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Wednesday, October 5, 2022

Dr Ismail Badjie, health entrepreneur, CEO of InnovaRx Global Health

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With Alagie Manneh

The Standard: Your father, Dembo Badjie, was a seasoned administrator and career diplomat who dedicated his life to the service of the nation. What lessons did you learn from him?

Dr Badjie: I learned how to love nation through my father. I think unfortunately, our school systems don’t teach Gambians how to love nation, but I was privileged to have a dad who sacrificed his entire career for the development of the country. I think I always had him as what loving country looks like, and what service to nation looks like. So, he has always been a guiding light in terms of the commitment and responsibility we all have to make The Gambia better. From that perspective, he’s definitely been a hero.

Can you tell us about your upbringing and some interesting information about yourself?

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I was born in Banjul. I’m very proud of my Banjul roots. My dad moved to Banjul from Bansang at a very early age. My mom is originally from Banjul. But I don’t remember much about The Gambia as a child because we left when I was a baby, after my dad became a diplomat. The first couple years of my life was not in The Gambia. We were in the USA and Belgium. I moved back to The Gambia in the early 1990s, and it was then that I started knowing what it means to be Gambian. I was seven at the time. That’s when I started my Gambian experience. That’s when I started learning the local language, getting to know more about our religion, about my family history, and that kind of shook my perspective. I was here from seven to 17, before leaving to go back to the US.

A lot of people thought that you would follow in your father’s footsteps, like your sister, former information minister Fatim Badjie did and venture into politics. Why did you opt for a career in medicine in the US?

Honestly, politics was never… it never crossed my mind. I was always curious about science. But I don’t think I chose the health care field, I think the healtcare field just aligned with what my skills were. I was leaving high school to become a civil engineer. I started university as a civil engineer, and decided no, I love the sciences more and switched careers. It was like an explorative process into finding out what areas of study… Obviously I had a good job in the USA. I had a good career, but how could I help as many people as possible? It’s always easy to say I had a dream to be a healthcare professional, to be a doctor but that’s not the case. Nobody in my family was a healthcare professional, prior to me. I think it just aligned, and it just so happen that academically I was able to excel in the sciences. It worked out. It really did.

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It was after your graduation from Gambia Senior Secondary School that you traveled back to the US. What did you study there?

I was a science student at Gambia High School. My first degree was actually in chemistry, with a minor in biology, and that degree is almost like a foundation degree to enter the healthcare field. So, you could either go to medical, dental or pharmacist school. After the first degree in chemistry, I did doctor of pharmacy, which is also a professional degree. I studied that for another four years and then started practicing as pharmacist in the US.

You are a health entrepreneur, therefore, why is the country’s healthcare system in dire straits?

I think the question is; when has it not been in dire straits? I think most of the times as citizens we are also not as honest with what the healthcare system has been, would be, and what we need to do to change it. I think Gambia since 1965 has never had an amazing healthcare. But at the same time if you look at the strides that have happened, our healthcare system is better today than it was 20 years ago. The question is, the burden is still higher than what we can deliver, meaning most health systems in The Gambia are overburdened, and under resourced. Any health system where you don’t have enough resources, be it financial capital, human capital and you have a lot of people who are getting sick, you are not going to have a good health system no matter how many changes you have. At the root of it, it’s like the only way out is more Gambians participate in reducing their health footprint, while we allow the systems to grow and develop and recruit more talents and as well train them. That’s the only way. The Gambia is one of only few places in the world where you go to a public health system and you pay D25 to receive sometimes a 100 or 200 dollars’ worth of healthcare. Can’t sustain it, right.

Like a lot of other diaspora Gambian intellectuals, you could have stayed in the US for a more lucrative job, and continue to butter your bread, but you did not. You came down and established InnovaRx Global Health (IGH), a tech-based healthcare solutions company. What was your motivation?

