realistic environment. AR gives doctors faster access to real-time information, aiding in diagnosis and treatment decisions. The technology can also be used to visualize patient organs and systems in 3D, a feature that will significantly improve the quality of surgery planning."

However, "challenges lie ahead for digital technology driven medtech innovation" including security, communication, regulation, and funding.

Based on my experiences of supporting and advising medtech companies, I concur that "[a]lthough we are in the midst of a transformative time for healthcare, it remains a challenge for emerging and established medtech players to keep up with increased competition and innovation from big tech organizations. The overlap amongst the different modes of digital disruption signals the importance of integration-friendly solutions. As the industry shifts into a more patient-centric and patient-owned environment it will be increasingly important for suppliers, providers, payers, and patients to embrace an end-to-end digital mindset. Key questions to consider along the way are:

• As digital healthcare evolves, what innovations give medtech a lasting edge?
• Is your company focused on the core areas for value creation?
• How scalable is your innovation?
• What organizations should you partner with to access the technologies and talent required for business model transformation?"

Moreover, "It is important to mention this transformation extends to well beyond the US – not just in developed markets, but also emerging ones. This raises key questions for medtech MNCs, such as:

• Are your company's innovations aligned with the needs of emerging markets?
• How much adaptation of your product to address the pockets and preferences of emerging markets is needed to successfully enter and capture the market?
• What are the key drivers and barriers of adoption of innovations in emerging markets?
• What does competition from innovative local players look like?"

Which digital health technologies do you think will provide the greatest impact on the healthcare ecosystem?

Aaron Rose is a board member, corporate advisor, and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

Report Explores How 'Make in India' Has Impacted the Country and the Emerging Opportunities for Medtech Multinationals

"In September 2014, the 'Make in India' initiative was started with the objective of making India an international hub for high-value technology goods," explains a report published by The Economist Intelligence Unit (The EIU). "The campaign also aimed to bring in foreign technology and capital into India and to bring self-sufficiency through domestic supply. Out of 25 shortlisted focus sectors, medical technology (medtech) is one of the sectors targeted for this initiative given its current high import intensity."

'Make in India' MedTech - Four Years On adds: "Following the launch of the 'Make in India' initiative, the Department of Pharmaceuticals (DoP) commissioned a task force to identify and promote domestic production of high-tech medical devices and facilitate the industry. In essence, in line with the 'Make in India' initiative, the task force was charged with the mandate of bringing self-sufficiency through domestic support and develop India as a Global medical device manufacturing hub."

The EIU's "report explores how 'Make in India' has impacted the country and the emerging opportunities for medtech multinationals (MNCs)."

On the topic of incentives and policies, "To build upon the initial momentum generated, the India government has committed to numerous other efforts in an attempt to make 'Make in India' an attractive proposition for the medtech industry." Furthermore, "To better align domestic development and manufacturing of medical devices with global practices, India's Ministry of Health and Family Welfare released the Medical Device Rules of 2017 (MDR 2017 or the Act) which took effect on January 1, 2018. The structure of the new regulatory paradigm appears to be on par with international standards, including the European Union's Medical Device Regulation, although the extent of these similarities will depend upon India’s implementation of the Act."

In order to create ecosystems for medical device manufacturing, "India's government has placed focus on improving local infrastructure for development and manufacturing of medical devices. State-level programs to setup specialized industrial parks to create an ecosystem for medical device manufacturing is expected to reduce set-up costs for companies, and support the production of better quality and affordable products."

Moreover, "In December 2018, the India government announced that it will set up the National Medical Devices Promotion Council (NMDPC) to boost manufacturing, attract investments and promote exports of the sector. While the medical devices industry has been growing in double digits, it is predominantly import-driven with imports accounting for over 70% of the domestic market and around 80% of critical-care medical devices such as cardiac monitors and ventilators. The setting up of NMDPC will address the issue of expansion of domestic manufacturing for critical-care devices.

"Specifically for medical devices, a slew of incentives were subsequently offered to stimulate interest in the sector" as represented in the chart below.

While there has been a positive impact in several areas after much effort in reforming infrastructure, policy and processes, the results are "below expectation in the manufacturing industry which the ‘Make in India’ initiative mainly targets at.

"Current economic data suggests that the impact of ‘Make in India’ has been lackluster and the initiative is a long way behind its intended target. Through the ‘Make in India’ initiative, Prime Minister Modi hoped to raise the share of manufacturing as a percentage of gross domestic product (GDP) to 25% by 2025, and create 100 million new jobs by 2022.

"However, GDP growth slowed between 2017 and 2018, with the manufacturing sector's contribution to GDP showing no increase. On the jobs front, published data from the World Bank records 5.5 million new jobs created yearly—hardly sufficient to catch up to the goal of 100 million new jobs by 2022."

With respect to medtech MNCs capitalizing on the country's growing medtech industry, the report says:

Unlike global manufacturing giant China, India lacks adequate infrastructure, the right set of know-how and an ecosystem to support MNCs in the 'Make in India' initiative. The prevailing perception among MNCs sees India as a hub for low-cost, entry-level products catered towards emerging markets. In 2007, medtech MNC Stryker opened an R&D hub in Gurgaon and its second facility the very next year. Stryker continues to bank on India R&D to gain edge in emerging markets. R&D at these facilities are aimed at catering to mid-tiered consumers of the value, no-frill devices segment.

