eStrategies 2016 Executive Summary

eStrategies AFRICAOUR DIGITAL FUTURE Collaborating to deliver real impact

Contents 4 Digital Economy Delivery Programme and Fund Round Table The digital economy delivery programme and fund that is geared towards increasing uptake and usage of modern ICTs 12 The Connectivity Roundtable Improving investment into the rapid implementation of connectivity solutions 20 eHealth Roundtable Connectivity at the core of eHealth success 28 The National eStrategy Roundtable Increasing spectrum for faster, more affordable broadband roll-out eStrategies MD Chris Hull opens the two-day event in Cape Town. He welcomed delegates and urged for the four sessions to produce a set of tangible actions2

ForewordI would like to thank all those who participated in the recent eStrategiesForum in Cape Town. It was important that such an influential group of keystakeholders were able to gather once again to discuss how South Africa’sdigital future should be shaped and plan actions that will see this futureimplemented with a real sense of urgency in the months and years ahead.eStrategies has been bringing these key stakeholders together in SouthAfrica since 2008 and, after all this time and with the continued support ofthe Ministry of Telecommunications and Postal Services, we are now seeingreal progress in moving from discussing strategy and advising on policyto planning for the roll out of broadband connectivity upon which so manyopportunities lie for so many in the country.It will be important now to keep up the positive momentum that was soevident throughout all the round tables that took place. This publicationis key to keeping that momentum going. We have worked hard with thechairs and rapporteurs from each session to summarise the discussionsand outline the follow-up actions that were proposed, detailing who will beresponsible for making sure progress is made.As we have always maintained, we do not want eStrategies to simply bea talking shop, which is why we seek to emerge from each session withconcrete actions and follow-ups that help move us all forward.At the previous event held in November last year, all delegates agreed that areal sense of urgency was needed to implement existing eStrategies whichis why we held this event just nine months later and have now committedto holding the next meeting next February. This is how we are trying to keepthat sense of urgency high up on our list of priorities.With this publication, we can now see how this group continues to helpshape real change in South Africa to deliver better healthcare, bettereServices and more opportunities for all.In a determined effort to maintain this sense of urgency, we will report on theprogress being made on all the actions we agreed upon over the two daysin Cape Town. To do this, we will interview each of the chairs in Novemberthis year to gauge this progress and to understand any barriers that may stillexist.These interviews will be at the heart of a special publication we will thenproduce before the February event and this document will help shape theagenda for those discussions.As you can see, we are facilitating regular debate, while reporting on theoutcomes these discussions deliver. This way, real change can happen.I believe with the support we have from government and all stakeholders,together with our commitment to facilitate these meetings and our reportingon the outcomes to provide a platform to monitor progress, we arebeginning to see that the sense of urgency needed to bring about rapiddeployment and improved services is taking holdI urge you all to remain part of this process and actively participate withthis group of stakeholders that is now firmly at the heart of delivering SouthAfrica’s digital future. 3

Cape Town 2016Digital Economy Delivery Programme and Fund Round Table A discussion that brought together key representatives across government, business, education and civil society to discuss the much-needed digital economy delivery programme and fund that is geared towards increasing uptake and usage of modern ICTs.2 eStrategies

Rapporteur The PanelMr Ryan Ravens, Chaired by Ms Mymoena Williams,CEO, Executive Director, Cape Digital FoundationAccelerate Cape TownDr Raven Naidoo Mr Brian Schreuder, Mr Brian Wafawarowa Mr Etienne StroebelExecutive Chairman, DDG Education, Western Executive Director for GM Transformation Projects,Future Perfect Corporation Cape Education Learning Services, Neotel Department PearsonMr Gavin Weale Ms Jaye Richards-Hill Mr Paris Mashile Mr Paul dos SantosManaging Director, Teacher Engagement Councillor, CEO,Livity Africa Manager, Microsoft ICASA JP-Inspiring Knowledge Education 5

The backgroundThe round table debate was framed within the following contextToday, we are still seeing major Round Table chair and Executive Director, Cape Digital Foundationinvestments in ICT infrastructure Mymoena Williams. CDF led this session(including digital technologies, DT)but very little money being directed to connect communities, schools etc. interventions. The CDF is looking fortowards unlocking the potential digital But while digital technologies have greater collaboration and investmentopportunities for citizens, businesses, by key stakeholders, which is neededentrepreneurs living in South Africa. been spreading, digital dividends have to achieve this, so how this may come not. We need to understand the reasons about was key to the discussion. We know that digital technologies (i.e. for this:the internet, mobile phones, and all the This round table also looked toother tools to collect, store, analyse and (i) There are still communities that explore the many digital dividends thatshare information digitally) have boosted are offline and can’t participate in are available in relation to the broadergrowth, expanded opportunities and the digital economy development benefits of investmentimproved service delivery. into digital technologies. Growth, jobs (ii) There is an urgent need to expand and improved services are the most However, what is amiss is their eSkills to enable the uptake of DT important returns to digital investments,aggregated impact. according to the World Bank, 2016 and (iii) Some of the perceived benefits this fact was at the heart of the debate. The World Bank Report 2016: Digital are offset by new risks.Dividends concludes that full benefits of The panel also discussed the proposedmodern ICTs will not be realised unless The purpose of the discussion digital economy programme and fund,there is continued improvement in looking to identify potential digitalbusiness, investment in people’s health The Round Table was led by the Cape dividend programmes and projects.and education and the promotion of Digital Foundation and its purpose wasgood governance. Secondly, better digital to examine ways to improve our digital The core focus of discussion wasdividends are seen when the technology readiness to enable an effective use the need for greater collaborationinvestments are complimented with of digital technologies, through more and co-investment to ensure digitalbroader economic reforms i.e. faster effective eLearning and other targeted transformation and eLearning was usedgrowth, more jobs and better services. as an example. The World Bank also highlightedthat, although there are many reportedindividual success stories, the neweststudies suggest that the “effect oftechnology on global productivity,expansion of opportunity for the poorand the middle class, and the spreadof accountable governance has so farbeen less than expected”. The impactof the under-utilisation of modern DTshows an increasing number of generalunemployed and, remarkably, very highunemployment and under-employmentof young people. Our unemploymentrate amongst the youth aged 15-34years has risen from 32.7% in 2008 to36.1% in 2014. Meanwhile, the World Economic Forum(WEF) and INSEAD ranked South Africaas 75th position in 2015. The WEF andINSEAD rankings have been published formore than a decade. They are the mostreputable global comparative rankingsand provide a very sound basis foraddressing national and provincial digitalreadiness issues. Technology can be transformational –the Government of the Western Cape hasinvested R2.8bn in broadband and alsohas a Universal Service Obligation (USO)6 eStrategies

