COVID-19 has presented an opportunity for the whole world to accelerate innovation, ingenuity and entrepreneurship in life-saving health technologies. In Kenya, we have seen entrepreneurs and innovators develop homegrown solutions, including locally assembled ventilators, contact tracing apps and rapid testing kits.

However, despite the policies, strategic frameworks and investments for innovation, the path to scale for Kenyan innovators is not always clear. That’s why Villgro has launched the Innovators Forum, designed to accelerate the creation of a vibrant industrial cluster of health technology manufacturers in Kenya.

We spoke to Robert Karanja, Co-founder and Chief Innovation Officer at Villgro, to find out more.

What is the Innovators Forum?

The Innovators Forum (IF) is a networking platform bringing together diverse actors in the innovation space. It covers everything from design to development to the adoption of health technologies, but in this case specifically focusing on medical devices and diagnostics. 

The target audience is academia - the people doing research, discovery and development of medical devices, the government, regulators, Pharmacy and Poisons Board (PPB), Kenya Bureau of Standards (KEBS) and National Quality Control Laboratory (NQCL) who are involved in addressing the quality standards. We are also targeting the private sector, which is able to take up these solutions after the science has been done to develop it into a readily available product. There is a whole range of participants from entrepreneurs and investors to people in the distribution chain.

We want to understand who the key innovation actors are, whether in the private sector, academia where the research happens or in government where procurement is key, with Kenya’s Ministry of Health (MOH) being the number one customer for health technologies. Getting their feedback and contributions to the innovation space is key.

The format will start off with conversations that create awareness about the need for medical devices and diagnostics, leading to deeper conversations on the opportunities, gaps and challenges. This is all with the aim of addressing the issues in the ecosystem that are bigger than any one actor. There are some things that need to have some level of ecosystem alignment in order to move ideas to the marketplace. The IF will facilitate the necessary discussions to enable them to happen.

What did COVID-19 tell us about the current biomedical innovation and manufacturing capacity in Kenya (and Africa more broadly)?

COVID-19 was a good demonstration of why the work we are doing is important. For Kenya, like most of Africa, over 90% of all the medical devices that we use are imported.This puts us at a major risk. 

When we realised this was a global challenge, our normal suppliers (whether for PPEs or diagnostics tests and now vaccines), produced for their own population first, what is now known as vaccine nationalism. In a situation like this, with no capacity, we are at the mercy of those who have the ability to produce. 

Being able to build capacity for Africa to manufacture so that we are not always behind is important. The last major global pandemic we had was HIV and it took us 10 years from when the ARVs had been launched for them to be readily available on the continent. Fortunately, we now have COVAX, which is trying to address this. 

The best thing we can do now is follow South Africa’s example by encouraging vaccine producing companies to licence the technology to local companies with capacity to manufacture vaccines so that they can start producing for populations within the region. Kenya currently does not have that vaccine manufacturing capacity. We can only receive 1 million vaccine doses against a population of 48 million. Similarly the reason we are not doing sufficient testing and contact tracing is because of this limited capacity for local manufacturing of laboratory testing reagents.

COVID-19 has been a good eye opener to the fact that local manufacturing and innovation is important. We need to continue building on that capacity so that the lessons from HIV and the innovation gap can be addressed. 

Who are the key stakeholders that the Innovators Forum will bring together and why is it important that they are involved? 

Innovation is complex. When you talk to academia they will tell you the potential of the technology but they may not be able to tell the cost of production. We require the private sector to come in and take up the invention, develop it and make it available. That comes with a commercial risk that academia is not designed to be able to cope with. The public sector creates an enabling space for innovation to take place through policies. 

Government speaks to how much of the national budget goes into research and development. As the private sector is taking the commercial risk, some of it has to be mitigated by the government. For example, the COVID-19 vaccine is licensed as an emergency product for them to bring it to the market. Government has had to indemnify the manufacturers and this is something only the government can provide. 

For innovation to take place you need the combined strength of academia, government and private sector to work together cohesively. That's why we are intentional about innovation as the main agenda.

What are you doing to make sure that the Innovators Forum is outcome-driven and more than just another talk-shop?