While most MNCs already operating in India may not have plans for aggressive local expansion, there are a number of medtech companies such as GE Healthcare, Philips Healthcare and Intuitive Surgical that have jumped on the 'Make in India' initiative. It seems companies that have already established a significant footprint in India or want to cap its future based on Indian demographic needs might be interested to invest despite setbacks from the ecosystem in the country.

Perhaps India will begin to see positive results in the coming years. As The EIU explains:

In September 2018 the government officially launched the ambitious Pradhan Mantri Jan Arogya Abhiyan or the Ayushman Bharat National Health Protection Scheme (AB-PMJAY), which it describes as the world's largest government-funded healthcare program. The scheme will provide health insurance cover of up to Rs500,000 (US$7,400) a year to 500 million low-income beneficiaries, aiming to cover 40% of the population. To date, AB-PMJAY is the boldest national health insurance plan in India's history, providing more people with greater coverage than any previous program. While current implementation remains at a nascent stage, this plan has the potential to generate huge demand for medical technology.

The report concludes by noting:

With the 'Make in India' campaign, the government intends to manufacture high-tech cost competitive products locally. While progress since inception has been below par, the government's continued efforts show its commitment in driving this plan to fruition. The recent launch of the Ayushman Bharat National Health Insurance is likely to further propel domestic access and demand for healthcare products and services. For medtech MNCs, there are potential synergies that can be unlocked should they explore manufacturing in India. However, careful considerations need to be taken in evaluating the most appropriate strategy for medtech companies looking for opportunities in 'Make in India.'

What investment or business opportunities are you seeing in India's medtech industry?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

GSMA Report Says Mobile Technology Will Enable Access to Life-Enhancing Services in the Pacific Islands

A post that I published in this forum in 2008 focuses on a project my colleagues and I developed in utilizing information and communications technology (ICT) to implement social and economic development initiatives in the Federated States of Micronesia (FSM). One significant outcome of our proposal was to create a digital strategy to be incorporated into the FSM's national development strategy. Eleven years later, I read with great interest a report, The Mobile Economy Pacific Islands 2019, that says "[m]obile technology can play a pivotal role in the digital transformation of the Pacific Islands, enabling access to life-enhancing services in areas such as health and education, while proving a catalyst for innovation and economic growth, with the promise of new jobs and increased tax revenues."

Authored by GSMA Intelligence, the research arm of the UK-based GSMA, below are the report's findings:

• Mobile helping to boost financial inclusion: The Pacific Financial Inclusion Programme (PFIP) was launched in 2008 and has funded 44 projects with financial service providers helping more than 2 million Pacific Islanders access formal financial services;
• The ongoing shift to mobile broadband and digital transformation: at the end of 2018 mobile internet penetration in the region was the lowest of any region in the world at 18 per cent. However, 4G connections in the Pacific Islands are set to account for more than half of total connections by 2023, doubling the figure from the end of 2018 and increasing access to services;
• Infrastructure challenges: Many countries in the Pacific Islands region face issues around insufficient infrastructure. Several countries are yet to complete the digital switchover process, including Papua New Guinea, Tonga and Solomon Islands; and
• Unlocking the full potential of mobile: The upcoming World Radiocommunication Conference will be one of the best opportunities for governments and industry to identify a significant amount of harmonized millimeter wave spectrum, which will result in massive economies of scale for 5G in the future.

Infographic: GSMA
Intelligence

The report encouragingly explains: "Mobile phones are bringing internet access to previously unconnected populations across the world, particularly in developing regions such as the Pacific Islands where there is a lack of alternative access technologies."

However, "Countries across the Pacific Islands still face significant challenges around funding infrastructure to provide mobile and internet access to their populations, which in turn reduces the ability of governments and policy-makers to address social and economic challenges. Providing mobile coverage is a particular challenge in a region often described as 'sea locked,' with large segments of the population living in remote and often inaccessible areas."

Further on the topic of the challenges of mobile connectivity in the Pacific Islands, the report notes:

The GSMA Mobile Connectivity Index measures digital inclusion in 163 countries across the world, including six countries in the Pacific Islands. The index is built around four key enablers of mobile internet connectivity, critical to creating the right conditions of supply and demand for mobile internet connectivity to flourish:

• infrastructure: the availability of high-performance mobile internet network coverage
• affordability: the availability of mobile services and devices at price points that reflect the level of income across a national population
• consumer readiness: citizens with the awareness and skills needed to value and use the internet and a cultural environment that promotes gender equality
• content: the availability of online content and services that are accessible and relevant to the local population.

There are many aspects of our 2008 proposal remain relevant in 2019 of using mobile technology as a pivotal role in the digital transformation of the FSM and throughout the Pacific Islands. Specifically, with the expansion of mobile technology, Pacific Islanders will be able to access digital health (mHealth), education, and financial technology (fintech) services. This presents a great opportunity for technology developers and investors to collaborate and support local small businesses.

In addition, with an early roll out of 5G services in 2020 and a projected 19,000 5G connections in 2025 (see left chart), frontier technologies such as artificial intelligence, blockchain, IoT and advanced data analytics will become available. "The Pacific Islands region might not be one of the first to roll out 5G services but it can benefit from a mature ecosystem and global economies of scale to see 5G develop in the same way as LTE has done in the region. New submarine cables with improved capacity and other technical advancements are setting the stage for advanced broadband services, including 5G."

What online content and services are you developing that are accessible and relevant to Pacific Islanders?

