Building the African Union Continental eHealth Network: Making

the case for Low Cost Wireless Broadband Infrastructure

Presented at the ICT-Africa 2008UNECA, 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 (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