MAPUTO, 25 October 2010 (IRIN) - Delayed test results often mean HIV patients in Mozambique fail to get timely

treatment, but new technology is reducing the need to send tests to far away laboratories, and speeding up test results and HIV treatment. Mozambiques Ministry of Health has increasingly begun experimenting with new technology to make diagnosing and monitoring HIV patients quicker and easier. After a successful 2009 pilot the country has nationally rolled out SMS or text message printers, which transmit the results of infant HIV tests electronically from two central reference laboratories in Maputo and the northern provincial capital, Nampula, to more than 275 health centres. Previously test samples and results would have taken on average three weeks, and up to several months to be transported to and from clinics via car, plane and even kayak in remote parts of the country. According to research conducted by the Ministry of Health and the Clinton Health Access Initiative (CHAI), who developed the technology, the time it took for clinics to receive test results from reference labs dropped from an average of about three weeks to about three days after the printers were introduced. Research presented by the Ministry of Health and CHAI at the International AIDS Conference 2010 in Vienna, Austria, showed that this, in turn, reduced the time it took to start infants on antiretroviral (ARV) treatment as part of national prevention of mother-to-child (PMTCT) HIV transmission services by about four months. The number of infants starting treatment also increased by 60 percent. How the technology works: Clinics collect dried blood spot samples from infants and transport them to the nearest reference lab, where technicians conduct the HIV tests. Results are entered into a database and uploaded onto an online server, which then uses a wireless phone network to transmit results back to clinics. These clinics receive a small, receipt-like print out of the results alongside a patient identification number. With interruptions in electricity and wireless network signal, the system has an added failsafe - if printers are offline, results are safeguarded in an online queue until the printer is available. The printer's small size also makes storage easy in space-constrained clinics, which must also ensure that the printer is kept in a secure room to guarantee patient confidentiality. Clinic-based, or point-of-care (PoC), CD4 count machines - vital to measuring an individual's readiness to start antiretroviral treatment - will also be rolled out to selected clinics by the end of November 2010, following positive results from a seven-site trial. Greater efficiency The introduction of a SMS printer to a Matola city clinic, about 30 minutes outsideMaputo, has not only meant that babies who test HIV-positive can be started on ARVs sooner - a potentially life-saving intervention - but also reduced the numbers of new mums who disappear from the clinics PMTCT programme during the long wait times or after having spent time and money on multiple clinic visits to check for results.

According to Mozambiques 2010 report to the UN General Assembly Special Session on HIV/AIDS (UNGASS), about 30 percent of babies born to HIV-positive mothers contract the virus, but only about 14 percent of these babies are tested for HIV before the age of 18 months. Without treatment one-third of HIV-positive babies will die in their first year of life, and almost half by the age of two, the UN Children's Fund (UNICEF) says. The clinic in Matola was also one of initial sites to pilot the PoC CD4 count machine. Smaller than a cash register, it has decreased the wait time for a CD4 count from one week to about 20 minutes, according to lab technician Gerardo Cumbane, who received one day of training on how to operate the new equipment. As many doctors are hesitant to start patients on ARVs without evidence that their CD4 counts have dropped below 250 - the threshold for treatment initiation in Mozambique - the faster results mean quicker access to the life-prolonging drugs. Currently, the CD4 count machines cost about US$5,000 each. Adaptation Ilesh Jani, head of the Department of Immunology at the Mozambican National Institute of Health, has led the push for new technology within the health system, along with a young team at the department. While he said that the same technology used by the CD4 count machines may be used to diagnose other disease like malaria in the future, he cautioned that many new technologies are not plug and play. The way the new technology changes patient flows and health workers case loads can have significant ripple effects, impacting everything from the way clinics are built to the demand for drugs. Jani said that other developing countries wanting to introduce new or PoC technology will need to consider everything from the size of waiting rooms to equipment durability. Most technologies that we work with are created in the Western world and sometimes the people designing [them] dont really know the field, he told IRIN/PlusNews. Theres a lot of dialogue that has to happen between us and the people who produce the technology. In the case of Mozambique, the Ministry of Health and its implementing partners learned

