India Africa Aligning for the changing global business dynamics

3. From President’s Desk
For centuries India and Africa have enjoyed a very close and cordial
multifaceted relationship. The strong political linkage provides a stable
base against which these two promising economies should strive to
elevate their economic relationship. The India-Africa Forum Summit
would lead to high level discussions and deliberations which will
eventually form the building blocs of long lasting partnerships.
As emerging economies, India and Africa share a lot in common - diverse
natural resources, similar demography, growing middle class, which
provides for a synergy for developing economic cooperation between
the two regions. Economies of India and Africa are complementary
to each other and stand to gain immensely from increased trade and
economic cooperation. Concrete efforts should be channelised towards
identifying and building upon the complementarities between the two
economies.
The total trade between India and Africa reached US$ 71.47 Billion in
2014-15, increasing at a CAGR of approximately 15% since 2009-10.
Africa claimed a share of 10.5% in the total exports of India in 2014-15
and 8.6% share in the total Indian imports in 2014-15, depicting a nearly
constant trend over the last four years. Moreover, Indian investments in
Africa have grown substantially across the continent and sectors.
Africa is increasingly becoming an attractive hub for foreign investors in
the light of various economic, political and social reforms that are being
implemented throughout the continent, resulting in a much improved
business environment which is conducive for foreign direct investment.
Apart from that, there is a widespread development of important social
and physical infrastructure as well as the presence of a large population
of well-educated, English-speaking workers in most countries across
the continent.
I am sure that this comprehensive report on India’s strengths in the
important sectors of infrastructure and healthcare would serve as an
informative guide to African policy makers, researchers and industry
stakeholders.
Alok B. Shriram
President

5. From Chairman’s Desk
‘India-Africa Cooperation in Infrastructure and Healthcare’highlights the
potential India has in these two sectors and how Africa could engage
Indian expertise in creating these facilities in their respective countries.
It gives me immense pleasure and honour to present it to our esteemed
readers.
Economic relations between India and Africa have enhanced greatly in
the last few years, particularly in the areas of – power, energy, healthcare,
ICT, agriculture, education and skill development, but a lot of untapped
potential still exists for the two regions. India has also developed a huge
reservoir of technical manpower through its wide network of technical
training institutes and can help Africa immensely by sharing its expertise
in setting up the infrastructure geared towards the needs of developing
economies.
Much of the dynamism, from the Indian side of the current India-Africa
trade and investment relationship, can be credited to the steps taken
by the Government of India. Initiatives like Focus Africa Scheme, Lines
of Credit projects, Pan-Africa e-network, India’s Technical and Economic
Cooperation Programme (ITEC) lays a roadmap to strengthen our
relationship.
The two sectors covered in the report – Infrastructure and Healthcare
formthepillarsofanycountry’sdevelopment.Foraholisticdevelopment
ofAfrica,issueslikeconnectivity,demandandsupplygap,electrification,
communication, lack of adequate infrastructure, affordable housing,
absence of quality healthcare, lack of trained medical professionals
and presence of life threatening diseases needs timely and sustainable
solutions.
IamsurethereportwouldgivevaluableinsightaboutIndia’scapabilities
and achievements in these sectors and new seeds of cooperation can
be sown between India and Africa.
Sanjeev Sardana
Chairman, International
Affairs Committee for Africa

7. From Co-Chairman’s Desk
India & Africa, the upcoming hubs of economic activities are fast
catching up with the developed economies in terms of global trade
and investment performances. The major trends driving this growth
are changing policy environments, a growing middle class that expects
fair social and economic policies, technology transfers, robust domestic
demand, and rapid mass urbanization amongst others.
The world economy has been witnessing rapid changes and one of the
most important of these changes is the growing share and increasing
role of developing economies. India and Africa are today playing an
active role in the global economy. Many of the economies within Africa
are outpacing economies anywhere else in the world.
Africa has emerged as one of India’s most important development
partners. India’s economic engagements with African countries has
been vibrant, extending beyond trade and investment to technology
transfers, knowledge sharing, and skill development. India has always
expressed optimism regarding the potential of the African continent
and has seen itself as a significant stakeholder in Africa’s development.
India and Africa can gain tremendously from each other, by promoting
bilateral economic ties in a sustainable way. India and African countries
should work together to impart stability to the global economy and
sustain growth in the two economies by leveraging resources, large
unsaturated demand, economies of scale and growing income levels.
In recognition of the growing importance of India-Africa ties and
prospects for closer development cooperation between India and
Africa, the Third India-Africa Forum Summit would open new gates of
partnerships for the two upcoming regions of the world.
Ranjeet Chaturvedi
Co-Chairman, International
Affairs Committee for Africa

