Middle Class in Africa

Global economies are facing a situation where in the West, there is a decrease in those falling into the middle class, yet the South and Africa are booming with an explosion of those falling into this class

The concept of a growing middle class especially in Africa has become fashionable in recent years. After all, a strong middle class is a good indicator of a stable society. They drive consumerism, promote economic growth and prosperity, while encouraging investment and entrepreneurship. As a collective they can bring about better governance, higher education expectations and where possible political stability. In Africa, South Africa has stood as a strong example of democracy and stability and a cursory examination of the country seems to confirm this construct, yet a deeper look shows that this is more of a Western ideal than reality on the ground.

Global economies are facing a situation where in the West, there is a decrease in those falling into the middle class, yet the South and Africa are booming with an explosion of those falling into this class. In Africa especially, this seems to suggest that a narrative of development and opportunity in the continent has been spun, convincing many that they are middle class and better off than what they actually are.

By Xebiso Blessing Kamudyariwa

A pertinent issue becomes that of defining the middle class. Does it actually exist in Africa? If it does in what form? Can its construct truly be compared to that of the Western world? In 2012, the African Development Bank (ADB) put the number of people in the middle class at about 300 to 500 million people, approximately a third of the continent’s population. How is such a number derived, what criteria enter individuals into the middle class? In South Africa the numbers of the middle class have at times even been touted as above 50% of the population yet the extent of poverty and the country’s fall in Gini coefficient seem to belie this supposed fact.

Most definitions of the middle class are built from Marxist or Weberian theory. The former classifies according to those to work for themselves and are owners or propertied, while the other looks at characteristics such as education and income. Both these theories though fail to properly accommodate the exact context in which Africa finds itself. In truth, no specific theory has been able to properly classify the middle class in Africa as it is still a developing concept.

AfDB defines economic categories as shown below while various authors define the middle class as hypothetical or even mythical. Defining the middle class as starting from those with a daily expenditure of $2 (this is at 2005 PPP[ PPP – Purchasing Power Parity] US dollars, could be estimated at $2.94 today) requires quite a stretch of the imagination in South Africa. Many in the floating category defined as emerging middle class are simply at not starving status and easily fall back into the poor category. With rising inflation and a declining economy, the lower middle class finds itself at risk each day, barely surviving.

The upper middle class by this categorisation are a part of the population that are currently finding themselves over indebted, unable to save and likely just about making ends meet.

there similar patterns in other strong economies on the continent to make this more of an African trend than an isolated occurrence?

Over the last 2 years, stability has become a concept that many more are grappling with regardless of their income status. Besides simple bread and butter issues, more are reconsidering their thoughts on the economic and political future of South Africa. With incomes reduced, livelihoods lost, for many it feels like the struggle has just begun. Where before there was hope, it looks as though reduced circumstances are here to stay and things will not be better for a while if ever at all.

A more realistic economic definition of the middle class keeping the Western context in mind could be that found in Credit Suisse’s Global Wealth report that considers middle class as individual wealth between US$50,000 and US$500,000. This categorisation drastically reduces the continent’s middle class to about only 18.8 million people. While this would be a third of South Africa’s population, SA makes up only 5% of the continent’s population.

From the schools of thought below, the more accurate middle-class definition would be that using median income. In South Africa for example, the median income is just under R30,000, at almost $2,000. They can truly be counted as consumers and driving entrepreneurship. They are typically educated, have a car, own property and for many, work in the public sector. The development of this class has been well noted especially in racial terms with the majority of this class shifting to black as opposed to white. As of 2012, using these criteria, of the 8,3 million people making up the middle class 4,2 million were black. This the group which will be referred to as the middle class moving forward as they more closely meet the original Western construct of the middle class.

Unfortunately

While it is always expected that the poor are especially vulnerable to shocks, the pandemic has shown that things are not so clear cut. The middle class, the one class expected to be able to weather shocks, to have savings, generally live an easier life has suffered unexpected setbacks from prior to covid. Some who were living relatively comfortable lives before found themselves with their income completely gone or drastically reduced. This is a trend that goes beyond the private sector as government has also found itself in dire straits in its various parastatals.

Statistics show worry over this class was becoming a focal point from as early as 2018. While studies may differ slightly concerning the actual size of the middle class, in 2019 a SALDRU study found that only 20% of South Africans belonged to the “stable” middle class. The implication is that it can be a transient class, something especially Covid has proven true.

