Vula Mobile

400 million people worldwide live with one of 7,000 rare diseases, 95% of which don’t have an FDA-approved treatment, let alone a cure. However, the good news is that some rare diseases do have therapies that may not be able to cure, but are able to manage rare diseases. One such disease is Sickle Cell Disease (SCD).  The problems to solve with SCD is to (1) improve the patient diagnostic journey (2) to link patients to treatment centres and (3) provide data sets that can be used for research that can guide future interventions.

 Sickle cell disease (SCD) is a rare genetic blood disorder characterized by abnormal hemoglobin, resulting in the distortion of red blood cells into a sickle shape. Considered a rare disease, with fewer than 200,000 cases in the United States. “Investments in discoveries and clinical care infrastructure have been limited and have not kept pace with other equally devastating but less common inherited conditions. In the United States, most individuals with SCD are racial and ethnic minorities — primarily African Americans — have economic disadvantages, suffer from reduced care access, such as few SCD specialists and treatment programs available, and encounter institutionalized racism and stigmatization.” (Julie Kanter, MD, Division of Hematology and Oncology, University of Alabama Birmingham, Birmingham). 

Globally, sickle cell disease is most prevalent in sub-Saharan Africa, the Middle East, and parts of the Mediterranean. It is estimated that around 300,000 infants are born with sickle cell anemia worldwide each year. The burden of SCD is particularly high in countries with limited resources and healthcare infrastructure. One of these countries is Ghana and the challenge is even greater in the Northern, more rural regions of the country.

Vula is solving the problems in the Upper East Region of Ghana. Primarily solving the specific problems that affect the patient journey and linkages to treatment centres. We partner with the Navrongo Health Research Centre by providing data and analytics that will contribute to local research. The goal is to provide a global example of how a rare disease can be managed in a low resource setting, providing a global centre of excellence and example for all countries.

Vula connects health workers to each other at the right time with the right information so that the right action is taken for the patient.

Vula is a platform that is accessed via mobile apps designed for low bandwidth settings. The app connects community based primary health worker conducting screening and testing with the specialist SCD services at the Navrongo Health Research Centre (NHRC).

How it works

1. Health workers use the app and web portal for free and are directed immediately to the most appropriate SCD specialist at the NHRC.

2. The health workers complete a form specific to the SCD service, ensuring that a clinical decision can be made efficiently.

3. The health worker and specialist use our secure chat to discuss the patient and manage the patient. Typically there are three outcomes:

• The patient is transferred urgently

• The patient is given an appointment

• The specialist teaches the frontline health worker how to manage the patient

Data analysis and reporting is provided to health managers, surfacing insights on previously unrecorded referral and chat data. Vula provides the NHRC with monthly data analytics that include data visualisations of activity. Data downloads are available at any time for research purposes.

This application is for our current solution for SCD in Ghana. 

(In South Africa we have programs running for other rare diseases including Gauchers, Mucopolysaccharidosis type I & II, and Pompe. We are working towards an additional campaign for Fibrodysplasia Ossificans Progressiva (FOP) and other  musculoskeletal conditions. For the solution in South Africa, Vula was one of the finalists for the 2022 Horizon Prize).

Vula's current target is the uninsured population in Africa living in rural, remote and underserved areas. This accounts for approximately 80% of total population typically living in deep rural areas, townships, shanty towns and poor peri-urban areas. This group is served by the government funded public health services.

The public health sector has dedicated health workers in the rural, remote and underserved areas, however they are often under resourced and have little support themselves. See: How Vula is revolutionising healthcare

To meet the needs of the population Vula's solution helps at 4 levels. 

1. Patient: Reducing the diagnostic journey both in time and travel costs. Patients get screened and treated with minimal cost and minimal travelling. Especially important in a remote, rural and lower economic area. This has an additional benefit of decreasing carbon emissions.

2. Health workers: Having easy access to specialist advice or to coordinate services means that they learn every time a cases is discussed on the secure platform. Feeling supported they stay for longer in public facilities and will be able to help more patients. 

3. Specialist services: Being able to coordinate care asynchronously and remotely vis Vula helps more patients get managed at their first visit and helps to ensure that the patients most in need are prioritised for journeys to specialist clinics. Testimonials

4. NHRC: The monthly data visualisation reports help provide data for their objectives to (1) Enhance the development of evidence-based policies by generating relevant and empirical knowledge and information on priority health areas. (2)To facilitate the process of translating research findings into policy through dissemination and publication in peer-reviewed journals. 