One of the key things we have done is to identify the low hanging fruit. So we are not talking about doing vaccine development, which has a product development timeline of 10 years and is very expensive. We are saying let's start with medical devices and diagnostics because there is capacity on the ground for that already. We have been able to move from one or two companies that could manufacture masks to over 100 that produce facial masks ranging in complexity from surgical masks to the n95 masks in the space of a few months.

The already-existing manufacturing capabilities in Kenya are such that medical devices and diagnostics are very much within our reach. The existing R&D capacity and expertise is also something we already possess. 

Even from a cost and timelines perspective, these are achievable given the economic wherewithal of Kenya as a country, both as government and private sector. We are targeting what is achievable and timely. With the new normal we need to understand how we can deliver healthcare remotely. There is wide scope for innovation, there is the need, the ability to produce and above all the political will with the Big Four Agenda, which talks about both universal health coverage (UHC) and manufacturing.

We have established innovation actors in the medical devices and diagnostics space from academia, including Kenya Medical Research Institute (KEMRI), Jomo Kenyatta University of Agriculture and Technology (JKUAT), University of Nairobi (UoN), Dedan Kimathi, Kenyatta University (KU). All of these institutions have amazing capacity and expertise. In industry we have medical device manufacturers such as IoT Numericals, Nairobi Enterprise Ltd and Revital Healthcare amongst others. We also have distributors and government agencies, which are able to understand the capacity that needs to be built in order to provide quality care. We are fortunate that the key actors are already well established organisations and it's just a matter of bringing people together to understand where the gaps are and how we can leverage each other to build synergies. This is what the roundtables are hoping to achieve.

Do you believe that the current crisis can act as a catalyst for innovation in Africa and if so, why? 

The pandemic has definitely acted as a catalyst. We saw so many universities developing ventilators with very frugal designs, for example. The demand and uptake of these technologies has also been accelerated. If we didn’t have COVID-19, the uptake of PPE would still be struggling. 

We are currently trying to look at the broader picture, beyond the immediate issues of the PPE manufacturing, to understand the health technologies we need to address all the other infectious diseases like Ebola, TB and malaria that are still a major health concern in countries like ours. 

What are the major barriers currently being faced by biomedical and diagnostics innovators in Kenya?

The biggest one is not having a common plan that stakeholders within the triple helix of academia, business and government are aligned with. Academia, private sector and regulators need to be able to anticipate each other's needs and read off the same page. There are things entrepreneurs cannot control that require policy makers and regulatory authorities to create a sandbox (e.g. the COVID-19 vaccine). These things can only happen if we facilitate dialogue and are deliberate about what conversations we have.

What do you believe that attendees will get from participating in the Forum? 

One of the things that we do not do in Kenya is document our successes. What we have done with PPE, for example, is phenomenal. In one month, we have moved from almost zero production to n95 quality. If we have done that in the heat of a crisis, what more can we achieve if we come together intentionally with a laser focus of where we want to go? Appreciating the capacity within each sector will allow us to be more targeted in the work that we do.

Secondly, we will be able to understand our challenges and why those challenges exist so that we can ultimately start to get around them.

In terms of networking, actors within the triple helix will have an opportunity to meet and know each other because everyone is currently working in silos. This will help to fast track the development and delivery of the solutions that are within our reach.

What is your medium to long-term hope for the Innovators Forum?

Within five years, we hope to see the emergence of a very robust industrial platform which is able to do everything from the invention to the development to the manufacturing to the distribution of medical devices and diagnostics within Kenya.

The timelines and the cost implication for medical devices and diagnostics are within the low hanging fruit category. It would be a great accomplishment if we are able to have between 10 and 20 innovative enterprises in Kenya that are developing medical devices and diagnostics for our market and for export.

In the long term, we want to take the lessons and learnings on how we have developed the ecosystem and facilitated the development of manufacturing capacity and start to replicate it in other sectors like agriculture. The formula for building a knowledge-driven economy is the same: it’s about bringing the triple helix together and delivering as if the different stakeholders are a single entity, despite being very different actors across the continuum of that value chain. It is something that we can learn, implement and replicate in many other sectors where Kenya has a competitive advantage.