It is now recognisedthat ICT is the keyenabler of all goalsin all sectors and willhelp us achieve ourdevelopment visionfor 2030. We nowneed sharper, morefocused strategies forrapid implementation- and that is whywe are here. We willdeliver impactDeputy Minister, Department ofTelecommunications and PostalServices opening the two-day event 57

On behalf of the government I say that we are proud to have a platform like this. We will support the fact that we are discussing these issues and reporting the plans for action. Let’s make the stories rather than telling them once they have been made. We are looking forward to a fruitful partnership Ms Stella Ndabeni-Abrahams, Deputy Minister, Department of Communications6 eStrategies

Executive SummaryThe round table opened with the for young people is at the front line of coordinate and drive alignment betweenacknowledgement that a digital the digital economy. Training young various spheres of government, asSouth Africa needs to move from people in digital skills that are in demand well as between various regions andstrategising and policy making to rapid should be a priority as all organisations departments.implementation, and that the Cape need digital talent. There is a supply ofDigital Foundation is one of the essential this talent in South Africa and this is an • Implementation is often not includedinitiatives to achieve this. untapped resource. in government planning, i.e. strategic initiatives, planning sessions, and visions The subsequent discussion focused The final central theme that framed need to be followed up with tangibleon eLearning and education, seen as the the debate was the need for leadership implementation plans.game changer and key to unlocking all at every level – leadership in schools toareas of digital development. manage change, leadership in industry • The need exists for repetitive to take risk and get things done and engagement and discussion in order The outcomes emerging from this leadership in government to create the to reinforce strategic alignment anddiscussion and the follow-up actions environment in which investment and implementation plans.that were then agreed upon, were based implementation can take place.on the guiding principles of digital • Continuity of programmes and ongoinginclusion, people-centred connectivity Keeping these core principles in mind, commitment to agreed objectives isand the need for greater collaborative the panel addressed specific questions in critical – especially where these extendefforts between the public and private relation to the Digital Economy Delivery beyond a standard political term ofsectors. Programme and Fund that CDF is leading office. in the Western Cape. The following Collaboration is seen as core to issues were highlighted in relation to the • Taking a long-term view of projects isensuring that all stakeholders – questions, both from the deliberations essential to success. Projects must alsogovernment, business and ordinary of the panel and the interaction with the be A-political and investments not beSouth Africans – benefit from access expert audience. subject to failure when there is a changeto ICT. These collaborative partnerships in political leadership.need to be genuine, however, with clear Questionoutcomes planned at the outset. The What are the major challenges faced • Government cannot do everything andprivate sector will always be happy to by government in relation to project therefore it requires effective partneringco-invest if they can see where the initiations and funding of digital through PPPs in order to bring strategicmoney goes and what they get out of it. projects i.e. USAO? What is needed visions to fruition. from investors to address these The need for investment within these challenges? • There is an urgent need to releasecollaborative partnerships was also additional spectrum. This wasa core theme. The consensus is that • Internal government alignment is anthe industry is looking to implement, ongoing challenge. There is a need toinvest and deliver ICT services that willultimately benefit communities andthe economy, and as such Governmentneeds to ensure that there are guidingprinciples and an efficient frameworkand policy that governs the sector. It wasagreed that there is money available,but long-term goals need to be set,roadmaps for action agreed and projectsneed to exist beyond a set political term.Investments need to be safe and notabandoned when there is a change inpolitical leaders. To ensure investmentby private sector we need continuity. Inthis sense, there is a need to create anecosystem that encourages and enablesbusiness to flourish. The importance oftangible, measurable objectives cannotbe overstated in this regard. The need to improve digital skills inthe country was also central to thediscussion. People need to be able to usetechnology and be made aware of whatis available and the benefits it brings.Similarly, creating better opportunities 9

• The skill of the individual should not be divorced from the technology being supplied, i.e. beneficiaries of technology should be empowered to use it effectively. • Existing assets can be creatively exploited through collaborative endeavour. • New business models should be created to utilise existing technology to address current socio-economic challenges. • Government is ideally placed to serve as a facilitator of larger programmes. • All collaborative efforts must be project based with a central coordination function and agreed roadmap. acknowledged by ICASA on the panel user friendly. Better communication • Policy objectives should be separated and assurances were made that this is a is needed to ensure people know that from political objectives. priority being addressed. the services exists and that there are benefits to using them. • Long-term apolitical approaches could • Broadband access is key to unlocking assist in driving continuity. value for marginalised communities • Youth have an enormous ability to through digital technology. adapt to rapidly evolving technology • It is vitally important to address (which is often underestimated) and required behavioural change at • Significant success has been achieved should be empowered to become classroom level. but this is confined to specific pockets of “liberators of themselves”. excellence, which need to be replicated • Connectivity is critical and utilising and scaled up. • Digital intervention should have a spare capacity in TV spectrum may be a specific purpose and not merely be possible short-term solution but this is • Partnering with government is often “digital for the sake of digital”. hampered by regulatory challenges. onerous – legislation governing PPPs as well as PFMA and MFMA regulations • Technology does not always need to be Questions are extremely inefficient and time top-end but should instead be matched What is needed to increase business consuming which is a major deterrent to to the requirement (which can often be participation in increasing investment effective partnering. satisfied with rudimentary technology). into digitization at a local and provincial, and national levels? What • Mobile penetration is key to delivery • Security of devices is critical – are the needs from Education and in rural areas, especially when combined equipping learners with expensive Civil Society to ensure a positive with increased spectrum. devices may expose them to criminal role for them in this transformation predation. agenda? • Government websites currently have very low usage rates and need to be • Skills development should be based on • Potential exists to leverage existing redesigned in order to make them more skill requirements of the future. government assets such as buildings, stadiums. Cape Town Stadium was used as an example and this should be explored further. • Public sector procurement does not necessarily need to involve cash but could also be a value-in-kind contribution from government. • eLearning is a key focus area that is attractive to both the private and public sectors. • Skills required for jobs of the future10

