Many African countries are still consistently looking forward to improve healthcare delivery to millions of people living in rural communities with little success. In this interview, Professor Mikhail Y. Natenzon, chairman of board of the “National Telemedicine Agency” Research-and-Production Union and also deputy head of the Regional Working Group for Telemedicine of the Regional Commonwealth for Communication of the CIS countries, tells Kester Kenn Klomegah, an independent researcher and policy consultant on African affairs in Russia and Eurasian region that the establishment of compatible national telemedicine systems, which has many advantages, can suitably be adapted to the local conditions of any particular African country.
How important is modern telemedicine technology for African countries? And the reasons why you are passionately exploring Africa?
Economic development of African countries reached the level where the government can begin a strategic reform of health systems to create a modern, meeting the world standards of health care. The implementation of these programmes will solve health problems and give African countries the opportunity to take the next leap forward in economic and social development.
African governments and international specialized organizations have now developed and are implementing various programmes to improve the quality of life of African populations. The most advanced project is the elimination of the epidemic of socially dangerous diseases such as HIV/AIDS, tuberculosis and malaria and allocate significant funds for it. Indeed, one of the problems of the slow development of African economies is the fact that people suffering from malaria are unable to work effectively and vigorously. Another important international project is the maternal and child mortality reduction programme.
Significant, multi-billion dollar funds have been allocated by governments and international organizations to these projects, and the results are clearly not in line with the efforts made. The efficiency of investments is not large enough.
The reasons for this are, inter alia, the inadequate health infrastructure in Africa, its concentration in major cities and the almost total absence in rural, remote and hard-to-reach areas, where about 60 per cent of the population-600 million people-live. It is obvious that the traditional methods of providing medical care can not work in the current situation.
Therefore, we have developed new methods to ensure accessibility and a single high standard of quality medical care for the population, especially in rural areas and remote areas. These system solutions, technologies and equipment are based on the widespread use of Russian information and telemedicine technologies. These proposals are now practically non-alternative, as confirmed by the documents of the UN, the world Health Organization, the International Telecommunication Union, the African Development Bank and other international organizations.
As it’s already known, many African rural communities are very limited or disadvantaged with sources of energy (electricity), but how could telemedicine be useful for these remote areas of the continent?
The problem of all rural areas in Africa is the underdeveloped social and health infrastructure. Its creation with the traditional approach is a long and very expensive project. Moreover, such infrastructure will always experience a shortage of qualified medical and technical staff. But most importantly, its exploitation will require large funds that are not available to either rural communities or the state. The only solution for the cost effective implementation of social development goals in Africa so far is the establishment of an integrated telemedicine system.
It consists of two parts: network of telemedicine consulting-diagnostic centers, established in stationary medical institutions of different levels, and communication associated with them system of the mobile telemedicine laboratory diagnostic facilities (the ITC) in various fields. The ITC is designed to address a wide range of health challenges and provide social services to people in rural, remote and remote areas. Built on international standards, it integrates with similar systems in other African countries and Russia, interacting with telemedicine systems in other countries.
A key element of the mobile telemedicine complex and mobile hospitals can provide medical care to the population in remote and inaccessible areas in a completely autonomous manner. They have their own power supply system, communication system, up to the satellite, life support systems, crew systems cleaning air and water and many other optional installed systems required for successful operation. Most importantly, the personnel of the ITC may not be a doctor, but an average medical worker. Use MTK allows radically solving the problem of comprehensive medical services to the rural communities. Their residents will not have to get to the city hospitals. The hospital will come to them.
At the same time, qualified doctors working in provincial hospitals, to which the ITC is assigned, can provide advice through telemedicine equipment to personnel of several ITC operating in different parts of the province. This solves the problem of shortage of qualified doctors and reduces the cost of operation of MTC.
Can you discuss innovative tools available in the plant and key competitive advantages? Do you have all the equipment and / or components manufactured in Russia?