Old Mutual rightly states that instead of focusing on the size of the middle class, focus should be on their state. South Africa’s economic sustainability is at risk with a relatively limited middle class facing high levels of indebtedness and a heavy tax burden. A model developed by Eunomix Business & Economics Ltd. Shows South moving from upper middle income to lower middle-income status. This is understandable considering that due to lockdown restriction at least 200,000 middle class jobs were lost in what has been termed “class suicide”. These numbers may seem relatively modest until one considers that South Africa is a working-class society consisting of a small middle class. Shedding this many jobs and reduced income in some cases have severely affected the standing of the middle class with debt income ratios for some sitting as high as 152%.

In recent years, various studies have shown the shrinking of the middle class and with it an accompanying downturn of South Africa’s fortunes. The question is, is there a causal relationship or it is more of correlation? In South Africa, does the middle class actually play the role its purported to or there are other factors at play? Are

Unfortunately for South Africa, its middle class is not sitting back and patiently waiting for things to improve. With only about 30% of the middle-class believing things will improve, about 27% are looking to emigrate within the next 5 years. Basically, professionals are seeking greener pastures elsewhere. Where before it was the white minority that was looking at emigration, the black majority are increasingly looking to leave the country too. The wealthier, upper middle class have also been identified as those jumping ship as they seek more stable economies elsewhere. The SARS commissioner has even flagged the fact that money and skills are leaving the country at unprecedented levels which will result in long term brain drain and tax base erosion issues.

The major question becomes how South Africa has come to be in a position where in recent years its middle class has shrunk by over 50% and is moving to lower income status. In addressing this issue, the Eunomix model points at political and economic decline. The country is headed towards failed state status because of its reduced tax base, policies that are not growing the economy, violence and rising discontent among the citizens. The stability fostered by a thriving and stable middle class is slowly being eroded.

One study focused on what keeps South Africans up at night zeroed in on these top three factors in order, crime, corruption, covid. A significant number of participants indicated intentions to leave as there was more focus needed on safety, governance and prosperity and it seems as though there is no will from government to improve the situation. The country has been so focused on commissions and reports, yet no practical or tangible action seems to be taken against offenders. Corruption has become a byword, something expected in all facets of society that it seems an insurmountable obstacle to progress. A quick glance of headlines shows the levels of violence experienced in this country, the crimes that are a daily occurrence, this sense of life being worth very little in this country. It is no wonder that those with the means are more than willing to look for better prospects.

Where before South Africa sat as the bastion of democracy and opportunity in Africa, attracting foreign talent from all over the continent and the world, today it is struggling to pull itself out of the doldrums of inefficiency, monetary wastages, a corrupt political base, policies that have benefited the few at the expense of the many and xenophobia against their black foreign counterparts. Skills that would have come to South Africa from within Africa are looking at Western shores an outcome likely to be lauded by those who do not understand the need for scarce skills and the shortcomings the country is facing with its labour force.

These problems revert one back to whether the middle class actually occupies the position it is said to or whether there is more to a country’s stability than their strong presence. The figure below shows what the middle class supposedly contributes and the current state of South Africa.

It is important to determine whether the state of the middle class is endemic to South Africa. On the continent, Kenya and Nigeria from East and West Africa respectively can be considered. Over the last two decades both countries have experienced growth in their middle class achieving middle class income country status.

From 2010, Kenya moved towards political stability with a new constitution that embraced a multi-party system. That stability has unfortunately not translated into greater security as its porous borders with Somalia, South Sudan and the Great Lakes Region leave it at risk from insurgents. Notwithstanding these challenges, the country has continued to develop.

Currently Kenya boasts the second largest economy in East Africa after Ethiopia. Agriculture has always strongly contributed to the GDP, but this has gradually decreased to just under 25%. Industry on the other hand has increased its contribution to about 21% and services are at about 50% of the GDP. Between 2014-2018, Kenya’s GDP went up 5,7% driven by the service sector in terms of real estate, finance and insurance, wholesale and insurance, education, transport and storage.

While Kenya has a vibrant private sector, it has a dichotomous structure. The formal business sector is strong but concentrated in few firms while there is a massive, informal, low productivity small business sector. While it did lose its gains in the Global Competitiveness Index, it still has viable business opportunities and attracts foreign direct investment for private sector investors. It has a variety of international organisations such as the United Nations, Coca Cola, General Electric, IBM and the World Bank regionally headquartered in Nairobi and recently Google announced it was setting up its first Africa product development centre there. The presence of such firms has helped foster the middle class which stands at 24% of the population according to the Kenya National Bureau of Statistics.

While the middle class have been improving in numbers, socially there are still high levels of poverty, limited access to basic services, inequality and unemployment. Kenya’s Gini index though fares better than that of South Africa at about 41%.