may not be adequately covered by the to be transformed entirely, not simply Agreed follow-upcurrent curriculum. digitised, in order to ensure effective facilitation and adoption of new ACTIONS• ROI could be measured as an increase in technology.levels of skill available in the market and Each round table session was askednot only in terms of financial returns. • It is important to share data in terms to produce some concrete follow-up of what’s currently happening in the actions that delegates agreed would• Development of human capital is the ROI ecosystem in order to drive collaboration be carried out before the next event infor educational projects. between government, business and February next year. Each action would academia – a single coordination function be assigned to a particular organisation,• It’s critical to build leadership capacity is critical in this regard in order to ensure who would be rersponsible for carryingin schools, particularly with regard to credibility of disseminated information. it out.developing the ability to manage change. The following activities were agreed • Aligned to the central coordination and the Cape Digital Foundation will be• Leaders like school principals are able to function should be a singular roadmap responsible for carrying them out.model behaviour for teachers and learners. underpinned by agreed deliverables 1. Finalise the draft Education Plan of and timelines that are measurable and the Cape Education Foundation by the• Digital resources provide the ability accountable. end of July. This plan will be work-to circumvent deficiencies in school shopped with all stakeholders for buy-operations. • Management of the human element in and commitment of investment (non is as important (if not more so) than and financial) over a five-year period.• There is a lack of effective government management of the technology. 2. CDF to schedule meetings withcommunication with regard to public DTPS, DOC, ICASA, Western Capesector initiatives, and visibility of these • Inequality is a key consideration within Education to ensure alignment of USAOinitiatives to the private sector would South Africa and it is important not to obligations to the Education Plan i.e.be critical for effective partnering and grow the digital divide. 191 schools.investment decision-making. 3. Provide a status update on the Plan • The end-user perspective is critical and and implementation thereof at the• Current usage of technology is often ignored – all initiatives should be eStrategies Forum planned for Julypredominantly for social learning (i.e. FB, geared toward the end-user. 2017.Twitter, etc.) rather than education – youthneed to be ‘attracted’ to educational • Education and learning can and should 11content. be taken out of the physical classroom, i.e. the classroom can be extended through• Teaching and learning practice needs adoption of digital technology.

Cape Town 2016 ChairpersonDrRosemaryFoster andRapporteurDrAndrew Robinsonpreparethisreport immediatelyafterthedebate The Connectivity Round Table Improving investment into the rapid improvement of connectivity in South Africa, addressing the need for network sharing, better coordination of effort and preparing for the deployment of 5G networks.122 eStrategies

The Panel Chaired by Mr Paris Mashile Councillor, ICASARapporteur Prof Darelle Van Greunen Mr Lumko Mtimde Mr Paris Mashile Center for Community CEO, Councillor,Dr Ntsibane Ntlatlapa Technologies, Usaasa ICASANetworks and Media Nelson MandelaCompetency Area Manager, Metropolitan UniversityCSIR Meraka InstituteMr Moses Mashisane Mr Rodwyn Grewan Mr Steffen LangeGeneral Manager , Legal Chairperson of the Head of Government,and Regulatory, MTN Northern Cape Enterprise, Public Safety Provincial Broadband for Africa, Nokia Steering Committee 13

The backgroundThe round table debate was framed within the following contextThis round table took place before the Round Table chair and Councillor with ICASA Mr Paris Mashila, urgingforthcoming publication of a report delegates to be brave in their ambition for the countryinto the ICT sector in South Africa,which will influence all government to examine the policy direction needed that now is the time to be brave andservices and focus on the rapid and to achieve this. change laws to enable rapid deploymentcost-effective rollout of broadband as of infrastructure.one of the government’s main priorities. The panel was asked to address theThe development of better government best route to rapid deployment taking The main purpose of the outcomesservices entirely depends on this rollout. into account the need for network of the discussion were to feed into sharing and the better co-ordination an annual report on the ICT sector in There are already strategies in place of efforts by both public and private South Africa, providing an opportunityto support rapid and cost-effective sectors, as well as the preparation to shape the immediate and futurerollout of broadband. The key national needed now to deploy 5G networks improvement to connectivity in Southstrategies, the National Development and to maximise the impact of this Africa. Discussion also focused on howPlan and the Broadband policy, SA technology. this report should be funded, its scope,Connect both emphasise the need for its benefits and how it can best be useda widespread communication system The chair wanted to frame the to attract further investment.that will be universally accessible, the discussion around the understandinginfrastructure of which should providean enabling platform for economicenterprise, active citizenship, socialengagement and innovation. But there remain two key challengesthat need to be addressed in orderto reach the stated objectives ofthe NDP with regard to connectivityinfrastructure. These are the high cost of accessand patchy availability of broadbandnetworks across the country andtogether these lead to a socio-economicand geographical digital divide. At the last eStrategies Forum, heldin November 2015, the call for thepublication of an ICT infrastructuredevelopment report was issued as well asthe request for an ICT Phakisa, throughwhich impetus would be given to theroll-out of improved connectivity aswell as improvements to eServices andlevels of eSkills which depend on betterconnectivity. With the ICT report due to bepublished in 2017, the ICT Phakisa wasonce again on the agenda providinga further boost to the need for rapiddeployment of broadband infrastructureand the collaborative efforts needed toachieve this.The purpose of the discussionThis round table looked to explore waysto improve investment into connectivityin South Africa, with the focus forthis investment being towards rapiddeployment. The discussion agenda was14 eStrategies

