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Application Form

After submitting the application form you should receive a confirmation email. Please check your email and spam folder and if you do not receive this confirmation email please contact us at: info@africayounginnovatorsforhealth.org

1. Personal Details

  1. Date of birth

    Confirm age

    Applicant must be between 18 to 35 years of age.

  2. Are you a Resident or Citizen of the country you are based in, or another African country?

  3. Social media handles:

  4. How did you hear about the Africa Young Innovators for Health Award?


2. Your Team

Please fill in the following details for each of your team members. First please select how many team members there are in your organisation? (Please use drop-down box to identify how many team members there are)

  1. Social media handles:

  2. Personal qualities and experience:

    What knowledge, skills and experience do you, and your team, have which will help ensure your innovation will be successful? (200 words max)

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3. Your Commercial Plan

    The purpose of this section is to be able to show that your innovation can be commercialized.
  1. In which sector(s) does your technology operate?

  2. What is your innovation?

    Please provide the name of your innovation, what it does and a summary of your solution. (250 words max)

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  3. Degree of Innovation and Uniqueness

    Please explain how your idea is a modification or improvement to already existing technologies, products or services or how you believe your idea can change the field completely? (For example, convenient, timely testing at the point of care resulting in faster, more cohesive patient care). Please also indicate your competitive advantage relative to the market. (250 words max)

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  4. The Market

    Please give a brief overview of the innovative solution your team is working on. Additionally, please discuss the market you are addressing including market size, risks and opportunity, how current and emerging trends are converging to create an opportunity for your innovative solution and how your project will be competitive in this particular market. (750 words max)

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  5. Your Operations

    What are the systems, equipment, people, and processes you use to make the organization function? (750 words max)

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  6. Establishing a clear time frame

    Please list your company’s sources of funding to date and funding plans and key milestones you plan to achieve in the next 12 months. (750 words max)

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  7. Commercial readiness

    What level of commercial readiness is your innovation at? Please assess according to the chart below and explain your level of commercial readiness. (500 words max)

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    Commercial readiness

    Taken from: Cloud Watch Hub

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  8. Why you should win

    Tell us why you or your team should win? Have you built something before? Have you thought of how you would deploy your idea? Have you thought of how you would scale it? Feel free to share any personal stories/hobbies relevant to your idea or business. (250 words max)

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  9. Benefits of the Financial Prize

    Please explain how you plan to use the financial prize to invest in and develop your healthcare innovation? What specific areas of development will you focus on and how will this help you build the business and take your innovation to the next level? (500 words)

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4.Partnerships and Endorsements

  1. Stakeholder Validation

    Please explain how you have engaged with key stakeholders regarding your technology and what the feedback has been. Additionally, please describe what type of partnerships you are exploring in order to advance your technology. (250 words max)

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  2. Endorsement by a Third Party (optional)

    Please upload a supporting document, which may include a letter of support (of no more than 2 pages) from:
    1. a university, research institution or school affiliated with the lead applicant
    2. a letter of support from an incubator, accelerator, tech hub or startup competition your business has previously been involved with
    3. document of incorporation for your business
    4. patent certificate for your innovation

      This should include:

      • details on the nature of the affiliation between the applicant and the university, research institute, incubator or tech hub;

      • an explanation of why the applicant is a suitable winner of the Africa Young Innovators for Health Award ;
      • comment on the involvement of the university, research institute, incubator or tech hub with the innovation so far;
      • a description of any Intellectual Property, its ownership and status
    Maximum upload file size: 2 MB.

5. Supporting Video (optional)

Please upload a short video, of no more than 3 minutes, to introduce yourself and your team and explain why you are applying for this Award and why you should win the Award.

Maximum upload file size: 2 MB.

AFRICA YOUNG INNOVATORS FOR HEALTH AWARD (“the AWARD”) APPLICATION TERMS

By submitting requested information (“Application”) as part of this Award, you on behalf of yourself and your company (“Applicant”) agree to abide by these Application Terms (the “Terms”), the terms and conditions of our vendor, and the decisions of the Award Secretariat (“Secretariat”) on this Award, which shall be final and binding in all respects.

By submitting an Application, Applicants warrant that no information provided as part of the Application IS OR can be deemed confidential OR proprietary, considered a trade secret or privileged.

The Award will be announced via email, press release and/or a social media post (collectively, the “Award Announcements”). An Award Announcement will include how to apply, the application deadline and the award for that Award.

WHO CAN PARTICIPATE:

Citizens and permanent residents of African Countries can apply. Applications should only be submitted by authorized representatives of the Applicant applying for the Award. To qualify, each Applicant must submit an innovative idea to support, equip, protect or train healthcare workers at the heart of delivering care.