The role of the middle class in Kenya has also been exaggerated by onlookers and failed to meet expectation. The class has proved rather fluid, based largely on economic parameters, and still bound by the cords of ethnicity and status quo especially in political matters. The growth of the middle class has been reflected in the economic growth of the country, with increases especially in consumerism. With economic success in hand, most tend to be wary of any change that could possibly reverse their fortunes which makes the middle class more accepting of the status quo to ensure their survival.

Nigeria on the other hand is a new middle-income country with an impressive GDP. As in Kenya, the services sector is the largest contributor to the GDP at 46% through financial and business services and real estate; creative arts and entertainment and information, communication and technology (ICT). Agriculture’s contribution is also decreasing and a decrease in tourism has also been noted. Nigeria is unique in that its budding entertainment industry actually contributes up to 2,3% of its GDP making it one of the largest employers in the country after agriculture. Final household consumption makes up about 80% of the country’s nominal GDP with this increase reflecting a growing middle class that makes up 23% of the population.

Above: In this photo taken, Sunday, Feb. 10, 2013 customers wait to buy Cold Stone ice cream in Lagos, Nigeria. As Nigeria’s middle class grows along with the appetite for foreign brands in Africa’s most populous nation, more foreign restaurants and lifestyle companies are entering the country.

( AP Photo/Sunday Alamba)

Unfortunately, the country still faces myriad challenges in security, fragility, slow growth, infrastructure deficit, low level human capital development, poverty, high inequality and rising youth employment. It is currently facing an economic recession due to volatile crude oil prices from pandemic. Its greatest challenge is diversifying from economy dependence on oil revenues.

As with Kenya, the private sector is dichotomous with large enterprises and a massive number of mostly informal Micro, Small and Medium Enterprises (MSMEs). Of the 41.5 million MSMEs, only 0,25 of these are Small and Medium Enterprises (SMEs). The micro enterprises make up 86,1% of the national workforce in the country. Even with such entrepreneurship the poverty numbers remain quite high with over 53% of the population surviving on less than $2 per day, and 92% on less than $6 a day.

Nigeria’s middle class has notably been indifferent to any forms of activism concerning the challenges in the country. The middle class has been missing from the po- litical arena since return to democratic civilian rule in 1999 where they were expected to promote democracy and its ideals. They have failed to act in the face of programs and policies that have proved detrimental to the class and its growth. Some feel the middle class has even worked against possible gains by siding with government in its failures, propping them up in spite of overwhelming evidence of incompetence in terms of health systems, security, education and corruption. Instead of holding government to account, they tout its failures as opportunities for foreign investment. The middle class is accused of ensuring the subjugation of the working class and ensuring the system works for a few at the expense of many. It is only in recent time they have been showing signs of trying to shake up with status quo especially with recent elections and the #EndSARS movement. As with South Africa though, the middle class is steadily emigrating as they look abroad for greener pastures.

An overview of Kenya and Nigeria is summarised as follows:

In all of three countries, it is clear how the middle class has tied its success to that of the ruling elite. Former ANC Secretary General, Gwede Mantashe famously said the black middle class must remember they were beneficiaries of the progressive policies of the ANC and while not indebted, they must vote consciously. He in essence voiced what most of the middle class acknowledge and live by. Where the middle class is supposed to ensure proper governance and keep government in check, they tend to be kept in check by the elite they uphold. Efforts to break free of the stranglehold of government have yielded limited results as seen by the 2016 South African elections where the ANC lost major metros to the opposition but managed to regain some of them when coalitions fell apart, the last elections in Nigeria where quite a number of independent candidates ran for office but faced defeat and the elections in Kenya where the middle class voted by ethnicity lines. With the dawn of democracy, activism has become more of a grassroots endeavour as the middle class shows apathy to the various challenges besieging their nations. All the ideals expected from their emancipation have failed to yield the expected results.

There is a need for the middle class to be independent of its governments. The fact that in Africa, the government is the largest employer and thus the foundation of the middle class means breaking free will be difficult for the middle class. Economies in the West are driven by massive employment in the private sector, and business prospects that are not dependent solely on government tenders.

The size of the middle class has been substantially reduced by the pandemic in sub Saharan Africa. This means more people have fallen into the poor income bracket. As long as accountability and activism are not a priority, the situation will continue to deteriorate. While not in the majority, the middle class holds the advantage of being the intellectual asset of the nation, they provide skills and knowledge that are critical for positive change. They need to find a way of leveraging their status, looking beyond the comfort of self and focusing on improving the standing of the working class. The middle class needs to come together as one cohesive unit for change to be realised otherwise they remain a myth creating mythical utopias while the reality is more dystopian.