9. Acknowledgements
PHD Chamber lauds the initiative taken by the Hon’ble Prime Minister
of India to build economic co-operation through strengthening South–
South Cooperation as now emphasis lie on diversifying our trade basket
and to transform the direction of trade.
I would like to express my sincere gratitude to the Ministry of External
Affairs, Government of India for giving PHD Chamber of Commerce and
Industry an opportunity to be a partner in this historic event.
My sincere thanks to Mr. Navtej Singh Sarna, Secretary (West), Mr. Syed
Akbaruddin, Additional Secretary & Chief Coordinator (India-Africa
Forum Summit), Mr. K Nagaraj Naidu, Director (ITP) and their teams for
their cooperation and guidance at every step of this summit.
I also thank RNCOS E Services Pvt. Ltd. for their efforts in producing
this report on understanding the Indian Infrastructure and Healthcare
SectorsandhowAfricawouldgainfromtheIndianexpertise,particularly
the success stories under the PPP model.
I commend and appreciate the tireless efforts of the PHD International
Affairs Committee for Africa team led by Ms. Shabnam Pareek, Secretary,
International Affairs and assisted by Mr. Abhishek Banwara (Deputy
Secretary), Ms. Aarushi Gautam (Assistant Secretary) & Ms. Komple
Sharma (Executive Officer) in organising the exhibition and seminar on
the side-lines of the Third India-Africa Forum Summit.
I would also like to thank the exhibitors at the Exhibition for showcasing
India’s strengths and contribution in economic development of Africa in
the Infrastructure and Healthcare sectors.
PHD Chamber has always acted as a catalyst in the development of
the nation. I hope this report will enlighten the stakeholders about the
untapped potential for India and Africa.
Saurabh Sanyal
Secretary General

11. 11
Africa is considered to be a land of opportunities. The region has emerged as one of the
major commerce partner for India. This sanguinity is fueled by the fact that Africa is a
natural resource rich continent, having a middle class population larger than that of India,
increasing per capita income and favorable political changes. All these factors suggest that
Africa is all set for an extraordinary journey towards economic expansion. For India, Africa
represents a significantly gigantic and less explored market as the continent offers a huge
market for Indian manufacturing goods like pharmaceuticals and automobiles. India, on
its platter, has enormous expertise in the healthcare, energy and Infrastructure sectors.
Consumer spending in Africa is poised to reach US$ 1.8 Trillion by 2020.
Modigovernment’sinitiativessuchasbuildingSmartCities,DigitalIndiaandtransforming
India into World’s Manufacturing Hub, social welfare schemes such as“Indradanush”which
aims to immunize all children against preventable disesases can be a great learning
opportunity for Africa to implement some of the successes in their countries.
Owing to world class engineering and technological advancement, the infrastructure
sector in India has seen significant growth in the recent years. There have been major
developments in infrastructure in terms of construction of highways (the Golden
Quadrilateral), Airports (Indira Gandhi International Airport) and Biotech parks (Shapoorji
Pallonji). On the other hand, air and road transports in Africa are expensive; connections
are patchy, and unsafe. Also, their ports are not well developed to attract calls from foreign
shipping lines. These aforementioned challenges require a significant amount of work.
Leading Indian infrastructure companies should develop several highways and roads in a
number of African countries to improve connectivity.
The Indian Energy sector is responsible for the growing industrial base, urbanization,
as well as improvement in the standard of living. Various development projects have been
undertaken by the government and private players in India such as Electricity Distribution -
North Delhi, National Hydrogen Energy Roadmap and Rooftop Solar PV System. Conversely,
Africa is far behind India in terms of electricity generation, in spite of plethora of fossil fuels
and renewable resources. The African nations suffer from huge power outages and poor
backups. India should make investment in Africa’s energy sector to help Africa reduce its
dependence on imports.
Similarly, healthcare sector in India has successfully implemented PPP projects for
remote healthcare (telemedicine network) and primary healthcare (ambulatory services),
particularly to provide healthcare services to the people living in rural areas in the country.
India has become one of the leading destinations for high-end diagnostic services with
tremendous capital investment for advanced diagnostic facilities, thus catering to a greater
proportion of the population. On the other hand, healthcare facilities in Africa are poor to
the extent that medical facilities are not available to the people living in tribal areas.
Indian companies/universities/hospitals can supply the required products like generic
pharmaceuticals, and services including healthcare, and technological support, to the
citizens of African nations. There exists a huge potential for mobile health. India should
expand its presence in the continent through Pan Africa e-network used for providing tele-
medicine and tele-education facilities to the African nations by deploying more hospitals
to the existing network.
Introduction1