Theres increasing talk about this type of technologys use in TB...theres a revolution that is going to happen and we need to be ready for it

some interesting lessons along the way. For instance, the lancets originally used to collect blood for use in the CD4 count machines had to be substituted for lancets that could more easily draw blood from the calloused hands of many rural Mozambican patients. Similarly, technicians had to adapt the way they drew blood as well. In rural areas with poor mobile phone uptake, technicians also needed more training to feel comfortable with the cell phone-like keypad of the CD4 machines. And implementing partners also found that printers in dry, dusty areas need more regular maintenance than initially thought. The country also found that the introduction of new technology drove up the demand for drugs at some facilities that were initiating more patients, more quickly. As a result, the entire drug supply chain had to be examined to ensure it could cope. After feeding back some of this information to product developers, who improved product design, the Ministry of Health is also working on establishing criteria to evaluate emerging technology, Jani told IRIN/PlusNews. In the field of HIV, well most likely be seeing instruments for viral load testing; theres increasing talk about this type of technologys use in TB, he said. Theres a revolution that is going to happen and we need to be ready for it. llg/ks/cb

Since beginning work in Mozambique in December 2005, I-TECHs main objective has been to provide technical support to the Ministry of Health (MISAU) to address the shortage of health care providers in the country. Central to this effort has been the training and mentoring of mid-level health care workers, such as tcnicos de medicina geral (TMGs, similar to Western physician assistants), nurses, and agentes de medicina (lower-level TMGs). In addition to providing training expertise and creating training resources and curricula, I-TECH strengthens innovative programs for peer support and clinical mentoring. Ongoing monitoring and evaluation measure the effectiveness of such programs so that I-TECH and MISAU can continue to improve programs and strengthen the health system in Mozambique.

TELEDATA DE MOAMBIQUE, LDA. A Teledata de Moambique, Lda constituda em 1989, uma empresa privada de direito moambicana, comparticipada pela empresa pblica Telecomunicaes de Moambique. A Empresa tem representaoes nas cidades de Maputo, Beira, Nampula e Nacala e conta com uma rede de agentes em todo o pas. Emprega actualmente cerca de 92 colaboradores a nvel nacional. Contact: Slvia Remtula, Directora de Comercial e Marketing Cell : +258 82 303 52 70 / +258 84 335 35 35 Phone : +258 21 353 500 Fax : +258 21 321 604 Email : teledata@teledata.mz Website: www.teledata.mz Address: Av. Ho Chi Min, nr. 710, 5 andar Province: Maputo Services: Telecommunications

VODACOM MOAMBIQUE (VM, SA) Vodacom Mozambique the number one network operator in Mozambique: in Internet, offers, network quality, promotions and customer service. Vodacom Mozambique is a Mozambican company that started its operation in Mozambique in December 2003 and its main objective is to offer a high quality, reliable mobile network and through new communication technology bring everything that's good for Mozambique. The shareholders of Vodacom Mozambique include Vodacom International Limited (85%) and local partners such as EMOTEL - Mozambique Telecommunications Company, SARL (5%), the Intelec Holdings Limited (5%) and Whatana Investments Limited (5%). Determined to offer the best service and focused on societal issues, Vodacom has developed important social responsibility actions in several areas, most notably in the rehabilitation and construction of schools, installation of computer rooms and distribution of textbooks and school supplies at various schools around the country. Vodacom continues to introduce new ways to take Tudo Bom to more people in the country.