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African startups making an impact in agriculture

Startups are gaining prominence and significance on the African content. It was reported that in 2020, there were an estimated 6,000 African startups and more than $4.5 billion venture capital was raised

Astartup can generally be described as a young company that is based on a creative idea or offers a new way of doing business, meeting a specific need in the world, and financed by external investors. While the rate of startup success is generally low, when successful, startups can grow into large entities that are influential and or generate large and even billion-dollar revenues. Some of the most renowned entities in today’s world that began as startups include Airbnb, Uber, WhatsApp, Snapchat, ByteDance; the parent company of TikTok, SpaceX, Canva, Pinterest, Instagram, Mailchimp, Netflix, Facebook, and LinkedIn, all of originating in countries such as China, USA, and Australia and outside Africa. One of the most talked about African startups is the Kenyan Mpesa.

By Talent N. Ndlovu

In recent years, startups are gaining prominence and significance on the African content. It was reported that in 2020, there were an estimated 6,000 African startups and more than $4.5 billion venture capital was raised, double the amount raised in the previous year. The countries with the highest numbers of startups are Nigeria, South Africa, Kenya and Egypt. African startups cover different sectors including financial, health, education, agriculture, transport and logistics, with financial startups being the most prevalent.

Recent years have also seen an increase in agricultural startups. In this paper, I will describe five agricultural startups that are amongst the most significant and high-impact startups on the African continent. These startups are; AgriPredict, Hello Tractor, AgriProtein, FarmCrowdy, and ColdHubs.

1. AgriPredict

Effective pest and disease risk management is essential for the success of agriculture, without which farmers can lose produce, the quality of produce can deteriorate, all resulting in loss of revenue, food, and export earnings. In Africa, the changing climate, particularly the warmer temperatures, appear to have increased the severity of pest and disease challenges. Examples of pests that are causing havoc in African agriculture include the fall armyworm, the Banana bunchy top virus, and maize lethal necrosis. These pests are causing massive damages across the continent, for example, the fall army worm is estimated to destroy more than 400 000 hectares of crop, worth $3 billion annually.

AgriPredict is a Zambian app that provides farmers with access to accurate, real-time pest and disease identification and management advice. Using this app, a farmer can upload an image of the pest, disease affected part of the crop. Using machine learning, AgriPredict then identifies the pest or disease on the image and suggests the most effective control method, and the nearest agricultural dealer. This information is then sent directly to the farmer, giving the farmer an opportunity to address the challenge timeously and effectively. This real-time service gives farmers a chance to detect and control pests and diseases early, hence, reducing the likelihood of crop damage and losses. This app could be highly beneficial for rural farmers, who rely mostly on the public extension services system, which is known to be poorly resourced, unreliable and unable to reach often remote, distanced rural farmers.

In addition to pest and disease risk management, AgriPredict also provides information about the weather, a critical service that increases a farmer’s preparedness particularly during this era of climate change, which is characterized by unpredictable weather patterns.

2. Hello Tractor

While the benefits of farm mechanization in increasing productivity and incomes are widely appreciated among African farmers, machinery, including tractors, is expensive and therefore out of reach for many farmers, especially smallholder farmers, who are responsible for most of the continent’s food production. As a result, some farmers hire tractors for certain stages of production, a process that is often difficult and expensive, with farmers having to search and bargain with tractor owners.

Hello Tractor has been widely adopted. It is now used in more than 10 countries including Kenya, Nigeria, and Tanzania, and has served about 500 000 farmers to date.

In 2014, an innovative Nigerian digital app called Hello Tractor was created to connect farmers with tractor owners, hence making tractors more readily accessible to farmers. Hello Tractor works in a sort of Uber-fashion, benefitting both the farmer and the tractor owner substantially. Using Hello Tractor, tractor owners register and hire out their tractors to farmers in their vicinity, generating income. The tractors are fitted with a monitoring device, which allows the owners to keep track of the location and activity of the hired tractor, hence facilitating an off-site, real-time monitoring option. The monitoring device keeps track of the number of hours worked and the condition of the tractor, allowing for fair, and transparent transactions between the farmers and the tractor owners. For tractor owners, this opportunity also ensures optimal use of their tractor equipment. For smallholder farmers, tractors are now just a click-away at affordable prices, hence, making tractors more accessible as and when required, reducing the costs and time spent searching for a tractor. Farmers register on the Hello Tractor app. They pay an initial fee and book a tractor for the date they want. When hiring, farmers can also pool together, saving costs. Hire prices are set according to the hours worked and the type of work done, which removes the need for bargaining or changing prices, creating a fair and transparent business environment.