12. The Group comprises of the following
companies :
LuckyExports
Expotec International Pvt. Ltd.
Coppice Technologies Pvt. Ltd.
Contactus at:
LOGIX TECHNO PARK, TOWER – C,
GROUND FLOOR, PLOT NO – 4 & 5,
SECTOR - 127, NOIDA (U.P) – 201301 (INDIA)
PHONE NOS. - (91) (120)-4745200/201;
FAX: (91) (120) 4745233,
EMAIL: info@expotecint.com
Web: www.luckygroupcompanies.net
Expotec International Pvt. Ltd., a Lucky
Group Company, is one of India’s leading
Engineering, Procurement and
Construction (EPC) Contracting Company
providing Design, Engineering,
Procurement, Construction and
Commissioning services to the needs of
discerning clientele worldwide.
With the synergy of the vast engineering
expertise, available resources and latest
technologies in diverse realms, the
Company’s multi-discipline expertise is
ably serviced by its well experienced
professionals under strategic business
units such as :
Industrial Projects Division
Energy Division
Transportation & Infrastructure Division
Agro Technology Division
Education & Healthcare Division
Information Technology
International Presence
Benin, Burkina Faso, Chad, Ethiopia,
Eritrea, Ghana, Guinea Conakry, Ivory
Coast, Lao PDR, Lesotho, Madagascar,
Malawi, Mali, Myanmar, Russian
Federation, Rwanda, Sudan, Senegal,
Sierra Leone, Tanzania, Togo, Uganda,
United Arab Emirates, Zambia

13. 13
Infrastructure Sector
Infrastructure sector is an essential driver for the Indian economy. The sector is highly
accountable for impelling India’s overall development. It receives intense focus from the
Government for initiating policies that would ensure time-bound creation of world class
infrastructure in the country. Infrastructure sector includes power, bridges, dams, roads,
telecom and urban infrastructure development.
Public expenditure on infrastructure in India in terms of percentage of GDP has increased
consistently since 2008. In 2014, the infrastructure expenditure was estimated at around
10.1% of the total GDP as compared to that of 7.54% in 2008. The government of India
is expected to rely heavily on the private sector for both capital and expertise, with PPP
projects being the favored route for both parties in the coming future.
India’s infrastructure is the backbone of India’s overall growth and development. The
Indian government continues to provide its strong support for the development and
progress of this sector. The Indian road network of 33 lakh kilometers is the second largest
in the world. In the recent years, massive road development projects undertaken by private
companies and foreign investors throughout the country have resulted in the creation of
new roads and highways that have been built to accommodate multi-lane systems.
India’s civil aviation sector is on a high-growth path. India aims to become the third-
largest aviation market by 2020 and the largest by 2030. Total passenger carried in June
2015 has increased 13% YOY. The private sector is being encouraged to become actively
involved in the construction of airports through different Public Private Partnership
models, with substantial state support in terms of financing, concessional land allotment,
tax holidays and other incentives. FDI inflows in air transport between 2000 and 2015 stood
at US$ 573.18 Million.
Source: Planning Commission
Figure 2‑1: Core Infrastructure Investment in Eleventh
Plan (2007-2012)
Electricity
Roads & highways
Railways
Irrigation
Water supply
Ports
40%
13%
13%
25%
7%
2%
2

14. 14
India Africa Aligning for the Changing Global Business Dynamics
Additionally, due to the high growth and expansion in IT, the telecom sector has opened
up for privatization thereby making it a highly competitive sector. Almost everyone,
including rural sections of the population have more than just basic telephone accessibility
these days.
Africa - Current Status & Challenges
Africa’s infrastructure sector has reported new frontiers of growth in the recent years
backed by the sound economic policies, debt relief, stronger institutions and high
investments. Africa’s investment in infrastructure accounts for more than 50 % of the recent
improvement in economic growth in Africa, and it has the potential to achieve even more.
Despite its colossal mineral and other natural resources, Africa has serious infrastructural
shortcomings across all the subsectors: energy, water, sanitation, transportation, and
communications technology.
In most African countries, particularly the low income countries, infrastructure is a major
constraint on doing business, and reduces firm’s productivity by around 40%. Additionally,
power emerges as the most restrictive factor in Africa, as it reduces the productivity of
manufacturing sector in the continent.
Additionally, air and road transports in Africa are expensive; connections are patchy,
and unsafe. In many countries, road maintenance remains inadequate. Only 30% of the
rural Africans have access to roads. Further, the ports in the continent have been largely
deregulated, many African countries maintain high port tariffs that discourage traffic and
increase costs. Other operational and regulatory bottlenecks also slow traffic through
Africa’s ports. Many are not large enough to attract direct calls from international shipping
lines, underscoring the importance of developing regional transshipment hubs. Policy
solutions include adopting a landlord port system that embodies international best
practices.However,IndiacanhelpAfricatodevelopitsoverallinfrastructurebycollaborating
with leading Indian engineering and consulting companies that can develop world class
infrastructure. Indian construction companies can deploy significant investments in
construction domain.
Mega PPP Projects in Infrastructure Sector as Success Stories
Metros
Delhi Metro
The total distance covered by Delhi Metro has increased from 25 km in 2002 to 208 km till
September 2015. The system has been certified by the United Nations as the first metro rail
in the world to get“carbon credits for reducing greenhouse gas emissions" and helping in
reducing pollution levels.
Bangalore Metro
It is a major environment friendly addition to the Bangalore City as it significantly
contributes to the reduction of carbon emissions. The first phase of its network consists of
two corridors: Purple line running east-west and a green line running north-south. 19.1 km
of the 42 km phase-1 is operational currently and the rest is under construction.
Mumbai Metro
The Metro Master Plan for Mumbai Metro has been prepared to provide a rail based mass
transit facility to people residing in the areas that are not connected by existing Suburban
Rail System so as to enable them to reach the stations within the distances of 0.5 to 1 km.