Aaron Rose is a board member, corporate advisor, and co-founder of great companies. He also serves as the editor of GT Perspectives, an online forum focused on turning perspective into opportunity.

5 Key Medtech Trends in Emerging Markets in 2019

"The Economist Intelligence Unit (EIU) Healthcare highlights key trends in the global medical technology (medtech) industry in 2019 – from the industry coming under pressure as US-China economic and technological rivalry continues to unfold to the pick-up of remote monitoring and telehealth solutions." The EIU's report, MedTech in Emerging Markets 2019, "focuses on the implications of some of these trends on emerging markets as companies look to gain greater access to these fast-growing high-potential markets. We look at various opportunities and challenges to help companies understand where and how emerging market medtech companies are evolving as even stronger competitors in 2019, and affordability and infrastructure issues in these markets."

The report presents the following five global medtech trends shaping 2019:

1. Data-driven healthcare approaches among consumers and healthcare providers demand for greater connectivity.

"Consumers are increasingly expecting medtech to connect over a single platform to offer a holistic solution to multiple needs and demands. High net worth individuals (HNWIs) in Asia, Middle East and Africa polled by the EIU believe that the collection of personal health data will improve their ability to care for their health."

Moreover, "Medtech needs to connect over a single platform for healthcare providers pursuing data-driven healthcare that will need broad sets of data to come together in a connected ecosystem."

Lack of trained healthcare professionals and gaps in local healthcare infrastructure, however, are two barriers to greater adoption of a personal data-driven approach to healthcare according to HNWIs in Asia, Middle East and Africa. But the report notes that 76 percent of healthcare organizations are planning to invest heavily in big data and analytics.

2. Medtech comes under pressure as US-China economic and technological rivalry continues to unfold in 2019.

An estimated total annual value of US$1.1 billion of medical imaging products were subjected to US and China tariffs implemented in 2018. The report further explains fast-growing and high value medtech segments to watch for intensifying competition and potential trade risks include high-value medical consumables, in-vitro diagnostics (IVD), and gene sequencing.

3. Emerging market medtech companies are bolstering their competitiveness in global markets through product innovation and successful go-to-market strategies.

"Emerging market medtech companies are cementing their presence in their domestic market." In fact, four out of 10 of the biggest IVD players in China are domestic companies.

The report further explains, "Emerging market medtech companies are increasingly capturing a larger share of overseas markets – in mid- and higher-end medtech product segments." Two out of three hospitals in the United States use medical equipment from Mindray – China's largest medtech company.

4. Wider adoption of remote monitoring and telehealth under favorable reimbursement schemes.

US healthcare providers polled report that less than 10% of their total care delivery is provided through telehealth and all US healthcare providers polled anticipate use of telehealth to grow over the next three years. Furthermore, "With reimbursement increasing, 45% of US healthcare providers polled expect a significant increase - more than 10% increase, in the share of total care delivery that will be provided through telehealth, over the next 3 years."

5. Big Tech is becoming a more direct competitor in medtech.

The report notes that in 2018, Amazon launched its own medical device brand focused on diabetes and cardiovascular devices that work with Apple Health and Amazon's Alexa. What is more, "80% of healthcare providers polled are paying close attention to Big Tech’s entry into the healthcare space, recognizing the opportunities to redesign their care models by working with these companies."

Healthcare providers see potential for collaboration with Big Tech in streamlining provider workflows, implementing consumer-focused services, and solving supply-chain challenges.

The report also provides insights on:

• What is the impact of the rise of domestic medtech companies in emerging markets?
• What are the critical issues challenging affordability and access to healthcare innovations in emerging markets, and how can governments and third-party payers help to improve access
• Interview with Swiss Re - one of the world's leading reinsurance company: Rethinking the alignment between diagnostic innovation and private health insurance;
• Where do hospitals in emerging markets lie on the adoption curve for healthcare innovation?
• How might companies approach and customize their medtech market access strategies in emerging markets?

Do you agree with The EIU's five key medtech trends in emerging markets in 2019?

Aaron Rose is a board member, corporate advisor, and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

Report Explores How Digital Technologies Are Shaping the Middle East's Healthcare Ecosystems

According to a report published by The Economist Intelligence Unit (The EIU), "5 out of 14 countries in the Middle East have a well-defined digital transformation plan for healthcare in action. Governments, healthcare providers and companies will have to figure out how to initiate entire healthcare ecosystems to adopt new technology-enabled ways of solving challenges in healthcare."

The EIU's report, Digital Health: Digital Transformation in the Middle East, explores how digital technologies are shaping the Middle East's healthcare ecosystems, activities and stakeholders in significant ways. It is also on this deepened understanding that we examine the opportunities and challenges that lie ahead in the realities of finding digital health solutions for this region. The report is segmented by three chapters.

Scaling up digital health solutions in the Middle East: The seeds of digital transformation 

"Government-led digital transformation efforts in several parts in the Middle East are reshaping how individuals and organisations in the healthcare ecosystem are interacting with each other. There is a stronger need for collaboration and companies will need to engage with other players on new terms."

Key implications:

• For digital health to take off, there must be a fundamental shift in how stakeholders collaborate. Achieving a vibrant digital health ecosystem often requires government action;
• Governments and organizations need a strategy not just for itself, but for the entire digital health ecosystem;
• To scale digital health use, companies need to understand and respond to local challenges and varying levels of readiness for technology adoption in different markets; and
• Companies can seed change in different markets more effectively and quickly by setting up centers for digital health in strategic locations with high digital density, leading to the formation of digital hubs.

