Searching unsuccessfully for a specific medicine prescribed by his doctors, a very sick man living in rural Angola listened by chance to a radio interview with Appy Saude, an e-health start-up based in the capital city of Luanda. He contacted Appy, who promptly sourced the very last units available on the Angolan market of the drug he so desperately needed – saving him time, money and even his life.
This is one of many success stories highlighting the major change in access to healthcare information and services offered by Appy Saude, winners of the ITU Virtual Digital World 2020 SME Awards in the e-health category. It is also demonstrates the company's founding principle: to connect as many people as possible to the healthcare professionals, medicine and knowhow they need using available digital tools.
In this case, that tool was a simple phone call: the ill man did not own a smartphone. But most Appy Saude users access their services through an online portal listing pharmacies, pharmaceutical products and prices, healthcare facilities, doctors, accepted insurance policies and appointment scheduling.
"We are trying to improve accessibility to healthcare services using the digital tools we have available today."- Pedro Beirão, co-founder and CEO, Appy Saude
"'Saude' means health in Portuguese," explained Pedro Beirão, co-founder and CEO of the three-year old platform, outlining how the start-up began. "We identified a major need to put information on health establishments online – instead of people having to walk around to find a pharmacy or hospital or clinic. We think having information available to everyone makes society more just, allowing people to make better decisions: the final user, the patient, but also hospitals, pharmacies and decision-makers in the healthcare sector."
Democratizing access to health information
Creating a directory of hundreds of pharmacies online was just step one. Appy then added online access to pharmacy stock listings, enabling price comparison across a sometimes-volatile market, where the same product could be offered at double – or half – the price in neighbouring pharmacies. The platform also allows medicines to be purchased online and picked up in-store or delivered at home; lists doctors and clinics; and provides an online appointment booking system.
"Just the fact of placing the information on one platform and allowing people to choose helps the market to readjust and reduce the inequalities in terms of pricing and availability," noted Beirão. This kind of market disruption naturally led to resistance from established pharmaceutical players, but convincing just one major player of the value of providing wider access to their products was enough.
Concerned that the platform was defining market costs, and keen to share increased visibility and consumer engagement, the other pharmacies quickly came on board, too.
"Today, people are more used to having information to make better decisions," said Beirão. "There is no stopping the future: we are just trying to enable it."
New markets, new partners
Appy is taking its model of information transparency in the healthcare sector international, with operations up and running in Rwanda, and Kenya within its sights. Both these markets are less heavily regulated than Angola, where stringent healthcare legislation has proved challenging. For instance, some products are not authorized for home delivery, and showing images of prescription products is not allowed.
Beirão believes that the lessons learned from this difficult environment will make international expansion easier. Strategic alliances with mobile operators, based on the successful partnership Appy has established with Angolan market leader Unitel, will be key to future success, according to Beirão.
"Working with Unitel, it was an open discussion where we identified our common aim: to reach more people and allow them better information on health," he highlighted.
"In terms of expansion, we see mobile operators as an important part of our growth, and of the digitization of health services. They have coverage everywhere, they are looking for solutions that people can use to access healthcare or other digital services, and they can help collect data on pharmacies and doctors on our open platform." And the mobile operator stands to gain more subscribers and visibility in a win-win partnership.
Appy is also planning new products to add to its portfolio. These include a tool to codify the different names under which the same pharmaceutical products are sold, a problem affecting up to 15 per cent of all products in Angola, said Beirão. Doctors often prescribe medicine under the market name used in Brazil, Portugal or Cuba, where many Angolan medical professionals completed their training. Identifying the correct local name for the same product is expected to be much easier with Appy's database for patients, and its planned electronic prescription system for doctors.
Expansion is not just international, however. Some 35 per cent of Angola's population of 30 million lives in Luanda, where around 60 per cent of all pharmaceutical markets and medical appointments are concentrated. Moving beyond the well-connected urban centre to rural areas means addressing different market segments – and developing new ways to connect people to information. Smartphone penetration is typically much lower in rural areas, so Appy needs to find alternative solutions to making reservations via the mobile app, website or WhatsApp. Initial ideas are focused on USSD or SMS services, taking advantage of their agreement with partner Unitel, who do not charge customers airtime for using Appy's service over their network.
As a start-up, Appy is also working to align itself with more established partners, including the Angolan Ministry of Health, companies, and NGOs working for social impact through healthcare.
This is the main benefit of winning the ITU Virtual Digital SME Award, according to Beirão: finding partnerships that help their solution to grow, become sustainable, and maximize its impact.
"Our vision is to connect everyone to our health service, which is what most NGOs and governments are working for – so let's find a way of actually doing it in partnerships in Angola and in other countries, too," he concluded.
Appy Saude are hoping to join ITU Digital World 2021 in Hanoi, Viet Nam, to share more stories and good practices, increase their visibility, and build on their relationships with mobile operators, NGOs and the broader UN network.
