The Making of a Healthy Backbone: Malawi and e-health

Information and communication technology has become a first order necessity, just behind access to water, electricity, and sanitation. Therefore it is no surprise that governments across Africa are undertaking ambitious infrastructure projects known as backbones, the industry terminology for the layout of long-haul optical fiber at the national level. These backbones are built with the future in mind, designed to consider current and future demand for bandwidth, and planned for anticipated economic growth.

Yet the question may be: why invest in ICT in Africa when other critical services need to prioritized, such as healthcare? On average Africa has only 52.6 physicians per 100,000 inhabitants compared to 300 physicians for OECD countries1, and nearly 40% of the continental population is urbanized2. There is a service gap between densely populated centers, where infrastructures tend to be concentrated, and the needs of the greater rural population. ICT can, however, bridge some of the geographic inequity in the distribution of basic services. For instance, one country has had success with an experimental program at the intersection of ICT and health: Malawi.

Malawi is a country with very limited resources in the realm of healthcare, with high rates of tuberculosis, malaria, and HIV/AIDS affecting its population. And yet over the past decade Malawi has led the way in the implementation of e-health services, through the Electronic Medical Record System (EMRS), a comprehensive health database of individual patients’ records accessible to hospital clerks and clinicians across the country. The successes of the program are multiple: health workers devote less time on administration and spend more time on patients, hospitals administrators can forecast demand in supplies with real time patient data, and policy makers can readily use the database to monitor changes in public health and to appeal to international donors.

Malawi’s e-health initiative predates its backbone, having relied mostly on wireless satellite connectivity, which can be slower and less reliable than fiber. However, the development of a fiber backbone along power lines and roads has been a game-changer. The construction of the national backbone began in 2008, and since then, the telecom sector’s contribution to GDP has increased from 3.5% to 4.5% and the number of internet subscribers has more than tripled3.

Fiber backbones have enabled the growth of telemedicine, or remote healthcare services. It cannot replace the need for hospital beds and medical staff; nor is fiber a prerequisite for the implementation of e-health programs. However, an anticipated benefit of a newly implemented backbone is the expansion of reliable and affordable channels of communication, which can drive further investments into more ambitious and lasting e-health programs. The Malawian government is offering incentives for mobile operators to service rural areas, and supporting this with continued expansion of the national backbone. These developments continue to drive e-health initiatives and the quality of healthcare available in the country, while providing an interesting model for countries facing structural challenges similar to Malawi’s.

Population Density and the Backbone4

In an attempt to identify areas potentially isolated from access to broadband internet, the map below presents the proximity of hospitals to fiber in Malawi within 1km, 5km, and beyond.

Hospitals and Proximity to the Backbone

Description: In green are hospital within 1 km of fiber, in yellow those within 5 km, and in red those beyond 5 km (the furthest hospital being nearly 70 km away from fiber)5

There is a visible concentration of hospitals southeast of Blantyre beyond 5km of the backbone, in an area that is non-negligible in population. However not all hospitals have taken part in the EMRS program (for a comprehensive list, visit the Baobab Health Trust website), and those far from fiber may be relying on wireless networks. Furthermore it may be equally erroneous to assume that all hospitals near fiber have necessarily been connected.

For these reasons, regulators and responsible agencies need to maintain updated records of fiber routes and public infrastructures connected to fiber in order to identify both inadequacies in services and opportunities for investments. InfraNav™, through its comprehensive and accessible database on the state of fiber in Africa, provides the information and tools to assist ICT professionals and infrastructure planners. A healthy backbone is one which provides for core services, from health to education, efficiently and reliably.

Please contact us at to request additional information, ask questions or express interest in our data and InfraNav™.

Fiber Wholesaling: Botswana’s Model for Success

Providing cheap, affordable, and widely available high speed internet is of interest to both a country’s government and private sector. Yet, internet prices across much of Africa are still high, and capacity through fiber is often too expensive for end users to purchase. However, adapting a wholesale model is one method to offset high costs. A wholesaler acts as an intermediate selling fiber capacity to resellers who provide internet to end-users. Wholesalers sell large amounts of capacity at low rates, which operators can purchase instead of constructing new long-haul fiber backbones – the lower costs carry over to end-users.

Botswana, a landlocked country in southern Africa recently implemented new telecommunication policy to encourage wholesale.  Each year thousands of international tourists flock to northern Botswana to experience the country’s pristine wilderness.  Botswana is known for its wildlife – the country is home to over 100,000 elephants, the largest population on the African continent.  The tourism industry has grown, and along with it, the demand for cheap, fast internet at hotels and lodges.  This presented a challenge: Botswana accesses high speed submarine cables via neighboring South Africa and Namibia, and these borders are far away from tourism hubs such as the Okavango Delta and Chobe National Parks. In 2007, state-owned Botswana Telecommunications Company (BTC) completed the Trans Kalahari National Backbone, expanding fiber connectivity into rural areas. However, costs still remained high and many hospitality facilities could not afford last mile connectivity.