Executive SummaryThe round table addressed the central and connectivity has been delivered a variety of levels as people in rural areasquestion of how to rapidly connect our to rural South Africa, the benefits have different skills.society, in order to take advantage of have been clear and there are quickthe digital dividend this will provide. This wins, particularly in terms of health, Collaboration was also seen as vital inquestion was addressed by considering employment and education. other areas of developing connectivity inthe challenges that exist in South Africa South Africa. Collaboration in Researchin implementing this connectivity. As in other discussions, collaboration and Development and human capitalThese challenges , it was agreed, include was seen as key to implementation, development should be encouragedconnecting rural and remote areas of with a coordinated approach involving between the private sector, governmentthe country, establishing a business organisations like SITA, Usaasa and the and civil society, it was argued. Thecase for broadband roll-out and seeing DTPS and together with the private issue of demand is crucial and there is aa return on investment, the regulatory sector seen as essential. This is not only real need to establish the mechanismsframework governing spectrum and important in establishing universal available for the private sector to comethe often complex nature of public, connectivity, but also in ensuring into untapped rural areas and stimulateprivate partnerships, which are central to take-up of available services through demand. Bringing connectivity is onesuccessful implementation. awareness building, delivering user- thing, but users are needed and uptake centric services people actually want needs to happen to make it work Delegates acknowledged, however, and need, and developing the necessary economically and sustainably.that South Africa already has excellent digital skills. Creating digital citizensstrategies and policies in place and it is to partake in this digital society is vital Linked to this was the issue of contenttime to move ahead with implementing but how do we do this on the ground? once again, with the need for it to bethese. SA Connect should form the People also need to understand the value relevant and local. South Africa, it wasbackground to this work. Where work has of having connectivity, while levels of argued, relies too much on foreigntaken place to address these challenges skills development needs to take place at content and this is not necessarily the best approach. Here, government and 15

the regulator need to play a central role, of describing how millions of things a commitment from industry to work on building an infrastructure on which affecting every aspects of our lives this,” said MTN. eGovernment services can be built will be connected to the internet soon. and on which other services can be But 5G and the IoT will not be done When considering the issue of shared. Infrastructure sharing is hugely tomorrow, it was said, and the network spectrum, its scarcity was discussed, important – duplication of efforts is a needs to be prepared for it. “Take this as with the conclusion being that spectrum waste of money, and that effort could is there – Spectrum is finite, but it is not and should be channeled elsewhere. scarce, so we need to find easier ways to use it and break the cycle we are now in. Cybersecurity was, of course, also Modulation and coding techniques could considered. The security of the future be effective in making spectrum go networks in terms of data, privacy further but this will need investment. and inclusion is important and, again, the collaborative involvement of both Investment in general was, of course, government and the private sector is key. at the heart of the discussion, with the general conclusion being that an Cybersecurity needs to be prioritized investment model needs to be developed and action plans to be communicated that can enable access to infrastructure in order to encourage people to take for rural areas and to stimulate long- up their use of ICTs. Meanwhile, it term investment from the private sector was acknowledged that the country for sustainability. is not prepared for the security of the networks, whilst there was a call for In relation to the strategies action in making the everyday citizen already included in SA Connect and aware of the security measures they to USAASA’s plans, there is a great need to take. need to consider an increase the contributions into Universal Service There was a great deal of discussion Fund to ensure that there is greater surrounding future networks and the impact in providing access to services as internet of things – or the internet per the developmental goals. proposal of everything as the prefered way was to increase it from 0.2% to 2%.16

An alternative proposal deom theDeputy Minister from the Departmentof Communications was that mobileoperators should direct at least 20% oftheir infrastructure spending to ruralareas. Either way, this considerationwas seen as a valuable contribution tothe debate as a way of incentivisingconnectivity throughout the country. To conclude, it was pointed outthat the eStrategies Forum is an idealplatform on which to discuss theseissues openly and honestly, with aview to agreeing actions involving allconcerned stakeholders. Gaps can beidentified and the challenges can betranslated into opportunities. Delegatesagreed to remain part of the initiative. A series of follow-up actions werethen agreed, with those responsiblefor carrying them out also identified.The panel concluded with a sense ofoptimism that important matters hadbeen discussed and actions agreedin a convivial atmosphere., with theconclusion made that if the panel cannotreport progress on these actions at thenext meeting, then the next sessionshould not be so cordial! 17

Six agreed follow-up actions 1. ICT infrastructure portal Key issue of taking stock of what we have – what is where. Need to build a portal for ICT infrastructure development. CSIR has the capability, skills, resources and capacity to do this. ICASA and the DTPS are key to enabling collaboration agreements with data owners to make the data available for the portal. ICASA will investigate this and call for private sector to come on board and supply data. CSIR will coordinate 2. Investment model Key issue of an investment model that can enable access. Two have been raised. MTN was challenged to provide 20% of their investment into infrastructure for rural areas. They are considering that. Additionally, there was a call for the Universal Service Fund to be increased from 0.2% to 2%. There needs a clear plan about what that additional money will be spent on and the impact this will have on the development goals. Usassa will work with DTPS and ICASA to coordinate. 3. Cybersecurity Security creates trust and if there is no trust in the services over the networks then it won’t be used. Clear need for security and to communicate actions people need to take. DTPS commits to raising cybercrime awareness. eStrategies will look to including a round table examining this issue at the February 2017 event, and will invite international experts. 4. R&D collaboration Encourage R&D collaboration and human capital development between the private sector, government and civil society by increasing interaction between all stakeholders. DTPS, CSIR to coordinate and involve academia. 5. Sharing guidelines The process for developing guidelines for rapid deployment, infrastructure sharing and open access will be fast-tracked. DTPS will coordinate. 6. Quality assurance ICASA to work with operators on how to ensure there is consistent quality of service. ICASA.18 eStrategies