Cell : +258 84 09 00 000 Website: www.vm.co.mz Address: Rua dos Desportistas, 649 Province: Maputo Services: Telecommunications

TELESCAN TELECOMUNICAES E SISTEMAS, LDA Siemens (PABX) dealer for Mozambique. Specialized in Navigation aids - Navigation Radio Aids for airplanes and airports, Meteorological equipment (all kinds of sensors), all kind of two way radios (HF, VHF, UHF, Microwave) and telephone systems. Contact: Carlos Costa Cell : +258 823080120 Phone : +258 2132 56 18 / +258 2130 90 74/6 Fax : +258 2132 07 65 Email : carlos.costa@telescan.co.mz Website: www.telescan.co.mz Address: Av. Karl Marx, 489 Province: Maputo Services: Telecommunications

Mozambique

Internet is booming in Mozambique

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afrol.com, 8 January - Mozambique is the second poorest nation in the world. Things ought to be more difficult, tougher, and more important than that because you are in Mozambique, technology ought to cost more. Internet cafes in Maputo charge US$ 3.00 an hour for access and dial-ups cost US$30 but despite all this the internet in Mozambique is booming. According to Tropical Connection, one of the 10 ISPs operating in Mozambique the number of users country-wide has more than doubled from 5,500 to more than 12,000 during the last two years. Until now a staggering 75% of the users were located in Maputo and surrounding communities and the remaining 25% at the provincial level. Until now this was also aligned with the disparity of economic growth countrywide for the past 5 years where the focus has been in Maputo, the capital city.

growth rate from 10% to 4% 27.09.2000 - Aid for Mozambican flood victims extended 27.08.2000 - Demining process in Mozambique lacks coordination Background Mozambique: growth with poverty Pages Afrol Mozambique Mozambique Index Page Mozambique News Mozambique Archive News, Africa In Internet Balancing Act IRIN - Mozambique TDM annual report 1999 MCEL facts and figures 1999 Tropical Connection Virtual Connection Teledata Lda Centro de Informtica da Universidade Eduardo Mondlane Projecto da Poltica de Informtica Mocambique, Dados Basicos Mozambique Study Group

The newly created National Commission on Information focuses on Information Technology policies. This is a high-level government body led by the Prime Minister, Dr. Pascoal Mocumbi that focuses on the establishment of a national policy for the internet, Information technology, research and the future of commerce through Internet. Additional objectives are to raise national conscioussness on the importance of Information in this day in age, in the areas of education, science, health and entertainment. Tackling the need to eliminate regional trade disadvantages, the commission promises to focus on investment in technologies for the commerce arena, enabling products to be marketable in a global marketplace. Until now that is. The trend is shifting towards Mozambique's nine remaining provinces. Newly injected USAID funds and a new multi-million dollar international partnership fiberoptics highway has promised to deliver solutions to the much needed rural communities that compose nothing less than 13 million of Mozambiques 15 million population. To put this speed of change into perspective, it is worth saying that the bottleneck thus far has been politics behind the technology.

International access will improve during 2001, following implementation of a new international gateway switch, new $150,000 USAID funded antennas in three provinces (alternate ISP), and a US$21 million fiberoptics project due for implementation during 2001. And improved inter-urban 64 Kbps leased line access as well as X.25 interurban access will be available in 2001 in two destinations in addition to Maputo. Local access in Maputo will improve as a result of the installation of fiberoptic loops around the city center, currently in execution. What is it like to connect via a sole ISP from a remote rural area? It can only be done via a monopoly supplier whose stagnation is literally frustrating, Teledata Lda, a partnership of Mozambique and Portuguese capital, holds rural users over a barrel. If you need access to the internet at the provincial level your only choice is Teledata. Needless to say that frustration was rampant. Users could not believe that a page with graphics should take anywhere from 2 to 4 minutes to download, but it was a realistic vision of the internet in Mozambique until now. The economics of communications According to the African Information Society Initiative (AISI) Mozambique spends 5% of its GDP on telecommunications. This figure is considered among the highest in the world. The results are visible. A new dynamic is taking shape, with emphasis on rural data centers supplied by Mondlane University (UEM), remote connectivity projects via radio link. South Africa's Bushmail plans to set up remote connectivity centers in the first quarter of 2001. These are but a few upcoming projects for the new year. With these initiatives the number of users at the provincial level is expected to double in 2001 from 2,000 to 4,000 users as telecommunication infrastructures are improved. The quality of the telecommunications infrastructure provided by the national telco to support applications such as full internet can be considered good in the capital city (Maputo) and the provincial capitals. Rural access is often poor and 64 Kbps access is not possible yet. This is mainly due to poor infrastructures and noisy telephone access. Improvement of the equipment in the network is showing marked results. In 1995, call completion rate stood at 74%, up from 66% in 1994. This is far higher than what is normally encountered in African countries. The number of reported faults per 100 lines is 54 in 1995. The average fault clearing time on a subscriber line is eight days, which is lower than what is reported from various other countries (e.g. Ghana, Kenya, Senegal). The rate of digitalization in switching has increased from 71% in 1994 to 90% in 1999. The digitalization rate in transmission increased from 85 to 93% in the same period. Communication with