The main goal and the main competitive advantages of the medical complex are the solution of four socially important tasks: ensuring accessibility of medical and social services to the population; providing a unified high quality medical and social services for citizens regardless of their place of residence and social status.
It helps optimization of the cost of healthcare while improving its quality and coverage and creation of permanent jobs for highly qualified technical and medical personnel, ensuring the creation and operation of complex.
Other important competitive advantages of the systems offered by us are: High capacity of MTC – up to 20,000 people per year, and therefore, almost 100% coverage of health care for the entire population.
Low cost of rendering medical services to the population due to use of the average medical personnel and absence of need to build stationary medical institutions and to spend means for their operation.
Possibility of step-by-step realization of the project, the complex telemedicine system. At the same time, the system itself begins to function fully from the start of its first segment. Connecting the following segments extends the functionality of the system and without requiring structural adjustment.
There is high investment attractiveness. The expected return on investment in the project is 5-6 years. The functioning of the system is an important contribution to the stable development of the state, providing an increase in the human capital development index. There is also professional development of medical personnel and the use of international standards and the possibility of organizing cross-border telemedicine consultations.
All equipment which is a part of complex telemedicine systems: stationary telemedicine consulting and diagnostic centers for stationary medical institutions of all levels (from the Central hospitals in the capital, to the para-medicine point in the small village), mobile telemedicine laboratory and diagnostic complexes of various medical appointment with all equipment, communication equipment, satellite communication systems, guarantee maintenance of system, preparation of medical and technical personnel for system functioning is the Russian know-how, certified and manufactured in Russia.
At the request of the customer, the system offered by us can be connected with the existing telemedicine systems in the country. The system can begin to operate immediately after the installation of equipment in the country and completion of training. The system is delivered on the principle of “turned on and work” without any complications.
What will be the main direction in terms of implementation of this medical technology projects in Africa? And what are your expectations from African governments?
The main direction of our project for Africa is the gradual creation of compatible national telemedicine systems that can interact with each other and in the long term to create a pan-African telemedicine system. The telemedicine system becomes economically and socially effective when it is a queueing system. This is exactly how the proposed system is designed.
Health systems in almost all countries of Africa basically are state-owned. Therefore, the establishment of compatible national telemedicine systems is possible only in close cooperation with the regional Ministries of health, so that the project can be adapted to the conditions of a particular country and at the same time maintain the universality of national telemedicine systems, so that they can interact with each other. We know the serious efforts that African Governments are making to promote health, and we hope that our cooperation in implementing telemedicine systems will yield significant, qualitatively better results.
The role of nuclear in Zambia’s sustainable economic growth
On August 6th, the 92nd annual Agricultural and Commercial Show wrapped up after six entertaining and educational days in Lusaka, Zambia.
Thousands of visitors received information materials about the role of nuclear in Zambia’s sustainable economic growth during the 92nd annual Agricultural and Commercial Show.
The show was officially opened by President Edgar Lungu, who highlighted the importance of the show’s theme, which was ‘sustainable economic empowerment’.
He noted that the theme was directly in line with government’s aspirations espoused in the Second National Agricultural Policy (SNAP) to have an efficient, competitive and sustainable agricultural sector which assures food and nutrition security, increased employment opportunities and incomes.
The Zambian Ministry of Higher Education in collaboration with Russian State Atomic Energy Corporation ROSATOM hosted a dedicated information stand on the future Zambia Center for Nuclear Science and Technology (CNST).
Representatives of ROSATOM and Zambia’s Interim Secretariat on Nuclear Science and Technology (ISNST), constituted by senior officers from various Government Ministries and Institutions, worked on the stand, explaining the specifics and benefits of the future nuclear facility to thousands of Zambian visitors.
The stand provided the public with information on the nuclear technology that is set to assist Zambia to grow and be economically empowered, such as: food irradiation technologies, nuclear medicine (which is already being implemented at the Cancer Diseases Hospital), material science, radioisotope production and mineral identification techniques.
The materials were prepared by ROSATOM, ISNST and International Atomic Energy Agency (IAEA).