Applicants are responsible for complying with any company policies related to participating in programs of this nature, including, but not limited to obtaining any necessary permissions from their company to participate and to provide the information required for the Application and to submit it.

WHO CANNOT PARTICIPATE

While all potential applicants are encouraged to apply, those that are Health Care Providers (“HCPs”), Government Officials (“GOs”) or any organization affiliated with either will be subjected to additional review to ensure compliance with the IFPMA Code of Practice and ultimately may not be eligible to participate. Definitions of HCPs and GOs are listed below. In addition, even if an Applicant is ultimately not eligible to participate, we encourage potential Applicants to still apply as they may be considered for future opportunities, separate and apart from the Award.

HOW TO SUBMIT AN APPLICATION:

Visit www.africayounginnovatorsforhealth.org and follow the directions provided to complete and submit the Application. You represent that all information provided as part of the Application is truthful and accurate. All Applications must be received by the deadline stated.

By submitting an Application, Applicants warrant that:
(i) All information contained in the Application is original to the Applicant or the Applicant has secured all rights to submit the Application;
(ii) No information is or can be deemed confidential or proprietary, considered a trade secret or privileged;
(iii) Neither the Applicant’s Application nor the Secretariat’s, Jury members’ or Business mentors’ use of the Application (or information contained therein or otherwise provided), in whole or in part, violates the right(s) of any third party and the Applicant has not received any notice alleging any such violation;
(iv) All activities of an Applicant’s business initiative are lawful;
(v) The Application does not contain offensive or libelous material, is truthful and not misleading;
(vi) The Applicant has considered and complied with all contractual and/or confidentiality commitments that may be applicable to his/her Application, including compliance with business privacy policies, data use policies, policies governing disclosure of company information, agreements with third parties, and any other company policies or commitments that may be applicable;
(vii) The Applicant is aged 18 years or older;
(viii) The Applicant is a citizen or permanent resident in a country in Africa;
(ix) The Applicant has not received funding from one or more third parties for the funding of the idea in their Application in a cumulative amount of greater than US$250,000; and
(x) The Applicant has submitted the Application in accordance with these Terms. No confidential relationship is established or implied by the Secretariat’s acceptance or consideration of an Application. All submissions are voluntary.

The Applicant understands that the government with jurisdiction over the Secretariat has in place certain sanctions against certain countries, individuals and entities and that the Secretariat and/or Award’s partners may be prohibited from engaging in transactions or other activities within the scope of those sanctions. The Applicant understands that the Secretariat may screen every applicant against these sanctions and will not enter into any transactions within the scope of the sanctions.

INTELLECTUAL PROPERTY

The following definitions and rules of interpretation apply in this agreement.

Definitions:

Intellectual Property Rights: patents, rights to Inventions, copyright and related rights, trademarks, trade names and domain names, rights in get-up, goodwill and rights in designs, rights in computer software, database rights, topography rights, rights to use and preserve the confidentiality of information (including know-how and trade secrets) and any other intellectual property rights, in each case whether registered or unregistered and including all applications (or rights to apply) for and rights to be granted, renewals or extensions of, and rights to claim priority from, such rights and all similar or equivalent rights or forms of protection which subsist or will subsist now or in the future in any part of the world.

Invention: any invention, idea, discovery, development, improvement or innovation, whether or not patentable or capable of registration, and whether or not recorded in any medium.

The Applicant understands and agrees to be responsible for applying for any necessary intellectual property protections in connection with any information provided as part of the Application, including, but not limited to, any patents, prior to submitting the Application. The Applicant acknowledges and agrees that the Secretariat is not responsible and will have no liability for any claims or actions associated with Applicant’s failure to do so. Each Applicant understands and acknowledges, to the extent permitted by law, that:
(i) The Secretariat, the Jury and any entity supporting the Award (the “Supporters”) have wide access to ideas, designs, protocols, methodologies and other materials (collectively, “Ideas”), and those new Ideas are constantly being submitted to it or being developed by their own staff;
(ii) many Ideas may be competitive with, similar to, or identical to content in the Application and/or each other in concept, approach, format, or other respects;
(iii) The Applicant will not be entitled to any compensation as a result of the Secretariats’, the Jury’s and/or Supporters’ development or use of any such similar or identical material that has or may come to them from other sources. Except where prohibited by law, each Applicant acknowledges and agrees that the Secretariat, the Jury and the Supporters do not now and shall not in the future have any duty or liability, direct or indirect, vicarious, contributory, or otherwise, with respect to the infringement or protection of the Applicant’s Intellectual Property Rights and/or Inventions in and to the submission. Finally, to the extent permitted by law, each Applicant acknowledges that, with respect to any claim by Applicants relating to or arising out of the Award, actual or alleged exploitation or use of any Application or other material submitted in connection with the Contest, the damage, if any, thereby caused to the applicable Applicant will not be irreparable or otherwise sufficient to entitle such Applicant to seek any injunctive or other equitable relief or in any way enjoin, otherwise interfere with, delay, or interrupt the production, distribution, exhibition, or other exploitation of any production based on, or allegedly based on, the Application, and, to the extent permitted by applicable law, Applicant’s rights and remedies in any such event shall be strictly limited to the right to recover out-of-pocket costs associated with entering the Award, if any, in an action at law.