Vula's data has already provided support for research conducted to drive health systems improvements. Read more here:Research publications on Vula's impact With Vula's solution the needs of the target populations can continuously be monitored so that interventions can be tailored.

The Vula team are passionate about healthcare. All of us have either experienced the need of being a patient in the public health sector, have a relative who is dependent on the public health sector or has worked in the public health sector. Of importance, one of our team has a rare disease, giving us first hand experience of what it is like to be a patient in the system.

The Team Lead, Stacey Ann Pillay, was born in a deep rural area in Kwa-Zulu Natal. She has ten years of experience working with government, international organisations & funders. She has developed strong relationships across different spheres by telling compelling stories and consistently delivering what was promised. Stacey is focused on building a deep understanding of a customer’s need and translating this into integrated customer centric solutions.

Rural foundations: Vula has founded in 2014 by Dr William Mapham. He combined his lived experience as a rural doctor, creating mobile health tech solutions and specialising in Swaziland as an ophthalmologist to create Vula. Vula’s audacious goal is to link 1 million health workers weekly. This means that rural health workers can get advice from specialists and get patients to the health care they deserve.

Rare disease experience: Since 2014 Vula has expanded from one specialty to over 75. In 2022 Vula specifically worked in the field of rare diseases, with its work in Gauchers and MPS (1 & 2)  being selected for the 2022 Horizon Prize. In 2023 the rare disease work expanded to Pompe and Sickle Cell Disease. We are working towards adding Fibrodysplasia Ossificans Progressiva (FOP) and Vula’s reach means that rare diseases such as babies with Spinal Muscular Atrophy are also picked up and health workers use Vula to link patients to care.

Partnership track record: Vula believes that partnerships are the key to delivering solutions. The SCD work combines the Vula’s rural experience, the in-house technical skills and the ability to forge partnerships. Fro example the Pompe project is through a partnership with Sanofi and the University of the North West (South Africa). The upcoming partnership for FOP is with Tin Soldiers, an organisation with global reach.The SCD programme is a partnership between Vula, Novartis and the NHRC. 

400 million people worldwide live with one of 7,000 rare diseases, 95% of which don’t have an FDA-approved treatment, let alone a cure. However, the fact that some rare diseases do have therapies that may not be able to cure, but are able to manage rare diseases. One such disease is Sickle Cell Disease (SCD).  The problems to solve with SCD is to (1) improve the patient diagnostic journey (2) to link patients to treatment centres and (3) provide data sets that can be used for research that can guide future interventions.

 While medical advances have reduced SCD child mortality in high-resource countries, most adults with SCD die before 50 years of age. Compared with other inherited conditions, such as hemophilia and cystic fibrosis, adults with SCD often become lost in the health care system and are not able to find optimal therapy. In a low resource setting the outcomes can be even worse.

 Together with the Horizon prize we can change this! Firstly, expanding the use of Vula in Ghana will increase the screening for SCD in additional rural and remote areas, linking them to treatment and reducing the diagnostic journey both in time and distance travelled. The increasing efficiencies have an additional benefit by helping to reduce the carbon footprint. Secondly, the partnership with NHRC and the data provide monthly will help facilitate publications and provide evidence of a high tech solution, adapted for a low resource setting that will provide a global example of how to deliver managed care for a rare disease.

Stacey Ann Pillay is deeply committed to improving rural health care.

Rural background and addressing health needs: Stacey is from a rural area in Kwa-Zula Natal. The local hospital battled to retain medical porfessionals. Her first job in 2011 was as a recruitment agent at Africa Health Placements, recruiting health workers specifically into rural hospitals in areas similar to where she grew up. She set the record for the number of health workers recruited in one year into rural public sector hospitals. She grew within the organisation, eventually becoming the CEO in 2018.

Research to guide implementation: Supporting rural health workers' professional development helps retain them. In Africa, with the vast distances between rural health facilities and academic centres, this support is a challenge. Interventions need to be rolled out and tested. Stacey recently presented her research on "Exploring the enablers and barriers to health care professionals completing professional development e-learning short courses" at the South African Association of Health Educationalists. Stacey is able to bridge the gap between rural interventions and evidence based solutions.