Well, not The Gambia. Quite frankly, I’m very honest when I say The Gambia’s not the reason why I came back; it is Africa. It was the reason why I came back. Because healthcare retail, healthcare in general, there’s a huge opportunity to revolutionise the way healthcare is delivered in Africa. So, I think it would be disingenuous for me to say that well, I love The Gambia so much and that’s why I came home. No. The Gambia was where I started because I saw it as an opportunity to give back to people that look like me, but also to test and try some solutions to see if it works. And if it is a successful Gambian solution, it could be a successful Ghanaian, and Nigerian solution. I think that’s the reason why I came back. I still think our solution was never a Gambia solution, Gambia just benefitted by being the first recipient of the solution. But The Gambia is a very difficult place to give up so much and come back to establish something because the system doesn’t reward you as fast. Africa is the reason why I came back, but am proud that the Gambian people are now experiencing a different version of healthcare to the region. The way InnovaRx is delivering healthcare is revolutionary anywhere in the world. If you think about a healthcare experience now that meets you where you are, and delivers the care you need at that moment, that’s a universal property. You can take Innovarex to Asia, to the United States, it’s still the same. How do you make some quality healthcare gets to people where they are, and making it in a kind of way that who’s paying for it does not matter? The most important thing is just preventative health, you remove barriers of access, making us reasonable as possible. People that have non-communicable diseases, you manage them properly, making sure they take their monthly medications. While you’re doing that, less people need to go back to the hospital. So, it goes back to how you build the health system. If The Gambia is like a 100 people, and you keep 80 people as healthy as possible, then only 20 people need the hospital.

Can you give us the genesis of the IGH?

I started practicing as a young pharmacist in rural North Carolina in the USA. At that time I started realising two things; that technology is changing the world in a way that I don’t think we realise, especially in healthcare. Healthcare and technology now are inseparable. Because of technology you are able to leapfrog and do so many things that were not possible in the past. I started seeing where healthcare was going in terms of the technology we use, but I also start realising that a lot of rural USA, it could be poor, white, or black Americans have the same challenges with healthcare as rural African people. You wouldn’t think so, but the challenges are the same. I realised that if I am immersed in all these kwowledge on how to run health systems, because I have the benefit of working for [walgreens] which is a giant when it comes to healthcare. I saw what they were doing and realised that I don’t have to wait 20 years to bring this version of healthcare to Africa. I could start now. We could build the biggest tech-based health system in the continent. That’s the genesis of it…

Exactly what do you do at the IGH?

Technology is the foundation of the company. We are a health-tech company. We realise that with technology you can do things that were unimaginable couple of years ago.

It is a well proven fact that health is expensive, particularly for the average Gambian. What is the IGH doing differently from the other established private healthcare providers to make its services accessible and affordable for all Gambians?

I think I beg to differ with the notion that healthcare is expensive. Healthcare is only expensive if your relationship with healthcare is only during a time of crisis or emergency. That’s the Gambian experience. Most Gambians only interact with healthcare institutions at the time of crisis or emergency, which at that point is expensive. Preventative health is not expensive. It doesn’t cost much to check your blood pressure. Preventative health is getting your blood pressure checked, regularly because then you get an assessment; do I have a normal blood pressure, am I at risk of hypertension, or do I already have hypertension… minimising the amount of sugar that you eat, exercises, all those things are preventative health, and they are not expensive. Which is why at InnovaRx, we have made preventative health free of charge. Since 2019, any Gambian or non-Gambian could walk into InnovaRx, and get a free screening for diabetes, for hypertension, and for obesity. We’ve done that for almost 4000 Gambians… this whole notion that healthcare is expensive depends on when you engage or how proactive are you seeking healthcare. Preventative health, even from a government stand point, the moment they make it almost mandatory, healthcare becomes less expensive.

What is your vision for the healthcare system in The Gambia?

The vision is to make The Gambia one of the healthiest countries in Africa. That’s what we want to do. I know that it sounds grandiose, but the numbers are in our favour. We are barely two million people. Half of our population is under 25 years old. So, if you poke us on five-ten years of democratising preventative health, managing chronic conditions the right way, making sure quality medications are coming into the country, making sure the medication is desegregated where the rural communities have the same access to quality medications like people of the urban, that’s the vision. Which is why we build the company to be able to level the playing field in a way now we have customers in Basse, Bansang, in Mansakonko. That’s the vision. We really think The Gambia could be the healthiest nation in Africa within the next ten years. And we want to do it by also allowing the diasporans to start spending money on healthcare, instead of sending money for healthcare. Our business model allows for people who don’t live in The Gambia to be able to pay directly into a company, and the company takes that care of their love ones. I think that’s the vision. There’s so much we can do while working with players that already exist, government support, private sector collaboration. But what we want is for a digital revolution to happen in healthcare where your phone the same way you can access your bank and social media accounts, you should be able to access your health by getting your records. And that’s what InnovaRx is doing now, with our digital health record system. We are running a completely paper-less institution. Those are some of the key hallmarks when it comes to revolutionising the way healthcare is being delivered.