15. 15
India Africa Aligning for the Changing Global Business Dynamics
The rail system will provide proper interchange facilities for connecting neighboring areas
of Thane, Navi Mumbai, Vasai, Virar etc.
Airports
Cochin International Airport
It is the first airport in the country which would be operating on solar power. It is expected
that when the photovoltaics (PV) panels laid across 45 acres near the cargo complex
become functional, Cochin airport will have 50,000 to 60,000 units of electricity per day
to be consumed for all its operational functions, which will technically make the airport
"absolutely power neutral".
Chhatarpati Shivaji International Airport (CSIA) – Mumbai
Modernization and redevelopment of GVK CSIA, Mumbai is a reflection of India’s rapid
growth.Itsdirectimpacthasbeenseeninanincreaseinjobsandincomedirectlyoriginating
from construction or its operations. During the year 2014-15, GVK CSIA is expected to have
contributed 3.5% to Maharashtra’s GDP, and 0.5% to the country’s GDP, with a total income
of INR 38,900 crore (US$ 6 Billion). Additionally, the new integrated Terminal 2 at the CSIA
increases the airport’s capacity to service 40 Million passengers and one Million Tons of
cargo annually.
Indira Gandhi International Airport T-3 Terminal- Delhi
In the year 2010, it became India's and South Asia's largest aviation hub. Also in the same
year, during the Commonwealth games, the airport saw 244,795 aircraft movements and
handled 473,218 Metric Tons of cargo. In 2015, Airport Council International (ACI), the only
global association of world airports, ranked the IGI Airport as the best in the world among
those handling 24-40 Million passengers annually.
Roads and Highways
Golden Quadrilateral
It is the largest highway project in India and in the year 2009, the four-laned highways
of Golden Quadrilateral were converted into six-lane highways. Districts that lie zero to
10 km from the its network experienced a substantial increase in the output of organized
manufacturing sector.
The Yamuna Expressway Project
The expressway included the building of new six lane roads, extendable up to eight lanes,
therebyreducingthetraveltimetoonly100minutes,whichwasearlierninetotentravelling
hours by road. The total length from Zero Point Greater Noida up to Agra is 165.5 Km.
Container Terminals
Nhava Sheva International Container Terminal (NSICT) project included construction of a
two-berth terminal, reclamation of 20 hectares of area for container yards, installation of
requisite container handling equipment and other facilities, with a projected capacity of
0.6 Million Twenty Foot Equivalent Unit (TEU) containers per annum.
Biotech Park
Shapoorji Pallonji Biotech Park was set up to identify and develop the facilities for
biotech entrepreneurs. About 17 companies have already set up their units at the Park,

16. 16
India Africa Aligning for the Changing Global Business Dynamics
making an investment of about INR 400 crore (US$ 61 Million). Several states have started
following suite and are making conscious efforts to create a conducive environment to
attract entrepreneurs to set up their units and leverage on the vast talent pool and rich
biodiversities in their respective areas.
Railways
In 2015, India proposed an ambitious rail budget, proposing to invest almost US$ 16 Billion
in rail projects. In 2014, it had liberalized the sector to permit foreign direct investment of
up to 100% across a range of rail assets. Additionally, the High Speed Rail Corporation of
India Limited was incorporated in October 2013 for high-speed rail projects.

