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 :
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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 WiFiWAN&LAN, VSAT- expensive, policy barriers
– Considering 3G
– Desktop
– Solar Energy
Laptops
WiFi -CellPhones
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:
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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 wirelessWiFi, microwave link
• Devices-Laptops, PDAs, PCs
• Reveals different solutions for national nodes- depends
on availability and costs of bandwidths
MiMComNational 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 (2007-2013) just started
– DigitalWorld FP7-216513 is an 18 month research project
• ICT-1-9.1 - 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