WHY MRI
THE PROBLEM
MRI is an essential health technology. The rapid translation of MRI research to useful clinical services has undeniably transformed the outcome of complex chronic diseases such as cancer, stroke, dementia, and heart diseases. While historically, disease burden in Africa has been largely driven by communicable, maternal, neonatal, and nutritional (CMNN) diseases, the burden of non-communicable diseases (NCDs), including heart disease, stroke, and cancer has increased to a similar level as CMNN diseases, and is predicted in 10 years to surpass it. As NCDs related disabilities continue to increase in Africa, it is critical to address barriers to NCD management to achieve the global target of reducing premature mortality from NCDs by one third by 2030.
One in two Black African Women die from breast cancer. In the US, that number is closer to 1 in 10.
ACCESS AND AVAILABILITY
Although MRI is an expensive and resource-intensive technology, it is routinely used to diagnose diseases and enable drug and treatment discoveries. In Africa there are just about 1 MRI scanner per million people compared to up to 37 MRI scanners per million people in the United States, which further overburdens the health care systems and comprises patient’s health and well being. Given the necessity of MRI in the management of NCDs, increased availability and utilization of MRI services are critical to improving healthcare access in Africa, in particular in Sub-Saharan Africa where availability and access are even more restricted than in the rest of the continent.
Global density of MRI scanners. All of Africa has minimal to no access to MRI
PERSONNEL TRAINING AND EDUCATION
This severe shortage in skilled MRI personnel has exacerbated the lack of access and has contributed to gross underutilization of MRI in Africa. There are roughly 2 radiologists per million people in Africa compared to 116 per million in Europe and North America. The African radiologists are typically non-subspecialized, work longer hours, face challenges of frequent scanner breakdowns and low supply of consumables and have to contend with sub-optimal infrastructure to care for a population with unique medical conditions. Around 65% of diagnostic imaging centers in Africa do not have access to an MRI physicist, which is troubling given that most scanners produce low-quality images, which can be augmented by trained physicists.
“Train more MRI radiographers. Extend working hours. Pay radiographers for research or make them co-authors”----CAMERA NAS
RESEARCH TRANSLATION CAPACITY
Of the 54 countries in Africa, only 11 produce research to advance MRI knowledge, representing 0.5% of the total MRI research output in the most recent 3 years. In contrast, High Income Countries such as Canada, Germany, England, South Korea and the US produced a combined 90% of the total MRI research output over the same period, representing 433 times the number of papers from Africa. The limited local knowledge production in Africa restricts translation of MRI technology and applications to solve the relevant and local unique medical needs.
Research publications amongst Lower-Middle Income Countries, Africa and Higher-Income Countries
Global relative research publications
SUSTAINABLE MRI TECHNOLOGY
The prohibitive cost of MRI service contributes significantly to lack of access, significant underutilization, and challenges to sustainability of MRI in Africa. At an average cost of US$200 for an MRI examination and an average monthly salary of roughly US $470 purchasing power parity, the average African cannot afford an MRI scan.
