Building resilient healthcare systems is a priority of African countries, and Rwanda has taken steps to prioritise accessible, affordable, quality, and efficient delivery of healthcare over the past years, to achieve universal health coverage. ALSO READ: Rwandan doctors mull project to detect genes with potential cancer risks The New Times’ Alice Kagina had an exclusive conversation with Dr Sabin Nsanzimana where he expounded on revolutionising the health sector with artificial intelligence, the impact of the exit of Babyl in Rwanda, and improving local treatment capacity to reduce transfer trips. Below are the excerpts: You have been pushing for use of Artificial Intelligence in the health sector, what’s the reason behind this? The power of AI should not be underestimated, rather, it should be seen as an opportunity we have to fill gaps and catch up in so many fields, especially, in the health sector. We have a scarcity of workforce and equipment in healthcare systems and we have seen an opportunity to find solutions besides the traditional way of acquiring them. AI can boost our sectors if we embrace it correctly and fast while being open to finding solutions to issues we cannot solve well ourselves. That’s why Rwanda is among the first African countries to put in place an AI policy in addition to a data protection and safety law to champion the fast-growing AI applications and interests. ALSO READ: Artificial intelligence to revolutionise healthcare systems — Minister Nsanzimana In medicine, it’s all about saving lives. The faster you know and act to take decisions, the more lives you save. We acknowledge that it comes without perfection and there might be inaccuracy in information and that’s where humans will always be necessary - to put in proper guidelines on limitations of what AI can do and ensure that it doesn’t replace what people do well but compliments them. How do you see AI being practically applied in the health sector? For instance, we have a few healthcare workers per population need. Currently, we are at one caregiver per 1,000 patients yet the minimum acceptable ratio by World Health Organization is 4 per 1,000. Below that, you are not treating properly and those doing it are overloaded which might have a negative impact on their lives as well. That’s where we see AI coming in. You can’t train people overnight but if you can incorporate AI to help one radiologist who takes three months to read CT-scan images for 1,000 people, it could take only one day. But also AI could predict outbreaks based on algorithms, equip community health workers to treat even other diseases beyond malaria, which they do so well at an average of 70 per cent, among other areas of intervention. When funded and guided, young people can make incredible inventions, they can take the lead in driving this technology forward. As you keep on making advances in strengthening Rwanda’s healthcare system, should we expect cutting of trips abroad for treatment of certain diseases? The first reason we send people abroad is for diagnostics, mainly for PET scan linked to cancer, it’s a technology that we are working hard to acquire very soon and I believe this will reduce the amount of money spent just for scanning. The second reason we were sending people abroad is kidney transplant but we are no longer doing those transfers because we have the capacity at King Faisal Hospital now with better outcomes. All the 10 kidney transplants are doing well. We also did more than 100 cardiac surgeries since last year with highly specialised doctors who are not only doing that in Rwanda but also training Rwandans. We plan that in the next three years, we will have fully equipped teams that can do all those highly advanced procedures without assistance from external experts. If those cases are put together, we will have reduced 90 per cent of transfers abroad. There is no country that can do everything on its own. Even within the country, we need to decentralise the capacity from King Faisal Hospital and CHUK to Bushenge, Mibirizi, Butaro, and Kibungo hospitals so that we also cut internal migration of people coming to Kigali for certain services. What capacity do you have to curb patients’ internal migration? We have already opened 10 second-level university teaching hospitals across provinces and we are staffing them so they can do the usual surgeries which can be done by a general trained surgeon, hence, reducing the movement. The principle is to take the know-how closer to communities rather than travelling long distances to seek care. We also want to ensure that health centres are led by general practitioner doctors which means caesarian section will be done in health centres, which only requires a trained doctor, a theater room, and a well-equipped team. This will cut movements and preserve more lives. Has the exit of Babyl had any impact on the health sector? We got to know about it ahead of time and we worked on mitigation measures, which did not have a huge impact on the sector. Babyl scale-up was in small phases and it wasn’t something to disrupt the care we give because we have other options. It was a system that we considered to be useful in the future and the first step was more into consultations. We were also looking at how to add diagnostics and treatment. Of course, there was minimal impact but it wasn’t a huge shift in our healthcare system. It was a great initiative but not able to sustain itself.