Locating technology's value proposition in different markets

"Digital health instantiates itself uniquely in different countries and markets faced with an exclusive set of healthcare challenges. We examine how quality care can be extended across distances by growing telehealth use in different settings and geographies. We also look at data-driven solutions that are used to create smarter, more efficient and more precise healthcare delivery and patient experiences."

Key implications:

• New insights will emerge from existing data that will challenge existing strategies and models in healthcare;
• Recognize and define what healthcare challenges can be addressed by technological solutions;
• Locate opportunities where technology can be used to enhance core products and value propositions of pharmaceutical and medical device companies, for example enabling more tailored treatments and services through big data insights;
• Determine how ready are different markets and adopters for the introduction of technologically-enhanced product and service offerings, and tailor a go-to-market strategy accordingly;
• Figure how incentives for adoption can be better aligned, e.g. initiatives to encourage patients to share their health data; and
• Healthcare companies will have to think hard how technology can be integrated in their overall growth strategy.

Future care models for the Middle East: Keeping people healthy

"Digital technology is making new care experiences possible by reshuffling delivery nodes of different medical services that will bring opportunities in decentralized and near-patient products and services."

Key implications:

• Companies need to think about how to offer value in a shifting healthcare delivery landscape as the delivery locus of different medical services gets reshuffled;
• Anticipate patient and provider needs amid digitization; and
• Remap patient pathways and journeys. Small preferences in using technology accumulates in broader changes in the patient pathway and journey.

The report further explains that "[w]hile the level of digital maturity is uneven across the region, and sometimes across different areas of healthcare, it is only a matter of time before the full benefits of digital health permeate the region. More than ever, healthcare companies need to respond to that future now."

If you work in the healthcare sector in the Middle East, how will digital health technologies shape healthcare?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

The Changing World of Digital Health

Organized through its Kirkland, Wash. office, Nan Hai, a Millbrae, Calif-based company that produces tech and business conferences to facilitate cross-border collaboration between companies in the U.S. and China, held its annual Seattle Biz-Tech Summit in Bellevue, Wash. on Sept. 30, 2017. The theme for this year's summit was "Innovation meets Connection," which continues the summit's focus on technology innovation and business exchanges between the Pacific Northwest and Asia. This post focuses on the presentation, "The Changing World of Digital Health," I gave in a breakout session titled "Technology & Innovation in Healthcare." The content of my presentation is primarily derived from three articles published by The Economist.

What Role Will Technology Play in the Delivery of Primary Care in China?

Starting with an article, "Shod, but still shoddy," published on May 11, 2017, I focused my discussion on the assertion that "many people who seek medical help in China bypass general practitioners and go straight to hospital-based specialists. In a country once famed for its readily accessible 'barefoot doctors,' primary care is in tatters."

In presenting the current conditions in China, the article explains:

It is not just long waiting-times at hospitals that necessitate more clinics. People are living far longer now than they did when the Communists took over in 1949: life expectancy at birth is 76 today, compared with 36 then. People from Shanghai live as long as the average person in Japan and Switzerland. Since 1991, maternal mortality has fallen by over 70%. A growing share of medical cases involve chronic conditions rather than acute illnesses or injuries. GPs are often better able to provide basic and regular treatment for chronic ailments. The country is also ageing rapidly. By 2030 nearly a quarter of the population will be aged 60 or over, compared with less than one-seventh today. More family doctors will be needed to manage their routine needs and visit the housebound.

Whether it is through wearables, telemedicine or other technological hardware or software platforms, what role will technology play in the delivery of primary care of China?

How Hospitals Could Be Rebuilt, Better Than Before

Referencing an article, "Prescription for the future," published on Apr. 8, 2017, I highlighted The Economist's observation that:

Today, hospitals are where patients go for consultations with specialists, and where specialists, with the help of medical technicians and pricey machinery, diagnose their ills. They are also the main setting for surgery and medical interventions such as chemotherapy; and where sick people go for monitoring and care.​ But high-speed internet, remote-monitoring technology and the crunching of vast amounts of data are about to change all that. In the coming years a big chunk of those activities—and nearly all the monitoring and care— could move elsewhere.​

I also explained that "technology firms are already playing a bigger part in health care as phones become more powerful and patients take control of their own diagnosis and treatment." Furthermore, "the more far-sighted hospitals are hoping to remain at the center of the health-care ecosystem, even as their role changes.​"

The following text from the article provided the central thesis of my presentation:

Picturing what hospitals could be, if the various obstacles are overcome, means abandoning long-held assumptions about the delivery of care, the role of the patient and what makes a good doctor . . . . Just as online banking made life more convenient for consumers and freed up branch staff for complex queries, online health care could mean fewer people need to come to hospitals to be cared for by them. Last year half of consultations ordered by Kaiser Permanente, an integrated American health-care firm that runs many hospitals, were virtual, with medical professionals communicating with patients by phone, email or videoconference.​

Mark Wen and Aaron Rose
at the 2017 Seattle Biz-Tech
Summit

What is more, as "more sophisticated diagnostics, including blood tests and virtual imaging, become available remotely, more patients could receive hospital-quality care without leaving home . . . . And with better remote monitoring some chronically ill patients who now need to be in hospitals will be able to stay at home, only coming in when their conditions deteriorate. Moving care outside institutions will both save money and raise standards, by making patients more comfortable and reducing infection rates."