By increasing farmers’ access to affordable tractors, Hello Tractor is making farming easier, increasing productivity and farmer incomes, especially for smallholder farmers who cannot afford their own tractors. Because of its positive impact on the smallholder farmer, Hello Tractor has been widely adopted. It is now used in more than 10 countries including Kenya, Nigeria, and Tanzania, and has served about 500 000 farmers to date.

3. AgriProtein

Food waste is a massive global challenge that has severe negative environmental impacts. It is estimated that, annually, more than 1 billion tonnes of food are thrown away as waste worldwide, with the main final destination being landfills. When this organic waste rots, it produces methane, which is one of the most potent greenhouse gases and largest contributors to climate change.

In 2008, founders Jason and David Drew from South Africa, came up with AgriProtein, a revolutionary concept that breeds and uses the Black Soldier Fly to recycle food waste and create a range of new, beneficial products that would also offer solutions to other challenges.

AgriProtein’s process begins with collecting food waste from restaurants, municipalities, malls, schools, hospitals, and food manufacturers. Next, the food waste is cleaned to remove any non-organic materials such as plastics and bottles, and crushed into a paste. Following that, Black Soldier Fly larvae, feed on paste, converting the food waste to protein. At pupae stage, the larvae are harvested and processed to creating 3 new products; MagSoil, MagOil, and MagMeal. MagSoil, which is used as soil-enhancing compost, is the residue that is left behind when mature larvae are harvested. MagOil, which is used to manufacture fish pellets and petfood, is fat extracted from pressing the mature larvae. Lastly, MagMeal, which is used to manufacture animal protein feed for fish and poultry, is made from crushing the larvae.

Through its innovative concept, AgriProtein offers solutions to more than just one environmental challenge. Firstly, it diverts food waste from landfills, thereby reducing greenhouse gas emissions. Secondly, it has produced an affordable alternative animal protein feed to fishmeal and soya. Replacing fishmeal is important as it means saving millions of fish that would have otherwise been harvested to create fishmeal for animal feed. Because of its economic potential, especially in producing an alternatively cheaper animal protein feed, the insect (Black Fly Soldier) farming concept has become increasingly popular in many countries around the world.

4. ColdHubs

Africa is known for its poorly developed storage infrastructure, particularly cold storage facilities for the smallholder farmers and their markets. It is estimated that up to 50% of perishable produce such as fruits and vegetables, never makes it to the consumer due to spoilage. Such huge losses translate to lower incomes, with farmers estimated to lose up to 25% of their profit and a wastage of resources used to produce the food.

In 2015, in an effort to reduce fresh agricultural produce losses post-harvest and at the market, Nnaemeka Ikegwuonu from Nigeria launched ColdHubs, a unique environmentally-friendly cold storage services solution aimed at providing efficient cold storage services to smallholder farmers, vendors, retailers and wholesalers. ColdHubs built solar-powered walk-in cold storage rooms (hubs) and placed the hubs strategically at markets and farms within the reach of smallholder farmers, vendors, retailers and wholesalers. The food is packaged in reusable crates, and stacked on the floor of the hub. Fitted with solar panels on its roof, each hub measures roughly 32 square meters, and can accommodate up to 150 units of crates, and store between 2 to 3 tonnes of food at a time. The hubs increase the shelf life of stored food by between 2 to 21 days.

To make the services accessible to smallholder farmers, vendors and small markets, ColdHubs charge for usage of the hubs per crate stored and at an affordable daily rate of $0.50c per crate per day. Each crate can carry up to 30kg of produce. ColdHubs are having a positive impact on the Nigerian market, with smallholder farmers and their markets have access to affordable storage, experiencing reduced produce losses, and increased sales, incomes and profits.

Demand for ColdHubs is high and growing immensely over the years, probably because of its fit to the smallholder farmers and markets, and its durability, with a projected lifecycle of 25 years. It currently services more than 5 000 farmers in Nigeria. The number of hubs increased from 25 hubs in 3 states in 2017 to currently 54 hubs in 22 Nigerian states, while the quantity of food stored increased from 40 000 tonnes in 2020, to 50 700 tonnes in 2021.

