Minister of Health Dr. Oly Ilunga using a tablet to monitor the Ebola response.

The Minister of Health in DR Congo reviews the Ebola dashboard from his tablet, keeping him connected in real time to the situation on the ground. Photo: Ministère de la Santé RDC.

The strength of digital health lies not in technology. Not in the latest software update. Not in the newest gadget. The real strength of digital health lies in the ability to connect people with the timely information they need to lead healthier lives. Digital tools make it possible for mothers in remote locations to speak to a nurse without walking for hours with a sick child and for decision-makers to see up-to-date information and spot health trends unfolding from their desks.

Everyone involved in digital health, from software developers to frontline health workers, is part of a system to create a healthier world.

Yet digital technologies are not a cure-all. Digital health requires people and policies and actions to turn computerized bits and bytes into better decisions that lead to better health care and ultimately healthier communities. These tools must reinforce the health care system—not overwhelm it. After the tragedy of the 2014 West Africa Ebola outbreak, which claimed more than 11,000 lives, the digital health community pursued the opportunity for more coordinated digital tools that could collectively address health emergencies and meet the needs of health systems.

Connecting the Ebola response

The Democratic Republic of the Congo (DRC), a huge country in Central Africa, is both the birthplace of the Ebola virus and the place where the virus is most challenging to control. When an outbreak occurred in May 2018, the country’s ninth since 1976, the Ministry of Health called on digital systems to support traditional, proven strategies. But this time, the country was better prepared with a brand-new national Emergency Operations Center (EOC) funded by the US Centers for Disease Control and Prevention (CDC) through its Global Health Security Agenda. In close coordination with World Health Organization (WHO), Médecins Sans Frontières (Doctors Without Borders), and other responders, the EOC leapt into action, guiding the use of digital tools to monitor and respond to the outbreak. Crucial decisions about where and when to deploy resources to counteract the spread of the virus suddenly had the benefit of timely data and information, and the support of decades of experience, both local and global.

Following successful containment of the outbreak, the Ministry and partners such as WHO, MONUSCO (the United Nations peacekeeping force in the DRC), and PATH shifted focus to the country’s next Ebola outbreak, which started in July. Through the EOC, partners continue to work together to provide up-to-date data and analytics to bolster disease surveillance-and-response efforts against one of the most difficult outbreaks ever, in the middle of a conflict zone. Digital tools are once again playing an important role in facilitating data-led action. Digital maps of the outbreak and even simple videoconferences instantly connect experts around the world—including CDC Director Dr. Robert Redfield in Atlanta, DRC Minister of Health Dr. Oly Ilunga Kalenga in Kinshasa, and the Ministry of Health’s frontline team in Beni, the epicenter of the outbreak. As this outbreak evolves, the digital tools supporting the EOC will also evolve to provide the data and insights needed.

The impact of the country’s EOC in connecting people with reliable information for better decision-making demonstrates the tremendous potential of digital health. Beyond emergency response, coordinated digital systems could extend and reinforce routine health services across the country. As cell phone networks continue to grow, the DRC—a country half the size of Europe but lacking adequate roads—is a prime candidate for the benefits digital health can bring. Strong, coordinated, and flexible data systems can identify health trends, predict medicine stockouts, and detect outbreaks far faster and more efficiently than analog systems. The DRC Ministry of Health is eager to apply the power of digital to the unique challenges it faces.

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Staff from the Democratic Republic of the Congo Ministry of Health and its partners gather for a video conferences in the Emergency Operations Centers in Kinshasa. Photo: PATH.

Connecting the health care system

Acting on this desire, the Ministry of Health in March 2019 launched a new national agency for clinical information and health informatics—the Agence Nationale d’Ingénierie Clinique d’Information et d’Informatique de Santé or ANICiiS. With a mission to improve management of the health care system, quality of care, and accessibility of services, the ANICiiS is the country’s first dedicated digital health agency. The new agency will oversee and accelerate the use of new technologies, including telemedicine, connectivity for the health information system, and biomedical equipment. Its chief objective is a lofty one: to facilitate the provision of high-quality, affordable health care services for all Congolese people and contribute to the government’s goal of universal health coverage.

Formation and launch of the ANICiiS was driven by the DRC’s Minister of Health, Dr. Ilunga, who made digitalization of the health care sector one of the pillars of his vision for the country. The agency builds upon the work of organizations already applying digital technologies to improve health services in the country, such as WHO, the Global Fund, World Bank, Gavi, PATH, Institute of Tropical Medicine Antwerp, University of California at Los Angeles, Bluesquare, and others.

The ANICiiS also builds on the success of other countries—engaging regional leaders in digital health to share and learn from their experiences. For example, PATH has seconded Dr. Ousmane Ly to the DRC Ministry of Health as a digital health advisor where he has provided insight and expertise from Mali (where he directed the government’s digital health agency) and many other countries in which he has worked. Dr. Ly has played a critical role in developing the EOC and has lent his expertise to the design of the ANICiiS.

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PATH's country director Trad Hatton (speaking) and DR Congo’s Minister of Health Dr. Oly Ilunga Kalenga (seated) at the launch of the Agence Nationale d’Ingénierie Clinique d’Information et d’Informatique de Santé or ANICiiS in Kinshasa. Photo: PATH.

Connecting with tomorrow

As a new agency, the ANICiiS is looking toward the future, not only in terms of technology to address health system challenges, but also in inspiring the country’s next generation of technology experts and innovators. To celebrate the launch of the new agency, the Ministry brought more than 50 students together for an Ebola-focused hackathon as a means to address the current, continuing outbreak, and the largest ever in the DRC. These students were asked to think up new ways that technology could support the Ebola response. Their ideas were wide ranging and included new approaches to help health workers identify patients, monitor individuals exposed to the virus, and provide accurate, reliable information to the community. By embracing digital technology and innovation, the ANICiiS is ensuring a brighter future for the DRC.

This new agency is not the beginning of the country’s digital transformation—but it is an important step. Just as the global community came together after the 2014 Ebola outbreak, the ANICiiS will bring together the digital community in the DRC to learn from the Ebola response, strengthen existing systems, and continue to move the country forward into a healthier world.

Hackathon-900.jpg . Participants in a hackathon in DR Congo chat with the minister of health. Photo: PATH

To celebrate the launch of the new agency, the Ministry brought more than 50 students together for an Ebola-focused hackathon as a means to address the current, continuing outbreak, and the largest ever in the DRC. Photo: PATH.