The article is correct to forewarn that "for all this to happen, primary care and home support will need to improve." Technology will play a significant role in such improvements.

In the future, the article suggests, "rather than checking patients' vital signs only at intervals, or parking ICU-nurses next to beds, live data-streams from medical machines and wearable devices could ow straight to such command centers, where supercomputers could screen them for anything worth bringing to the attention of medical stations. Doctors in the command center, or even in their own homes, could be at patients' bedsides virtually with a swipe of a touchscreen. All this would not only make the hospital safer and more efficient; it would also give medical staff a more complete record of patients' progress."

Moreover, "A command center could watch over patients not only in hospitals, but also at home. Wearable devices that track vital signs, contact lenses that monitor blood-sugar levels and smart-stitches that measure the pH level of fluid in wounds would all mean fewer patients in hospital for monitoring."

On the topic of robotics, "The surgeon's job, too, could be transformed. Today, the use of robots in the operating room is limited because they must be steered manually with a joystick. In future robots might be able to carry out some standard procedures such as hip replacements autonomously, with a surgeon getting things started and the robot doing the rest."

In addition, more complex operations via "a supercomputer linked to a real- time virtual-reality (VR) machine could help walk surgeons through their operations. It could, for example, highlight where a tumor sits in the liver and warn a surgeon about impinging on an artery, just as a satnav warns of traffic jams ahead."

The article accurately the discusses the world's growing need for healthcare workers. "The World Bank," notes The Economist, "estimates that by 2030 the number of health-care workers will need to double, compared with 2013—an extra 40m workers globally." Additionally, "High rates of stress and burnout are already a problem in health care; if workloads continue to increase they will only rise further. But if medical staff are made more productive with the help of computers, monitoring devices and robots, they can be freed up to do the work that only humans can do, and helped to do it better and more happily."

China's Audacious and Inventive New Generation of Entrepreneurs

My presentation then focused on the wave on new Chinese companies that are transforming the digital economy domestically and abroad. According to an article, "The next wave," by The Economist, "China's nimble new innovators are using world-class technologies from supercomputing to gene editing. Having established themselves in the cutthroat mainland market, many are heading abroad."

China's health industry "is antiquated and dysfunctional," the article claims. "Long queues are common at state hospitals and access to drugs is complicated by an opaque system of dispensation." This, however, has provided an opportunity for entrepreneurs and well-established Chinese companies alike. "AliHealth, an arm of Alibaba, is now a leading online pill-peddler. WeDoctor helps patients book medical appointments using smartphones. Venus Medtech has invented a retrievable heart valve intended for patients with high calcification in their arteries."

The Sept 23, 2017 article further says: "The best example of a local health-care disrupter with global potential, however, is iCarbonX, a health-data analytics firm from Shenzhen, a metropolis near Hong Kong. It is the brainchild of Wang Jun, who is a picture of the active health he wants to encourage with his startup. He formerly ran BGI, one of the world’s leading genomics-research firms. The Chinese company was involved in the global race to decode the first human genome and at one time owned half the world's gene-sequencing equipment."

ROI3's English Language Learning for Medical Terminology​

I concluded my presentation with a discussion about a mobile app my colleagues and I at ROI3 developed to help medical doctors and healthcare professional in China to learn English language medical terminology. Not only does our app correspond to the growing international presence Chinese companies are experiencing, but many studies suggest that over 90 percent of global medical research is published in English. Chinese medical universities and research institutions have recently made significant investments in building their research and development programs with the aim to share their innovation with partners and customers worldwide.

I want to express my appreciation to the panel's moderator, Dr. Mark Wen, Vice President & Director for Seattle Children's Hospital Global Business Development and International Medical Services, for inviting me to speak at this year's summit. In addition, a special "thank you" to my colleague, Jingyan Zhang, for her help with creating the PowerPoint presentation, which may be downloaded via SlideShare.

What are your predictions on how technology will change the global healthcare industry?

The Changing World of Digital Health from Aaron Rose (罗安伦)

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

Integrating Technology to Solve the World's Healthcare Challenges

"The time for leveraging technology to solve the most pressing healthcare challenges across the world has come," writes Ivy Teh in the "Forward" of a report published by the Economist Intelligence Unit. Ms. Teh, who serves as Global Managing Director of EIU Healthcare Consulting, continues: "With the explosion of technological innovations ranging from artificial intelligence and big data technologies to ever more powerful sensors, the possibilities of using technology to improve healthcare are endless. The challenge now is less about technology than it is about finding viable models to implement those new technologies in order to make a real impact on the healthcare challenges that the world currently faces."

According to Ms. Teh, the report, Digital Health: Total Convergence, explores "how digital health is already changing the healthcare landscape in different parts of the world, in order to provide a deeper understanding of the topic of digital health, which has been dominating conversations in the healthcare industry. Based on this deepened understanding, we also examine the opportunities and challenges that lie ahead in terms of the practical realities of finding digital health solutions for the world."

Witnessing the digital health evolution over the past several years, I have become discouraged by the view held among many entrepreneurs and innovators that technology alone is the answer to solving the healthcare industry. Therefore, I was pleased to read the report's assertion that "the current challenge in digital healthcare is no longer purely about technology. Companies have to figure out how to initiate entire healthcare ecosystems to adopt new technology-enabled ways of meeting the innumerable challenges faced in healthcare."

