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Nov 28
Sand Technologies
Last week’s Norrsken Africa/Week brought together over 500 founders, investors and ecosystem enablers in Kigali, all focused on exploring how technology, capital and collaboration can drive sustainable impact across the continent. Sand participated as the presenting partner for HealthTech, hosting discussions that examined how AI and GovTech are reshaping healthcare systems and policy decision-making across Africa.
Dr. Pamela Icyeza, Sand’s Rwanda Country Director, opened the Health Track session with interactive questions that immediately focused attention on Africa’s healthcare challenges: How big is the healthcare gap? What percentage of African countries lack reliable birth and death data?
The answers were sobering. Africa holds 24% of the global disease burden but only 3% of the health workforce. Around 615 million people in sub-Saharan Africa lack access to essential health services. And approximately 67% of African nations still lack comprehensive data on births and deaths. These aren’t just statistics. They represent the very real barriers preventing effective healthcare delivery across the continent.
This data fragmentation was a recurring theme throughout the sessions. The absence of comprehensive information isn’t simply a statistical gap. It represents a basic lack of the information that governments need to allocate resources, plan interventions and measure outcomes effectively.
The consequences extend throughout health systems. When facilities lack connectivity, data gets collected on paper forms that sit for months before compilation. By the time decision-makers see aggregated information, it’s too old to inform timely action. Outbreaks go undetected. Supply shortages aren’t flagged until facilities run empty. Health workers in rural areas operate in isolation, unable to consult specialists or access patient histories when needed.
This fragmentation helps explain why Africa holds 24% of the global disease burden but only 3% of the health workforce. Addressing this gap requires more than hiring additional doctors or building more clinics. The infrastructure for coordination and data flow needs to be established first.
The fireside chat between Andrew Gwadiva from Boehringer-Ingelheim and Dr. Ikpeme Neto from WellaHealth surfaced important insights about funding realities in African healthtech. For years, donor dependency created what Neto described as “pilotitis,” in which projects launched with grant funding, showed promising results in controlled environments, and then struggled to scale when transitioning to commercial viability.
What’s shifting now is a growing recognition that financial sustainability needs to be designed into solutions from the start, not treated as an afterthought. This doesn’t mean abandoning social impact goals. Rather, it requires business models that can operate without perpetual external funding. For investors focused on sustainable ventures, the question centers not just on potential impact but on clear pathways to long-term viability.
Neto’s observations about fundraising timelines were particularly revealing. The Silicon Valley model of rapid scaling doesn’t directly translate to African markets, where infrastructure gaps, regulatory environments and payment systems create different constraints. Founders working in these contexts need realistic expectations about longer timelines and alternative funding structures. The encouraging development is that solutions are beginning to achieve genuine scale, though on terms different from those many initially expected.
Perhaps the most valuable part of the panel discussion was the focus on practical implementation rather than theoretical possibilities. Manasseh Gihana Wandera from Society for Family Health shared insights from operating 350 health posts across Rwanda, with 160 now digitized. Beyond the 80% reduction in operational costs, the more significant impact comes from what digitization enables in terms of system responsiveness.
Real-time visibility into remote facilities changes how health systems can function. Instead of waiting months for reports, managers can see supply levels, patient volumes, and health worker attendance as situations develop. This isn’t groundbreaking technology. It’s a basic data infrastructure that previously didn’t exist at this level.
However, when the conversation turned to AI implementation, the panel was direct about the gap between potential and current reality. Annie Maxwell from Anthropic emphasized that AI requires rigorous evaluation, testing against specific use cases, and clear definitions of what success looks like in each context.
Manasseh stressed something that often gets overlooked in technology discussions: innovations must be rooted in field reality. In deep rural areas with intermittent connectivity, the constraints differ fundamentally from urban environments. End users are health workers with varying levels of technical literacy, working in facilities with limited power supply and internet access. Solutions imposed without understanding these constraints lead to expensive failures.
The question isn’t whether AI can contribute, but where deployment makes practical sense. Justin Lorenzon from Field Intelligence argued that back-office applications often offer more immediate opportunities than frontline clinical applications. Agentic AI can digitize semi-formal delivery notes, contracts, and compliance checks at considerable speed. What used to take a month now happens in a day. While this sounds less dramatic than diagnostic algorithms, it’s where the technology can deliver tangible value in the near term.
Justin’s work with Field Intelligence highlighted a frequently overlooked component of healthcare delivery: supply chains. When Field Intelligence began distributing oxytocin in Nigeria, they discovered that public-sector clients were significantly underprocuring, not because of a lack of demand or distribution networks, but because of insufficient working capital.
By digitizing the supply chain, they could design financing solutions that address the actual constraint. This created both financial sustainability and measurable social impact. The insight here is that technology solutions need to address real bottlenecks rather than assumed ones. Linking supply chain data to fintech services created what Justin called an “engine for growth,” but only because it solved a specific, concrete problem blocking healthcare delivery.
During the Q&A sessions, questions arose about cloud adoption and data sovereignty. These concerns reflect legitimate governance considerations. Governments face valid questions about storing sensitive health data, and technical explanations about data handling, while accurate, don’t always fully address the political and regulatory dimensions that policymakers must navigate.
Justin offered a practical perspective: local hosting remains possible, but comes with significant costs. Governments need to understand these tradeoffs and develop more sophisticated approaches to procurement decisions. This isn’t about advocating for one solution over another. It’s about enabling informed choices based on actual capabilities and constraints.
The broader point is that sovereignty concerns require thoughtful navigation. Technology providers cannot simply dismiss them as technical misunderstandings. Building trust involves transparency, clear data governance frameworks, and a willingness to work within regulatory constraints even when they create inefficiencies.
A consistent theme throughout the event was the emphasis on collaboration rather than competition. As Andrew noted during the fireside chat, the ecosystem is no longer operating on Silicon Valley assumptions. The challenges facing African healthcare are too complex for any single organization to address alone. Progress requires coordination among governments, startups, investors, and implementers, each contributing distinct capabilities and navigating distinct constraints.
This collaborative mindset represents a maturation of the African tech ecosystem. There’s growing recognition that helping the broader ecosystem succeed benefits everyone working within it. This shift from competition to coordination may prove as crucial as any specific technological advancement.
Events like Norrsken Africa/Week provide valuable opportunities to examine what’s working in practice, what challenges remain and why specific approaches succeed while others struggle. The conversations throughout the event reinforced several consistent themes: the importance of getting data infrastructure fundamentals right, designing business models for sustainability rather than for dependency, and deploying technology that addresses real constraints rather than theoretical possibilities.
The path forward requires more than technological innovation. It demands collaboration, creativity, and a willingness to adapt approaches to what actually works in specific contexts. For organizations working on healthcare transformation in Africa, understanding these practical realities proves more valuable than another set of ambitious projections.
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