SYNOPSIS

As maritime neighbours, India and the countries of East Africa have a long history of trade relations, as well as cultural and educational exchange. The current COVID- crisis has thrown up huge prospects for Indian-East African engagement, particularly to strengthen healthcare cooperation.

COMMENTARY

A FRIEND in need is a friend indeed. This is especially true when the whole world is reeling under unprecedented crisis due to the COVID-19 pandemic. As maritime neighbours, India and the countries of East Africa have a long history of trade relations, as well as cultural and educational exchanges. The large and influential Indian diaspora in East Africa has often been at the forefront of these interactions.

Under the premiership of Narendra Modi, however, India and the countries of East Africa have visibly enhanced their level of direct political engagement and development cooperation. Modi refers to India’s increasing ties as the ‘Indian Ocean Family’ in East Africa. These include: Delhi’s provision of a US$100 million line of credit under which Seychelles can purchase military surveillance equipment from India; the donation of medical equipment, notably the Bhabhatron, to support improved cancer care in Kenya; as well as the deployment of three navy vessels to deliver humanitarian assistance to Mozambique in the aftermath of Cyclone Idai in 2019.

India-East Africa Healthcare Cooperation

Given the current health pandemic, are there prospects for Indian-East African engagement to strengthen further, particularly in healthcare? There is considerable precedence for such cooperation. Indian pharmaceutical firms, such as Cipla Ltd. in the early 2000s and, more recently, Mylan and Aurobindo, have provided many of the generic anti-retroviral drugs imported by African states to combat HIV/AIDS.

Meanwhile, India’s Pan-African e-Network, first launched in 2009, has connected hospitals in 53 African countries with medical practitioners in India to provide tele-medicine training and consultations.

The speed and ferocity at which COVID-19 has placed existing health systems under strain, however, begs the question of whether such health-focused cooperation remains viable and, if it is, where it may be most effective. India and a number of East African countries share an array of common challenges with the current pandemic.

Each have under-resourced health systems (particularly in rural areas), young populations, significant rural-to-urban migration, urban overcrowding and large informal sectors whose workers are struggling to cope with some of the world’s strictest national lockdowns. However, there are two areas in which India and its East African partners may stand to benefit from healthcare-focused cooperation.

Two Areas for Expansion

The first of these areas relates to contact tracing. While entailing controversy over matters of personal data privacy, the Aarogya Setu app, created by India’s National Informatics Centre, is already beginning to have an impact in using Bluetooth technology to effectively track COVID-19 patients and those they come into contact with.

This, in turn, is providing Indian authorities and medical practitioners with the data they require to understand the spatial dynamics of the virus and to forecast the virus’ near-term spread. This brings with it the prospect of India’s national and state governments being able to implement more geographically-targeted lockdowns rather than the blunt nationwide lockdown currently in place.

For countries like Kenya and Mozambique, which have followed India’s lead in putting in place similar – if not quite as rigorously enforced – national lockdowns, the absence of similar rigorous contact tracing data or, equally likely, an inability to actively interpret and make use of these data in real-time, may prove catastrophic.

Cooperation in the area of contact tracing may pertain partially to apps development, though a number of East Africa’s own burgeoning tech firms are likely more than capable to developing appropriate, if perhaps less comprehensive, equivalents. Perhaps most useful would be direct engagement by Indian policymakers and medical practitioners.

As they gain knowledge and experience through Aarogya Setu, they can liaise with their counterparts in East Africa – and particularly those working at sub-national levels – to share lessons learned and knowledge on how to interpret data from contact tracing technologies and build these data into epidemiological models capable of informing intelligent and responsive containment measures.

Given some of the similarities between the two geographies, Indian insights may prove more relevant and credible than engagement from equivalent authorities in the global north.

Deepening South-South Ties in Healthcare

The second area, perhaps slightly longer-term in focus, pertains to the education and training of health professionals. The eVidya Bharti e Arogya Bharti (eVBAB) project, launched in October 2019, builds on the Pan-African e-Network to provide an expansive e-portal, inclusive of more comprehensive tele-medicine training opportunities for African doctors, nurses and paramedics.

Mauritius and Mozambique are the two East African countries being prioritised for eVBAB’s initial rollout by the Indian Ministry of External Affairs and Ministry of Health and Family Welfare. While e-trainings relating to COVID-19 could potentially be useful to medical professionals of all types, a particularly impactful approach may be to use the projects’ tele-medicine platforms as an opportunity for experience exchange among Community Health Workers (CHWs).

CHWs are at the forefront of community-level care for COVID-19 in countries like Mozambique; the experiences of their counterparts in India, Accredited Social Health Activists (ASHAs), could prove invaluable in outlining ‘best practices’ for identifying, tracking and supporting COVID-19 patients, their families and communities.

India and the countries along Africa’s Indian Ocean coast have a long history and cultural connectedness. As India and East African states increasingly engage at the political level and as partners in development, COVID-19 provides a clear opportunity for deepening ‘south-south’ cooperation and establishing Delhi as a leader in healthcare policy and practice.

About the Authors

Rajeev Ranjan Chaturvedy is Visiting Fellow with the South Asia Programme, S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University (NTU), Singapore; Graham Sherbut is Research Director, Frontline Group South Africa and doctoral fellow at Stellenbosch University. This is part of an RSIS Series.