Dmitri Shornikov, CEO of Rosatom Central and Southern Africa, explained the future benefits of the Center and expressed the importance of educating the public on these benefits: “It is very important for the Zambian citizens to understand that the future Center will empower agriculture, medicine and industry, thanks to wide application of radiation technologies.”
“The CNST will also promote the growth of national education and science through the training of highly qualified experts in various fields. It represents the new stepping stone for Zambian scientific, economic and technological growth. Similar facilities have been contributing to more than 50 countries’ around the world for more than 60 years. Currently, there are 245 working research reactors in the world with 58 units operated in Russia”.
Mr. Reuben Katebe, National Coordinator of the ISNST noted that the Center was directly in line with the theme of the show as well as government’s policy and that it would help the agricultural sector to grow sustainably and ensure food security: “The use of radiation for food preservation will improve food safety and create conditions for the increase of Zambian agricultural exports. We hope that our information stand helped many farmers to understand all the benefits that the Center will bring to them.”
Apart from agriculture, healthcare will also benefit from the Center’s activities like single use medical product sterilization,” said Mr. Katebe: “The radioisotopes produced here will be used to diagnose and treat primarily cancer and cardiac diseases. This Center will increase availability of high-tech nuclear medicine for Zambia’s population.”
State Atomic Energy Corporation Rosatom and the Republic of Zambia signed a general contract for the construction of a Center for Nuclear Science and Technology (CNST). The signing took place during the 10th international Atomexpo-2018 forum in Sochi. Construction of the center is the first joint project of Russia and Zambia in the field of nuclear technologies.
The center will be located 10 kilometers away from the capital of Zambia, Lusaka. The CNST will include a nuclear research facility based on a multipurpose research water-cooled reactor of up to 10 MW, a state of the art laboratory complex, multipurpose irradiation center as well as a cyclotron-based nuclear medicine center.
The project will be implemented in several stages within 3-6 years from the work commencement date under the contract. Rosatom has built more than 120 research reactors in Russia and abroad.
China- Africa Framework: Strategic Cooperation
The Forum for China Africa Cooperation (FOCAC), built up to link relations between the two states, is due to hold its next meeting later this year. This evaluates what the benefits from that meeting will be on this developing, active, and mutual relationship. China’s engagement in African states goes back several years. In the last decade, from the mid-1950s to late 1970s based more on spontaneous confidentiality than that of 1980s and the period after the cold war. currently, the relationship sets up more on pragmatic economic considerations and cooperation. China is already Africa’s third largest trading partner. This multi-leveled partnership between China and Africa is both intricate and active. As China and its African participants arrange everything for the next FOCAC summit.
What does China want in Africa?
China’s relationship with African countries is very active, some perspectives have sustained stable. The most significant of these are the principles and outcomes of Chinese foreign policy through African and other developing countries. According to the Beijing’s Africa Policy issued in January 2006, China will: China-Africa friendship, will be proceeding from the basic benefits of both the Chinese and African peoples, build up and develop a new kind of strategic partnership with the African continent, presenting political equality and mutual trust, economic win-win cooperation and cultural exchange
The fundamental laws and aims for leading Chinese foreign policy in Africa as set out in this arrangement of government policy are: (1) Goodwill, friendship, honesty and equality; (2) Mutual benefit, cooperation and common prosperity; (3) Common mutuality, support and close reciprocity; and(4) Learning from each other and pursing, sharing common development. This mostly is the government expression of how it views, and ambitions, to manage its relationship with the African continent.
While the Chinese policy announcements are mostly clear; there is still skepticism about what China wants in Africa. Take the principle of non-intervention, one of the Five Principles of Peaceful Coexistence, which have been regularly highlighted guidance of Chinese foreign policy in one hand, and its Africa policy in the other. The most significant examples are Sudan and Zimbabwe. In current years, Sudan has seen a conflict of perspectives, with the US and other superpowers placing pressure on Beijing government to use its impact in Sudan over the condition in Darfur, and China responding that it is preferable to help in continued development in such states, and determining them this way. Therefore Beijing’s commitment to non-interference in African domestic affairs and its intention to establish partnerships based on cooperation and mutual respect have been generally welcomed by leaders of the African continent, just as it has got some critiques from the West especially the US.