18. ADD_2.indd 1 19-10-2015 16:58:53

19. 19
Energy Sector
India has emerged as one of the fast growing economies in the world, having recorded
an annual average growth rate of 8% during the last four years. The energy sector holds
the key in accelerating India’s economic growth. India’s energy sector has a mix of all the
resources available, including renewables. Coal is the leading source of energy and its
dominance in the energy mix is likely to continue in foreseeable future. In the year 2014,
India’s coal accounted for 56 % of the total energy demand.
Source: Ministry of Statistics and Programme Implementation (MOSPI)
Figure 3‑1: Per Capita Energy Consumption in India
(Mega Joules), 2008-2014
India’s core strength in energy sector lies in renewable source of energy. The Indian
power sector has achieved a lot over the last decade in the areas of policy reforms, private
sector participation in generation and transmission and new manufacturing technology
and capabilities. The State governments have strengthened their alliances with more
private sector participants in order to promote growth in this sector. Bharat Heavy
Electricals Limited (BHEL) is the country’s largest energy and power infrastructure provider
and continues to undertake huge efforts to meet the nation’s demands in this sector.
In the 12th five year plan, India has planned to add close to 75 GW of power generation
capacities. The huge capacity addition plan also offers opportunity for developing
evacuation capacities and supply related OEMs like conductor manufacturing, insulator
manufacturing, tower fabrication and EPC.
India’s power sector is one of the most diversified in the world. Sources of power
generation range from conventional sources such as coal, lignite, natural gas, oil, hydro and
nuclear power to viable non-conventional sources such as wind, solar, and agricultural and
domestic waste. Electricity demand in the country has increased rapidly and is expected to
rise further in the years to come. Additionally, around 293 global and domestic companies
have committed to generate 266 GW of solar, wind, mini-hydro and biomass-based power
inIndiaoverthenext5–10years.TheinitiativewouldentailaninvestmentofaboutUS$310-
350 Billion. Also, a joint Indo-US PACE Setter Fund has been established, with a contribution
of US$ 4 Million from each side to enhance clean energy cooperation.
15400 15840
18040 18480 18920 19800 19360
2008 2009 2010 2011 2012 2013 2014
3

20. 20
India Africa Aligning for the Changing Global Business Dynamics
Africa - Current Status & Challenges
Although the African continent is well endowed both with fossil fuels and renewable
resources, these are not evenly distributed, creating windfall profits for some countries
and exacerbating the crisis in others. Chronic power problems impede growth and
productivity in more than 30 African countries. Inadequate generation capacity, limited
electrification, low demand for power, unreliable service, and skyrocketing prices cause
serious bottlenecks in the power sector.
24% of the population of sub-Saharan Africa has access to electricity as compared to
40% in other low income countries. Excluding South Africa, the entire installed generation
capacity of sub-Saharan Africa is only 28 GW, equivalent to that of Argentina. Also, African
manufacturing enterprises experience power outages on average 56 days per year. As a
result, firms lose 6% of sales revenues in the informal sector.
Wind and solar power generation projects are also dependent largely on subsidies
and government support. The majority of its resources are underutilized due to shortage
of skilled manpower and advanced technology. Therefore, Indian companies have vast
opportunities to explore the underutilized resources of the continent which could benefit
both the regions in future.
Mega PPP Projects in Energy Sector as Success Stories
Electricity Distribution - North Delhi
This project has successfully reduced the power outages in North Delhi. These have come
down from up to five hours a day to nearly zero. Since 2002, the project has brought
aggregate technical and commercial (AT&C) losses down from 53% to 12%. The cost of
distribution has reduced from 122 paise per unit in 2003, to 2 paise per unit 2012, despite
double-digit inflation, hikes in salaries and other operational expenses.
Energy Efficient LED Street Lights in Agartala City
This initiative has saved 875 KW of total energy per day in the city. The government’s
immediate goal is to generate two Trillion Units (kilowatt hours) of energy by 2019. This
Source: IBEF
Figure 3‑2: Energy Consumption Pattern in India (2014)
Coal
Oil
Natural gas
Hydro electric
Renewable Nuclear energy
56%
28%
7%
5%
2% 2%

21. 21
India Africa Aligning for the Changing Global Business Dynamics
means doubling the current production capacity to provide 24x7 electricity for residential,
industrial, commercial and agriculture use.
Renewable Energy
Renewable energy is becoming a mainstream source of power across the world. Continued
technological advancement, reduced cost of modules and investment in utility has helped
reduce the cost of renewable energy. Some of the mega PPP projects in the renewable
energy sector in India are: Hydrogen power generation station at various dams, Installation
ofWindmills, National Hydrogen Energy Roadmap, Rooftop Solar PV Systems Project,Water
supply and management etc.
National Hydrogen Energy Roadmap
The project was undertaken to reduce India’s dependence on imports of petroleum
products, promote the use of diverse, domestic and sustainable new and renewable energy
sources and promote the use of hydrogen as a fuel for transport and power generation.
After the success of Indian Oil H-CNG dispensing station at the Faridabad R&D Centre, IOCL
set up another H-CNG dispensing station at its retail outlet at Dwarka, Delhi in the year
2009.
Solar Energy
Rooftop Solar PV System reduces the requirement of land for addition of solar capacities,
dependency on grid power and diesel generator dependency. Numerous states in India
have already adopted this system, with the first in the row being Gujarat, which initiated the
5MW Rooftop Project in Gandhi Nagar, providing better access to power for an estimated
10,000 people. Besides adding power generation capacity, the project reduces more than
7 Million Metric Tons of greenhouse gas emissions annually.
Wind Energy
Installation of windmills was proposed by Indian Railways in collaboration with various
private players in 2013 to generate electricity by installing a 25 MW wind energy plant
near Jaisalmer in Rajasthan. The Indian railways use over 4,000 MW power to operate its
network. Installation of windmills will reduce railways’ energy dependence from state-
owned power distribution companies by developing large scale in-house capabilities that
would also help in reducing the overall energy bill from current levels of INR 8,700 crore
(US$ 1.3 Billion) annually.
Biomass Power
The Biomass Power Generation Project was started in 2010 by the Punjab Energy
Development Agency (PEDA) in collaboration with various private players to generate
power in an environmental friendly manner, in various districts of Punjab. Punjab has
substantial availability of Biomass/Agrowaste, which is sufficient to produce about 1000
MW of electricity. PEDA has planned to develop some of the available potential talukas/
tehsils with the aim to promote and install biomass/agro waste based projects. PEDA has so
far allocated 30 sites/tehsils for setting up of total 332.5 MW capacity Biomass/Agrowaste
based power projects under three phases.