Stacey understands the healthcare needs in rural areas. She has experience in using data to drive evidence based solutions. She is supported by a team with rare disease experience as well as experience in Ghana. The partners for this project, such as the team at the Navrongo Health Research Centre, compliment her approach.

Vula runs software to connect health workers. This is different to telemedicine systems that connect a patient directly to a health worker. Typical telemedicine can help one patient at a time. However, with Vula, each time health workers communicate with each other they learn, meaning that health care delivery improves incrementally. Vula also enables a connected network of health workers that can help individual patients as a team. It is impossible for one health worker to know everything and Vula's innovative approach is especially importance for improving healthcare for patients with specialised and rare conditions. Vula is now used in over 70 specialties by 126 types of health worker. 

Health workers use Vula every day, collecting valuable data every time they use the app. There are many services that collect hospital level, clinic level or patient record systems. However, Vula collects data that is different. The Vula data is the communication between health workers, getting advice from each other often across multiple health facilities, making referrals between health facilities, prioritising appointments and organising urgent transfers. This data and the way it is visualised before sending to health managers helps catalyse better decision making. Testimonials

We aim for broader impact. Broader impact requires research and publications that can demonstrate findings to a wider audience. To work towards this we offer technical support for busy health workers at the frontline to conduct research on their own Vula data. We help them with their ethics applications and if needed any data analysis. This approach has resulted in 7 publications so far... Publications

Vula has a sustainable approach to impact. Working with a wide range of specialties opened up Vula to partnerships with a range of organisations, government departments and businesses. Our goal is to improve health care in the public sector, so Vula is offered in that setting at no cost. However, we look for commercial partners to sustain and grow our efforts. An example is the rare disease division within Sanofi and the Sickle Cell Division within Novartis. They recognised that many people with rare diseases were not being diagnosed, no tests were being done and people were not receiving treatment. We ran a survey with the health workers to see what they knew. We demonstrated that health workers had little knowledge about rare diseases, were unaware that free rare disease testing kits could be delivered to their facility and were not sure how to manage patients with rare diseases. 

Vula's impact and capacity to change health systems has been recognised locally as well internationally. See UNDP award

Vula is a network of health professionals.

To provide value and impact at a patient level we need to increase the number of connections on Vula. We measure both whether the health workers use the app or dashboard as well as how often and what they like to use Vula for.

Impact metrics

Our primary metric is "patients helped in the last 24 hours". This is collated and presented monthly to the whole team.

Impact evaluation metric

The real value of Vula is best demonstrated by the health workers using Vula. Typically health workers in Africa find it difficult to find time and help to conduct research. Therefore we offer support with ethics processes and data analytics. Our goal is then to take their independent views of Vula and improve our services.

Vula runs software that connects health workers so that they can get patients to the right healthcare. Each health worker we add to the network increases the number of patients getting the healthcare they need.

Our Big Hairy Audacious Goal is to grow exponentially and have 1 million health workers using Vula weekly by 2032.  

Five year goal: 125,000 active health workers

Impact metric: Patients helped

Total to date since 2014: 1,155,345 (26th June 2023) 

Five year goal: total of 3,500,000

Impact metric: Publications

Impact evaluation metric: Number of publications by African health workers using Vula data

Total to date: 7

Five year goal: 20

Sustainable Development Goals: 

Through the Google Start Up programme our progress towards SDG Goal 3 with Targets 3c, 3.4, and 3.8 was evaluated and progress can be tracked. See spreadsheet

In 2021 the UNDP voted Vula was one of the top four innovations increasing access to healthcare.

Vula's Theory of Change is based on the evidence provided by the existing publications on its impact. Download the PDF

Core technology per type of person:

Patients: receive SMS messages from health workers (requires no data connection)

Health workers: use the app and web portal for free. Can be used offline, but connection is required for chat messaging or calling.

Health workers at specialist services: use the app and web portal for free. Can be used offline, but connection is required for chat messaging or calling

Health managers & Researchers: use the data reporting and Vula's data visualisation services.

These services are constantly adapted to best serve the user needs. This helps to ensure that Vula is scalable and facilitates networks between health workers.

15 Full time

3 Part time

1 Contractor

9 years

Vula believes diversity is essential and we drive this approach at different levels of the organisation. Currently we are a remote first company and have employees. Our country naturally has a range of cultures which we aim to represent and we we aim for gender equity.

