Patient Data Privacy in the Age of Telemedicine: Case Studies from Ghana, Rwanda and Uganda

By CIPESA Writer |

With the increasing adoption of digital tools in healthcare provision in Africa, these case studies on e-health startups in Ghana, Rwanda and Uganda show how countries are dealing with privacy implications around patient data.  

Telemedicine is broadly defined as the delivery of healthcare services including diagnosis, treatment, research, education and evaluation to communities and individuals over long distances using information and communication technologies.  

A variety of other terms such as e-health, e-medicine, and tele-health are sometimes used interchangeably to mean the same thing as telemedicine. Remote delivery of healthcare services using telecommunications infrastructure helps overcome various barriers where access to quality healthcare is still a challenge. They ensure that no matter the patient’s location, they can still access timely care via telephone consultations with a physician, or obtain an express pick-up service of diagnostic tests and home delivery of results, or online access to prescription drugs. This is increasing equity in healthcare access for many in Africa. 

Covid-19, A Blessing in Disguise

Following the outbreak of Covid-19 in 2020, many African countries instituted some of the harshest containment measures to stop the spread of the disease. Entire economies were shut, from markets to schools to public transportation, and any activity that involved people getting into physical contact with one another was severely restricted. 

During the period, healthcare-seeking behaviour changed, since hospitals were at the epicentre of the crisis, receiving patients and hosting isolation centres. As a result, many African governments increased their reliance on digital technologies to contain the spread of the virus. Some of the measures included increasing digital transformation efforts, expansion of e-government services, mobile money services, and internet access. Furthermore, ministries of health relied on digital technologies and mobile applications for contact tracing, ambulance management, delivery of drugs, and awareness creation, and encouraged citizens to seek medical care online. This dramatically increased the visibility and popularity of hitherto unknown e-health startups and led to the rapid development of new ones.

For example, Uganda’s Rocket Health, a telemedicine start-up in existence since 2012, saw a dramatic increase in the number of subscribers. Similarly, Ghana’s mPharma, a startup that originally specialised in running a network of online pharmacies, diversified its services from simply delivering drugs to facilitating patient-physician telephone consultations. Also, Rwanda’s e-government Portal Irembo became the de facto hub for ordering Covid-19 tests and applying for and renewing Mutalle des sante, the country’s community-based health insurance scheme.

With a doctor-to-patient ratio of 0.2 physicians per 1,000 people compared to a global average of 1.6 as of 2018, the appeal of telemedicine in Sub-Saharan Africa is not surprising, given the enormous gap in healthcare providers. In addition, the increasing access to mobile phones (43%) and internet penetration (46%) in Sub-Saharan Africa are a great enabler of the surge in e-health adoption.

Patients’ Data Privacy Concerns

Inevitably, the increasing adoption of telemedicine is generating questions about the quality of care and the protocols in place to safeguard and protect patients’ health data. Until recently, there were few legal and policy guidelines regulating the use of telemedicine in most African countries. Bodies such as the World Health Organization (WHO), the African Union (AU), and the Africa Centres for Disease Control and Prevention (CDC) have in the recent past published digital transformation strategies to leverage the current surge in digitalisation. 

However, while several countries have enacted data protection laws and policies, they tend to be broad in outlook and are not focused specifically on e-health, the data it generates or how to safeguard it. Likewise, despite several African Ministries of Health drawing up Digital Health Strategies (see for instance UgandaMalawi and Ghana), measures to safeguard digital patient data privacy and protection have not been extensively elaborated. 

A 2021 study assessing the attitudes of telemedicine users in Sub-Saharan Africa found that trust, data safety and privacy concerns were among the biggest worries users had about telemedicine platforms. While the study revealed a wide usage of telemedicine technology across the region, it also showed that technological, organisational, legal and regulatory, individual, financial, and cultural issues were major barriers to the successful implementation of telemedicine in the region. Moreover, concerns regarding patients’ security, privacy and protection of medical data were highlighted as major barriers to the adoption of e-health technology as they created doubt for both clinicians and patients in terms of protection against potential abuse of patients’ data and unlawful disclosure of confidential medical records. 

A Closer Look at Select Telehealth Startups and their Data Privacy Policies 

Most e-health apps have long and elaborate Terms of Use and data privacy policies to assure users of their data privacy and security. These policies may differ from one app to the other, depending on the services provided, the nature of the operation of the start-up (for example, some are Public-Private-Partnerships where governments have a stake) and the legal framework in the country of operation. However, some terms of use are too long and stepped in too much legalese that most users do not read them or when they do, may not sufficiently understand the provisions or their implications. 

  1. Rocket Health (Uganda)

Rocket Health is a telemedicine service offered by The Medical Concierge Group (TMCG) Ltd. It offers teleconsultations, an online pharmacy with home delivery of medicines, laboratory services, and clinic services. Recently, it opened a number of physical clinics around Kampala. 

Rocket Health’s popularity exploded following the outbreak of Covid-19, moving from a few thousand virtual consultations a year to about 400,000. The company charges a USD 3 consultation fee and USD 1.5 for drug delivery, making it affordable to a majority of its clientele. Currently, the company reports over one million interactions facilitated with up to 80,000 active users. Since its inception, Rocket Health has grown its reach to 42,597 voice call users, 6,862 WhatsApp users, and 40,000 followers via the different social media platforms through which its services are also available.

