Recommendations to Increase Access to E-Commerce Services in Central Africa

According to a report jointly produced by the UN Economic Commission for Africa (ECA) and the GSMA, the digital economy in the Economic Community of Central African States (ECCAS), which is comprised of the nations of Angola, Burundi, Cameroon, Central African Republic, Chad, Congo, Democratic Republic of Congo, Equatorial Guinea, Gabon, Rwanda, Sao Tome & Principe, "is expanding rapidly, driven by strong adoption of mobile services. Overall mobile subscriber penetration in the sub-region grew from just 18% at the start of the last decade to 42% by the end of 2019, while the number of mobile internet users had reached 46 million by the same date."

Titled Enabling e-commerce in Central Africa: the role of mobile services and policy implications, the report adds: "E-commerce is a key component of the digital economy, allowing buyers and sellers to interact and transact online regardless of time and location. This has the potential to generate significant social and economic benefits, particularly in emerging countries. It can create jobs and stimulate economic activity by encouraging investment and opening up new markets to otherwise isolated rural communities. Women and young entrepreneurs in particular are increasingly using e-commerce platforms to grow their businesses, reducing inequalities and helping local value creation."

The ESA and GSMA note that governments in the sub-region have a significant role to play in implementing policies to support and stimulate investment in e-commerce services. And as such, they identify key areas where action is required to increase access to digital services in general and e-commerce services in particular: enhancing digital and financial inclusion; taking the right approach to data regulation; addressing key challenges in the business environment; and leveraging stakeholder collaboration.

I support the recommendation for Central Africa's eleven governments to adopt policies to accelerate e-commerce, including better access to digital services and public-private collaboration. Yet, the report says "ECCAS member states are still a long way from maximizing the e-commerce opportunity due to a combination of infrastructure, macro-structural and regulatory constraints. As governments in the sub-region increasingly recognize the potential for e-commerce to drive economic growth and sustainable development, they must now move to address the key challenges to e-commerce adoption, working together with other stakeholders in the e-commerce ecosystem."

"A first step is to get more people online, by addressing the access and affordability barriers to connectivity for unconnected citizens, and create an enabling environment for e-commerce services to scale and reach new customers."

What are your recommendations for how Central African governments can support the growth of its e-commerce sector?

Aaron Rose is a board member, corporate advisor, and co-founder of great companies. He also serves as the editor of GT Perspectives, an online forum focused on turning perspective into opportunity.

Telemedicine Consultations Could Be Key to Addressing Growing Economic Cost of Treating Diabetes in the Gulf Region

"Saudi Arabia and the United Arab Emirates (UAE) are two Gulf nations witnessing an explosive growth in the prevalence and incidence of diabetes, having some of the highest rates in the world," The Economist Intelligence Unit (The EIU) explains in a briefing paper. In addition, "According to 2019 reports, prevalence is as high as nearly one in five adults (18.3%) in Saudi Arabia and about one in six adults (15.4%) in the UAE. Telemedicine has been an important part of care in these countries' evolving healthcare services to keep affected patients healthy and costs down."

Supported by Abbot Laboratories, an American company that produces health care products, Telemedicine and diabetes care in Saudi Arabia and the United Arab Emirates explores how healthcare systems in these two countries have used telemedicine to remotely monitor people living with diabetes during the pandemic. The paper suggests that the "experience and lessons may serve as a helpful guide for other countries in the Gulf."

The paper presents four "reasons why the rollout and adoption of telehealth for diabetes in Saudi Arabia and the UAE have been particularly noteworthy, and why these successes are worth continued examination:

"Diabetes care has been in dire need of enhancement: it is well known that Saudi Arabia and the UAE have a high prevalence and projected increase in diabetes among their populations. The resulting healthcare costs are significant. It has become imperative to national health, as well as healthcare budgets, that better, more innovative and sustainable management and prevention tools are explored to their fullest.

"The legal framework is expanding possibilities: telemedicine has long been on the radar as a cost-effective option, but only recently—and just prior to the covid-19 pandemic—have regulation and legal

frameworks allowed it to take shape. Leading up to the pandemic, adoption was already picking up.

"Cost models are shifting: in many ways, telemedicine has reduced costs for patients and doctors and supported social distancing during covid-19. For patients, less travel to clinics has added convenience as well. Better adherence to health recommendations can also lead to fewer costly co-morbidities and complications like stroke and amputation. For doctors, the experience has also been positive. However, some concerns have been raised regarding the increased influx of data from these apps, which requires additional time and effort for analysis, followed by explanations and tailored recommendations to patients which is more intensive, and may require updates to how providers are compensated. Going forward, advances in predictive modelling may improve the efficiency and quality of care. Clinics will also have to determine the safest and most cost-effective hybrid model of in-person and virtual clinic interactions.

"No going back: according to those interviewed and studies published, the rapid rollout and adoption of telemedicine for diabetes have been largely welcomed and deemed successful by many patients, doctors and the wider health system. Emerging evidence suggests telehealth is helping this population to achieve better self-care. More long-term studies will be needed to judge its true safety and efficacy, as well as cost-effectiveness, but doctors and patient groups we spoke to are keen to progress this care pathway based on the experience during covid-19."

The paper concludes that "The covid-19 pandemic and its lockdowns have meant a sudden change in the delivery of healthcare, with telehealth and digital solutions becoming the go-to options. In Saudi Arabia and the UAE, the transition of care to telehealth and remote services for people living with diabetes has been supported by patients and doctors alike."

"The experience has meant that patients are now more comfortable sitting in front of a screen and streaming data in real time to their doctors. In return, they have become familiar with continuous monitoring and virtually received advice on better self-care."

Importantly, "Telehealth diabetes care has been given a boost by covid-19, and it is vital that Saudi Arabia and the UAE seize it to its fullest in order to mitigate the worrying trajectory of their national diabetes trends. But indications suggest that new hybrid models of care will emerge in future involving in-person care, remote care and predictive modelling supporting real-time care."

My colleagues and I have followed the growing telemedicine sector in the Gulf region (see "Tackling Diabetes and Obesity in an Age of Digital Acceleration in the Gulf Cooperation Council," "An Analysis of 'Diagnosing Health Care in the GCC'," and "Report Explores How Digital Technologies Are Shaping the Middle East's Healthcare Ecosystems"). This paper by The EIU presents the latest evidence that telemedicine consultations could be key to addressing growing economic cost of treating diabetes and other non-communicable diseases.

What are your thoughts about the paper's findings? Do the experience and lessons serve as a helpful guide for other countries in the Gulf?

Aaron Rose is a board member, corporate advisor, and co-founder of great companies. He also serves as the editor of GT Perspectives, an online forum focused on turning perspective into opportunity.