5. FarmCrowdy

A major challenge for smallholder farmers across Africa, is the lack of capital to finance farming activities. For example, without adequate finances, farmers cannot afford to purchase adequate good quality seed, fertilizers, herbicides, has no access to modern farm machinery or equipment, and cannot invest in good quality irrigation or storage facilities. This affects different stages of the production process, ultimately leading to reduced produce quantities and qualities of produce, and underutilization of agricultural land.

In 2015, a group of Nigerians, founded FarmCrowdy, a digital platform that links smallholder farmers to spon- sors who invest in farm activities in return for a portion of the farm profits. To ensure that both the farmer and the sponsor benefit from the arrangement, FarmCrowdy works with farmer associations and sometimes, local authorities to select farmers with potential, followed by rigorous production planning. Throughout the entire production cycle, farmer progress is monitored closely and technical, training and marketing support are provided.

To be a sponsor, one registers on the FarmCrowdy platform. The FarmCrowdy platform provides detailed information about of each the registered farms; including the type of farming enterprise and the expected return of investment, to guide the sponsor’s selection process. After selecting their preferred farm, and making payment, sponsorship funds are used to fund the purchase of required inputs, farm equipment and infrastructure, and to provide training and support for the selected farm. The sponsor is provided with regular online updates on the FarmCrowdy platform detailing sponsored farm progress, and also permitted to visit the farm physically, which gives the sponsor an assurance of their investment. Upon completion of an investment cycle, the sponsor’s initial investment is paid back in full. Thereafter, the profits are split between the farmer, Farm Crowdy and the sponsor who gets their return on investment.

FarmCrowdy is an innovative application that has found a way to solve the financial lack challenges of smallholder farmers, empowering the farmers to reach their full potential, maximize use of farmland and increase farm incomes. To date, it has worked with approximately 300 000 farmers and close to 20 000 acres of farmland across Nigeria. Over the years, FarmCrowdy has expanded, offering many other digitalized solutions to various players along the agricultural value chain.

Conclusion

In Africa, as it catches up with the rest of the world, it is no longer business as usual in every sector of the economy including health, finance, agriculture and transport, as African innovators are using startups to fund their innovative ideas, which were previously untapped due to lack of funding. In this paper, we described some of the most revolutionary startups in the agricultural sector, a sector that is critical to providing food, income and employment to more than 60% of the African continent. The selected startups are only a preview of how startups can be used to solve some of the strongest and most ancient bottlenecks that have hampered agricultural production and environment on the continent, and therefore, serve to highlight the importance of startups on the African continent today and in the future.

How will 5G impact healthcare?

5G technology could represent an SIP for healthcare, but all of that is hinged upon how fast we can find uses for it and leverage it for the betterment of our society.

In business there is something called a Strategic Inflection Point, this is defined as “a time period when an organization must respond to disruptive change in the business environment effectively or face deterioration. An inflection point, in general, is a decisive moment in the course of some entity, event or situation that marks the start of significant change.”

“What is an inflection point?

An inflection point is an event that results in a significant change in the progress of a company, industry, sector, economy, or geopolitical situation and can be considered a turning point after which a dramatic change, with either positive or negative results, is expected to result. Companies, industries, sectors, and economies are dynamic and constantly evolving. Inflection points are more significant than the small day-to-day progress typically made, and the effects of the change are often well known and widespread.

Key takeaways

By Denver Ncube

• An inflection point refers to a key event that changes the trajectory of some process or situation related to the economy or society.

• Inflection points are more significant than the small day-to-day progress typically made in a company, and the effects of the change are often well known and widespread.

• When an inflection point is identified, it is often a sign that the affected industry must make certain fundamental changes in order to continue to operate.

• Inflection points can be intentional (actions taken by a company or competitor) or unintentional (those that occur by accident or from unforeseen events).

• If companies are not able to adapt to an inflection point, they will fail to keep up with competitors and cease operations. For those that can adapt, inflection points can be an advantage”.

Much has been said about 5G, early in the COVID-19 pandemic the internet was awash with many conspiracy theories that 5G was in fact to blame for the pandemic. It was obscenely ridiculous but the one thing that the architects of propaganda know is that “narrative trumps/ supersedes facts” something does not need to be true, it only needs to be repeated enough times and once the narrative sticks it is hard for the truth to be uncovered. Well, this article is not meant to dwell much on those outlandish theories but rather consider what the possible impact of 5G on conventional healthcare. 5G technology could represent an SIP for healthcare, but all of that is hinged upon how fast we can find uses for it and leverage it for the betterment of our society.

Data transmission and access

In recent times, healthcare has shown that it generates an enormous amount of data. Everywhere you go (apart from some areas in the “third world”), data is a currency in and of itself. The new age of the internet has opened a new field where huge amounts of data need to be transmitted online to the cloud or to other data processing centers in real time.