To some extent does China manage Sino-Africa relations?
Yet, Chinese national interests in Africa are multi-aspects and multi-leveled, so the aspects who engage in China’s Africa policy making and implementation are generally diverse. This faces great challenges for China’s management capability, which is the real reason why FOCAC was established. Similar to the different trend of China’s interests and outcomes in Africa, we can highlight many types of aspects who have a sound in China’s Africa policy-making and performance. First of all and most important type of aspect is the government, both central and provincial, including officials–diplomats and other state-owned enterprises. Secondly coves several private corporations and their representatives in Africa. Inspired by the Chinese government’s “Go Out” policy, these private entrepreneurs chanced to Africa in seek of business opportunities. The third and importantly significant aspect is individuals, both influential middle-businessmen and the general Chinese laborers in Africa, which may amount to somehow a million people by 2009.
With the number of aspects rising, the traditional decision-making and strategy implementation system is under great pressure. In term of policymaking, power is centered at the top, in the Office of the Foreign Affairs of the Communist Party of China (CCP) Central Committee and the Foreign Affairs Office of the State Council. The top engine of executive power is the State Council, which includes the premier, vice premiers, and ministers. The Ministry of Foreign Affairs points out Chinese leaders and helps implement African policy. It cuts responsibility between a unit for Sub-Saharan Africa and one for West Asia and North Africa. The Ministry of Commerce plays a significant job in trade, aid, and investment. It has a Department of Foreign Aid. China’s State-owned Assets Supervision and Administration Commission (SASAC) is equally ranked with the Ministry of Foreign Affairs and the Ministry of Commerce. SASAC is either mostly owns a state-owned enterprise (SOE) or sustains a supervising share of stock in a public SOE, several of which function in Africa. SASAC has branch offices in African countries. China’s Export-Import Bank is the only state-owned firm that allocates official economic assistance in the frame of low-interest loans, export credits, and guarantees. Additionally, The CCP’s International Department communicates with African representative to lay the pillars for business trading and diplomatic cooperation, encourage visits and to ensure that policies are implemented in accordance with CCP strategic goals.
What are the Challenges of China In Africa?
Under the policy of FOCAC and its follow-up perspectives, China has adopted its Africa policy-making and implementation and made several contributions to African development. However, the challenge of China-Africa relation is based on two main aspects. The first, the Chinese economic slowdown decreases the resources that are likely accessible for the next FOCAC meeting. Xi Jing ping said at G20 summit that China will, within its goodwill and potentiality, carry on to enhance its aid to Africa, decrease or cancel African states’ debts, enlarge its trade and enhance business investment in Africa, achieving the commitments it made during the Beijing Summit of the Forum on China- Africa Cooperation in 2017. On the other hand, because China’s economy now is export-oriented, the situation will greatly reduce the volume of China-Africa trade due to the western states’ needs decreasing. For instance, 50% of Sudan’s oil exports ship to China, but this number does not mean that this oil is bought by Chinese consumers. As a matter of fact, China National Petroleum Corporation(CNPC), the company which subdues the oil transactions between China and Sudan, does not sell the oil imported from Sudan on the Chinese domestic market. Instead, CNPC sells it on the international market for many profits. And in 2006, Japan was the largest single recipient of Sudanese oil. Now, because of the economic problem, the needs of the international market have dropped off.
The last decade has observed a key and very important enhance in China’s engagement in Africa. FOCAC was built up and is now working, as the main means by which to manage dialogue and talk between different African countries and China over where the general direction of this partnership should go. Basically, it gives an integrative foundation for treating Africa as a single actor, which will surely promote the identity-building of Africa and differentiate itself from other relationship. In the coming years, China will surely enhance its interests in the African continent. Therefore. the FOCAC process provides Africa a new opportunity for a partnership with China and the prospect of a long-term win-win partnership with the world’s largest-growing economy.