The report provides a relevant and insightful discussion on three subtopics:

1. Digital health hubs: Scaling up digital health solutions for the world;
2. Digital divide: Locating technology's value proposition in different markets; and
3. Digital adoption will prompt a radical rethink of existing customer segments.

With respect to digital health hubs, "The interactions between technology and healthcare ecosystems in different parts of the world are creating digital health hubs with distinct areas of specialization and focal points that have formed in response to local healthcare challenges." The report "examines how the geographical dispersion of innovations and testing of digital health solutions will be critical to the implementation of high-impact solutions on a global scale."

On the topic of the digital divide, "Digital health instantiates itself uniquely in different countries and markets, each of which faces its own particular set of healthcare challenges. The value offered by digital healthcare lies in the way in which companies can apply recent breakthroughs in science and technology to different healthcare challenges to bring value to users." The report examines "how companies are extending their reach to new patient pools and markets by growing telehealth use in different settings and geographies." It also looks gives attention to "data-driven solutions that can be used to create smarter, more efficient and more precise healthcare delivery and better patient experiences."

As for digital adoption prompting a radical rethink of existing customer segments, the report illustrates how "digital technology is creating new market spaces in healthcare. New customer segments, such as internet hospitals, have emerged. Digital technology has also reshuffled the delivery points of the various medical services, in a way that will create opportunities in decentralized and near-patient products and services. Patient pathways and journeys will need to be remapped in response to patient demand for technologically enhanced products and services."

Encouragingly, the report "explores the true value of digital health—namely, the convergence of technologies to support healthy living around the world. This definition reflects the aim of this report: to provide a comprehensive and integrated view of how technology is used to solve the most pressing challenges that are faced in healthcare today."

I recommend reading the report if you have an interest in digital health. For those who read it, what are your thoughts?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

2010 Global Social Entrepreneurship Competition Presents Innovative Solutions

I had the pleasure to serve as a judge in the 2010 Global Social Entrepreneurship Competition (GSEC) organized by the University of Washington's Global Business Center at the Michael G. Foster School of Business. The purpose of GSEC is to engage “creative minds around the world to encourage bolder and less conventional business solutions to global poverty.” US$18,000 in prize money was available for the sixth annual competition. (Photo: Nuru Light)

GSEC plans are judged on three criteria: (1) effect on the quality of life and poverty alleviation in the developing economies, (2) financial sustainability, and (3) feasibility of implementation. 161 applications were submitted from 36 countries and this year’s five finalist teams traveled from Bangladesh, Canada, China, India, Rwanda, and the United States. Unlike my role of judging the semi-final round in 2009, I participated in this year’s GSEC as a judge in the Investor’s Choice Award, evaluating each team’s brief elevator-pitch and trade show exhibit.

The Grand Prize of $10,000, sponsored by Microsoft, was awarded to Nuru Light, which provides a solution to the lighting crisis in Rwanda. Through the POWERCycle, the Nuru Light (Nuro means light in Swahili) provides an affordable, safe, and clean lighting solution to replace kerosene in households without electricity. Nuru lights can be recharged quickly via the world’s first pedal generator. In addition to the Grand Prize, Nuru Light was the winner of the Investor’s Choice Award of $500, People’s Choice Award, and the second place Global Health prize of $2,000 for the health benefits of POD lights including decreased exposure to particulate matter and lowering the risk of kerosene burning. Team Nuru was represented by Charles Ishimwe from Adventist University of Central Africa in Rwanda and Max Fraden of the University of Massachusetts Medical School. (Photo: University of Washington)

The University of Washington’s Department of Global Health sponsored the Global Health Prize of $5,000, which was awarded to TouchHb, an affordable, prick-less anemia scanner used by low-skilled village health workers in rural India that measures, helps diagnose, monitors and screens for anemia. Team TouchHb consists of two doctors, Yogesh Patil and Abhishek Sen, from the Maharashtra University of Health Sciences in India. (Photo: University of Washington)

For this year's GSEC, judges spontaneous created an award and personally donated a total of $3,000 for the Judges’ Choice Award, which Malo Traders received for their business plan that provides technological consultation that minimizes risks of post-harvest losses for small-scale rice farmers in the West Africa nation of Mali. Team Malo consists of two brothers who grew up in Africa and are now studying in the United States: Mohamed Ali Niang is a student at Temple University Fox School of Business in Philadelphia, Pennsylvania and Salif Romano Niang, a doctorate student in political science at Purdue University in West Lafayette, Indiana. (Photo: University of Washington)

Aaron Rose is a board member, corporate advisor, and co-founder of great companies. He also serves as the editor of GT Perspectives, an online forum focused on turning perspective into opportunity.

EatWell: Building a Community through Mobile Phones to Live a Healthier Lifestyle

A researcher at the Georgia Institute of Technology has created a system that allows community members to build a support system and live a healthier lifestyle by using mobile phones. According to news release dated February 17, 2010, “The system, known as EatWell, uses mobile phones to record and share audio stories with other members from their community. The idea is that people working together can encourage each other with their stories of how they’ve successfully overcome temptation in an effort to live a healthier lifestyle.” (Photo of Andrea Grimes courtesy of Rob Felt/Georgia Tech)

Presenting her research at the Conference on Computer Supported Work in Savannah, Georgia, Andrea Grimes, Ph.D. candidate in Georgia Tech’s College of Computing, said, “I wanted to make a system that was able to harness the community-held expertise, not just bringing in outside expertise. With mobile phones, I saw an opportunity to use technology to make that information even more visible.” Ms. Grimes conducted her pilot study with 12 participants from a working class background in Southwest Atlanta.

