GICMED

We are targeting breast and cervical cancers, which are the leading causes of cancer related deaths in sub-Saharan African women for several decades now, account for more than 50% of all new cases of cancers in women and causing hundreds of thousands of deaths yearly according to statistics from the World Health Organisation. Up till now a woman dies of cervical cancer every 2 minutes, globally.

Estimates from the World Health Organization International Agency for Research on Cancer group reported that in 2018, there were 569,847 new cases globally and 311,365 deaths resulting from cervical cancer, 85% of which occur in low- and middle-income countries, and this rate is expected to increase to 98% by 2030, furthering the disparities as the total number of annual worldwide mortalities increases to nearly 400,000.

In Cameroon, the contribution of breast and cervical cancers to the national burden of cancer is very high since more than four decades, and breast cancer accounts for 31.5% of all cancers in women, while cancer of the cervix ranks second, representing 23.9% of all cancers in women. 

Though early diagnosis and treatment of cancer cases have been shown to significantly increase survival rates, breast and cervical cancers continue being a burden in Sub-Sahara Africa particularly because of lack of access to screening, diagnosis, and treatment services especially in rural areas where the disease burden is highest, a great scarcity of qualified medical specialists; for example, a country like Cameroon counts less than 30 Medical Pathologists found only in a few big cities, and some other African countries have just 2 pathologists. The third reason is due to the absence of required medical equipment because of their high cost; for example, colposcopes used for the screening of cervical cancer costing at least $10,000 and mammography machines for breast cancer screening costing $40,000, added to the fact that they require skilled personnel to manipulate them who are not available in developing countries, and whenever they break, they are dumped because of no means to repair them. Because of these factors, studies reveal that currently only about 5% of target women have access to cancer care services not only in Cameroon, but same sad situation in other Sub-Saharan African countries.

Making things worse, more than 80% of cancer cases found are diagnosed at late to end stage of the disease, when treatment options are extremely limited and often not even available. Till date, there has been no functioning system or health project in Sub-Saharan African countries to enable cancer cases to be detected and treated early, and this accounts for all the negative statistics cited above.

The best way to fight cancer especially in the developing world is catch it early, and treat it early, and all will be fine. It is with this philosophy that we have built a series of innovative and proprietary medical technology solutions, adapted to the Sub-Sahara African context to solve this problem, made up of a smart speculum device, a smartphone digital microscopy system, a simple biopsy device, a Telemedicine platform, and an e-training platform. These technologies permit women, even those living in the most remote and enclave areas, to get screened and diagnosed for breast and cervical cancers, at the point of care, in the same communities where they live and at a low and affordable cost. Through these technologies, all medical data required by Medical Specialists for the diagnosis of these cancers following standard WHO guidelines are captured at the point of care by frontline nurses, then transmitted instantly to a Medical Specialist anywhere in the world, who then reviews the data and remotely places a diagnosis. These technologies designed in the developing setting context, work even in the most enclave areas, thus making cancer care available to every woman at the point of care no matter her location or social status. After the screening and diagnosis process, women identified with early-stage lesions are treated at the point of care. Thus, women receive the full package of cancer care at the point of care in a single contact for the two most deadly cancers, and by this, cancer cases are detected early and treated early as well thereby significantly reducing the number of advanced disease and deaths.

GICMED is targeting women aged from 21 years and above, who count to about 300 million in Sub-Sahara Africa, and about 5 million in Cameroon, and who based on national and international health guidelines and recommendations are required to get screened regularly for breast and cervical cancers. Particularly women in rural areas, who constitute the bulk of the female population, and currently have completely no access to any cancer care services. Through GICMED, they can permanently have access to breast and cervical cancer care in their communities, at a far lower cost and in a faster turnaround time.

