Across Sub-Saharan Africa health burdens for women are systematically underestimated, with an absence of data that exclude or undervalue important conditions. Women face barriers to care, diagnosis, and treatment. In addition, there has been lower investment in women’s health conditions relative to their prevalence, reinforcing a cycle of weaker scientific understanding about women’s bodies and limited data to de-risk new investment.

Low- and middle-income countries (LMICs) are plagued by weak primary healthcare systems and poor digital infrastructure. No digital health records exist for individuals in Sub-Saharan Africa. The result is centralised datasets and trusted resources for patients and investigators are sparse, fragmented, and not shared among the communities they are meant to serve. Data management platforms to create a unified health record through data ingestion and to provide data governance to store, manage, share, find and use data critical for the implementation of AI in healthcare are beyond reach for LMICs. This ultimately costs lives, reduces the quality of life for women and girls, and precludes LMICs from participating in innovative R&D and realising benefits in the full potential of technological advances in healthcare.

The impact of digital technologies on the lives of women and girls, particularly in relation to sexual and reproductive health and rights, must be placed at the start of the effort to avoid the structurally flawed approach that over time leads to a proliferation of data silos. Under such conditions the collection, storage, and use of personal health data may happen without adequate consent or even awareness. Unauthorised access and use may have harmful consequences for individuals, particularly for women and girls.

The lack of systemised governance and empowerment of individuals has led to “AI” deployments in health contexts in Sub-Saharan Africa where the underlying datasets and models are not available for interrogation and validation. Not only are proper scientific and engineering foundations necessary for improved outcomes, but the deployment of algorithms without transparency and accountability can perpetuate bias and discrimination, amplifying existing health disparities.

Lastly, any interventions to improve health outcomes must do so holistically by uniting the provision of critical products and services to systems for the assured provision of products and services to those in need.

Elle’s approach is a holistic, integrated solution leading South Africa in:

1) ElleHealth: The state-of-the-art patient driven data platform to enable the collection of comprehensive patient data, while preserving privacy, ensuring security, and placing the patient in full control where patients themselves contribute directly to health information.

2) ElleStudies: The state-of-the-art research platform to enable the collection of good quality healthcare data, in a trusted and safe way to revolutionise the management and tracking of chronic disorders and diseases. ElleStudies aims to democratise exceptional care and the research process to accelerate effective diagnostics, treatments, and cures for women’s health. It provides the platform through which stakeholders can communicate traversing silos to share learning and enhance collaboration across initiatives to improve collective effort. It connects patients to verified information on best care practices, medical professionals, clinical trials, and similar patients near them to create community. ElleStudies addresses representation and equity for research recruitment that more accurately represent the diversity of disease.

3) Moxie: The smart menstrual product dispenser enabling the controlled access to menstrual care products across corporates, schools, and communities, and supporting the provision of connectivity in underserved communities. The dispenser is networked for efficient stock management and usage data is used to optimise resource allocation. Near Field Communication and biometrics are used to control the dispensing of items to prevent abuse in environments where the contents are free, and to control the dispensing of NSAID’s and vaginal rings.

4) Womany: To support women and girls with access to trusted sources of information and the detection of gynaecological diseases and disorders. The application utilises a symptom-disease classifier and monitors whether a gynaecologist is warranted based on the observed symptoms. The application is being developed to support AI driven diagnostic medical reasoning and conversation, which will be extended to a range of women’s health conditions.

5) Manufacturing: Production lines for fully sustainable pads, liners, tampons, and flushable wipes to provide women and girls with their choice of affordable, effective, and safe menstrual care that is environmentally friendly. Fully localised in South Africa the product line, including the packaging, is plastic-free and biodegradable. No synthetic or semisynthetic fibres are utilised, and no bonding agents. The product line utilises the latest generation of manufacturing technology to incorporate organic plant-based fibres cultivated in South Africa.

6) Elle diagnostics: Elle has taken the lead on bringing to market two non-invasive at-home diagnostics for endometriosis, including a bioassay and a biosensor.

7) Elle SSA: Elle is the public benefit organisation leading the Elle Sub-Saharan Africa (Elle SSA) consortium, to initiate collaborations linking institutions in LMICs across academia, government, and industry to create a powerful nexus to democratise data, AI technologies, and the implementation of solutions to support accessibility of essential services to vulnerable communities, especially women. Elle is to serve as the custodian assuring the development and management of healthcare data at scale and the open sourcing of AI models trained on the data utilising approaches like differential privacy and federated learning, intended as benchmarks to advance diagnostics, treatments, and pathways to cures.