How regional bloc can build an integrated healthcare system

Under the social pillar, the development and improvement of health and medical services is one of the main thematic areas. [Collins Oduor, Stndard]

The Lake Region Economic Bloc (LREB), established in 2015, is one of the six economic blocs
in Kenya and the most dynamic. Covering 14 counties, the LREB’s vision is to build an equitable and sustainable society for the 14-plus million citizens in this region under three strategic pillars.

Under the social pillar, the development and improvement of health and medical services is one of the main thematic areas. This is a welcome move as lack of access to better and affordable healthcare still plagues the region. Despite the remarkable progress of healthcare services, infant and maternal deaths remain high in member counties.

Furthermore, multiple infectious diseases, including malaria, tuberculosis, HIV/Aids, and other vector-borne parasitic diseases, are still endemic in the region, with other non-communicable diseases such as diabetes, heart diseases, and cancer in the ascendant. Infectious disease-associated pediatric cancers including endemic Burkitt lymphoma and Kaposi Sarcoma disproportionately affect children from this bloc.

Thus, improving healthcare and medical services is crucial in realising other strategic goals of the LREB. Strategic ‘bloc-wise’ investments in integrated healthcare infrastructure with complementary basic and translational research facilities are vital to the realisation of this pillar.

Since its inception, the economic bloc has successfully implemented different healthcare initiatives, including cervical cancer awareness campaigns across the member counties. The ongoing plan to establish a centre of excellence in health education and training, capacity building, and research in member counties is another excellent initiative.

While these ongoing initiatives underscore the existing political goodwill within the bloc, member counties must synchronise their infrastructure investments in referral and research facilities. Although it has been 10 years since the new constitutional dispensation, most cancer patients, including frail children with advanced Burkitt lymphoma cases from all corners of the bloc, must seek treatment at the Moi Teaching and Referral Hospital in Eldoret, Uasin Gishu County.

While ‘one referral hospital per county’ is a great move, having fully equipped and funded referral and research hospitals in all member counties is impractical. Collaborative healthcare infrastructure development within the bloc is the best solution to this painful and torturous ‘medical tourism’ imposed upon locals.

This framework includes sub-regions such as Busia/Siaya/Kakamega, Nandi/Kisumu/Vihiga, Kericho/Nyamira/Bomet, Kisii/HomaBay/Migori, and Bungoma/Trans-Nzoia should synchronise their infrastructure investment projects around different specialties. This could also include local training, medical internships, and hiring specialists such as oncologists, nephrologists, surgeons, cardiologists, and mental health specialists, among others.

You get the gist; coordinated healthcare infrastructure systems within the bloc will reduce the burden of medical tourism and increase access to medical care by providing access to treatment and post-therapy care in member counties. The lack of a centralised medical information system across the country impedes the provision of quality healthcare services. The creation of the LREB bloc provides a great opportunity to develop a central medical information system through disease registries and connected secure patient portals.

For example, creating a decentralised LREB cancer registry would complement the Kenya National Cancer Registry, a KEMRI-based entity funded almost exclusively by the US National Cancer Institute. Furthermore, a centralised, secure medical information portal developed, maintained, and funded by the bloc will enhance patient care by enabling the free flow of patient information among caregivers. It is not a bloc until it is connected with an integrated health information system that allows medical professionals to share and access crucial patient information anywhere in the bloc.

The LREB is also home to exceptional medical research facilities, including KEMRI, CDC, and Walter Reed laboratories in Kisumu, KEMRI Alupe in Busia, and Walter Reed in Kericho, among other satellite research units in Homabay, Nandi, and Kakamega. While different infectious diseases are still endemic in the region, the brilliant research and surveys spearheaded by local and international scientists have contributed to better management and control of prevalent infections, including HIV, TB, and malaria, among other diseases. However, the majority of these centres and their research projects are foreign-funded.

The regional bloc must develop a research and infrastructure-funding framework to achieve its goals. This will strengthen the local scientific community’s capacity, knowledge, and research skills coupled with pursuing specific objectives for research and technology transfer to industry, which will benefit member counties. The Broad Institute of MIT and Harvard success story is a perfect model that the bloc can emulate to develop a locally funded collaborative research hub. Academics from local universities within the bloc have succeeded in an environment with zero local support to spearhead different research projects and student training.

Through elaborate collaboration anchored on shared values and goals, the LREB has the opportunity to create a regional healthcare hub akin to New England in the northeastern United States. With just six member states, New England is home to three Ivy League universities, with excellent healthcare networks and collaborative research institutions.

Like New England, the bloc can metamorphose into a healthcare epicentre, creating one or multiple clustering hubs like Kendall Square in Massachusetts.