We have a strong and dynamic team made up of individuals with diverse backgrounds and extensive experiences in both the medical, mechanical/design engineering, and ICT domains. Our CEO has over 10 years of experience working in the frontline in rural communities as a medical doctor and hospital director and has been able to witness in real time the burden of the diseases we are targeting for women in underserved areas. Our COO, with a background in public health and over 8 years experience has lead health related ventures in rural settings, targeting women especially, and has a real grasp of the extent to which these cancers are a burden to women. Our CTO has designed a series of technology focused solutions targeting health challenges for the past 10 years, and has equally led both national and international organisations towards cocreating health related solutions in Africa. Added to these every other team member we have brings in a valuable contribution towards the venture from personal start-ups they have created before or working in an organisation that has given them much experience in the context we are working in.

It is through these engagements and experiences in rural settings that we were able to better understand the burden of these cancers for rural women especially, which then became our motivation to build and implement a scalable and adapted solutions that will make no woman ever suffer the burden of these diseases no matter where she is.

The process of building our solutions has involved carrying out 5 pilots so far working with 23 health facilities, This has not only helped us create the most adapted technologies, but also helped us create a unique implementation model which involves partnering and working in collaboration with health facilities (hospitals and clinics) located in target sites. Through these partnerships, we are able to use these health facilities as the main implementation sites for the screening up to treatment, and also, we train the frontline nurses in these health facilities on how to use our technologies to implement the venture, and they become the main pillars implementing the venture at the point of care. This training is being done through our gamified training model using our e-training platform, which has been proven to enable low skilled frontline nurse to get trained on these skills 8 times faster than any other learning method. This implementation model enables a better socio-cultural integration and acceptability of the venture in all communities, particularly because it is the nurses whom the women in the various communities already know well and trust who will be implementing the venture. In addition, the partnerships also enable us to exploit already existing communication channels present in rural settings such as engaging community health workers or organising massive screening campaigns, to mobilise women in the various communities towards the health facilities so that they can benefit from the venture.

We believe we were able to design these unique technologies because at the start of our brainstorming stages we involved a co-creation design model, where we built our technologies with potential users and stakeholders represented, and not just building for the users, and ensuring that we use frontline nurses in various communities for implementation and scale.

We are pioneering the development of new medical devices combined with designing better systems for implementing innovative health tech solutions in Africa. Being based in Africa, we face the challenge of regulation in the health tech domain, which is usually absent in many Sub-Saharan Africa countries, or diverse while moving from one country to the other. We are hoping therefore to get the best guidance and mentorship towards scaling new solutions like ours to different emerging markets in the most cost-effective manner. This can be through helping us grow our network or get mentorship from more experienced individuals and companies.

In addition, as we plan on bringing this solution to every area where it is needed, we hope to extend our networks, creating partnerships through the Solve network and thanks to the visibility that accompanies this challenge, and find the right implementing partners, mentors, and investors as well in order to rapidly reach our next milestones. 

So far, we are the first and only venture providing a full package and cost-effective cancer care services at the point of care, accessible even for women in the most enclave area. Our indirect competitors in Cameroon and Sub-Saharan countries generally are the few specialised hospitals present in some big cities where women can equally access these services.

We are unique and have an edge though because our innovation is implemented and works well right at the sites where it is needed the most, that is rural areas, is far cheaper, and takes a shorter time to obtain results.

Our smartphone digital microscopy system is the first in Sub-Saharan Africa to introduce the concept of digital pathology in rural settings particularly, and equally permitting whole slide digital imaging and review of digital slides, with instant second and third opinions.

In addition, our Smart speculum functions both as a speculum and a colposcope, but 100 times cheaper, and can easily be manipulated by low level nurses with minimal training. Our clinical studies demonstrated that it enables better and easy visualization of the cervix for health providers thus facilitating the screening workflow, and it is far more comfortable and acceptable by women, serving as a motivation for women to adhere to screening. Based on these exciting results, we see a potential of revolutionising speculum examinations for diverse gynaecological examinations apart from cervical cancer screening, enabling women experience the most comfortable speculum exams.

