Published By Jean Clandier
Editorial Board, on 10th Ocotber 2022.
Lagos, Nigeria
For more than a decade, Nigeria has retained the unwelcome title of Africa’s highest tuberculosis (TB) burden country, a public health crisis claiming countless lives. Despite robust intervention programs from both government and international donors, the challenge has remained persistent. TB’s deadly capacity often surpassing even HIV in its speed of fatality when untreated has placed immense strain on healthcare systems nationwide.
In September 2022, a transformative shift in TB detection and diagnosis in Lagos State captured national attention. The Lagos State Ministry of Health, under a Global Fund partnership, unveiled a groundbreaking initiative integrating Artificial Intelligence-powered digital chest X-ray technology into TB diagnosis. At the heart of this achievement was Owolabi O Babatunde, then serving as Program Officer in the Grant Management Unit of the Ministry.
A New Chapter in TB Fight
The project was designed to address a persistent bottleneck: the limitations of Gene Xpert machines, the gold-standard molecular diagnostic tool. While effective, Gene Xpert saturation, maintenance challenges, and limited capacity had created diagnostic delays.
Instead, the AI-powered chest X-ray solution introduced in Lagos was the first in Nigeria to be deployed not only as a screening tool but as a diagnostic instrument validated for high specificity and sensitivity.
“We wanted a solution that didn’t just add to the diagnostic chain but fundamentally changed it,” Owolabi recalls. “AI gave us the precision, speed, and scalability we needed without being held hostage by hardware limitations.”
The system’s capacity to generate near-instant results meant suspected TB patients no longer had to wait days for confirmation, slashing the time to treatment initiation and boosting case detection rates.
Cloud-First, Security-Centric Approach
One remarkable aspect of the intervention was its cloud data architecture, a concept rarely adopted in Nigeria’s health sector at the time. The design followed the “CIA” principle Confidentiality, Integrity, and Availability ensuring patient data security, accuracy, and uninterrupted access.
“Data integrity was non-negotiable for me,” says Owolabi. “When you’re dealing with sensitive patient information, especially in a disease area as stigmatized as TB, you cannot afford breaches or downtime.”
The AI models were seamlessly integrated with secure cloud storage, enabling real-time transmission of X-ray results from both static hospital sites and mobile vans to central repositories accessible to authorized health personnel.
Scaling Beyond the Hospital Walls
The deployment was ambitious: in addition to installations in public hospitals and select private facilities, three fully equipped mobile X-ray vans roamed high-burden communities, offering doorstep diagnosis.
“We didn’t want innovation to be a luxury only for those near a hospital,” Owolabi explains. “Our mobile units were proof that cutting-edge healthcare could be both portable and accessible.”
The mobile units reduced patient travel costs, cut missed workdays, and critically reached individuals in hard-to-access urban slums where TB transmission risk is highest.
From Pilot to National Adoption
By the end of its first operational year, the Lagos AI TB project had achieved two significant milestones:
- Reduced pressure on Gene Xpert testing sites by handling a majority of presumptive TB cases.
- Increased treatment initiation rates due to reduced diagnostic delays.
The success prompted other Nigerian states, and eventually national TB stakeholders, to adopt AI-embedded chest X-ray technology as a national standard.
“It was humbling to see something that started as a Lagos pilot shape national policy,” Owolabi says. “It’s proof that local innovation can have nationwide impact.”
A Broader Digital Health Vision
Owolabi’s leadership extended beyond TB control. His tenure at the Lagos State Ministry of Health saw him direct state-wide e-health initiatives, leveraging digital tools to improve healthcare delivery across the HIV, TB, and RSSH (Resilient and Sustainable Systems for Health) portfolios.
This included integrating digital health platforms for over 500,000 HIV screenings and 30,000 diagnosed cases, as well as training hundreds of healthcare workers and ministry staff to operate and maintain these platforms.
“Digital health isn’t just about the tools,” Owolabi notes. “It’s about creating an ecosystem where people trust and effectively use them.”
Driving UNAIDS 90-90-90 Targets
His earlier work as State Program Manager for the TBNetwork Nigeria and the Global Fund HIV/AIDS Initiative laid the foundation for his e-health expertise. There, he implemented mobile health solutions that improved healthcare-seeking behavior in remote communities, increased HIV testing rates, and boosted ART enrollment key elements in Nigeria’s progress toward the UNAIDS 90-90-90 targets.
“If you can’t see your data in real time, you’re always playing catch-up,” Owolabi says. “For HIV, TB, or any chronic disease, timely data means timely action.”
Technical Leadership and Risk Management
The AI TB initiative was as much a cybersecurity project as a public health one. Owolabi’s dual expertise in public health and cybersecurity proved essential in designing secure systems compliant with international standards like GDPR and HIPAA.
“We treated patient data security as seriously as banks treat financial data,” Owolabi emphasizes. “Without that trust, patients won’t come forward, and the system collapses.”
His architectural design ensured encryption at rest and in transit, strict access controls, and robust backup protocols a forward-looking decision that anticipated the growing global concerns about health data breaches.
Collaborating Across Sectors
The project’s success required more than technical ingenuity; it demanded extensive cross-sector collaboration between government agencies, healthcare providers, international donors, and technology partners.
“Public health isn’t a solo sport,” Owolabi says. “The partnerships we built were as important as the technology we deployed.”
His coordination efforts aligned technical teams, clinical staff, and policymakers, ensuring smooth integration into existing health systems without disrupting service delivery.
Cost Efficiency and Sustainability
Compared to Gene Xpert testing, AI chest X-ray diagnosis proved significantly more cost-effective in Lagos. The operational savings enabled the Ministry to extend services to more facilities and sustain the program without constant external funding.
“Cost efficiency isn’t just about spending less,” Owolabi explains. “It’s about designing systems that can sustain themselves when donor funding ends.”
This principle has guided several of his other projects, where sustainability is factored in from the earliest design stages.
Impact Beyond TB
Today, the AI-driven chest X-ray approach pioneered in Lagos is being adapted for multi-disease screening, including COVID-19 pneumonia and certain occupational lung diseases.
“The beauty of AI is its adaptability,” Owolabi remarks. “Once you have the framework, you can train it for multiple conditions without starting from scratch.”
This flexibility has positioned Nigeria as a leader in AI health diagnostics in Africa, with Lagos serving as the innovation hub.
Recognition and Forward Momentum
While Owolabi has since transitioned to global roles in cybersecurity and e-health consulting, his contributions to Nigeria’s TB response remain a benchmark for innovation-driven public health.
“Looking back, the lesson is clear: don’t wait for perfect conditions to innovate,” he reflects. “Start with what you have, but design it to grow.