23. 23
Healthcare is one of India’s largest and crucial sectors as it generates huge revenue and
employment. It comprises hospitals, medical devices, clinical trials, telemedicine, health
insurance and medical tourism. The healthcare sector in India is growing at a rapid pace
due to its strengthening insurance coverage, services and increasing expenditure by public
as well private players. In 2008, the overall Indian healthcare expenditure was US$ 45 Billion
and had grown to US$ 81.3 Billion in 2014, at a CAGR of around 10.4% during the period
2008-2014.
Healthcare expenditure is a crucial expenditure for any country and the per capita
expenditure on health in India has been increasing since 2008. The growth in per capita
healthcare expenditure has provided a strong tailwind to the overall healthcare sector
in the country, having increased by 42% in 2013 as compared to that of 2008. Public
expenditure on health in India in terms of percentage of GDP has not increased in the last
couple of years.
In 2013, the healthcare expenditure was 4% of the total GDP. It covers the provision of
health services (preventive and curative), family planning activities, nutrition activities, and
emergency aid designated for health.
The Indian healthcare sector is split into five segments: Hospitals, Pharma, Medical
Equipment & Suppliers, Medical Insurance and Diagnostics. In 2012, the healthcare sector
in India generated its maximum revenue from hospitals, which are further segmented into
government and private hospitals.
The Indian healthcare sector is backed by the large pool of well trained professionals,
doctors, ample research and development programmes. The country has also become
one of the leading destinations for high-end diagnostic services with tremendous capital
investment for advanced diagnostic facilities, thus catering to a greater proportion of the
population. The hospital and diagnostic centers attracted Foreign Direct Investment (FDI)
worth US$ 3.14 Billion between 2000 and 2015.
Healthcare Sector
Source: IBEF
Figure 4‑1: Healthcare Expenditure in India (Billion US$),
2008-2014
2008 2009 2010 2011 2012 2013 2014
45.0
51.7
59.5
68.4
72.8
77.0
81.3
4

24. 24
India Africa Aligning for the Changing Global Business Dynamics
Source: IBEF
Figure 4‑2: Break-up of the Healthcare Sector (2012)
In the last decade, public sector in India has gained momentum with the adoption of
the Millennium Development Goals (MDGs) as the government set target to reduce the
maternal mortality rate by three quarters between 1990 and 2015 to eliminate the spread
of HIV/ AIDS, malaria and other major diseases. It is noteworthy that Polio has already been
eradicated in India and initiatives have already been taken to eradicate Tuberculosis (TB)
from the country.
Africa - Current Status & Challenges
Sub-Saharan Africa claims 11% of the world’s population and accounts for 24% of the global
disease burden. In Sub-Saharan Africa it is anticipated that the demand for health care is
likely to reach a market value of US$ 35 Billion by 2016. This surge in demand and ensuing
growth has resulted in the creation of colossal opportunities for the healthcare sector
players. With an estimated 500,000 - 650,000 hospital beds to be built in the next decade,
and the resulting demand in hospital equipment, medical devices and pharmaceuticals,
the healthcare sector in the Sub-Saharan African continent is poised for substantial growth.
There are many diseases which are prevalent in African nations and often prove
fatal when they are not treated swiftly and efficiently. Some of these diseases include
tuberculosis and HIV/AIDS. Other diseases such as African sleeping sickness, are specific
to the African continent. Particularly, Africa has been hardest hit by the HIV/AIDS, although
in the recent times on account of meliorated access to anti-retroviral treatment, the HIV/
AIDS incidence rates have started plummeting. Nevertheless, the death toll of AIDS still
claims nearly one Million lives every year in sub-Saharan Africa. On the other hand, parasitic
disease such as Malaria is also widespread and leads to death of one African child every 30
seconds. Malaria is the leading cause of death amongst children below 5 years of age in
many African countries. Moreover, Polio, now eradicated from several parts of the world,
is still endemic in Nigeria and outbreaks reportedly occur in other African nations as well.
Mega PPP Projects in Healthcare Sector as Success Stories
Pharmaceuticals
Jan Aushadhi Scheme
The prices of medicines at Jan Aushadhi Stores are around 5 to 10 times less than that
of market price. The number of medicines listed for sale at the Jan Aushadhi stores has
Hospitals
Pharma
Medical
equipment
& suppliers
Medical
insurance
Diagnotics
71%
13%
9%
4%
3%

