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[CAPE TOWN] Less than half of South Africa's telemedicine sites — set up partly to bring medical services to remote parts of the country — are functional, a government review has found.

Of 86 sites, just 32 were operational at the beginning of this year, according to the study, carried out by the country's department of health.

The failures are the result of a lack of coordination and leadership, inadequate budgets and inefficient use of available funds — factors that have crippled the sites — Aaron Motsoaledi, South Africa's health minister, told the inaugural Southern Africa Telemedicine conference, in Cape Town last month (16–17 September).

"Weak ICT [information and communications technology] infrastructure; inadequate and unreliable connectivity; and problems with the coordination and management of work [have] added to the challenges," he told the meeting.

Telemedicine uses ICT to allow patients to 'visit' physicians live over the Internet for immediate care or diagnosis and follow-uptreatment. It also enables long-distance medical training.

South Africa piloted many such projects more than a decade ago, which led to 28 telemedicine sites being established between March 1999 and September 2000. This has expanded to 86 sites offering a range of services such as tele-radiology and tele-education.

But the country — and the region — lacks a telemedicine strategy, speakers told the meeting, hosted by South Africa's Medical Research Council.

"The vision is to grow efficient telemedicine in the Southern Africa Development Community and then rest of Africa," Jill Fortuin, acting director of the council's Telemedicine Platform, told SciDev.Net.

Fortuin said a policy would bring affordable and timely treatment for patients and closer supervision of numerous HIV/AIDS patients.

"Telemedicine is an instrument through which the socially vulnerable sections of the population can enjoy the freedom that comes with being a citizen in democratic state," said Derek Hanekom, deputy minister of science and technology, highlighting South Africa's lack of trained medical specialists and the problems in getting health care to remote areas.

Any national telemedicine strategy should aim to contribute directly towards increasing life expectancy, reducing maternal and child mortality, combating HIV/AIDS and tuberculosis, and strengthening the effectiveness of health systems, said Motsoaledi.

The meeting — attended by healthcare practitioners, trainers, medical device developers, ICT infrastructure providers, academics, researchers and policymakers — was also told that such a strategy should include a standard operating procedure, guidelines, and rules on data security.