CaCpaepeToTwown n20210613 ChairpersonDrRosemaryFoster andRapporteurDrAndrew Robinsonpreparethisreport immediatelyafterthedebate eHealth Round Table Continuing with the theme of connectivity, this time in relation to eHealth, the round table examined ways to enable National Department of Health eServices220 eStrategies

The Panel Chaired by Professor Darelle Van GreunenCentre for Community Technologies, Nelson Mandela Metropolitan UniversityRapporteur Mr Gerrit Henning Mr Henry Adams Prof Hlengiwe MkhizeProfessor Paula Kotze Executive Director, Country Manager, Deputy Minister, Ministry of Health Systems Technologies Intersystems South Africa Telecommunications andChief researcher, Postal ServicesCSIR Meraka InstituteMr John Watson Mr Martin Weiss Mr Rodwyn GrewanBusiness Unit Manager IT, Senior Technical Officer, Chairperson of the NorthernAgfa MRC-PATH Global Health Cape Provincial Broadband Innovation Accelerator Steering Committee 21

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The backgroundThe round table debate was framed within the following contextPrevious Round Table discussions at the Round Table chair Professor Darelle Van Greunen made it clear from theeStrategies Forum have focused on the outset of the session that she was looking for concrete outcomesbarriers that exist to effective eHealthand mHealth implementations in many • Who will be responsible for providing eHealth, including network connectivity,African countries, architectures for a National eHealth Network? How are national broadband, the roll-out of HPRSeHealth and issues of interoperability, current connectivity initiatives going and the establishment of a nationalleadership and governance structures to contribute to this National eHealth master patient index, the roll-out offor effective eHealth implementation. Network? electronic medical record systems toThey have also examined actions needed clinics and hospitals in the public sector,for policy and decision makers to bring • The requirements for the introduction compliance testing of systems forabout a more equitable and accessible of eServices for health, for example adherence to the HNSF, etc.healthcare system in South Africa. infrastructure, legislation, policies, implementation plans, finance, etc. • The need for a multi-disciplinary Many of the issues highlighted at task team from various National andthese round tables still persist, but • How to make provision for connectivity Provincial Departments to drive andprogress is being made. Progress since with mobile and other devices, e.g. manage the implementation of eServicesthe first Round Table in 2012 have mHealth applications and other for health.included the publication of the eHealth connected medical devices.Strategy South Africa 2012-2016, which • The establishment of a forum oris currently under review, as well as • Appropriate technologies for different engagement model through whichthe publication of the National Health geographical areas, for example urban private companies with a good trackNormative Standards Framework for and semi-rural with basic infrastructure record in the provision of electronicInteroperability in eHealth (commonly and some connectivity and service medical record systems can engage withreferred to as the HNSF), Gazetted in provider presence, and rural areas with the National and Provincial DepartmentsApril 2014. The HNSF addresses the poor or no infrastructure or connectivity of Health to assist with moving eHealthissues of patient identification and and no service provider presence. and mHealth initiatives forward on aauthentication linked to a national national scale.master patient index, the sharing of • Progress with the implementation ofpatient centric demographic and clinical national and provincial infrastructure fordata among electronical medical recordsystems (also including laboratory,radiology and pharmacy systems) andwith a national electronic health record,in order to address care coordinationand continuity of care. The HNSF is alsodue for an update to make provisionfor advances in eHealth and mHealthtechnology and use. The implementation of several of thetopics raised in the eHealth Policy andthe HNSF is still problematic though. Theissue of connectivity is one of these:connectivity of systems, networks andpeople; all which have a role to play indelivering eHealth.The purpose of the discussionThe Round Table deliberately avoidedfocusing only on technologies,but instead addressed the topic ofconnectivity in the wider sense, and didthis by addressing the following:• What is the goal and scope of aNational eHealth Network? 23

Executive Summary The Round Table addressed several key issues current and future connectivity initiatives will roll-out of HPRS and the establishment of a during a very interactive and lively panel contribute to the National eHealth Network national master patient index, the roll-out of discussion not only involving the panel to provide the national shared infrastructure electronic medical record systems to clinics members but also the audience. Throughout for the deployment of the national electronic and hospitals in the public sector. The global the discussion careful attention was paid health records, master patients index, clinical trend is the move towards the centralisation to ensuring the issues were addressed with repositories as envisaged in the HNSF, of clinical data and this forms the basis of concrete follow-up actions in mind and which was Gazetted April 2014. Discussions any interaction between patient and health that agreement should be reached on these touched on issues related to eServices in the professional. South Africa should follow deliverables. context of infrastructure, legislation, policies, these trends. Large, centralised networks will implementation plans and finance. be needed for this and these networks should In shaping these follow-up actions, underpin the health service. delegates discussed the following aspects The discussion then shifted to appropriate of eHealth in South Africa, with specific technologies for different geographical areas, Standards were also discussed in relation reference to connectivity issues that will for example urban, semi-rural with basic to the development of this network for it to ultimately enable the delivery of better infrastructure and some connectivity service work universally and for all devices to have healthcare through technology. Framing provider presence, and rural areas with poor the ability to connect and interact with each the entire debate was the simple statement or no infrastructure or connectivity service other. It was suggested that we have the that the purpose of eHealth was to provide provider presence. The issue of mHealth and skills to develop these standards within South the enabling of a long and healthy life for the collections and integration of data from Africa and don’t always need to adopt those all south Africans – a simple but ambitious medical devices were also highlighted. that may not be appropriate for the country. statement. CSIR was suggested as the organisation Progress with the implementation of which could deal with this issue and that a Initial thoughts focused on the goal national and provincial infrastructure for digital health solution could be standards and scope of a National eHealth Network. eHealth was also discussed, including net- based. Aspects of this addressed issues of how the work connectivity, national broadband, the24