At present, in the medical field, at least in the US and other nations, this data transmission has been principally transmitted using the now ‘ancient’ 3G network. With the advent of high-speed 5G network overlaid on existing architecture, this could allow the transmission of data from critical diagnostic machinery such as MRI, CT scanners etc. to specialists in a much more reliable and faster way. Previously, using machinery such as PET scanners generates extremely large files, somewhere in the range of 1GB per patient.

To transmit this data to specialists would require considerable network efficiency to make this happen, but with 5G this would happen as soon as the patient is out of the scanner. Faster processing of such routine medical assessments will improve health delivery and potentially increase better patient outcomes due to early intervention.

There are some medical conditions which have slim windows of intervention to significantly change the prognosis, waiting for inordinately long periods of time to obtain results could literally be a matter of life and death or permanent disability. This is all bound to change and help healthcare providers improve their response time. In addition, patients will also be able to access their medical records in central repositories in an efficient manner.

Acceleration of telemedicine

The COVID-19 pandemic accelerated telemedicine which had already been forecasted to grow in earlier years. To quote Anuja Vaidya (2017):

“The global telemedicine market is anticipated to expe- rience rapid growth over the next six years, according to a Market Research Future report.

Here are five market trends:

1. The market is expected to grow at a compound annual growth rate of 16.5 percent from 2017 to 2023.

2. Factors driving the market include an increase in demand for healthcare services in rural areas and a rise in government initiatives.

3. However, the high installation cost of the telemedicine technology solutions may limit market growth in developing nations.

4. North and South America currently account for the largest share of telemedicine market.

5. The Asia Pacific is expected to the fastest growing region during the forecast period, due to a rising geriatric population, increasing prevalence of chronic diseases and developing healthcare infrastructure.”

A common challenge to all countries is making sure that access to healthcare is equitably distributed and key to this is ensuring that every corner of the country has adequate coverage. To address this, telemedicine requires a network infrastructure that can support real-time high-quality video which is entails a wired network. With 5G healthcare systems can enable mobile networks to handle telemedicine appointments which would greatly increase the reach of the program. It is important to note that although all these possibilities are set to be unlocked or are already unlocked in developed countries, Africa lags in many ways. In some places 3G network is still inaccessible hampering the development of technologies that could better serve communities in these remote enclaves.

Streamlining augmented reality/ virtual reality in healthcare

There are studies that have shown that AR and VR can be used with great success in rehabilitation and care. Researchers have found that by putting patients in a different environment (virtual or real), they can distract patients from painful or anxiety-driven experiences (Mallari et al., 2019). Using AR/VR. Healthcare professionals can improve patient’s outcomes through minimizing their pain and drastically reduce their time in healthcare institutions.

At present, VR for hospital and therapeutic use is still expensive and it is wired to ensure low latency, resulting in a fully immersive experience with no lagging. In the current set-up, patients cannot be highly mobile due to the expensive wired set-up. With 5G, VR and AR treatments will move to a wireless set-up allowing comprehensive mobility and reduced hardware cost while improving on data transfer. Another facet of healthcare that will be transformed through 5G is surgical training/rehearsal.

Complex surgical operations cam be simulated with input from off-site specialists guiding the process. This literally brings the world’s expertise to every corner of the planet!

Remote robotic surgery and training

Robotic surgery is already happening with the only difference being that the surgeon will be standing next to the robot rather than remotely. Generally, the procedures are conducted using real time haptic feedback and high-definition image streaming coupled with high throughput communication. With 5G, a surgeon in one part of the world will be able to operate a patient on the other side of the globe. The simple requirement is the availability of 5G networks in both locations and the installation of robotic surgical arms at the patient’s location.

Given the existing inequalities in access to specialized surgical operations with some surgical procedures having waiting lists extending 3-5yrs from present day especially in countries like Zimbabwe, it would be a significant game changer. Medical tourism has been premised on the absence of affordable specialist diagnostics and care. Fusing telemedicine and remote surgery could significantly reduce the need for patients to move from country to the next in search of medical interventions.

Advancements in connectivity that will be brought to the fore by 5G will greatly improve health outcomes in areas where physically present healthcare workers are absent. Also, due to globalization, health specialists from one country could sit for surgery exams in a country halfway across the world from the comfort of their home institutions.