From our pilots, our e-training platform which uses a gamified learning model has equally proven to train low skilled frontline nurses 8 times faster than any other learning or training system. And these technologies are pioneer in enabling remote diagnosis for women cancers in the world.

We are creating a huge digital cancer registry through our venture, with data even from rural settings, which will be unique and pioneer in Africa, and this gives room for more opportunities to explore in future such as developing artificial intelligence diagnostic systems or even permitting the drafting of more meaningful policies surrounding cancer care for developing settings.

Within the next year, we are working towards obtaining international certifications for our innovations, and by this we are carrying out and finalising a series of clinical trials that will be a solid base to obtain these.

Thereafter, our plan will be implanting GICMED in every health area through partnerships with the local health centres, upgrading the healthcare offer at the primary healthcare level.

We have an ambitious objective of scaling the venture first within Cameroon, targeting at least 10% (about 500 thousand women) of target women within 3 years, then scale to other Sub-Saharan African countries where we already have contacts with partnerships being established, and implementing fully within the next 5 years, serving at least 5 million women.

Achieving this will imply a significant reduction in the number of women suffering from advanced stage cancer and dying from cancer, as well as a significant increase in the number of women especially in rural settings who will have constant access to cancer care services at the point of care.

In addition, this will have a positive economic impact in these communities as the expenditure on healthcare will significantly reduce with a healthier population.

GICMED is a venture designed for a great social impact and by a team obsessed about impact. Our unique implementation model enables us easily and progressively track our impact in each community or health area in real time as we scale. And the main aspects we currently tract are:

Number of health facilities and communities actively implementing the venture

Number of frontline health professionals effectively trained with skillsets to screen for breast and cervical cancers through GICMED

Number of target women screened in each health area

Number of early-stage lesions detected and treated

Proportion of advanced stage lesions tracked to specialised health facilities

Using the data and analytics on our platform, we constantly track the number of women screened in any community versus the total number of target women in that community, to access our level of impact at any point in time, as well as the number of cases detected and treated, which enables us to have a real time picture of the impact we are creating in each health area at any point in time. Our platform enables continuous tracking of these KPIs, and with time this will constitute the most diverse cancer registry in Sub-Saharan Africa and pioneer in obtaining data from any setting and tracking in real time.

As we scale, we will then be able to tract the proportion of women who show up for screening regularly, which will be an indicator of the level of adherence towards the venture.

In the absence of our solution, target women who can afford must travel hundreds of kilometres from their villages to big cities in order to get screened, diagnosed and treated for these cancers at a higher cost, while bearing an extra cost for transportation, and queuing up for days in hospitals before finally consulting a specialist, then waiting sometimes for several months before receiving results, of which about 80% of the time diagnosis and advance lesion with unaffordable or limited treatment options. This is why only 5% of these women currently get screened, and over 80% are diagnosed at late stages.

Through GICMED, all women no matter their location or social status, will have access to standard and quality cancer care services in the same communities where they live, in a truly short time, at a lower cost, and without the necessity of abandoning their families and children to access these same services in big cities.  And through this, cancer cases can be detected early and treated early as well, thereby significantly reducing the rates of advanced disease and deaths. Bringing point of care diagnostic technologies closer to the targets will enable more women get screened, more lesions detected at early stages and treated early, and result to a significantly higher proportion of women accessing these services compared to the current 5%, which has already been proven in all the communities where we have been able to carry out pilots and begin implementations.

We have also been able to demonstrate that using our technologies, task shifting and skills upgrade of frontline nurses using our innovations can effectively lead to universal access to cervical cancer care, thus reducing the burden of this diseases. This has also been proven through our pilots to be a turning point in solving the issue of lack of enough medical specialists in developing settings, as we can now bring their expertise remotely to any location and enable the few available to diagnose and impact far more women compared to the past.