To address this problem, in late 2012, Botswana’s government pushed for a wholesale model and split the state-owned Botswana Telecommunication Corporation (BTC) into two separate entities: BOFINET and BTC. BOFINET took ownership over long-haul fiber assets, and BTC would act as a telecom operator. This split was the first step toward the privatization of BTC. BOFINET began to sell wholesale capacity to BTC and private operators like Mascom (MTN) and Orange. As a result, operators could focus on providing end-user/last mile connectivity while using capacity purchased from BOFINET for long-haul connectivity. BOFINET resources could prioritize fiber expansion, upgrades, and the development of a cost-effective, long-term wholesale model.  The results are visible; BOFINET’s establishment has decreased internet tariffs by almost 40% in Botswana.


Figure 1: Botswana’s fiber network, data extracted from InfraNav™ HIP Consult’s interactive fiber database. A preview of InfraNav analytic capabilities is also included; statistic includes completed and under construction fiber.

HIP Consult’s InfraNav™ and its analytical capabilities can be used to assess the effectiveness of the BOFINET network. Our calculations indicate that today, the long-haul portion of the BOFINET network involves approximately 4,300 km of fiber, with approximately 1,000 additional kilometers under construction along the following routes: Sekoma-Tsabong, Sehithwa-Mohembo, and Maun-Ngoma-Kasane. These new links will increase rural internet penetration to approximately 15,000 additional people living within 5 kilometers of BOFINET fiber, resulting in an overall 500,000 people across the entire network. More importantly, the new links will create a fiber loop in northern Botswana, ensuring that resort towns like Kasane, Kazalunga, and Maun will have access even if a fiber is cut.

In the next phase of InfraNav’s development, HIP Consult’s mapping team plans to incorporate other key infrastructure data. In Botswana, hospitality facilities are an important part of the country’s economic infrastructure and require access to fiber to provide high-quality internet to support a thriving tourism industry.  Both hotels and internet providers need to know the distance between a facility and long-haul fiber to help determine the cost of constructing last-mile/end-user connectivity.

Please contact us at to request additional information, ask questions or express interest in our data and InfraNav™.

Regional and Multi-Sectorial Cooperation

The Keys to Fiber Expansion in Western Sahel

Fiber optic networks have the potential to provide higher capacity Internet relative to microwave. However, due to low initial demand and economic uncertainty, internet operators in the Western Sahel (Mauritania, Mali and Senegal) have historically chosen microwave, the lower capacity and cFheaper option. But, increasing demand – both in terms of bandwidth requirements and number of consumers – is stretching the limits of what microwave can provide. In Mauritania the percentage of people with access to the Internet has jumped from 0.5% in 2004 to 6.2% as of 2013 (a compound annual growth rate of 32%). To meet this demand, internet operators, national governments, and international organizations have increased funding for fiber infrastructure expansion.  The result is three regional fiber expansion projects that have emerged in the Western Sahel: the OMVS Network, WARCIP, and the Trans-African Optical Cable. These networks can be viewed in the visualization below.

Figure 1: Fiber optic networks in the Western Sahel. This visualization was extracted from InfraHub™, a fiber map and database developed by HIP Consult.

Figure 1: Fiber optic networks in the Western Sahel. This visualization was extracted from InfraNav™, a fiber map and database developed by HIP Consult.


Incorporating high capacity fiber into large-scale development projects, notably electrification and railways, offers great potential for fiber expansion. Excess capacity can be sold to telecom providers, boosting project revenue while ensuring both present and future capacity needs are meet. The Organisation pour la Mise en Valeur du Fleuve Senegal (OMVS), is a multinational project aimed to develop the Senegal River watershed. OMVS has installed aerial fiber alongside power lines, which is utilized by national telecommunications operators SOTELMA in Mali, Mauritel in Mauritania, and SONATEL in Senegal. By utilizing OMVS fiber telecommunications operators save money, which otherwise would be spent on building separate fiber networks. Thus, regional and private-public sector cooperation can help offset fiber construction costs, while supporting a collective long-term vision of improved internet access for all.


The West Africa Regional Communications Infrastructure Program (WARCIP), a $300 million project, is working to further expand fiber infrastructure in West Africa. In 2013, Phase 2 of WARCIP began with a focus on Mauritania, proposing the construction of a terrestrial fiber cable along the border with Senegal to provide domestic redundancy and optimize regional integration. A fiber cable connection between Nouakchott and Choum in northern Mauritania was also proposed. Current fiber rollout plans in Mauritania involve laying over 2,000 kilometers of new long-haul fiber, providing improved Internet connectivity to rural areas while replacing the existing slower and aging microwave linkages.  Phase 3 of WARCIP plans to expand fiber in Mali by constructing a fiber link between Mopti and Gao, which holds the potential to extend to the Algerian border. Telecommunications providers in Algeria could build a fiber link to the Algerian-Mali border, and lease capacity in Algeria to Malian operators. This would provide a complete fiber connection across the Sahara to submarine cables in the Mediterranean Sea, and onward access to Europe.