What 5G means for Africa

The obvious disparities in mobile network infrastructure is a significant limiting factor, so far 5G networks are topical issues in developed countries such USA, UK, Australia, South Korea, China and others. There is a huge gap between these nations and African countries. Despite this chasm, African nations can make a huge leap by avoiding some developmental mistakes that advanced countries made on their path from 4G to 5G.

There is need for an investment in the right infrastructure that allows us to scale this gap and unlock a new lived reality for the continent. For the most part, installation of 5G capable antennas can be centralized to healthcare facilities so that the interchange of skills and sharing of access to specialist care reaches the populace. The challenges all seem daunting, and for sure there is need to fix structural and political leadership issues on the continent, but we cannot wait idly and somehow hope for the best.

Some analysts predict that 5G will add an additional $2.2 trillion to Africa’s economy by 2034. This is a welcome analysis because the World Bank, before the COVID-19 pandemic had estimated that by 2030, poverty will be an exclusively African phenomenon, such a bleak projection whether it is an over estimation or not means that there is a certain level of vigilance and drive that our leadership should be invested in to avert an almost certain danger.

With the reality of climate change lurking behind the corner, agrarian based economies will be hardest hit, thus the move to service industry-based economies might be a possible solution. In the United States alone, the service industry accounts for about $17 trillion of America’s $22 Trillion economy. Will Africa leverage 5G to accelerate what would be arguably the biggest service-based industry in modern times? Africa has a population of just over 1 billion and arguably the biggest continental free trade area in the entire world. How can we leverage 5G to unlock a period of sustained growth and economic prosperity? So far, a few African countries have started trialing 5G networks.

These countries include Ethiopia, Botswana, Egypt, Gabon, Kenya, Lesotho, Madagascar, Mauritius, Nigeria, Senegal, Seychelles, South Africa, Uganda, and Zimbabwe (yes, Zimbabwe is there!). The sad thing though, is that before African can dream of 5G, it urgently needs to work on 4G first. According to the industry body GSMA, as of 2019, 4G internet signals only covered about half of the continent! This is appalling to say the least. Reports on illicit financial flows show that Africa leaks about $50 Billion USD per annum, this would be enough to revolutionize the technological landscape of the continent. It is also shocking that only 10% of Africa’s population presently uses 4G (source Vodacom).

The process of transitioning from 3G/4G to 5G has a universal roadmap. Prior to developing such a roadmap, governments should agree on general objectives for future digital development.

Governments in Africa must be clear in terms of what spectrum is available and best meets their needs. The steps given in Figure 2, might be similar but the detailed activities may vary from one country to another.

The key frequency bands to prioritize for 5G are, the 3.5 Ghz range. 700 MHz and mmWaves. It is important to note that there are alternative bands based on what has already been awarded for mobile, so as part of the groundwork regulators should consider the specific spectrum needs of 5G, including the provision of contiguous, bandwidths, exclusive use, peakiness of demand and need for harmonization.

Care must also be taken to also consider the ease of moving existing technology and the impact on services and users. The greatest hurdle for African countries is the paucity of 5G capable mobile devices. The introduction of 5G means that highly expensive devices tailored to receive signals must be accessible to consumers.

This presents a challenge where the average disposable income is not significantly high enough to allow more people to purchase such devices. The average price of the cheapest 5G capable device is around $300USD which would be expensive given the levels of income in areas of the continent such as Sub-Saharan Africa.

The availability of 5G across the African continent could unlock several industries as well as improve on agricultural monitoring, cybersecurity and enhance the movement towards “smart homes”. However, there is still a lot of work around the regulatory and technical framework and Africa can best observe and learn how the first movers on the technology globally have tackled them.

Where other countries are thinking of autonomous vehicles, Africa still needs to tackle the challenge of improving its road networks, including building the actual roads too, while we talk about modernizing agriculture through technology, there are still many citizens across the continent using ox-drawn ploughs to till the land, so the real question is, how to do we maximize the use of existing technology and not fall too far behind the rest of the world.

As it stands, 42 countries out of 54 have not even, started thinking about 5G and the ones who are the pioneers, it is still restricted to urban centers. Make no mistake, 5G is highly likely to turn out to be a Strategic Inflection Point in the development of modern societies

“5G is a core foundation, upon which modern societies – their economies and their militaries alike – will rest. [This network of networks] will be essential to how industries compete and generate value, how people communicate and interact, and how militaries pursue security for their citizenry. 5G is potentially one of the most important networks of the 21st century. It is the very definition of critical infrastructure.”

We have to make strategic moves and plan to respond to a world that is set to change forever. My last words to Africa are, “Today is the first day of the future, and one step made in the pursuit of a dream surpasses an infinite number of intentions”.