South Africa’s Normative Standards alreadycall for a national shared infrastructure foreHealth consisting not only of a nationalhealth nformation record but all the patientinformation. This should be available fromany compliant system in the country – toextract information and to contribute.Acknowledgement was made that to dothis, we need very good connectivity andnetworks. It is clear that there is an urgent need fora multi-disciplinary task team from variousNational and Provincial Departments to driveand manage the implementation of eServicesfor health. Business is key to driving thingsforward but it was felt by some that theyare often ignored in the development ofimplementation strategies and this needs tochange. In this regard, the establishment of anopen forum through which private compa-nies with a good track record in the provisionof electronic medical record systems canengage with the National and ProvincialDepartments of Health to assist with movingeHealth and mHealth initiatives forward ona national scale. Linked to this the need formultidisciplinary task teams to interact andengage in integrating and collaborating onvarious initiatives, were raised. 23

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Agreed follow-up actionsIssues related to connectivity and sharing of infrastructure:1. Connectivity currently happens in islands, for example NHLS has their own network, the provinces have their own networks,municipalities have their own individual networks, and more. Consolidation or integration of these networks and communicationbetween these entities and with vendors would provide the big picture and be a more effective and productive way to go ahead.2. Most issues are about consolidation of infrastructure, the sharing or the establishment of shared data centers, the collaborationwith various network infrastructure (fixed, fibre, wifi, and mobile) providers, SITA (as access point to network service providers),DTPS, and other key connectivity role players.3. In addition the needs for the establishment of a multi-disciplinary task team using available resources should be established toshare best practices, lessons learnt during practical implementations.4. Increasing the connectivity plans in the OR Tambo District in the Eastern Cape (USAASA) with private sector partnerships toserve as model for establishment of rural footprints.Issues related to communication and collaboration between various key players andstakeholders:1. The need for the development of an engagement and communication model between the National Department of Health(NDoH) and private companies or industry role players that have a substantial track record related to health and healthinformation systems, was raised and highlighted as a key issue going forward. The industry role players can provide key advice onstrategic and implementation issues based on their past experience. Currently the National Department of Health turns away fromengaging with industry leaders at large – engagement only happens with a small industry component and mainly those who haveclose relationships with the MRC, the CSIR and HISP; all of which currently play both an advisory role and implement HISs for theNDoH, which are perceived as to be deliberately excluding other role players.2. Likewise, there is a necessity for the various Government stakeholders (e.g. NDoH, Provincial Dohs, DTPS, SITA, ICASA, USAASA,Sentech, etc.) to engage on a direct basis to flesh out the issues of connectivity and infrastructure requirements for a NationaleHealth Network. A similar approach to the SCRUM methodology used in software development is proposed, with hard deadlinesand requirements and an independent referee. Reference was also made to the DTT Network (Sentech) with strong collaborationwith SITA and Broadband Initiative to the Departments of Health, Social Development, Education and Agriculture in the samecontext, aiming to developing communities that are under-served.Issues related to the update of strategies and guidelines:1. The current version of the HNSF does not address end-user interaction with national/provincial HISs, EMRs and other healthcareapplications. With the proliferation of mobile and other medical devices, and the necessity to address the needs of clinicians andcommunity health workers (CHWs) working in both rural and urban areas, it is proposed that over and above the revision of theHNSF to include new developments in both technology, standards and use, the HNSF also be extended to address the use of end-user devices and access of these devices to the national, provincial and local eHealth applications in existence and planned forfuture roll-out.2. There is a need to move from e-strategy to e-implementation. The next version of the National eHealth Strategy should beaccompanied by a clear implementation plan with responsibilities (not only due dates), based on best practice from industry andin collaboration with a multi-disciplinary task team not only involving NDoH, but also Provincial DoHs, local government andother stakeholders (such as the EMR and connectivity industry, science councils and academia), which will be responsible forimplementing the strategy at grass root level.3. The National eStrategy is under review and it cannot be business as usual. There needs to be a special focal point on doingthings together: government, industry and citizens. There is a risk to manage in this regard and a suitable management modeltherefore should be developed. Phakisa for ICT and Health needs to interact on how to play a leadership role in moving eHealthforward on a national scale. DTPS is therefore important to NDoH and is prepared to play a leadership role to ensure workingtogether and establishing a closer collaboration between DTPS, SITA, DoC and NDoH, and a better alignment with NDP partners.Topics for future eStrategies:Report on the successes and wins, and documenting lessons learnt for the others to learn from – even reporting on what did notwork. 27

Cape Town 2016 The National e-Strategy and eServices Round Table As the Department of Telecommunications and Postal Services works on a National e-Strategy discussion paper, the round table met to act as a platform for further input into the draft document, taking on the expert views of all stakeholders from the public and private sectors, academia and civil society28 eStrategies

The Panel Chaired by Professor Hlengiwe MkhizeDeputy Minister, Ministry of Telecommunications and Postal ServicesMr David Mphelo Mr Pandelani Munyai Mr Jan Liebenberg Ms Jeanette MorwaneGM Public Sector, CTO, Head E2E Solutions team for Chief DirectorMTN Business SITA Southern Africa, Nokia ICT Innovations ProgrammeMs Makhotso Moiloa Mr Mlamli Booi Mr Walter MudauExecutive Manager Operations, CEO, Acting Dep DG, Office of theUsaasa Sentech Government CIO, Dept of Public Service Administration 29