PRIVACY:

The Award is committed to protecting the privacy of the Applicants. Please see Award’s Privacy Policy  [UM1] for more information. By agreeing to these Terms you are also agreeing to this Privacy Policy.

APPLICANT SCREENING AND SELECTION:
Initial Application Review: Applications submitted for the Award may be transmitted to/from other countries where members of the Secretariat or Jury members are based or located in. Applications may be submitted until 31 March 2021 (“Award Period”); provided, however, the Secretariat may at its sole discretion extend the term of such Award Period. Eligible Applications received during the Award Period will be reviewed for eligibility and eligible Applications will be judged by the Secretariat based on the following criteria:
(i) does the idea support, equip, protect or train healthcare workers ;
(ii) is the idea innovative. Does it break new ground and meet a challenge in its municipality, region or country;
(iii) is the idea scalable;
(iv) does the idea have  a measurable impact on healthcare workers; and

(v) is the idea have the ability to compete effectively with its competitors and to make a profit?

Final Application Review: Selected Applicants (“Finalists”) will have their Applications reviewed by a judging committee (“the Jury”). The Secretariat may, at its discretion, ask a Finalist to submit certain confidential information regarding its Application in order to assist the second judging committee in making its final selection. Any such subsequent disclosure would be made pursuant to a mutually agreeable confidentiality agreement executed by the Finalists and the Secretariat.   Where the Applicant fails to enter into such confidential agreement, it is deemed to have withdrawn its Application from the Award.  The “Award Recipients” will be determined by the second judging committee from among the Finalists. The Secretariat reserves the right to not provide all Awards if it does not receive a sufficient number of eligible and qualified Applications. Decisions of the Secretariat are final and binding in all matters. Award Recipients will be announced on the date specified in the Award Announcement. Potential Award Recipients may be required to execute and return an Applicant Agreement and Release as well as other documentation within a time period specified by the Secretariat. If such documents are not returned within the specified time period, a potential Award Recipient cannot be contacted within a reasonable time period or is not in compliance with these Terms, such potential Award Recipient will be disqualified and another Applicant may, with the Secretariat’s sole discretion, be selected and the Award awarded to this eligible Applicant in accordance with these Terms.

AWARD:
The Award will be set forth in the Award Announcement. The exact value of the Award will be provided to the Award Recipient at time of notification. The Award may not be substituted, assigned or transferred. Recipients are responsible for all applicable federal, state, provincial and local taxes, if any, as well as any other costs and expenses associated with Award acceptance and use not specified herein or in the Award Announcement as being provided. The Applicant agrees that it has no entitlement to receive the Award, including in situations in which they have previously received one.

PUBLICITY GRANT:
By accepting an Award, each Award Recipient agrees to the use by the Secretariat and its designees of Applicant’s name, company name, trademarks and logos, city and province/state of residence, images and/or likenesses for promotion purposes, in any manner, in any and all media, now or hereafter known, worldwide for 5 years, without compensation (unless prohibited by law) or additional consents.

RELEASE OF LIABILITY:
By submitting an Application, to the extent permitted by law, Applicants agree to release, discharge, hold harmless and indemnify the Secretariat, the Jury, and the Supporters (“Released Party” or *Released Parties”) from any and all injuries, liability, losses and damages of any kind (including, without limitation, arising from claims based upon invasion of privacy, defamation, or right of publicity or any violation of any Intellectual Property Rights and/or rights related to the protection of Inventions) to persons, including death, or property resulting, in whole or in part, directly or indirectly, from Applicant’s participation in the Award and/or the use of the Award or any Released Party’s use of any information provided as part of the Application.

