India has engaged historically with Africa through the Non-Aligned Movement (NAM) and South-South Cooperation (SSC) frameworks, which have emphasised a shared legacy of colonialism and unequal integration into the international economic order. India’s engagements with the continent have been reinvigorated after its own experiments with economic liberalisation since the 1990s. This occurred against the backdrop of the end of the Cold War, the rise of China and geostrategic concerns associated with an emergent multipolar order.
Following a decade of reforms, India joined the club of emerging market economies (EMEs). Groupings of EMEs such as the BRICS (Brazil, China, Russia and South Africa) became established players in global financial ecosystems. BRICS nations now transfer their financial and technical capacities on concessional, non-concessional terms or as blend portfolios to disadvantaged countries (LDCs, HIPC) in the South based on the prioritises of the host country. In recent years, the SSC framework has been recalibrated into strategies for human development, poverty reduction and sustainable growth by the emergence of an ‘intermediate layer’ of nations in the Global South.
The growing power and influence of emerging countries has resulted in a reconfiguration of traditional development assistance from the Global North. The premiership of Prime Minister Narendra Modi in particular, has witnessed a more energetic African outreach by India than ever before. India has often described its development compact with Africa as ‘demand driven’ and for ‘mutual benefit’. In 2018, PM Modi declared before the Ugandan parliament, that Africa would be at the top of India’s priorities, as he unveiled ‘10 Guiding Principles’ for his country’s engagement with Africa.
The focus of this project is on the Pan African e-Network Project (PAEN), which combines India's competitive advantages of ICT, education and health expertise through a public-private partnership (PPP) model. A key aim of this project is to better understand how SSC activities shape perceptions and influence of India’s influence in three (similar, yet different) country contexts of Senegal, Malawi and Mozambique.
The overarching goal is to examine the extent to which SSC activities shape Indian foreign policy and motivations for re-engagement with Africa. Another goal is to better understand how African countries can use this growing interest from India to their advantage- such as building local capacities and technology transfer. On the other hand, it will also study how the telemedicine project has furthered India’s soft power on the continent, generated good will and support at various international fora and improved market access for trade and investments in the host countries.
1. India-Africa relations
India’s engagement with Africa has traditionally included peacekeeping, student exchange and scholarship, capacity building, concessional loans, cooperation on climate change, the blue economy, counter-terrorism, and defence. In addition to Indian government and public sector initiatives, a number of private sector players, multinationals, and NGOs are present in Africa across a wide variety of sectors. Further, the Indian diaspora are active agents in African economic landscapes, and help foster cultural and trading links between the two geographies. Africa’s geopolitical and economic importance to India has gradually changed over the last decade – what are the key drivers of India’s new Africa policy?
2. Cooperation in the medical and health sectors
India has emerged as a favoured destination for ‘medical tourism’ on account of state-of-the-art hospitals and medical facilities, and competitive costs. Indian hospitals, such as Fortis Healthcare, have recently partnered with Ciel Healthcare Mauritius to open speciality hospitals in Nigeria and Uganda. Apollo has a presence in the Democratic Republic of Congo, Nigeria, Mauritius and Tanzania. Dr Agarwal’s Eye Hospitals are located in at least 10 African countries. The Pan-African e-network (rebranded as e-Bharti Arogya) has connected several Indian and African super speciality hospitals for over a decade – this scheme has been mutually beneficial, as Indian stakeholders have been able to share their expertise to African stakeholders, thereby facilitating their entry into African markets, while Africans have benefitted from low-cost Indian innovation and technical expertise and access to healthcare. eHealth (online platform) and mHealth (mobile platform) schemes, which have been tested in India, may be scaled up in Africa in the future. One of the key enquiries of the project is: While prioritising skill development in Africa, how can India build capacity and medical infrastructure in Africa?
3. The pharmaceutical sector
Approximately 20 percent of India’s pharma exports valued at USD 17 billion are to African countries. With a formidable reputation for high quality medicines, Indian companies have steadily established themselves as partners of choice for international healthcare NGOs and aid agencies. Southern and western regions of Africa are the largest importers of Indian drugs – as these regions have the highest number of people living with HIV/AIDS. In 2001, only one in a thousand HIV+ Africans had access to anti-retroviral (ARV) drugs, which were developed in the Global North and cost USD 10,000+ per person per year. The Indian generic pharmaceutical firm Cipla Ltd sold ARVs in Africa for just USD 350 per year per person, which came as a lifesaving reprieve for many. In 2017, two Indian generic pharmaceutical companies, Mylan and Aurobindo, began supplying ARV drugs for USD 75 per patient a year in Africa. India is considered the ‘pharmacy of the developing world’. We seek to further enhance our understanding of the presence of Indian pharmaceutical firms in African markets and how they plan to extend life-saving drugs more significantly in the post Covid-19 scenario.
4. Covid-19 and India-Africa relations
India has been adversely impacted by the ongoing Covid-19 pandemic, with over 9.1 million registered cases and 134,000 deaths to date. Yet, India has supplied Hydroxychloroquine (HCQ), Paracetamol and other drugs required to fight Covid-19 to 25 African countries. In addition, several Covid-19 specific telemedicine and e-courses have been developed by ITEC, and offered to African medical practitioners. Given their past experiences in handling pandemics and with the advantage of youthful demographics, some African countries have had remarkable successes in containing the pandemic. West African countries in particular, such as Senegal, have leveraged and adapted lessons learnt from the Ebola outbreak of 2014 to fight Covid-19, with laudable results. To date, Senegal has recorded only 15,000+ infections and 300 + deaths. A pertinent area of enquiry is to better understand what lessons India could learn on disease control from her African partners. With the prowess of the pharmaceutical sector and ability to mass produce medicines and now the anti-Covid vaccine, how could India potentially scale-up its Covid-19 diplomacy in Africa?
5. Post-pandemic scenarios
With the search for a Covid-19 vaccine coming to a close, Indian manufacturers of Covid-19 drugs could successfully position themselves in African markets. Market-oriented medical strategies will have to be developed for effective dissemination of medical expertise and products. The Covid-19 pandemic has led people to rethink medical dissemination. Instruction and interaction in this area have moved largely to virtual platforms and thereby reinforced once again the relevance of telehealth outreach programs. Against the emerging scenario, how can telemedicine and e-medicine be developed for a mutually beneficial engagement between India and Africa? What other broad strategies could Indian firms use to showcase their expertise in this area? It is against this setting that the project on understanding India’s tele-health program, the Pan-African e-network (PAEN) and its refurbished versions, the e-Arogya Bharati and e-Vidya Bharati, assume immense relevance.
6. Alternative medicine
Another novel area of study for India-Africa engagement in the healthcare segment is that of alternative medicines. India has long championed alternative, indigenous medicinal systems, institutionalised in 2014 the AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) ministry. AYUSH has conducted several workshops with African traditional healers and practitioners, for sharing expertise and joint learning. AYUSH remedies have gradually found mainstream acceptance in India. A potential area of cooperation between AYUSH and practitioners of African traditional systems of medicine offers scope for mutual learning. How can the study of African traditional medicinal systems be closely incorporated into the workings of the AYUSH in India?
Research Team (India)
Renu Modi: Professor and Director of the Centre for African Studies, University of Mumbai. Her areas of research include South-South Cooperation, Agricultural transformations, and Global Studies. She teaches and researches on India-Africa relations.
Vidya Vencatesan: Professor at the Centre for French Studies and Head of the Centre for European Studies, University of Mumbai
Meera Venkatachalam: Postdoctoral Fellow at the Centre for African Studies, University of Mumbai.