In addition, our smart speculum innovation solves the problem of discomfort and poor screening outcome linked to the regular speculum, by providing a more acceptable and comfortable speculum with an added function as a portable colposcope, which has been clinically validated. This means, women will stop shying away from screening because of speculum discomfort, but instead be more adherent to screening services. 

Our Smart speculum’s design involves a first piece which is a redesign of a speculum into a new instrument with unique design and features that makes it more comfortable and acceptable for women through thousands of feedbacks so far, with an integrated endoscope visualisation system that connects to any smart device, enabling the health provider to visualise the cervix fully and clearly in the smart device just like a colposcope. The smart speculum also enables images of the cervix to be captured directly through a smartphone.

Our biopsy device is a unique pencil like syringe adapter, with a unique design that can easily be 3D printed and assembled in any developing setting. The design enables easy manipulation with a single hand, even by less skilled nurses and provides better biopsy yield through precise and more accurate movements.

Our Smartphone Digital Microscopy system is made up of a software that enables the capture of microscope slide images through a microscope design, then stitching the tiles to form one whole digital image for each slide. It comprises a portable system made up of a lighting source at its base, an automated robotic stage for movements in the x and y axis of the specimen, an array of lenses to magnify the image from the specimen.

Our telemedicine platform designed to be HIPAA compliant enables medical data in various formats to be captured using our hardware technologies (smart speculum and digital microscopy system), then transmitted and stored securely. It contains a mobile app used mainly by frontline nurses to capture data at the point of care, and a web portal used by Medical Specialists to review data.

Lastly our e-training platform permits frontline nurse access gamified learning content with 3D simulations, through mobile and web platforms.

The philosophy of our organisation is integrating anyone from all backgrounds, region, religion, or gender, sharing a common passion for innovation and complementing each other’s skills to cocreate and develop cost effective MedTech innovations to solve the most pressing health challenges in the developing world. Our team which is female dominated confirms this philosophy, and we owe our successes so far to the diverse nature of our team.

Our implementation model also is built on the foundation of inclusiveness where we leverage on existing personnel and skills present in each community to better implement. So far 95% of the frontline nurses trained and implementing are women. 

Based on our solutions and technologies, we will have 2 main sources of revenue at this point:

• Direct sale of screening, diagnosis and treatment services for breast and cervical cancer to target women (in partnership with local health facilities). Through this revenue stream, we then engage in a revenue sharing scheme with the partner health facilities.
• Direct sale of some of our products, which are:
  • sale of our smart speculum to health facilities to be used for various gynaecological procedures
  • Sale of our Fine needle biopsy device to health facilities.
  • Offering Telepathology services for hospitals, universities and researchers and research organisations in Africa,

It is worth noting that we intend to leverage on our technologies to target more diseases such as tuberculosis, malaria, and other cancers, by enabling point of care remote diagnosis, and this will translate to more revenue. 

First, we will focus on scaling our solution to more sites, to targeting more women translating to more revenue. This will be done by replicating our Implementation model from one health area to the next. From our estimates and experience so far, implementing in a new site enables us break even after about 6 to 8 months, and this can guarantee sustainability of the venture.

Parallelly, we will keep on with the commercialisation of our products to health facilities for various uses, which is a great boost so far in enabling us sustainably scale the venture.

Also considering that most Sub-Saharan Africa countries are working towards finding best strategies to enable universal health care by 2030, we plan to exploit this opportunity by partnering with ministries of health and other important stakeholders to scale our solution to more sites, which provides a universal access to cancer care in the most cost-effective manner.

Through grants and prizes we have been able to obtain funding from organisations such as Johnson and Johnson, USAID, CISCO, Expo Dubai 2020 under the Expo Live program.

These permitted us form a solid team, develop, and test our solutions past MVP to current finalised versions, and carry out five pilot studies to validate our concept and technologies.

We just kicked off implementation and we will soon be raising a seed round to boost this next milestone and implement the venture in targeted new areas by Q4 2022. This scale up strategy is currently in motion as we are building a list of implementing partners, with over 250 LOIs received already.