The backgroundThe round table debate was framed within the following contextAt the eStrategies Africa Forum in Round Table chair Professor Hlengiwe Mkhize announced that the DTPSNovember 2015, it was recommended was committed to the urgent delivery of the National eStrategythat a PHAKISA for ICT should beestablished to ensure more rapid The purpose of the discussion • Research, Development and Innovationprogress to the implementation of theNational eStrategy. It was argued that The whole eStrategies forum provided a • Human Capacity Developmenta PHAKISA for ICT would accelerate platform for further input into the draftthe deployment of ICT, lead to more National eStrategy document. With this • Rural Developmentinvestment and add a sense of urgency aim in mind, the discussion on this roundinto delivering on the promise and table focused on the following topics: • G overnance and eStrategypotential of our existing policies and Implementation (Institutionalremoving any barriers that exist to • S ector eStrategy Development mechanisms)implementation. The ideals of PHAKISA (eHealth, eEducation etc)for ICT formed a backdrop to this The panel also focused on the enormousdiscussion. • Local Content Development and opportunity for eServices to be provided Software Applications through mobile phones. In the spirit of Since the November 2015 meeting, ICT PHAKISA, these were discussed andclarity has been reached in terms • Industry and SME Development their exploitation considered.of the drive to implementing theDigital Agenda for South Africa andOperation PHAKISA for the ICT sectorwill be embarked upon along withother prioritised sectors such asOceanography and education. This is an important development,not least for economic reasons – theinternet economy’s contribution toGDP growth is likely to be in the regionof five per cent in 2030, while thecontribution of the ICT sector will be atleast four per cent by 2020. PHAKISA ICTwill help maximise this potential. This forum was part of efforts tocontinue this work through a varietyof channels. It is important that theinformation society receives even widerengagement involving all stakeholdersand society at large and this debateshould promote further engagementbetween the public and private sectorand the general public. With this aim in mind, the DTPS, whichchaired this round table, is currentlydeveloping a National eStrategyDiscussion Paper. Consultation aboutthis paper will take place with Provincesand then National Stakeholders. Following this consultation process, adraft National eStrategy document willbe finalised for approval by the DTPSMinister, then by Cabinet, in March 2017.Conclusions from this round table frompublic and private sector considerationswill help define the content of thisNational eStrategy and this documentwill be presented to the Department.30 eStrategies

ICASA acknowledged the concerns about the delaysin the release of spectrum for services that aredependent on broadband and admitted that thisorganization has been a blockage. ICASA committedto responding, ensuring the environment is there torelease spectrum for broadband.Executive SummaryThe panel and the audience involved be making this a priority. Release of the work it has been doing with TVrepresentatives from all relevant spectrum should not wait for analogue White Space trials in South Africa andstakeholder groups providing a valuable switch off. There is nothing stopping the the success it has had in deliveringall-round perspective on the issues DTPS and regulator helping the private broadband through this service. Itbeing addressed. The chair ensured sector to roll out spectrum faster. committed to make this part of thethose topics stayed focused on those ongoing strategy, once all roadblockslisted in the agenda and contributions Of course, the regulatory framework have been removed. Sentech, toofrom the panel and the floor all fed needs to be addressed in this regard, and committed to make use of TV Whiteinto the development of the follow-up ICASA committed to speed this process Space to bring broadband to ruralactions, which will in turn feed into up. ICASA acknowledged the concerns communities.the e-Strategies discussion document about the delays in the release ofcurrently being prepared by the DTPS. spectrum for services that are dependent In terms of the overall landscape on broadband and admitted that this on which the eStrategy should be All present agreed that making organization has been a blockage here. developed, comment was made aboutspectrum available can only help increase This will change, however, and ICASA the eCulture of South Africa, which isconnectivity throughout the country, committed to responding, ensuring very much driven by entertainment onand in particular in rural, under-serviced the environment is there to encourage mobile. There is a need to harness thisareas. Within the TV spectrum there investment, to make sure services momentum and use it for the good ofis TV whitespace available and this is are provided and licenced to release the nation.being trialled by many with success. It spectrum for broadband.was agreed that this potential to deliver There were many suggestions of howbroadband should be maximized and “There is no excuse for countries this momentum could best be harnessed,that there was not reason for any further to pass us in this area,” said ICASA with some conclusions agreed upon.delay. councillor Paris Mashile. “We want to Taking stock of the national assets correct the dereliction of duty – we already existing in South Africa was seen Sentech said that in looking at could have done better and we should as key – and this should include all assetsinnovative means for making this do better. We will use all benchmarks of both the private sector and publicspectrum become a reality, we need to – successes and failures and learn. The sector. Once this is done gaps can beinvolve all stakeholders and particularly proof of principles have been made in identified and strategies for filling thosethose from the private sector. MTN other countries and we will use this.” gaps devised collaboratively. As well asagreed, with SITA saying that they would this physical asset audit, gaps should be Meanwhile, Microsoft outlined 31