At 36, you are a young man. Has your young age been an asset or a liability in the pursuit of your business?

Oh, that’s interesting. I’m a young man, but based on a Gambian man’s life expectancy, I’ve already lived half my life. The average Gambian man dies before 63. That’s our life expectancy, but a 36-year-old-Gambian man would be called young, when based on the statistics I have lived out half my… [laughs]. But that’s the reality, and its something a lot of Gambian men don’t know. So, if anything, I don’t have enough time because I may be have like for example 20 years of my consistent marching towards a vision that I may not live to realise. I may not live to see the fruits of what InnovareX can be… there’s also a significant risk that comes along with a 36-year-old man leaving the USA at the height of his career, and jump into a market that most people die, that’s doing business in Africa. It’s a very interesting place, but I think that’s what makes the journey almost spiritual because we have signs from God that make you realise that you’re doing it for the right reasons. But based on my statistics, I have already lived half my life.

Dr Badjie, you once made a public account of your own health status. How much of an inspiration would that be to other people who might otherwise unknowingly be in the same condition?

You have to be sympathising because I’m a 36-year-old. Physically, in The Gambia, I can comfortably say I’m one of the fittest 36-year-old men when it comes to physical fitness because I’m a fitness fanatic. But am also hypertensive. I was diagnosed when I was 28 years old. Remember, I told you my grandmother died at 56, from diabetes hypertension. My mother has diabetes and hypertension. So, there’s a genetic component to this. I could be the fittest person in the world, I eat clean, I don’t eat sugar, I do all these things right, but because of my genetic components, am only adverse for a condition that now I have a choice to make; either I control the hypertension, or the hypertension controls me. So, I always use my story to let other people know that one, knowing it, is part of the solution. A lot of Gambians are afraid to find out what their health status is, because of stigma, but for me I am like no, lets switch it around. Let’s have more Gambians run towards finding out, and knowing that now they could control it. Because the things that am doing now, is ensuring that I don’t die at 56, which most Gambian men who have had hypertension, die at 56. But because I know I have a condition and if I take medications every day, if I reduce down my salt that I eat, if I exercise regularly, I am giving myself a chance to be 80 years old and get to see my grandkids. It’s as easy as that. And before I start a solution, I use myself as an example because am a living testament on what happens when you know about your condition.

Let’s talk about one issue. The recent increase in the proliferation of fake medicines across the country is a major concern for a lot of Gambians. Why is that the case, and how can this be controlled?

A lot of people don’t know; counterfeit medications is a billion-dollar industry in Africa. Almost half the world’s fake medications are found in sub-Saharan Africa. One because it’s easy. We sourced our medications from the US, not because the USA is special. Some of the medications we sourced from the US are manufactured in India because India supplies the most generic medications to the US market. But the USA has systems in place that only certain manufacturers that meet certain level of quality, assurance – they called it GMP – Good Manufacturing Practices – that the MDA regulates. They are protecting the consumers from counterfeit medications. So, until Africa gets to a point where we tell these manufacturers if your medications are not good enough to sell in the USA, they shouldn’t be good enough to sell in Africa, we will always be at risk. Because unfortunately, a lot of people that are in the pharmaceutical industry, are not healthcare providers; they are business people. They are selling commodities, not doing this for others. They play volumes game. The quality, they rich enough to know how to consume it, because when something’s wrong with their healthcare, they are on the first flight to buy quality medications. We are susceptible. We don’t have a system in place that could police every single medication that’s coming here. It’s virtually impossible… We don’t even have a 100 pharmacists, who are trained, for a nation that’s two million people. Right… some people are taking medications daily, and medications that aren’t working.

Left unchecked, what are some of the dangers associated with this?

Well, death. And you always want to start with what’s the worst consequence. If you’re diabetic and you’re taking counterfeit medications, you are more likely to die sooner…

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