Georgia Tech’s announcement explains that Ms. Grimes “decided to create the system on a mobile platform because she knew it was a pervasive device that is owned by people from all income levels. She also knew that people could leave messages much faster than typing into a desktop computer or into the mobile phone would allow.”

“People talk about being engaged with the content in EatWell because they actually hear the emotion in people’s stories,” Ms. Grimes said. “They could hear the pride and excitement people felt when they tried a new smoothie recipe, or when this guy talks about trying out the veggie burger at Burger King and coming back later that day bringing his girlfriend.”

Ms. Grimes’ research produced some surprising results. One result is people reported feeling a connection with others in the study, although though they did not know the other participants. Another result is the transcriptions contained very little in the way of statements of encouragement or talk of collective action. Ms. Grimes explains, “Most of the research says that for you to have a strong thriving community there needs to be a lot of interaction between the community members. But from our study, we saw that people felt a sense of community even though there wasn’t a lot of interaction.”

Free Mobile Health Service for Pregnant Women, New Mothers Launches in U.S.

Pregnant women and new mothers in the United States are now able to receive health information delivered to their mobile phones by text message at no charge through a public service program by a coalition of mobile phone service providers, health professionals, and federal, state, and local agencies. The White House Office of Science and Technology Policy’s (OSTP) press release explains, “The new program, called text4baby, is a free mobile information service that provides timely health information to women from early pregnancy through their babies’ first year. The service sends important health tips that are timed to the mother’s stage of pregnancy or the baby’s age.”

One of the primary objectives of text4baby is to improve prenatal and infant care by providing pertinent information to pregnant women and new mothers. OSTP says that “in the United States more than 500,000 babies – 1 in every 8 – are born prematurely and an estimated 28,000 children die before their first birthday, a rate among the highest in the industrialized world. Premature babies can face lifelong health and intellectual development problems.”

Providing women with information about prenatal care through text messages will, hopefully, reduce the risk of delivering premature babies. OSTP says that “medical expenses for babies born prematurely average about ten times those for babies born after a full-term pregnancy. All told, premature births cost the Nation tens of billions of dollars—at least $26.2 billion in 2005, according to the U.S. Centers for Disease Control and Prevention.”

How does text4baby work? Women who sign up for the service online or by texting BABY to 511411 (or BEBE for Spanish) receive three free SMS text messages each week timed to their due date or baby’s date of birth. The messages focus on topics critical to the health of moms and babies, which include: immunization, nutrition, seasonal flu, prenatal care, emotional well being, drugs and alcohol, labor and delivery, smoking cessation, breastfeeding, mental health, birth defects prevention, oral health, car seat safety, exercise and fitness, developmental milestones, safe sleep, family violence, and more. Text4baby messages also connect women to public clinics and support services for prenatal and infant care.

The OSTP announcement notes that several “U.S. government agencies are involved in the design, outreach, and evaluation of text4baby, and will serve women and babies who learn about their services through the program. These include the Department of Health and Human Services, the Department of Defense Military Health System, and the Office of Science and Technology Policy. Participating carriers include: Alltel, Assurance Wireless, AT&T, Boost Mobile, Cellular South, Cellcom, Centennial Cellular, Cincinnati Bell, Metro PCS, N-Telos, Sprint Nextel, T-Mobile, U.S. Cellular, Verizon Wireless and Virgin Mobile USA.” This represents a majority but not all mobile operators in the United States. Approximately 90 percent of all mobile subscribers in the United States are able are to receive the free text4baby messages.

The text messages were developed by the National Healthy Mothers, Healthy Babies Coalition with support from the Centers for Disease Control and Prevention and the Health Resources and Services Administration. Following message development, they underwent a vigorous review process by several government organizations including the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Center for Disease Control and Prevention, Health Resources and Services Administration, the Department of Health and Human Services, the Office on Women’s Health and the National Institute on Child Health and Human Development. Text4baby is an educational program of the National Healthy Mothers, Healthy Babies Coalition (HMHB), made possible through a public-private partnership that includes more than 100 entities.

The Gates Foundation claims that 10 million kids under the age of five died in 2005 and the United Nations International Telecommunications Union reported that the number of mobile cellular subscribers worldwide reached the four billion mark by the end of 2008, which represented over 60 percent of the global population. Given these statistics, I see great value in implementing a similar text message system to reduce the global infant mortality rate.

EpiSurveyor: A Data Collection Tool Transforming Public Health for Underserved Populations

Mobile phones are widely used throughout the African continent and we are seeing unique services in health care, banking, and education. This blog has presented different telemedicine services and I think there is value in discussing an innovative solution that uses mobile phone technology and the Internet “to deliver more effective public health services throughout the developing world,” according to a Voice of America (VOA) report by Natalia Ardanza. This report provides another prime example of using information and technology (ICT) solutions in providing essential services for the world’s underserved populations. Click here to watch Ms. Ardanza’s video report. (Photos: DataDyne.org)

Joel Selanikio and Rosa Donna co-founded DataDyne.org, a nonprofit dedicated to providing sustainable information technologies in poor areas. Ms. Ardanza says that with financial support from the United Nations Foundation and the Vodafone Foundation, Selanikio developed EpiSurveyor -- a free, mobile, Web-based and open-source data collection tool that is transforming the way public health is practiced in under-served areas of the world.” EpiSurveror was developed in collaboration with the Kenyan Ministry of Health and DataDyne’s website notes that its “multiple-award-winning EpiSurveyor.org is the first web 2.0 application for international development and global health.”