Zimbabwe and South Africa have improved dramatically. These digitalization rates are also significantly higher than in many other SADC countries. The national telecommunications operating company is Telecomunicacoes de Mocambique, E.E. (TDM) and is the dominant service provider. The posts and telecommunications functions of the parastatal for national communications services were separated in 1981. TDM was reorganized in 1991 and emerged with a new commercial board of directors. The first annual report of TDM was released in 1993. The government through the Ministry of Transport and Communications in consultation with the Ministry of Finance must approve capital expenditure by TDM which otherwise enjoys autonomy within the framework of its universal coverage obligation. TDM is currently implementing an investment Telecommunications Indicators during 2000 program worth US$ 60.6 million. For some projects (notably those in rural areas) TDM is able Population: 17.5 million to attract donor finance. For the GSM project, Total GDP: US$ million 2,500 est which is the largest single investment, a private Per capita income: US$ 236 est Telecommunications expenditure in % of sector partner has been selected. TDM does not GDP: 5% entertain special working relationships with its Number of main lines: 79,000 Teledensity/100 population: 0.39 professional customers and requirements of Telecom service joint ventures: No professional customers beyond the provision of Independent Telecomm Regulator: Yes direct exchange lines are not being addressed in a Number of telecom operators: 2 * Number of ISP providers: 10 responsive manner. There are relatively few of Internet Connections: 12,000** technicians within TDM who have a background in Number est data communications. Experience shows that a *Source: Telecomunicacoes de Mocambique; close working relationship between professional Telecommunications Foundation of Africa * users and the telecommunications operator is an non TDM or TDM subsidiaries important one and can prevent delays and ** This number may be underestimated, the actual figure may be much higher. ISPs implementation problems on the part of routinely underreport their subscriber datacommunications service providers such as numbers to avoid high value-added taxes Internet service, lease line service and understand imposed on their businesses. This is true and may have major tax implications, which the data needs of its customers. MCEL expansion One widely held belief is that the wireless revolution, namely that cellular communications, sat phones and radio (bushmails approach) can be a part of the solution. The irony may be that African countries, Mozambique in particular, may be using digital technology while US uses analogue technology; hence a faster development of Internet products and solutions. The number of cellular users is estimated in 12,400 and is mainly focused in Maputo surrounding communities. With
would dramatically raise the mega-byte cost to prohibitive levels for doing business.

