Okoa, the technology fighting drug theft in Tanzanian hospitals
|June 26th, 2017|
|tags:||Drug theft, Global Fund to Fight Aids, malaria, OKOA, Tanzania, Tuberculosis|
In Tanzania, as is the case with most African countries, millions of people rely on government or subsidised health care. International charitable organisations also work with governments to provide cheap and free medicine to tackle some of the most life-threatening diseases like Malaria, AIDS and Tuberculosis. But the theft of these drugs from government clinics - which are then diverted, repackaged and sold for a premium price- is putting millions of lives at risk.
In an investigation by the Global Fund to Fight Aids, Tuberculosis and Malaria, (a respected public health donor), over $2.5 million worth of drugs had been stolen or diverted from intended use in 13 countries mostly in Africa between 2009 and 2011. The investigation further revealed that in some 70 per cent of the cases, the drugs had been stolen at warehouses operated by governments and had been orchestrated by top officials in cohort with doctors.
In Tanzania, Bukhary Kibonajoro has come up with an innovation dubbed Okoa, Swahili for 'save', that monitors the flow of drugs right from government stores to patients at health facilities up to the last tablet. It is working wonders, with cases of empty shelves at public hospitals reducing, and more patients now saying they can easily access prescription drugs at government pharmacies. He talked to Fairplanet about this venerable technology, the resistance he has faced from the cartels and his ultimate dream of making every Tanzanian and African enjoy public health.
Fairplanet: How exactly does Okoa innovation work?
Bukhary Kibonajoro: Okoa is a cloud based software platform that is used simultaneously by health facilities, public medical Stores, Ministry of Health, local government authorities and the ordinary citizens. Each of these users can access data reports that is relevant to them. The database is hosted at a central server and holds data from both medical stores and health facilities. It tracks the supply chain of medicines and medical supplies from national medical stores to the local stores, health facilities and finally to how those medicines have been dispensed to patients. It then can generate a series of intelligence reports that can help show if there is a probability of theft in any part of that supply chain. These reports can be accessed by the Ministry of Health (Nationwide) and Local Government Authorities (in its local area). Okoa is being scaled up to also alert citizens on checking the availability of drugs at particular health facilities before visiting the facilities or checking the number of patients in a particular hospital at a particular time to avoid long queues.
Why an innovation to stem drug theft? What was the motivation?
Drug theft is a big problem in Tanzania. 68 per cent of Tanzanians live under $1.25 a day and are thus poor. They rely heavily on government hospitals for medical attention. It is therefore crucial that drugs in government hospitals that are bought by tax payers money for the welfare of the public, reach the intended beneficiaries and in time. This innovation dubbed Okoa, which is Swahili for 'save', is meant to ensure that no drug bought using public funds is lost, and that as a country we are able to save lives, because there are many avoidable deaths.
How serious is the drugs theft and shortage in Tanzania?
Drug shortage as a result of pilferage in Tanzania is an acute problem. There are even reports that indicate that there are trucks full of drugs which left medical stores destined for health facilities across the country and have never reached there years later. There has been no news of their whereabouts. It is a systemic problem with drugs worth millions of dollars of our tax money being stolen every year. The painful thing is that they are diverted to private pharmacies by rogue health officials who will create this shortage at the public health facilities so that patients can buy them from the private pharmacies at exorbitant prices.
How easy or hard is it to tamper with this innovation? How tamper proof is it?
Advanced security measures have been taken into consideration while developing this technology, while we cannot guarantee 100 per cent security as is the case with other technologies, we can say that the system is tamper proof.
How would you quantify the success of Okoa innovation?
Okoa success can be quantified by checking how much supply of drugs to patients has improved over time, and how much revenue collection has improved as a result. Generally where Okoa is being used, the pharmacists are very keen on ensuring that not even a single tablet is lost because they know the technology will force them to account for it. This has greatly improved medical access with patients in the hospitals where the innovation is implemented saying they are able to get the drugs prescribed to them and in the right time.
Have you faced any difficulties with cartels who would want to keep stealing the drugs or creating a shortage for their own benefit?
Yes, it has been an uphill task especially when I started the pilot project. Drug theft is an organised crime and a multi-million dollar business that involves high profiled people including staff at the central government, health facility officials, businessman and doctors. I faced so much resistance from all quarters I nearly gave up. I am glad I never did. And there is no turning back now. This vice has to come to an end once and for all.
As a young innovator working on creating homemade solutions to local problems, do you feel your government and governments across Africa are doing enough to incentivise (motivate) innovators?
No, our governments do not do enough to motivate local innovators. It is evident in how they even opt to purchase some of the technologies or supplies, usually of inferior quality from foreign countries and at even higher prices than what is available locally so that they can create a conduit to steal through kickbacks. Remember some of these international tenders are breeding grounds for corruption. Policies are not favourable to local innovators.
You have been recognised by institutions across Africa and the world for this innovation. What does this mean to you and your resolve to tame pilferage in the health sector?
This mean a lot for me. It has helped me innovate more, it has helped me meet influential people in the country and beyond where it otherwise would have been impossible. It has also opened up more opportunities for me which has given me the impetus to ensure the public health sector in Tanzania is benefitting the people it is meant to.
What has been the toughest challenge in this journey?
I would say trying to convince the government to adopt to the technology. There have been too many red tapes and bureaucracies in trying to get the government to embrace and see the value in what we are doing. Of course there are those in government who feel this technology will kick them out of business, so they try as much as possible to block it, but we are glad for the milestones we have achieved so far.
The health sector in Africa has faced a myriad of hiccups including understaffing of medical personnel, shortage of medical supplies, emerging diseases. How key is technology in addressing these challenges?
Technology is our saving grace especially for vital sectors like health. From early diagnosis, timely interventions, improving operations to taming fraud. If Africa wants to streamline its health sector then it definitely has to embrace technology, there are no two ways about it.
What is the ultimate plan for Okoa moving forward? Any plan to scale it further?
My plan and hope is to make sure that by 2022 Okoa is used throughout Tanzania and some other neighbour countries. I also intend to scale it to also address other aspects of the health sector including diseases, deaths and births. The goal is to make sure that it becomes the platform that centralises all health data throughout the country and continent.
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