You can see a picture of our enthusiastic team here: Vula Team

Senior Mx Team: 

Female > Male

Entire team: 

Female > Male 

Black > White

Vula is a double sided network of health professionals. 

On one side we connect health workers with each other. They use Vula at no cost. On the other side we have customers. Customers include companies wanting to market to health workers, organisations who want to have impact in healthcare and health data companies. 

We now have product market fit in 3 streams and have demonstrated revenue. 1. High performance medical marketing 2. Health systems impact 3. Health data contracts.

1. High performance medical marketing. We started to offer in-app advertising space in 2014 as well as advertising on the monthly analytic reports in 2021 . We have sold these opportunities to a curated range of health companies. Customers like Vula because it is highly targeted, highly relevant and delivers content that health workers find useful. Below are some images from our marketing media pack.

*(Note: The Gaucher in-app advert above is a GIF that rotates as puzzle pieces that put together the diagnosis).

2. Health systems impact: Vula's second product market fit is 'selling the impact'. There are organisations, businesses and occasionally government institutions that want to fund impact in healthcare. Examples from Vula include foundations like the Johnson & Johnson Foundation - they want to see improvements in the public health sector in South Africa. The collaboration is focused on supporting nurses by connecting them to specialist services and strengthening data analytics for referrals and health communication. See the link: Below is an infographic produced by the J&J Foundation

Another example, outside of South Africa is with Novartis. We have a strategic contract with their global division to scale Vula firstly in Namibia and Botswana. This is a commercial contract, specifically for ophthalmology, with the long term goal of their in-country brand managers having high performance medical marketing contracts with Vula in the future. See Novartis and Vula partnership. "“Novartis is committed to actively engage patients and healthcare systems, enable broad and fast access to innovation as well as improve health outcomes,” assured Racey Muchilwa, Head of Sub-Saharan Africa at Novartis. Customers like Novartis like Vula because we can demonstrate impact, track the change in health systems and over time offer new innovative attractive digital marketing opportunities.

3. Health data contracts: Now that Vula is scaling we are collecting a source of data that is different to that typically collected in patient records and hospital management systems. Vula collects the data related to discussions between health workers, across different facilities. With our strong focus on compliance, which is required for all research on Vula data. See the 5 current publications We have a way for health data to be analysed at a macro leve in order to help train AI services. eg Most Dermatology AI systems have been primarily trained on white skin data in Europe or America. This makes many of the current tools irrelevent in an African setting. However, all our dermatology cases are on 90% dark/black skin. This is one of the reasons why the data customers like Vula. We realise that we need to partner with institutions that want to produce globally relevant AI tools and services. In addition to our current contracts I hope that in the future, through this challenge, we can find partners to help look through the 780,000 cases on Vula and find the patients with rare diseases that may have been missed and to actively improve the care for people with rare diseases in the future.

Our Business model described above shows that we have well defined sources of revenue. Our sustainability has evolved over time and we aim to break even in 2025.

Years and progression of sources of income:

2014 - 2018: Grants and angel investors

2018 - 2020: First advertising contract, first government tender and seed investment round.

2021: First commercial health systems contract and investment round

2022: First international health systems contract

2023: First data contract.

Vula is a double sided network of health professionals. 

On one side we connect health workers with each other. They use Vula at no cost. On the other side we have customers. 

We now have product market fit in 3 streams and have demonstrated revenue. 1. High performance medical marketing 2. Health systems impact 3. Health data contracts.

1. High performance medical marketing customers include: Sanofi Rare Diseases, Essity, Next Biologics, Sanofi Mental Health, Ingress Practise Management and Western Cape Department of Health.

2. Health systems impact customers include: Novartis Sickle Cell, Novartis Ophthalmology, Johnson & Johnson Foundation, Astra Zeneca.

3. Data related customers include: Clinton Health Access Initiative (demonstrating that Vula can be used to guide specific campaigns during COVID). Dermatology AI development company.

Grant funding: We count grant funding from foundations as income that is used to fast track growth and to scale systems. This then increases our commerciality in the long term. I sincerely hope that we are accepted for this challenge. It is the only application that I have found so far that focuses specifically on the combination on tech, low resourced areas and rare diseases. 

With your help the  Sickle Cell work in Ghana can be expanded and become a model for other countries to follow.