Trans-African Optical Fiber Cable

WARCIP projects in northern Mali have experienced delays due to armed conflicts, but major strides have been made in the south. The Malian section of the Trans-African Optical Fiber Cable was completed in February 2014, funded by SOTELMA. The project involved the installation of over 1,000 kilometers of terrestrial fiber between Sikasso and the Mauritanian border, passing through Segou and Bamako, the cable will connect to Mauritel’s network in Mauritania. International connectivity is key for Mali, as the state is landlocked and all fiber capacity must pass through neighboring coastal countries to reach high-capacity submarine cables.

Regional Overview

Fiber optic infrastructure in the Western Sahel is developing with increasing complexity. HIP Consult’s mapping and analytics platform InfraNav™ provides a means to examine fiber expansion, alongside analytics to assess the effectiveness of current and future fiber projects. According to InfraNav’s calculations, over 70% of Senegal’s population lives within 5 kilometers of existing fiber infrastructure. In Mali and Mauritania, the percentage is substantially lower, but progress is being made thanks to the projects discussed. Over 800,000 people live within a 5 kilometers reach of proposed longhaul WARCIP fiber links in Mali and Mauritania.[1] By geographically analyzing fiber supply and demand, InfraNav can help assess the effectiveness of existing and future projects. As fiber continues to expand, HIP Consult’s experienced mapping team will continue to track its growth in the Western Sahel and throughout the continent. We welcome any relevant information, as we are constantly working to maintain the most comprehensive, accurate fiber optic infrastructure database.

[1]                      HIP Consult defines Fiber Reach as a statistic that represents fiber connectivity potential. It shows the number the people who live within 5 kilometers of fiber, which provides a measure of the how many potential customers could request last-mile connectivity from local telecom providers and operators.

Please contact us at to request additional information, ask questions or express interest in our data and InfraNav™.

Introducing: InfraNav™ Insights

Mapping is a tall order. On one hand, the concession stands that no maps are without distortions, and on the other, that the value of a map is in its accuracy. Cartographers have the daunting task of working within these constrictions, while remaining cautious not to misrepresent information. Maps are powerful; they help us to navigate between the mental perception of space and objective reality, distances and destinations—between knowledge and ignorance. Maps are the narratives of the geographies we inhabit and experience.

At HIP Consult we abide by a candid slogan: revealing business. This is our innate mission each time we draw a new map feature. Over the past year our dedicated team of analysts diligently researched, mapped, remapped, reviewed, and analyzed fiber-optics networks per telecom provider in Africa. The end-result is a charted journey across 55 countries to reveal existing and future fiber infrastructure in a rapidly and tumultuously changing continent.

InfraNav™, HIP Consult’s new interactive mapping tool, provides an effective means to track and study the expansion fiber optic networks in Africa using interactive and analytical tools.

InfraNav™ will assist professionals the ICT industry to make better informed decisions regarding the development of Africa’s telecommunication infrastructure. InfraNav™ is a versatile GIS tool that can help with managing the successful implementation of strategic solutions by providing relevant and up-to-date information on:

  • How many people live within a given radius of a fiber network;

  • Where service providers can find collocating opportunities to save on costs and invest in untapped markets;

  • Which passive infrastructures, such as power line grids or railways, are suitable options for future fiber expansion projects; and

  • Where to locate future projects based on demographic trends and forecast demand.

InfraNav™ depicts a distinct story of the emergence, current status, and potential trajectory of the development of telecommunication infrastructures in Africa—the home of more than one billion diverse peoples, and a rich landscape which stretches thrice the size of the contiguous United States. The world is taking notice of the rapid development occurring in Africa. Foreign investments are expected to topple a record $80 billion by the end of 2014, a trend confirmed by the recent commitment from U.S. firms to invest more than $14 billion in sectors varying from banking to information technology. Africa may still be catching up in providing accessible bandwidth to its citizens, yet household Internet access continues to grow by double-digits. Case in point: the number of internet users in Africa has doubled in just the past four years, representing a fifth of the continent’s total population.

As we chart Africa’s connectivity, we will periodically share insights about current projects, impacts, and changes stemmed from the continent’s fundamental transformation in its communication infrastructure. The mapping of African fiber optic infrastructure is not just an exciting story of economic growth; it is an essential asset in understanding the potential for future investment and development in a century of unprecedented flow of information.

Please contact us at to request additional information, ask questions or express interest in our data and InfraNav™ .