25. 25
India Africa Aligning for the Changing Global Business Dynamics
increased from 319 in 2008 to 504 in the year 2015. Jan Aushadhi Stores have been opened
across the States of Punjab, Haryana, Odisha, Andhra Pradesh, Rajasthan, Delhi, Uttrakhand,
West Bengal, Jammu & Kashmir, Himachal Pradesh, Jharkhand and the UT of Chandigarh.
2015- The Year of API - Make in India
This initiative encourages Indian players to manufacture API in India rather than relying on
imports. The Government is setting up the National Institute of Pharmaceutical Education
and Research at 6 new places across the country. This is being done to strengthen the skill
base and fill the gap in research and development of APIs.
Remote Healthcare
Telemedicine is one of the key initiatives to improve healthcare services for the people
living in rural parts of India. It improves access to quality specialty care and reduces both
time and cost, improving the quality of health care through timely diagnosis and treatment.
The most important aspect of tele-medicine is the digital convergence of medical records,
charts, x-rays, histopathology slides and medical procedures (including laboratory tests)
conducted on patients. Some of the mega PPP projects undertaken in Telemedicine field
are as follows:
Karnataka Integrated Tele-medicine and Tele-health Project (KITTH) for Car-
diac care
It is an on-line health-care initiative in Karnataka for cardiac care using ISRO satellite. This
project functions in the Coronary Care Units (CCU) of selected district hospitals that are
linked with the Narayana Hrudayalaya hospital. Each CCU is connected to the main hospital
to facilitate investigation by specialists after ordinary doctors have examined patients.
Since 2002, over 53,000 patients have been treated in the remote locations.
Telemedicine Centers in Haryana and Rajasthan for Cancer and Ophthalmo-
logical Treatment
Telemedicine centres were opened in Gohana in Haryana and in Kaithun in Rajasthan in
2007 by the state governments of Rajasthan and Haryana in collaboration with Sir Ganga
Ram Hospital (SGRH), Delhi. It is an initiative to provide primary healthcare and treat and
examine the eye problems and cancer among women in the remote areas of Haryana and
Rajasthan through satellite courtesy the Indian Space Research Organization (ISRO).
Telemedicine Centre in Odisha for Diabetic and Oncological care
The global pharmaceutical giant Biocon collaborated with Odisha Trust of Technical
Education and Training (OTTET), Planning Commission and Public Health Foundation of
India in 2014, to establish eHealth centres as well as diabetic and cancer centres in the
under-served areas of the State. The eHealth centres are ICT-based establishments linked
with PHCs to augment existing health infrastructure.
Primary Health Care
Primary Healthcare is the first level of care provided by health services and systems with
trained personnel. It includes health promotion, illness prevention, treatment and care of
the sick, community development, and advocacy and rehabilitation. Some of the mega
PPP projects undertaken in Primary healthcare field are as follows:

26. 26
India Africa Aligning for the Changing Global Business Dynamics
108 Emergency Ambulance Service
This initiative provides emergency response services, particularly attending to health
situations relating to pregnant women, neonates, parents of neonates, infant and children.
Theinitiativehasnowbeenspreadto29states/UTs.Additionally,thenumberofambulances
has increased from 101 in 2008 to 649 in 2014 and the total emergency cases addressed by
the service have increased from 42,343 in 2009 to 56,970 cases in 2014.
Mobile Health Vans in Uttrakhand
Mobile vans are set up to improve access to health services for people living in hilly
areas, who do not have access to nearby healthcare facilities. These vans are fitted with
medical equipments to provide health services including RTI and STI diagnosis, IUCD
insertion, general physician consultation, immunization, obstetric and gynecological
examination, antenatal and postnatal care, blood and urine tests, X-ray, ECG, ultrasound
and immunization.
Primary Healthcare Centres in Gujarat
The focus of the initiative is to provide primary healthcare services, especially to women,
children & elderly. These services are strongly supported by a well-equipped modern
laboratory,X-rayandultra-sonographyunitsalongwithoperationtheatresandappropriate
blood storage facility.

