The Handheld Cardio-Pad: Tackling Cardiovascular Disease in Africa Through Innovation

Stephen Ezell August 29, 2017
August 29, 2017

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(Ed. Note: This post is part of Innovate4Health, a joint project of GMU’s Center for the Protection of Intellectual Property and the Information Technology and Innovation Foundation providing case studies on how IP-driven innovation is tackling some of the world’s toughest health issues.)

Healthcare challenges in the developed and developing worlds are converging, forcing life-sciences innovators to deal with similar challenges, even if from unique perspectives. Consider heart disease. Today, it is the leading cause of death in sub-Saharan Africa for citizens over the age of 30. Meanwhile, on the continent as a whole, 46 percent of Africans over 25 suffer from hypertension—more than anywhere else in the world—though the challenge isn’t limited to Africa. Indeed, citizens of low- and middle-income countries bear 80 percent of the world’s death burden from cardiovascular disease. And, in fact, by 2020, non-communicable diseases such as cardiovascular disease and diabetes will account for 70 percent of fatalities in developing countries. Fortunately, developing-country innovators are stepping up to the challenge.

Meet Arthur Zang, a 29 year-old Cameroonian engineer who invented the handheld Cardio-Pad, the world’s first medical tablet facilitating heart examinations and remote diagnosis. The Cardio-Pad is a touch-screen tablet device for conducting cardiac tests such as electrocardiograms in remote locations, and then sending the results to cardiologists in city centers often hundreds of miles away. The system works in pairs: Nurses in remote villages (or patients’ homes) apply wireless electrodes that record patients’ heart signals, which are transmitted over-the-air to the nurses’ Cardio-Pads. The data is then sent to a cardiologist’s Cardio-Pad, so the doctor can remotely assess and diagnose a patient’s condition.

As is the case in many developing nations, fewer than 50 cardiologists support Cameroon’s population of over 23 million citizens. Without solutions that close the distance between cardiologists located in cities such as Douala (Cameroon’s largest) and Yaoundé (the capital), many citizens, and especially those living in remote locations or those in the most urgent need of care, will simply lack access to proper cardiovascular care. Facilitating remote diagnosis and evaluation of heart conditions further substantially improves conditions for patients, alleviating the need for expensive, time-consuming, and often difficult journeys (especially for elderly patients) to city centers, and eliminating the need to wait in offices while doctors make their diagnoses. At the same time, the solution improves the efficiency of Cameroon’s health care system, allowing cardiologists to service more patients and helping to digitalize health records, so that information on patients’ conditions are more readily accessible to individuals and health-care providers alike.

Mr. Zang founded a start-up company, Himore Medical, to market the Cardio-Pad, providing an excellent example of “reverse innovation,” which refers to products that were initially developed to serve the needs of developing markets, but which, often by dint of being more cost-competitive, find wider appeal in large global markets. With a typical cardiac examination in central African costing about $40, while most citizens live on less than $5 per day, the need for cost-efficient solutions is paramount. That’s why Himore initially sought to price the Cardio-Pad at €2,200 ($2,700), a fraction the cost of commercially available, less portable devices. (Himore estimates the manufacturing of a complete kit used to perform a 12-leads heart examination costs about $2,000.) In addition to being economical, Zang designed the Cardio-Pad attuned to specific needs encountered in developing countries: The device is humidity-resistant and easy for health-care providers to read and manipulate. Reflecting on the simplicity and user-friendliness of the Cardio-Pad for patients and medical professionals alike, Zang explains that “the basis of innovation often [comes from] a desire to solve other peoples’ problems.”

Innovation lies at the heart of Zang’s Cardio-Pad, but the entrepreneur-innovator was quick to secure intellectual property rights for his invention. He filed a patent for the Cardio-Pad (specifically the novel hardware/software combination constituting it) with the African Intellectual Property Organization (AIPO) in 2011. As Zang astutely observes, “patents enable you to protect yourselves against rivals who simply want to copy your work.” Zang further notes that the intellectual property system in Africa “helps us give credibility to African products” and has been instrumental as a validator as his company seeks investors to support its expansion. And that actually points to one of the most significant benefits of intellectual property rights for innovators: It affords them the ability to capture a reasonable share of profits from one generation of innovation to finance investments in the next. Indeed, Himore has leverage the core hardware/software technology behind the Cardio-Pad to develop additional products, such as ultrasound devices for scanning and radiology. Zang has also sought trademark protection for both the Cardio-Pad and his company, Himore Medical.

Zang hopes that Himore’s success with innovative, low-cost medical device solutions may give rise to a medical diagnostics cluster in Cameroon. He also attributes his success to the thoughtful innovation policies of Cameroon’s government, which provided him a modest €30,000 grant as a promising young engineer-entrepreneur (Zang initially conceived the Cardio-Pad at age 24) as part of a series of seed grants designed to bolster Cameroon’s startup and innovation economy. Mr. Zang has justifiably received numerous awards, including the 2016 Africa Prize for Engineering Innovation awarded by the UK’s Royal Academy of Engineering.

The Cardio-Pad provides an excellent example of how the convergence of advanced information and communication technologies, including semiconductor-enabled devices, wireless, software, algorithms, and big data, are enabling the creation of transformative healthcare technologies that improve the lives of citizens in developed and developing countries alike. It also shows the power of intellectual property to protect innovators and facilitate a virtuous cycle of innovation that enables them to continue developing innovative products and solutions that benefit citizens far downstream from the initial innovation.