Building the African Union Continental eHealth Network: Making the case for Low Cost Wireless Broadband Infrastructure Presented at the ICT-Africa 2008 UNECA, Addis Ababa Ethiopia

Health Problems in Africa Lack of Infrastructure and Capacity Healthcare delivery Brain Drain: International and Local (Rural vs. Urban) Africa has 10% of world population with 25% of global health burden but with only 3% of global health workforce Poverty & Financial constraints –HIV/AIDS accounted for 2.4 million deaths alone in 2002 –40% survive on less than $1 per day –Malaria related mortality is at 1 million deaths (mostly children) yearly Enormous economic cost on health systems –10% of individual income Human resources impact (Brain Drain) 10% of global population with 25% global diseases burden tackled by only 3% of global healthwork

African Regional Policy for eHealth Africa Union through New Partnership for Africa’s Development (NEPAD) calls for using ICTs : to improve patient care for sharing health knowledge To build human resource capacity for health system development EU/Africa Partnership (Lisbon Strategy) in Africa: –Health sector development –Telecommunication sector development –eHealth infrastructure for Africa

Multi-sectoral collaboration for eHealth eHealth is the use of information (data) and communication technologies for health processes (Health System) either locally and at a distance (WHO 2005) NEPAD’s Action Plan Strategy on sector development –Alignment between telecom and health sectors –Calls for a continental-wide eHealth infrastructure based on Satellite Infrastructure NEPAD’s eHealth for: –Communication system –Integration of & access to vertical HISs –Extending healthcare to isolated and rural communities and populations

Why eHealth in Africa? To provide access to distributed health knowledge and information to mostly rural health workers. Urgency is required to meet the MDGs targets and to reverse the poor health and developmental ratings Geographical barriers to access health service provision especially in Africa (rural areas). Connectivity ( wireless telecommunications) is becoming widely accessible and available even in rural communities Issues: Cost, existing health problems etc

From eHealth to mHealth: Voice of Reason Mobile devices are relatively cheaper that Fixed computers Consumes less power (Lack of electricity) They are portable, hence more secured? Wireless networks are relatively cheaper and faster to build relative to build than fixed networks. For example, the Nigerian case Mobile/ Wireless technologies provide the best opportunity for Africa to achieve the “ Africa interconnectivity objective and for building eHealth Infrastructure (EU strategy) Case studies below supports this proposition

Emerging Africa-wide eHealth initiatives Africa Health Infoway (AHI) –WHO-led Telemed Task Force eHealth for Africa –EU/ESA-led Pan African e-Network –Indian Government-led All have in common satellite network for providing access

Broadband Telecom Infrastructure & eHealth Convergence AU/NEPAD calls for collaborative alliance between the telecom and health sectors for eHealth applications development in Africa Beyond SMS/Cellphone to: –Broadband Wireless -WiFi, WiMax, Satellite, (VSAT), EDGE/3G/ HSPDA –Broadband Access devices- Laptops, PDAs, Smartphone, Desktops Barriers –Telecommunication Infrastructure ( policy, high investment costs, availability) –Power /Electrical Infrastructure –Economic Infrastructure - Low-income

Lessons from African Cases UHIN-GPRS:- still limited in bandwidth –Early generation PDAs-Planning for Smartphones –Solar Energy Cell-Life- GPRS/3G- Business model –PDAs/Smartphones FMFI/MUTI Telehealth- Long distance WiFi- WAN&LAN, VSAT- expensive, policy barriers –Considering 3G –Desktop Laptops WiFi -CellPhones –Solar Energy

Issues 70% of IT projects globally are failures: Note failure here is multifaceted Africa is not faring better either Same problem with eHealth projects especially in Africa Hence, problem is sustainability which can be: – Organisational – Social/cultural – Human (Health Workers) – Technological

Lessons: An Africa-wide eHealth Network Multilateral Initiative on Malaria Communication Network (MiMCom) –A continental-wide eHealth Infrastructure with 12 National nodes Inter-national nodes mostly with VSATs –VSATs chosen over fibre-optics at inception Intra-national communication with terrestrial wireless- WiFi, microwave link Devices-Laptops, PDAs, PCs Reveals different solutions for national nodes- depends on availability and costs of bandwidths

MiMCom National nodes Telecom Infrastructure

Issues & Solution Issues –Non-availability of Broadband Access –High costs of broadband access especially of satellite connectivity access Possible solution ? –New paradigm needed: Shift towards High Efficiency Terminals (Low cost is not the ideal terminology!) –Low Cost laptops and mobiles and backbone is the new paradigm shift that is happening –Low-cost Broadband Wireless Infrastructure –Introducing EU funded DigitalWorld project on Low-cost Technology –Bring this issue into global business and developmental agendas

DigitalWorld EU Project: Introduction European Research Framework –Framework Programme 7 ( ) just started –DigitalWorld FP is an 18 month research project ICT International Cooperation (Africa and Latin America) Coordination and Support Action Duration: 18 Months Start: January 1, 2008

DigitalWorld EU Project areas:

Conclusion eHealth is strategic to health system development in Africa/developing countries as in EU-Africa strategic policies Broadband Wireless Infrastructure for eHealth Infrastructure in Africa New technologies for low cost satellite transmission where nothing else extends to New mobile and wireless and new low cost solutions in terminals Understanding contextual organisational issues is paramount DigitalWorldForum for extending EU-Africa Partnership on Low-cost Wireless Infrastructures