Furthermore, according to Ms. Ardanza, “EpiSurveyor replaces cumbersome and costly paper-based data collection that can take months, and sometimes years to produce results. ‘Instead of collecting data today to plan for a campaign next year, changing from that to collecting data today to plan for what we do tomorrow,’ Selanikio explained. ‘That is a pretty radical change.’ Public health relies on the rapid collection of accurate data to track disease outbreaks, monitor vaccine supplies and other similar functions.” Watch a demonstration video of EpiSurveyor on YouTube at http://www.youtube.com/watch?v=5aS6R1fUCBU.

DataDyne provides consulting services combining information technology, mobile phones, epidemiology, public health, and clinical medical care into a valuable service in treating underserved populations in developing nations. According to DataDyne’s website, the Washington, D.C.-based organization creates and implements ICT solutions for a clinical setting, evaluating a public health program, or building a SMS-based drug notification system.

DataDyne’s EpiSurveyor is now used as a World Health Organization (WHO) standard method of data collection. In addition, more than 500 organizations in over 100 countries are using EpiSurveyor in areas such as agriculture and public opinion polling. In 2009, Dr. Selanikio was the recipient of the $100,000 Lemelson-MIT Award for Sustainability.

African Union Ambassador Visits Seattle Promoting Business Opportunities

I had the pleasure of meeting Amina Salum Ali, Ambassador of the African Union (AU) to the United States, during her visit to Seattle. Hosted by the Trade Development Alliance of Greater Seattle and the Africa Chamber of Commerce of the Pacific Northwest on October 27, 2009, Ambassador Ali gave a presentation titled "An Integrated Africa: An Overview of African Economies and the African Union." Since her appoint as the AU ambassador in 2007, this was the Ambassador's first trip outside of Washington, DC that focused primarily on promoting Africa as an investment opportunity. (Photo of Ambassador Ali courtesy of the Trade Development Alliance of Greater Seattle/Allison Peterson)

Ambassador Ali gave an excellent presentation outlining the economic benefits of investing in the African continent. Specifically, she noted the opportunities that exist in manufacturing, agriculture, mining, health care, transportation, and information and communications technology including using mobile phones for banking, education, and medicine. While Africa is not immune to the economic recession, said Ambassador Ali, many investors in Africa are seeing a positive return on their investment. She also encouraged investors to focus on establishing processing operations, which are greatly lacking throughout Africa. Not only is De Beers mining diamonds in Africa, Ambassador Ali noted, the diamond conglomerate is the only company processing its product (diamonds) locally.

Ambassador Ali highlighted the benefits of the African Growth and Opportunity Act (AGOA), which was signed into U.S. law in 2000. According to a website maintained by the U.S. Department of Commerce, http://www.agoa.gov/, AGOA "provides beneficiary countries in Sub-Saharan Africa with the most liberal access to the U.S. market available to any country or region with which we do not have a Free Trade Agreement. It reinforces African reform efforts, provides improved access to U.S. credit and technical expertise, and establishes a high-level dialogue on trade and investment in the form of a U.S.-Sub-Saharan Africa Trade and Economic Forum."

While acknowledging the humanitarian and military conflicts that exist in Africa, she reminded the attendees, who included several members of the African Diaspora that conflicts will dissipate as standards of living increase and people improve their lives through access to education, job training, medical services, and economic development support. She encouraged the African Diaspora to help promote the benefits of doing business in Africa by speaking positively about their home continent noting Africa's abundance of natural resources, vast landscapes, and diverse cultures.

I had the opportunity to ask Ambassador Ali two questions: (1) What is AU's strategy for combating corruption and properly training local government officials to eliminate corrupt practices that often impede economic development and (2) what legal recourse do investors have to resolve business disputes? In responding to the former, Ambassador Ali noted that many African nations have taken significant steps to combat corruption, which is evident by the regular media reports discussing the latest arrests or convictions. The broad media attention on Africa's corruption, she explained, is not about a failed system, but representative of effective actions and policies aimed to eradicate corrupt practices. She also noted the adoption of the "African Union Convention on Preventing and Combating Corruption" in 2003 and ongoing collaborative efforts between the AU and the World Bank.

With respect to second question, Ambassador Ali said that many local and regional courts have the capacity of handling legal cases to resolve business disputes. Moreover, some parties have opted to seek arbitration or have their cases heard in jurisdictions outside of the AU. I prefaced my question saying that many American investors may take the risk of investing in Africa where infrastructure may be limited, but their concerns reside in not understanding the options available to resolve business disputes.

Having traveled extensively throughout Africa, I know the benefits the continent has to offer for investors. While Ambassador Ali is correct in listing energy, health care, mining, agriculture, transportation, and manufacturing as ideal business opportunities, I favor the opportunities that exist in information and communications technology. As I often discuss on this blog, ICT and specifically mobile communications are producing substantial financial returns for investors and making a social difference for all of Africa.

I commend Ambassador Ali for making Seattle her first U.S. destination outside of Washington, DC to promote the business opportunities that exist in Africa. It is important that other diplomats and government officials representing developing nations take a more proactive approach in attracting foreign direct investment. Feel free to contact me if you are interested in learning more about the investment opportunities that exist in Africa. I am happy to share my experiences of doing business in one of the world's most diverse markets.