Grants as an Alternative to VC Investments in Digital Health. Digital Health Interviews: Andreas Tamberg

This episode of Digital Health Interviews is special for our channel. Why? It’s the first time we have a guest from an NGO basically and the Global Fund in particular. Welcome our great guest — Andreas Tamberg.

Introduction:

Andreas Tamberg: International Public Health Professional & Portfolio Manager at the Global Fund; has led country teams managing Ukraine, Sudan, India, and other countries in Eastern Europe and Central Asia. He has also served as acting Regional Team Leader for South and West Asia. As a senior advisor for Enterprise Risk Management, he focused on assurance planning, internal controls, information security, and business continuity management systems.

The Global Fund, which Andreas represents, is an international financial mechanism. It isn’t a standard NGO or a standard international organization: “We leverage donor support to provide additional resources to countries in their fight against HIV/AIDS, tuberculosis, and malaria as well as the strengthening of their healthcare systems. We seek to leverage our investments to help people around the world, and we invest in over 100 countries, improving their health, lives, and prospective future. We work with ministries of health, non-governmental organizations, a range of technical stakeholders, and implementers in various countries around the world, who are making use of the money that we can generate and provide to effect change in their countries.”

The Global Fund is based in Geneva: it doesn’t have country or regional offices. So it fully relies on technology to get the job done as it were: “We depend on our cloud services and on our ability to reach out to people around the world through telecommunications means. We at the same time are very mindful of the need to keep our information secure, accurate, and accessible to those who need it. We seek to maximize our strengths while leveraging our partners’ capacities to reach people around the world.”

The Global Fund has adopted a digital health framework even before COVID. It looked at partners’ abilities and achievements in this area: “We’ve been working with countries on implementing so-called digital health interventions to further strengthen their disease control programs. We don’t believe in digital health for digital health’s sake, but we want to be able to leverage best practices and recommendations for the use of interoperable systems and means to collect and use data by various actors for their own health goals and also for our reporting purposes.”

When speaking about things like adherence to certain regiments, the Global Fund tries to involve the individual in these decisions as much as possible. The healthcare provider plays a key role but it ultimately has to be an advisory role, it can’t be an enforcer: “If someone doesn’t want to take a medicine, that person isn’t going to take that medicine unless forced to do so. Those rights don’t extend to infecting others, but if we’re talking about HIV treatment, the patient has to be at the center; the individual has to make the correct decisions on an informed basis to improve his or her health. And we firmly believe that making those informed decisions will yield the right decisions, if the information is out there. That’s partially our responsibility together with our partners to make sure that the right information is available to people who need it to make the right health decisions for themselves. And that type of approach isn’t limited to the information age. That’s always been a sort of a tenet of good public health practice.”

What the Global Fund does is it helps support principally financial programs that have been embodied in funding applications that are subsequently reviewed by an independent technical review panel and approved by the Fund’s board. This means that these programs are connected, evidence- and data-based and that people can leverage technology in a way to make the dollar spent go further: “It depends on the context: not everyone will have a reliable electrical connection, and not everyone will have a reliable Internet connection, and we have to take that into account because we don’t always work in conducive environments. We work in very many challenging operating environments: in war-torn countries, in countries with civil unrest, in countries with governments that don’t appreciate foreign agents working on their territory, etc.”

The Global Fund accepts funding applications from so-called country coordinating mechanisms or in some cases regional coordinating mechanisms, which represent themselves partnerships of governments and civil society organizations representing in most cases national disease control programs: “If somebody comes to us independently with digital health technology, chances are not in all cases, but that’s a tough road for funding. But if an organization works together with partners in a country or a region to develop a solution that will bring it closer to a disease control goal, that with something that our technical review panel and the Global Fund consider, because from the viewpoint of efficiency, effectiveness value for money and ultimately impact against the diseases a given technology might be that accelerant or that catalyst that gets a country closer to its ultimate objectives. That’s saving lives and improving overall health status. A company that works in that area at least as far as the Global Fund is concerned, needs to understand that sort of that constellation of actors that are working together to achieve those types of public health goals.”

Since Andreas works with organizations from different countries, where does he see a boom in digital health companies?

Andreas Tamberg: “The fascination to me is that the technologies that are being adopted stepwise are beginning to affect how the programs are operated. When people think about digital health, they think of telemedicine. Telemedicine is good, but it has certain limitations starting from the fact that you’re not interacting with an individual healthcare provider in the same room in an environment where body language, emotions, and general feelings can be discerned apart from a particular problem. That does present a barrier, but I’m not belittling telemedicine. For example, if you look at the Eastern European region, there is a system that has provided the ability for migrants and refugees to access counseling and direction to potential treatment is a really big step up to the ability of a regional network to provide sort of insurance policy to beneficiaries from not only Ukraine but from around the region. And the fact that’s being championed and managed by civil society organizations is frankly very impressive. I can find other examples, the district health information system is one of them. Many applications have helped the Global Fund implement a market-shaping strategy for health products especially pharmaceutical products around the world. Through digital technologies, we’re able to monitor gauge and negotiate prices with suppliers around the world. If you consider all those areas, we’re impacting global health and we’re in a better place than we were 10 years ago.”

In 10 years Andreas would like to see healthcare improved to the extent that we can detect, diagnose and treat major communicable and non-communicable diseases more efficiently and more effectively than we do today: “We move more as it is doing now in the direction of preventive and health-enhancing technologies rather than means designed to cure diseases that are otherwise preventable. I think we can make major advances in our technical and medical knowledge and the means by which we apply that knowledge to improve people’s lives worldwide. This is eminently achievable.”

Our previous episode was with Sebastian Anastassiou: Building Relationships with VCs in Digital Health?