Building a nuclear industry in Africa
Russia’s nuclear energy diplomacy in Africa has hit stumbling blocks, it’s been at the crossroad over the past two decades after the collapse of Soviet-era.
In order to find long-shelf solutions to chronic power shortages, African leaders and Governments that have shown interest in adopting Russian nuclear energy, signed necessary legal documents but lacked the needed funds for prompt implementation and final realisation.
“Rwanda’s annual budget stands at US$3 billion while the construction of the nuclear power plant would cost not less than US$9 billion which is equivalent to Rwanda’s entire gross domestic product.” David Himbara, Rwandan-Canadian Professor of International Development at Canada’s Centennial College, wrote in an emailed interview.
He said that Rwandan President Paul Kagame always believed that he must validate his supposedly visionary and innovative leadership by pronouncing grand projects that rarely materialised.
Currently, all African countries have serious energy crisis. Over 620 million in Sub-Saharan Africa out of one billion people do not have electricity. It is in this context that several African countries are exploring nuclear energy as part of the solution.
There is only one nuclear power plant on the entire African continent, namely, Koeberg nuclear power station in South Africa. Commissioned in 1984, Koeberg provides nearly 2,000 megawatts, which is about 5% of installed electricity generation in South Africa.
According to Himbara, “Of all African countries that have shown interest in nuclear energy, none have so far gone beyond the stage of conducting preliminary feasibility study, project costing and financing models, except South Africa.”
But, the South Africa US$76 billion deal with the Russians to build a nuclear power plant collapsed along with the Government of Jacob Zuma that negotiated the deal in secrecy, in fact when such corporate projects have to be discussed by the parliament and necessarily have to pass through international tendering process, he pointed out.
Russia and South Africa concluded an intergovernmental agreement on strategic partnership in the nuclear sphere in 2014. The agreement provided in particular for construction of up to eight NPP power units.
“Nuclear waste will pile up, and where are they going to put it? The Sahara? The US is always trying to force nuclear waste repository on some poor or indigenous community and when that fails, the waste keeps piling up at the reactor sites, creating greater and greater environmental risks,” he said.
He added that “Managing nuclear waste and its safety is universally complex and dangerous. The Chernobyl disaster in Ukraine and Fukushima in Japan, remind the world of the human and environmental costs of nuclear power accidents. Millions of people are still suffering from radiation and radiation related diseases till today.”
Foreign Minister Sergey Lavrov, in an interview with the Hommes d’Afrique magazine in March, described Africa as rich in raw material resources, including those that are required for high technology and for moving to a new technological pattern. Apart from mining, Russia and African countries are cooperating on high technology.
What was more important for Africa’s energy sector when he informed that Rosatom has been considering a number of projects that are of interest to Africans, for instance, the creation of a nuclear research and technology centre in Zambia. Nigeria has a similar project. There are good prospects for cooperation with Ghana, Tanzania and Ethiopia. Talks are underway on the construction of a nuclear power plant in South Africa.
Shadreck Luwita, Zambian Ambassador to the Russian Federation, informed that the processes of design, feasibility study and approvals regarding the project have almost been concluded. The site of the project is yet to be designated as it is equally a process and it is envisaged that construction should commence, in earnest, not later than the second half of 2018.
In addition, he affirmed that the Russians envisaged technology transfer in the development of this massive project by way of manpower development capacity. For now, there are only a few Zambian nationals, who are studying nuclear science in one of the Russian universities in Moscow.
The Zambian Government hopes that upon commissioning of this project, excess power generated from this plant could be made available for export to neighbouring countries under the Southern African Development Community Power Pool framework arrangement.
From all indications, Russia wants to turn nuclear energy into a major export industry. It has signed agreements with African countries with no nuclear tradition, including Rwanda and Zambia. And is set to build a large nuclear plant in Egypt.
