India's Footprint in Africa: South-South Cooperation and the Politics of Gifts and Reciprocity

There is great interest and rivalry among the major world powers for influence in Africa. Some argue that a "new battle for Africa" ​​is taking place, with major Western powers and newer global players such as India and China all vying for the continent's attention. An important channel for Indian engagement has been through South-South cooperation (SSC), where India promotes the so-called Triple A technology (Affordable, Accessible, Adaptable) as an alternative to Western models. In particular, health and education through ICT has enabled India to differentiate its SSC activities from China's. Our focus in this project is India's competitive advantage in ICT, education and health skills (including Covid-19 vaccines). A key objective is to better understand how India's SSC engagement affects socio-economic components in three African countries; Senegal, Malawi and Mozambique, as well as perceptions of and the significance of India's increased influence. Findings: In recent years, India has stepped up its global ambitions and its foreign policy engagement with African countries. India is now the third largest export destination and the fifth largest investor on the continent. At the same time as India tries to challenge China's dominant presence in Africa, the country has signed a number of bilateral agreements. India has also strengthened its diplomatic presence and is actively promoting trade, infrastructure and private sector investment. It appears in our research with the University of Mumbai that India has good expertise in sharing digital skills related to access to universal health services. On the African continent, New Delhi has renewed its infrastructure for telemedicine and online video consultation. The effect is a cost-effective and safe alternative for the treatment of infectious diseases. During the pandemic, India's expertise in affordable holistic services has gained greater importance. New Delhi is already reaping the benefits of an ambitious diplomatic initiative aimed at supplying Indian-made vaccines to developing countries. As one of the world's largest drug producers, India produces 60 percent of the global share of vaccines. Several African countries have bought these medicines, or received them as gifts. India has strengthened its diplomatic ties and its global recognition as a result of its capacity and willingness to share COVID-19 vaccines. However, the second wave of infection in May 2021 led to a decision to stop vaccine exports. This created a bump in the road for India's reputation in Africa, but we expect India's reputation to be restored as soon as vaccine supply resumes. Since 2018, the India-Africa partnership has been based on a set of principles that have emphasized "local priorities". A joint effort to change global institutions, overcome climate change and fight global terrorism are overarching requirements. The principles also highlight capacity building for agriculture, education, digital technology and cooperation around peacekeeping and maritime issues. How, and to what extent, can Africa benefit from India's growing interest in the African continent? We identify three sets of health-related benefits and opportunities that could shape the future of the India-Africa relationship. The first deals with India's reputation as "the world's pharmacy". India has actively contributed to meeting the global demand for vaccines, over-the-counter medicines and affordable generic medicines. As production costs are low, Indian products are cheap all over the world. Africa receives nearly 20% of India's pharmaceutical exports, which equates to $17 billion. Southern and western regions of Africa represent the largest importers of Indian medicines. This includes antiretroviral (ARV) drugs, which are far less expensive than the drugs produced by Western companies. The second concerns cooperation and capacity building in the health sector. Indian healthcare professionals collaborate with African partners, and some have opened or are planning to open specialist hospitals in several parts of Africa. India has also grown to become an attractive destination for 'medical tourism' by offering good healthcare services at competitive costs. The third concerns India's active "medical diplomacy". Africa relies on affordable medicines, including a COVID-19 vaccine; a need that will probably only increase in the future. At the same time, India can learn from Africa's success in preventing the spread of the Ebola virus. More experiences with disease control in African countries will thus also be able to contribute to improving India's health sector. Together with our partners at the University of Malawi, we have started to study the Pan-African E-Network (PAEN) project at Chancellor College in Malawi, more specifically the "tele-education" component. We have conducted several interviews with relevant actors, including the Indian diaspora. However, what we have not found sufficient information about is the telemedicine component of PAEN.