By Gift Briton
With disproportionate disease burden, limited resources, and healthcare workers stretched thin, a virtual learning platform is changing how health professionals in Africa respond to emergencies and deliver care to underserved communities.
Introduced in Africa nearly ten years ago, Project ECHO– a digital learning platform that uses a case-based learning approach and connects experts with healthcare workers- made it possible to contain disease outbreaks that would have otherwise morphed into a larger crisis if this sort of technology was not available.
ECHO’s success was demonstrated when the Africa Center for Disease Control (Africa CDC), the World Health Organization (WHO), and African ministries of health used the platform to effectively contain Mpox in the Democratic Republic of Congo (DRC), Ebola in Uganda, and the recent Marburg virus disease outbreak in East Africa.
The platform facilitated rapid dissemination of evolving information from WHO and Africa CDC to the ministries of health and frontline workers in communities. This ensured healthcare providers had timely access to protocols and updates to handle the outbreaks effectively.
“Within two weeks of the Mpox outbreak being declared a public health emergency, we had mobilized experts and set up ECHO sessions,” says Dr. Caroline Kisia, Project ECHO Africa Director. “This rapid coordination helped contain the outbreak before it escalated into a larger crisis.”
In Africa, most doctors are concentrated in urban areas. Yet, most rural health facilities are managed by nurses or clinical officers, with little access to specialized consultants. This disparity in healthcare distribution has long been a barrier to effective medical interventions.
Through video conferencing, ECHO connects rural healthcare workers with experts to ensure that they receive real-time guidance on patient management.
Whether it is an infectious disease specialist mentoring a nurse in a remote clinic or an endocrinologist advising a rural doctor, the model ensures knowledge is democratized, allowing best practices to reach the most underserved populations.
The ECHO video conferencing sessions also integrate disease surveillance and early warning systems. When healthcare workers notice unusual infections, they can raise red flags during the sessions, allowing ministries of health to act swiftly.
In Namibia, ECHO has been instrumental in managing HIV/AIDS. Originally launched in 2015 to address high prevalence rates (14%), the platform allowed doctors in remote areas to consult specialists in Windhoek, the capital city. Instead of patients traveling long distances, their cases were discussed virtually, medications were dispatched, and follow-ups were conducted remotely. This has since expanded, with the platform now being used to tackle HIV drug resistance and tuberculosis.
“Sub-Saharan Africa, with 16 % of the global population, carries 24 % of the global disease burden, yet we only have three percent of the global healthcare workforce and only one percent of global resources that are spent on health. We must think outside the box and make sure that we are supporting all our healthcare workers with the information they need to be able to do as much as they can for our underserved population. We partner with governments, faith-based organizations, private hospitals, and NGOs to help upskill healthcare workers quickly, at a lower cost, and with higher quality,” Dr. Kisia adds.
The model’s effectiveness was also proved when ECHO was used to disseminate HIV guidelines to healthcare workers in Kenya. Previously, in-person workshop was the method used to train and disseminate these guidelines. The workshops required over a year to cover all 47 counties for $820 per participant. With ECHO, this training was completed in just two months, reducing the incremental cost per participant to under $21.
The Project has a presence in 33 African countries and has connected over 340,000 healthcare workers with experts across various specialties. It continues to be used to address various health conditions across the continent, including Antimicrobial Resistance (AMR) stewardship involving seven African countries, training senior medical students in Sudan to provide critical care during the ongoing war, and the African One Health University Network that connects 19 universities across 11 countries in Africa to address food safety and security.
As external funding for health programs declines, Dr. Kisia emphasizes that Africa must take ownership of its healthcare solutions, including adopting cost-effective innovations like Project ECHO to ensure that limited financial resources yield maximum health benefits.
“We must think outside the box,” she says. “By leveraging digital platforms, we can prepare for emergencies in advance and respond swiftly. This prevents outbreaks from escalating and ultimately saves lives and livelihoods.”