Interestingly, Egypt’s dreams of building nuclear plant has spanned with agreement that was signed (as far back in March 2008) during official visit to the Kremlin by the ousted President Hosni Mubarak, and then again with former Egyptian leader Mohammed Morsi who discussed the same nuclear project with Vladimir Putin in April 2013 in Sochi, southern Russia.
During the dawn of a new era, Vladimir Putin and Abdel Fattah Al Sisi signed an agreement to set up four nuclear plants in El Dabaa, on the Mediterranean coast west of the port city of Alexandria, where a research reactor has stood for years.
The deal signed on the heels of talks held between Putin and Al Sisi, where both expressed high hopes that Russia would help construct the country’s first nuclear facility. Egypt began its nuclear program in 1954 and in 1961, acquired a 2-megawatt research reactor, built by the Soviet Union.
However, plans to expand the site have been decades in the making that Rosatom will provide its fuel, personnel training, and build necessary infrastructure. The four blocks of the nuclear power plant will cost about $20 billion.
However, Director Anton Khlopkov and Research Associate Dmitry Konukhov at the Center for Energy and Security Studies, co-authored a report to Valdai Discussion Club, part of RIA Novosti Agency, that success of Egypt’s nuclear project depends on three key factors.
These are the political stability and security situation in Egypt, a viable financing mechanism that reflects the country’s economic situation, and the government’s ability to secure support for the project among the local residents of El Dabaa, the site chosen for Egypt’s first nuclear plant back in the 1980s.
In reality, Ghana has a similar never-ending dreams and fairy tales of owning nuclear plants. The agreement re-signed on June 2, 2015. The Russian reactor, 1000 MW plant, will cost a minimum of $4.2 billion. The financing scheme has not been finalised. And it will take about eight to ten years from site feasibility studies to commissioning of the first unit.
As local media reported, Ghana’s quest to industrialise for economic growth and development has fast-tracked plans to establish nuclear power in the country within the next decade, that means by 2029 and export excess power to other countries in the sub-region.
With “One District, One Factory” – Ghana’s industrialisation agenda might not be realized under Nana Addo Dankwa Akufo-Addo’s administration based on the roadmap of the nuclear power programme to commence construction by 2023 and inject nuclear energy into the grip by 2030.
The African countries’ MoUs and Agreements with RosAtom including Nigeria, Kenya, Tanzania and the rest are stacked. Nearly three decades after Soviet collapse, not a single plant has been completed in Africa.
Some still advocate for alternative energy supply. Gabby Asare Otchere-Darko, Founder and Executive Director of Danquah Institute, a non-profit organisation that promotes policy initiatives and advocates for Africa’s development, wrote in an email that “Africa needs expertise, knowledge transfer and the kind of capital imports that can assist Africa to develop its physical infrastructure, add value to two of its key resources: natural resources and human capital.”
Russia has respectable expertise in one key area for Africa: energy development. “But, has Russia the courage, for instance, to take on the stalled $8-$10 billion Inga 3 hydropower project on the Congo river? This is the kind of development project that can vividly send out a clear signal to African leaders and governments that Russia is, indeed, ready for business,” he said.
The renewable energy potential is enormous in Africa, citing the Grand Inga Dam in the Democratic Republic of Congo. Grand Inga is the world’s largest proposed hydropower scheme.
It is a grand vision to develop a continent-wide power system. Grand Inga 3, expected to have an electricity-generating capacity of about 40,000 megawatts – which is nearly twice as much as the 20 largest nuclear power stations.
Researchers and Experts strongly believe and further estimate that the cost of building nuclear power does not make any sense when compared to the cost of building renewables or other sources of energy to solve energy shortages in Africa.
According to the company profile, Rosatom offers a complete range nuclear power products and services from nuclear fuel supply, technical services and modernisation to personnel training and establishing nuclear infrastructure. Currently, Rosatom has built more than 120 research reactors in Russia and abroad.
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