the expansion of cell phone services to the rest of the country this number will dramatically rise, providing an additional means of internet connectivity. The national telecommunications backbone has been rehabilitated following the war. The transmission capacity is being expanded significantly, from 3,542 circuits in 1994 to 9,500 in 1999. Switching capacity has likewise been expanded since then. In 1995, the infrastructure had 59,904 connected direct lines. The annual growth of connected lines is between 7 and 8% and by 1998 72, 840 subscriber lines were in operation. Average cost per new line is US$ 4,500. MCEL, the sole cellular provider in Mozambique, has budgeted US$ 33 million for remote connectivity construction during 2000-2002. End-user economics The major issues related to Internet in Southern Africa and particularly to Mozambique are directly linked with the ambition to connect with foreign partners to do business at a less cost. The number of foreign entities, consultants, and NGOs does tend to promote communication to all regardless of costs to support business processes. The start-up costs are exorbitant but as time goes by the telecommunication infrastructures are closing the gap, thus slowly reducing costs. The price of computers is also a factor. With IBM compatibles costing as much as US$ 236 some form of subsidies (either governmental or donor based) has to take place to ensure that the new infrastructures are fully utilized. The literacy factor There is often the belief in Africa that the one of the main barriers is illiteracy. Are we going to let that stop us? No. We can program computers, enable telephony, use wireless communications and use e-commerce through PCs and workstations and download MP3, compile CDs, and recognize voice through 64kbps lines. Mozambicans are not waiting and are very optimistic that the lack of infrastructure will not deter adherence to new technologies. Internet usage in Mozambique has increased dramatically and promises to duplicate yearly for the foreseeable future. With the improvement of bandwidth, telecommunication infrastructures and the expansion of ISPs throughout the country it is expected that such usage will explode. The currently existing bandwidth no longer satisfies the needs of users and the demands of businesses in Maputo as well as the needs of the other entities that ISPs provide services to. Therefore provision should be made to improve the bandwidth to Internet to at least 1Mbps full duplex link, i.e., 1Mbps for uplink and downlink. Most ISPs are currently able to provide stable 64Kbps uplinks and similar speed downlinks. The number of leased lines is on the upward trend as well. Even with innovative telecommunications

pricing and internet policies, Mike Jensen, a consultant from South Africa stated that, the price of access calls is still prohibitive throughout Mozambique. If you consider that in some African countries you can pay US$ 8 or more per hour for a dial-up call, with the charge in at least 10 countries at US$ 4, according to Jensen. In countries with a more competitive market, the charges can be as low as US$ 0.60 per hour, but even there call charges still form the most expensive part of access costs. This major variance brings Mozambique into perspective since the actual cost of US$ 3 per hour is aligned with the majority of African countries. The high license fees and license conditions of telecommunications and service providers, limitations imposed on wireless and very small aperture terminal satellite access, excessive import duties on equipment, and limited skill and knowledge of the available options for providing access are among the major factors delaying the speed of implementation in Mozambique. Yet restrictive government policies are not always adhered to. ISPs are putting in a lot of illegal wireless equipment regardless of the law. Telephony among other equipment is being tested. Country telecommunication policies are not able to keep up with the advances in technology. It is obvious that this trend will continue. This is a clear indication that in Mozambique and other SADC countries technology is moving much faster despite the desire of government to keepup with flexible policies. Artur Manhica is an IT Manager, Project Manager and developer of MIS Solutions.
Source: This article is reproduced with special permission from Balancing Act

ADVANCES IN TECHNOLOGY
There are times when the industry is stymied and projects cannot move ahead until technical challenges are met. In such cases, the technical experts of SGS can be called upon to develop new technologies that address these issues for the mining sector.
We have earned the reputation as a technology partner, helping you address challenges that limit your growth. As a result of such applied development, we can bring new approaches to the table. Recent developments include:

MOBILE METAL IONS (MMI)

MMI is an advanced surface exploration technology that is enabling companies to explore areas that have previously been unsuccessful for surface geochemistry. Companies can target buried deposits with deep soil cover to discover newer and bigger hidden ore deposits.

GEOMETALLURGY
Geometallurgy significantly reduces the impact of spatial uncertainty in mine planning because it documents the variability in a deposit. The data is applied to the deposit block model or mine plan and models are used to generate economic parameters such as throughput, grind size, grade and recovery. This lowers project risk.

CYANIDE RECOVERY
SGS has been instrumental in developing, and improving, processes for safely recovering cyanide from solutions or tailings. We have the technical expertise and capital equipment to work with you to develop and demonstrate the safest, most effective process for recovering the cyanide from your gold circuit.