GENERAL CONDITIONS:
To the extent permitted by law, Released Parties are not responsible for lost, late, incomplete, damaged, inaccurate, stolen, delayed, misdirected, undelivered or garbled Applications; or for lost, interrupted or unavailable network, server, Internet Service Provider (ISP), website, or other connections, loss of any data or information, availability or accessibility or miscommunications or failed computer, satellite, telephone or cable transmissions, lines, or technical failure or jumbled, scrambled, delayed, or misdirected transmissions or computer hardware or software malfunctions, failures or difficulties, or other errors or difficulties of any kind whether human, mechanical, electronic, computer, network, typographical, printing or otherwise relating to or in connection with the Award or the Application process, including, without limitation, errors or difficulties which may occur in connection with the administration of the Application process or in any Application and Award-related materials. Released Parties are also not responsible for any incorrect or inaccurate information, whether caused by site users, tampering, hacking, or by any equipment or programming associated with or utilized in the Application process or the Award. Released Parties are not responsible for injury or damage to any person's computer related to or resulting from participating in this Application process or downloading materials from or use of the website. Persons who tamper with or abuse any aspect of the Application process or website, who act in an unsportsmanlike or disruptive manner or who are in violation of these Terms, as solely determined by the Secretariat, will be disqualified. The Secretariat reserves the right at its sole discretion to suspend, modify or terminate the Application process at any time and for any reason. CAUTION: ANY ATTEMPT TO DELIBERATELY DAMAGE THE WEBSITE OR UNDERMINE THE LEGITIMATE OPERATION OF THE APPLICATION PROCESS MAY BE IN VIOLATION OF CRIMINAL AND CIVIL LAWS AND SHOULD SUCH AN ATTEMPT BE MADE, The Secretariat RESERVES THE RIGHT TO SEEK DAMAGES AND OTHER REMEDIES (INCLUDING ATTORNEYS’ FEES) FROM ANY SUCH INDIVIDUAL TO THE FULLEST EXTENT OF THE LAW, INCLUDING CRIMINAL PROSECUTION. Void where prohibited by law. Award is subject to all applicable federal, provincial, state and local laws.

CHOICE OF LAW:
To the extent permitted by law, Applicant understands that any dispute, controversy or claim arising out of or in relation to this contract, including the validity, invalidity, breach or termination thereof, shall be resolved by arbitration in accordance with the Swiss Rules of International Arbitration of the Swiss Chambers' Arbitration Institution in force on the date on which the Notice of Arbitration is submitted in accordance with these Rules.

The number of arbitrators shall be one;

The seat of the arbitration shall be Geneva, Switzerland;

The arbitral proceedings shall be conducted in English.

The Expedited Procedure shall apply.

(i) any and all disputes, claims and causes of action arising out of or connected with the Award or any award provided shall be resolved individually, without resort to any form of class action,

(ii) any and all claims, judgments and awards shall be limited to actual out-of-pocket costs incurred, and in no event will I (Applicant) be entitled to obtain attorneys' fees or other legal costs;

(iii) no punitive, incidental, special, consequential or other damages, including without limitation lost profits may be awarded (collectively, "Special Damages"); and

(iv) Applicant hereby waives all rights to claim Special Damages and all rights to have such damages multiplied or increased.

(v) Swiss law governs these Terms and all aspects related thereto.

“Government Official or GO” means any official or employee of a government agency or instrumentality of the government including but is not limited to a political party, party official or candidate, or public international organizations. It also includes individuals representing himself or herself as a GO, for example, a customs official, inspector, auditor, investigator, elected official, or employee of a government ministry or agency. Note that this definition includes agents or employees of some non-governmental (NGO) organizations where those organizations perform quasi-governmental services such as distribution of drugs and medical devices or delivery of health care services, an individual who is an agent or consultant to a government agency, or provides a primary business address at a government facility, uses a military title or rank, supplies an email address associated with a government entity or is otherwise known or believed to be a government employee. Health Ministries and government-owned hospitals often employ HCPs who may be GOs under local law. A private HCP that provides consulting services or otherwise acts as an agent of the government, these individuals should be considered Government Officials.

“Health Care Provider” or “HCP” means: 

  • All physicians; and 
  • Any other individual, institution or entity with the ability to prescribe, acquire or influence the prescription or acquisition of medical products or services, and either of the following: 
    • The products are regulated or registered as medicinal products or devices (or their equivalents) in the applicable country; or 
    • The products or services are subject to reimbursement by government or third parties; or, are offered for sale with products or services subject to such reimbursement. 

Examples of HCPs -- depending on the nature of the products or services at issue -- may include, but are not limited to, doctors, nurses, physician assistants, pharmacists, other para-medical staff, members of product formulary committees, health economists, key opinion leaders including scientists and/or PhD’s, clinical investigators and researchers, administrative and management employees of private and public hospitals, HCPs-in-training and medical societies


Privacy Policy

  I AGREE TO THE APPLICATION PRIVACY POLICY

Declaration

I consent to submitting this data and receiving information from Africa Young Innovators for Health Award regarding my application.
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