Why India is Banking on Health Diplomacy to Grow African Footprint

By Dan Banik, Professor of political science, Director of the Oslo SDG Initiative, Host of “In Pursuit of Development” podcast, University of Oslo and Renu Modi, Professor in African Studies, University of Mumbai. Originally published at The Conversation.

India has stepped up its global ambitions and foreign policy re-engagement with African countries in recent years. Its bilateral trade increased from $7.2 billion in 2001 to $63 billion in 2017/18. India is now the third largest export destination and the fifth largest investor on the continent.

While it plays catch-up with China’s commanding presence in Africa, India has signed numerous new bilateral agreements. It has also strengthened its diplomatic presence and is actively furthering trade, infrastructure and private sector investments.

In our research under a multi-year project, we found that New Delhi promotes an alternative model of development. It showcases the successes of its Green Revolution and advances in information, communication and technology. But it also highlights its ability to develop “Triple A” technology – affordable, appropriate, adaptable.

India’s expertise in affordable healthcare has assumed increased significance during the ongoing pandemic. New Delhi is already reaping the benefits of an ambitious diplomatic initiative to deliver Made-in-India vaccines to developing countries.

India is one the largest producers of drugs globally. It manufactures 60% of the world’s vaccines. Many African countries have purchased or received these as gifts.

New Delhi’s capacity and willingness to produce and share COVID-19 vaccines have further boosted the country’s diplomatic heft and recognition as a global power.

India’s Africa Policy

India’s historical footprint in Africa differs from that of other powers. New Delhi offered support for African countries in their struggle against colonial rule. Indo-African partnership followed in the post-colonial period. This was cemented by solidarity with and support for the Non-Aligned Movement and the fight against racism.

India also offered support for South Africa in its struggle against apartheid. In addition, New Delhi points to the presence of a sizeable Indian diaspora and their economic and philanthropic contributions on the continent.

Since the early 1990s, India has moved from idealism to pragmatism and the explicit pursuit of commercial interests. The change was driven by robust economic growth at home and the need to access raw materials and new markets.

India’s push for South-South cooperation relies on three broad elements. The first is a shared identity as part of the “Third World”. Second is expertise in cost-effective development technologies. Third is a recurrent articulation of the principles of mutual respect and solidarity.

Its long history of being democratic and its successes in reducing poverty and preventing famines have also bolstered the legitimacy of its developmental approach in the Global South.

Since 2018, the India-Africa partnership has been based on a set of principles. These have emphasised “local priorities”. They call for joint efforts to reform global institutions, combat climate change and fight global terrorism. They also highlight capacity building for agriculture, education, digital technology and cooperation on peacekeeping and maritime issues.

How and to what extent might Africa benefit from India’s growing interest? We identify three broad sets of health-related opportunities and benefits that may shape the future of India-Africa relations.

Three Major Areas of Collaboration

The first relates to India’s formidable reputation as the “pharmacy of the world”. It has actively contributed to meeting global demand for vaccines, over the counter medicines and low-cost generic drugs. The relatively low manufacturing costs make Indian products affordable throughout the world.

Almost 20% of India’s pharmaceutical exports, valued at US$ 17 billion, are to Africa. Southern and western regions of Africa are the largest importers of Indian medicines. These include antiretroviral (ARV) drugs that cost only a fraction of those produced by Western companies.

The second relates to capacity building and collaboration in the health sector. Leading Indian healthcare providers are collaborating with African partners. Some have opened or plan to open speciality hospitals across Africa.

Since 2009, the Pan-African E-Network supported by India has offered tele-medicine services. This also connects Indian hospitals and educational centres with their counterparts in Africa. With its state-of-the-art medical facilities, which offer services at competitive costs, India has also emerged as an attractive destination for “medical tourism”.

The third relates to India’s active “medical diplomacy”. Africa’s reliance on a cheap supply of essential medicines in addition to an affordable COVID-19 vaccine is only likely to increase in the near future.

But Africa’s success in containing pandemics such as Ebola offers lessons to India, too. An illustrative example is Senegal, which has adapted its experiences from the 2014 Ebola outbreak to fight COVID-19. Numerous additional lessons on disease control from African countries can also be scaled up to improve India’s health sector.

Future Collaboration on Health

India appears well-poised to share its digital capabilities for improved and affordable access to universal healthcare. New Delhi has revamped its tele-medicine and online video consultation infrastructure on the continent. This offers a cost effective and safe option for treating contagious diseases.

In the near future, India’s partners may benefit from its online and mobile applications to improve accessibility and affordability of healthcare. Online platforms can be used to access information on blood banks, public hospitals, and organ donation. Mobile applications can help track the vaccine status of children and disease awareness.

But there are also some challenges that must be resolved. Combating the menace of counterfeit medicines on the African continent is one. In addition to existing measures to curb criminal activity, mobile apps can verify medicines to tackle the problem.

A major challenge is improving access to generic medicines through negotiated intellectual property rights waivers. At the World Trade Organisation, India and South Africa have taken a moral stance against “vaccine nationalism”. Their joint proposal in October 2020 for a temporary waiver on drugs and COVID-19 vaccines was nevertheless rejected by the organisation.

Since then, however, mainly African countries have shown growing support for the proposal.


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  1. Thuto

    India for affordable drugs and expertise in telemedicine, Cuba for affordable, world class medical training, two key pieces of the puzzle to help Africa build up capacity to offer universal healthcare for its citizens. The riches are in the niches and healthcare in Africa is a profitable blue ocean niche that both countries can occupy without much competition from the West or China. India already exports billions of dollars in drugs to Africa, while Cuba already supplements some excellent local universities by training thousands of medical students from the continent every year, all that’s needed is to stitch the two components together into a cohesive, overarching Pan-African healthcare care development plan for the next 25 years. This plan would need to be adopted at the level of the African Union (AU) and be supported by:

    1. Ringfencing a portion of each nations healthcare budget to invest in critical on-the-ground infrastructure (e.g. hospitals, teaching universities, manufacturing and e-health hubs etc).

    2. Clearly defined terms on licensing, technology and skills transfer to enable the scale up of local teaching and manufacturing capacity.

    This could become a seminal template for independently coordinated South-South development cooperation unsullied by extractive motives common with the West and lately China.

  2. The Rev Kev

    African countries may have to be a bit wary about India spruiking their medical prowess. After all, in just one day they have registered over 100,000 people in India newly infected. Not a great recommendation that. In addition, yes India is a powerhouse in drug production but much of the precursors actually are imported from China. It might be wise to ensure that no supplies are needed from China for the Indian manufactured vaccines as in case relations go real sour between China and India, that might have an effect on Indian vaccine production.

    1. Thuto

      Interesting comment Rev, though China isn’t known for tit-for-tat moves in geopolitical skirmishes (i stand to be corrected). When India banned the tiktok app over the border confrontation with China, the Chinese side didn’t opt for retaliatory measures. This dovetails with their drive to carve out a reputation for themselves as a more benevolent and trustworthy global partner, one that won’t resort to coercive sanctions to discipline other nations so I doubt they would ban exports of critical medical precursors to India as this would result in a huge reputational blowback. That aside, I think medical supplies are typically exempted from any sanctions though the US reportedly finds a way around this by threatening to sanction any companies involved in the logistics of transporting supplies to Iran.

    2. Jerri-Lynn Scofield Post author

      On your medical prowess point, there’s great variation in how well different Indian states have coped with COVID. Kerala initially performed particularly well.The FT reported that 57,000 of the cases recorded on Sunday were in Maharashtra – where Mumbai (Bombay) is located; these are just the latest of the state’s difficulties dealing with COVID.

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