identified geographically with thought network architecture to deliver an the necessary software. Agreement directed at what works to see if it can end-to-end network that delivers all was reached that the longer we take be repeated. services, serving all sector and that to clamp down on this, the more this end-to-end ecosystem should opportunities the country will lose Similarly, the partnerships that are include all parties – devices, networks to produce materials for the whole required to fill in the gaps should be (transport, backbone, analytics). The continent. East Africa and West Africa established in terms of capacity, skills, end user and those interacting with the are doing this already so we need to connectivity and finance models. end user, operating the network and lock down the SADC region and we are The partnerships should, of course, delivering the applications should be moving too slowly. The government involve all stakeholders. The DTPS central to this eco-system. is key here and should provide the acknowledged that pockets of expertise springboard for development in this exist in South Africa and these should It is clear that in developing the area. be examined in the context of this eStrategy so far, there has been a assessment and should include the focus on health and education to The round table provided a valuable private sector. The purpose of the date. This focus should now be on the platform for the DTPS to outline strategy will be to look at those and implementation of the eStrategy in progress being made towards a digital include them in the strategy document. all areas, taking in the infrastructure South Africa it is helping to shape. It The DTPS committed to being bold in and the content. On the issue of this was clear that leadership is needed in terms of how we move this forward. infrastructure, SITA commented that this regard and the department has applications are easy to develop and the been seeking to deliver this by taking Finally in relation to the strategy technology is there, but the challenge on board the inputs from different moving towards implementation, there remains about connectivity. Through SA government departments, starting is a need to look at consumption models Connect, however, we are responding to engage with the provinces and – what services are required in different to these challenges and this will help municipalities and then devising the areas? How do we take the successful improve the lives of people all over strategy that identifies the building ones from areas like the Western South Africa. blocks needed. These include: Cape and repeat them elsewhere – in very different environments? What Here the issue of local content • Infrastructure – broadband infrastructure is needed to repeat this development was brought into focus. connectivity success? It was agreed that if this was not addressed, South Africa will be flooded • Integration and networks In terms of the network needed, with international material that is not it was agreed that the landscape is relevant or only relevant in the short • Interoperability – software solutions changing quickly and that attention term. Local content development is also for rollout must be given to ensuring that what a huge economic opportunity for the is developed is future proof and country. • Service security economically viable. Agreement centred on the need for a converged network, Devices can and should be built here, • Inclusion – services to reach all areas, with changes also necessary for the while we also have the skill to develop address gender issues and disabilities32

• Human capacity development –eSkills to develop ICT systems and forcommunities to use ICTs – looking atinterventions for youth to develop ICTliteracy skills• Interventions with partners to ensurepeople can use ICT• eCommerce – looking at addressingissues of security• Research and innovation – howto take advantage of innovativetechnologies like cloud services andmobile. Developing strategies to ensurethe innovations don’t create spillovereffects.• Work with research – looking to closethe gap on results feeding into thestrategy• Focus on creating an enablingenvironment for local contentdevelopment – digitizing governmentinformation, for example• Creating an enabling environment forSMEs – engaging with industry. PositionSA ICT sector to be globally competitive.• Setting institutional mechanismsto involve all stakeholders and ensureinformation flow and reporting.• Framework for measuring impact,capturing success stories andcommunicating them. In addressing this programmedesigned to speed up implementation,the following challenges need to be met:• Regulatory restrictions prevent onlineservices from being made available• Budgeting framework and restraints– we have to go through anotherdepartment to eEnable services.• Technological change requires changemanagement• Digital divide impedes the benefitsthat can be achieved with eServices –people are often unable to use them It was agreed that the eStrategiesForum offers the opportunity forall stakeholders to contribute to theleadership being shown in addressingthese challenges and that with effectiveleadership South Africa cannot fail. 373

Agreed follow-up actions 1 Coordinate collaboration To get collaborative efforts from different departments in government is difficult – so, the DTPS will lead the coordination of other government departments at all levels (national, provincial and local). It was proposed that this could be the Department of Performance, Monitoring and Evaluation and SITA will assist as they are already working closely with the DPME. Responsible: DTPS 2 Change management It was agreed that change management was essential for the successful implementation of the national eStrategy, but that there has not been sufficient planning for effective change management on the ground. USAASA agreed to investigate an effective change management strategy. Responsible: USAASA 3 Legislative issues and blockages Countries that have succeeded in the deployment of eGoverment solutions (eServices) have a clear legislative framework, for example, a framework that encourages front line government departments to go “paperless“. The requirement for citizens to make job applications through a Z-3 form is another classic example that will make it impossible for on-line application to succeed. DPSA will investigate what the blockages are and how to remove these. Responsible: DPSA 4 Spectrum ICASA is committed to resolving spectrum issues. There are concerns about the delays in the release of spectrum for services that are dependent on broadband. ICASA acknowledged that there has been a blockage in this regard and they are responsible for this. ICASA commits to correcting this and will respond promptly. Action will include using all available benchmarks – successes and failures and learn from them. There is proof of principles that have been made in other countries and this will be used. Responsible: ICASA 5 TV White Space The use of TV white space can be used to improve connectivity. Microsoft said: Microsoft can fund work on TV white spaces and is prepared to commit to this as part of a strategy – as long as the roadblocks are cleared Sentech will make use of TV white space spectrum to help bring connectivity to remote areas in support of the eStrategy. Responsible: Sentech and Microsoft Additional actions raised in the debate – to consider Further collaboration between DoH and DTPS. Henry Adams said: Need collaboration between the two departments. DoH needs to tell DTPS what they want to achieve and by when – DTPS need to be kept informed by Health regularly. What do you need, by when and where? Set up a mechanism for this communication, initiate communication with people on the ground – project manager etc Usaasa Report In November Usaasa will report on progress being made on an app they are developing about access gaps in the country – you will be able to see what capacity is there and what is missing. Operators will be able to use this to raise funds to build infrastructure where it is missing. Investors will also be able to assess investment potential and predict ROI using this application. New focal point between eStrategies Africa and the DTPS Confirm the role of the Chief Director of the ICT Innovations Programme in the DTPS to act as the focal point between Chris Hull (eStrategies Forum) and the Ministry in driving the eStrategies Forum and involving all stakeholders. Clarity about how this engagement will work will be confirmed from The Chief Director’s division. Part of this clarity will involve ensuring actions from this event are followed up and reported on in November.34

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Setting the news agenda The eStrategies Africa Forum 2016 attracted the attantion of national news broadcaster SABC. Broadcast immediately after the event, the station confirmed eStrategies Africa as one of the pillard for ICT and broadband roll out in South Africa. Watch it here: https://www.youtube.com/watch?v=T-M3BprPDNg36

eStrategiesA digital South Africa needs to move from strategising and policymaking to rapid implementation and the Cape Digital Foundation is one of the essential initiatives to achieve thisBe part of 2016Be part of eStrategies 2017 in collaboration with www.estrategies.co.za