27. The Group comprises of the following
companies
Lucky Exports
Expotec International Pvt. Ltd.
Coppice Technologies Pvt. Ltd.
Contact us at:
LOGIX TECHNO PARK, TOWER – C,
GROUND FLOOR, PLOT NO – 4 & 5,
SECTOR - 127, NOIDA (U.P) – 201301 (INDIA)
PHONE NOS. - (91) (120)-4745200/201;
FAX: (91) (120) 4745233,
EMAIL: info@luckyexpindia.com
Web: www.luckygroupcompanies.net
Lucky Exports, a Lucky Group Company, is
one of India’s leading Engineering,
Procurement and Construction (EPC)
Contracting Company providing Design,
Engineering, Procurement, Construction
and Commissioning services to the needs
of discerning clientele worldwide.
With the synergy of the vast engineering
expertise, available resources and latest
technologies in diverse realms, the
Company’s multi-discipline expertise is
ably serviced by its well experienced
professionals under strategic business
units such as :
Industrial Projects Division
Energy Division
Transportation & Infrastructure Division
Agro Technology Division
Education & Healthcare Division
Information Technology
International Presence
Benin, Burkina Faso, Chad, Ethiopia,
Eritrea, Ghana, Guinea Conakry, Ivory
Coast, Lao PDR, Lesotho, Madagascar,
Malawi, Mali, Myanmar, Russian
Federation, Rwanda, Sudan, Senegal,
Sierra Leone, Tanzania, Togo, Uganda,
United Arab Emirates, Zambia

28. For more information contact: www.invest.mp.gov.in

29. 29
}} Lines of Credit: The Government of India (GOI), in 2003-04, formulated the Indian
Development Initiative (IDI), now known as Indian Development and Economic
Assistance Scheme [IDEAS] with the objective of sharing India’s development
experience by extending concessional Lines of Credit (LOCs) routed through Exim
Bank to developing partner countries towards creating socio-economic benefits in
the partner country. More and more African countries should reap benefit under this
initiative.
}} Leading Indian Construction Companies Should Make a Move: African
companies by collaborating with leading Indian engineering and consulting
companies can develop world class infrastructure. These companies can deploy
significant investments to construct roads, rail lines and ports in various African
nations.
}} Focus on Challenging Infrastructure Projects: Taking example from RITES and
WAPCOS (for establishing railway corridors and water resource management
respectively), more public sector firms can execute some of the most challenging
infrastructure projects in Africa.
}} Signing MoUs/BITs and Preferential Agreements: More and more Indian firms/
hospitals/institutions etc. should sign MoUs with African their counterparts, so as
to facilitate the delivery of healthcare, infrastructure, energy, technology and other
much required services and products. Furthermore, government on both sides
should sign additional treaties, as it cushions the reliability, trust, financials, and
other trade related aspects for traders across the countries. So BITs can certainly
afford and provide the protection needed by Indian companies looking to invest in
other African countries. Apart from BITs and MoUs, preferential trade agreement is
another way of facilitating trade between the continent of Africa and India. Moving
in the same line, both India and Africa agreed for early finalization of the India and
SACU preferential trade agreement in order to secure the economic progress of
both the developing regions against fluctuations in the Western countries. Such
agreements are likely to expedite the cooperation in areas including infrastructure
and human resource development, thereby enhancing economic ties.
}} Implementation of Energy Efficient Projects: In order to iron out bottlenecks
of Africa’s energy sector, African nations, with the help of Indian companies, can
take crucial steps for reducing power cuts and enhance system reliability in a cost
effective manner which can further lead to an increase in manufacturing output.
Many public sector firms can follow suit of ONGC and CIL (for production of natural
India-Africa Strategic
Partnership: Some Specific
Areas of Cooperation
5

30. 30
India Africa Aligning for the Changing Global Business Dynamics
gas and coal respectively) and can successfully execute energy efficient projects in
Africa.
}} Establishment of Healthcare Institutions/ Colleges/ Hospitals: More number
of medical colleges and hospitals can also be established to have an ample supply
of medical professionals and healthcare services as there are many diseases which
are prevalent in African nations and often prove fatal as they are not treated swiftly
and efficiently in the existing hospitals.
}} EnhanceTelemedicine Network: Major hospitals of India can be empanelled and
more remote/mobile healthcare centers can be established in order to enhance
the telemedicine network in Africa. Additionally, there exists a huge opportunity
in terms of e-health as the number of internet users is increasing on the continent.
Therequirementforcontentdevelopment,mobile/tabapps,realtimetelemedicine
devices, and network setup is substantial as it can prove to be a time leap for the
African nations.

36. Head Office: 3/101, Kaushalya Park, Hauz Khas, New Delhi-110016.
Tel. : +91 11 43577777 I Email : enquiry@yamunapower.com
www.yamunapower.com
CELEBRATING
YEARS
Jointing Global Power Supply
Our systems solutions, always, help enhance product performance.

38. Organised by International Affairs Committee for Africa

40. A - 142, Second Floor,
Sector 63, Noida - 201301, INDIA
 : +91 - 120 - 4224700/ 01/ 02/ 03, Ext: 203/ 208
 : +91 - 120 - 4224707
: marketing@rncos.com
: www.rncos.com
PHD House, No. 4/2, Siri Institutional Area,
August Kranti Marg, New Delhi 110016, INDIA
 : +91 - 11 - 26863801-04, 49545454
 : +91 - 11 - 26855450, 49545451
: phdcci@phdcci.in
: www.phdcci.in