STOCKPILE INVENTORY MEASUREMENT

Stockpile Inventory Measurement is a scientific/instrumental method using state-of-the-art technology to determine volume of raw material in a stockpile. It is an independent, accurate method trusted by sellers and buyers globally. The innovative technologies that SGS provides can help companies solve problems due to:

Complex mineralogy Legislation (especially concerning the use of cyanide) Very fine mineral grain size Overwhelming presence of penalty elements

Large tonnage ore body, with metal grades too low to be economic with current technology

SGSs philosophy is to initially apply traditional, proven methods and technologies to industry challenges. However, we have the expertise and equipment to provide technical leadership when new technologies are required for a difficult project. Partner with SGS for new solutions to old problems

Mozambique: A look at its ICT landscape

In the last 10 years, Mozambique has exhibited a steady economic growth averaging between 6% and 8% annually, from 2002 to 2012, one of the strongest growths in the continent In fact, early this year, reports revealed, that Mozambique is expected to become one of the ten largest producers of coal, and top twenty producers of natural gas in the world. Already, the country has invested $2.7 billion on mining and hydrocarbon industry. It is estimated that Mozambiques gas reserves is worth more than $350 billion, giving the country a potential $20 billion earnings during the gas fields lifetime. If managed efficiently, this

new opportunity will drive growth in other sectors in the country, particularly the banking and technology sectors.

Where does ICT come in?

As Mozambique grows, it needs to be able to easily connect to the outside world to enable it to compete in the global market. ICT will provide Mozambique access to information to the global market that will enable them to get better negotiating power and better pricing. Not only that, but ICT is also a channel that the country can use to take their products and services to the global market. But before the country can exploit the potential of ICT, it needs to have reliable infrastructure and connectivity. And it needs local experts who can use new technologies to drive the countrys economy forward. Recognising the importance of ICT in the development of the country, Mozambique government has defined a national vision for ICT and created legal framework to regulate the industry. It is also promoting access to IT innovation and research.

Mozambiques ICT achievements so far

Mozambique is making headway in ICT, particularly in telecommunication and connectivity. It is now connected to the rest of the world, thanks to SEACOM (African Cable System) and EASSy (Eastern Africa Submarine Cable System). The deployment of SEACOM in 2009 and EASSY in 2010 has brought more internet connection in the country and reduced the cost of internet and data communication. In 2003, Mozambique also liberalised the telecommunication sector and open it to competition. This move also helped reduce the cost of mobile services. By 2012, Mozambique had three mobile operators, Mcel, Vodacom and Movitel. As the largest operator in the country, Mcel, has the most extensive network coverage. As of 2012, it has the most subscribers at 4.5 million. The Mozambique government, in partnership with UNESCO, Eduardo Mondlane University and international donors, also launched a network of multimedia community centres in some remote areas of the country. The multimedia centres provide internet access, photocopying, fax and other communication services for a small fee.

Challenges Facing Mozambiques ICT Sector

Although, Mozambique ICT sector is gaining traction, it still has a long way to go before it catches up with more advanced African countries. Its teledensity remains low. At the end of

2011, there were around 7.8 million mobile subscribers in the country, which brings its mobile penetration rate to 31.7%. This is a very low figure against the average 76.4% mobile penetration in the whole of Africa. Additionally, 70% of mobile subscribers in Mozambique are concentrated in the capital city, Maputo. This is largely due to the fact that mobile signals in the country dont go beyond urban areas. On paper, the countrys 128 administrative districts have mobile network coverage, but in reality, the coverage only extends within the 5km radius of the town where the district headquarters are located. This means that very few people in remote areas can get a signal; therefore, many dont bother owning mobile phones. Furthermore, the country has only one fixed line operator, TDM, which is government owned. According to the Central Intelligence Agency, there are only 88,100 landlines in the country. And, although, mobile services costs have gone down, it is still quite expensive. Voice calls are charged at around 25 cents a minute and mobile internet access costs around $18 a month. It cant be denied, the challenges facing the ICT sector in Mozambique is vast, but the country is making progress in tackling them. And with the potential big revenues from its rich gas resources, it may just make it.