In 2022, Rocket Health raised more than USD 5 million from investors and commenced scaling up its operations. The Medical Concierge Group Africa has now set up shop in Kenya and Nigeria to enable it to venture into more tele-health innovations and plans are underway to expand their portfolio to other African countries.

Users mostly access Rocket Health Services through its website or by downloading the Rocket Health Android app on their smartphones. In addition, the service can be accessed through a USSD service (*280#) for those with feature phones, and through chat on its social media channels on WhatsApp, Facebook and X.

Rocket Health collects and processes an enormous amount of data from its clients. It is worth examining how the company guarantees the safety and privacy of its patients’ data. The company has an extensive data privacy policy on its website that explains in detail the data it collects, how it collects it, and how it uses it. The policy states that “TMCG may collect some information from other third-party applications such as Facebook, Twitter, when you subscribe to our services, participate in surveys, login into our websites using a third-party login system (including, but not limited to, Facebook, Twitter, etc.), or otherwise communicate with us”. 

 The company adds that it takes precautions to protect collected personal information from loss, misuse, unauthorised access, disclosure, alteration, or destruction, taking into account the risk level and the nature of the data. However, it adds that clients “are responsible for taking every reasonable precaution on your end to protect any unauthorised person from accessing your TMCG account.”

 The c companies also adds a disclaimer that “…due to the design of the internet and other factors outside our control, we cannot guarantee that communications between you and our servers will be free from unauthorised access by third parties.”

The Personal Data Protection and Privacy Act (2019) is the primary legislation governing the protection of personal data in Uganda. The law aims to safeguard the privacy of individuals’ personal information and to regulate the processing of personal data by data controllers and processors. It further spells out the obligations of data collectors, processors and controllers while handling personal data. It also regulates the use and disclosure of personal data. It specifies the rights of the data subject, including seeking consent, explanation of the nature of the data being collected and its purpose. 

Moreover, the law established the Personal Data Protection Office (PDPO) under the National Information Technology Authority – Uganda (NITA-U), mandated to oversee the implementation and enforcement of the Act, receive and investigate complaints from data subjects, and establish and maintain a data protection and privacy register. The Uganda Data Protection & Privacy Regulations 2020 provide specific rules and requirements for adherence to the Personal Data Protection and Privacy Act.

All organisations collecting personal data are required to register with the PDPO for compliance monitoring and submit annual compliance reports on how they adhere to the data protection law. 

briefing by the PDPO on data protection and privacy in Uganda’s public and private health sector stated that “Principles and obligations in the health sector Health-related data are sensitive information and the Data Protection and Privacy Act establishes them as a special category of personal data due to the possibility of discrimination based on the results of processing it.” The briefing calls on actors in the sector to adhere to the law:

All players in the health sector must be accountable to the individuals from whom data is collected (data subjects) by registering with the Personal Data Protection Office (PDPO), which is the regulator of processors and controllers of personal data. These players must also establish technical and organisation measures which demonstrate compliance, such as having a Data Protection Officer, data protection and information security policies, maintaining a record of all processing activities within the organisation, and conducting data protection impact assessments to mitigate the risks associated with the processing of personal data.

The PDPO online data protection register shows that Rocket Health’s parent company, The Medical Concierge Group Ltd, only registered with the authority in September 2023, over 10 years after its establishment.

A 2021 Privacy Scorecard report for Uganda by Unwanted Witness found that health services in the country recorded the lowest performance for robust data security, with private health facilities exhibiting the worst levels of vulnerability in compliance with data protection standards.

Image poto

Visual Credit: Unwanted Witness

In its Health Information & Digital Health Strategic Plan 2021-2025, the Uganda Ministry of Health aims to “Improve data security and disaster recovery to ensure continuous access and availability of health data as well as compliance to data protection and privacy act.” Under this goal are key strategic interventions including to:

  • Develop guidelines for data privacy and protection in the health sector including secure handling and use of data and ICT assets. 
  • Undertake a census of all data controllers in the health sector to facilitate monitoring for compliance to established guidelines. 
  • Implement security protocols for data access in the health sector.
  • Undertake capacity building of health workers on data security, privacy, and protection in conjunction with the GoU data protection office.

There is so far no publicly available evidence that the Ministry and the PDPO have started this collaboration or when it is expected to start.

  Irembo e-Government Platform (Rwanda)

 Irembo (which means ‘Gateway’ or ‘Door’ in the local Kinyarwanda language), is an e-citizen portal for the provision of various government services to the public. The portal is managed by Irembo Ltd, a local technology company, in partnership with the Government of Rwanda. Started in 2015, the Irembo portal has enabled most Rwandan government agencies to digitise their services, eliminating paperwork and long wait times. Many services in sectors such as family and social affairs, immigration, identification, land, health and education offer services on the platform. Since its launch, the platform has processed over 25 million applications worth USD 300 million.

 Some of the health services provided on the platform include ordering and paying for Covid-19 tests and purchasing Mutuelle, a popular low-cost national community-based health insurance. Irembo is regulated under the Rwandan privacy law and is required to safeguard the privacy and security of its users’ data.

Furthermore, Irembo has published its Data Privacy Policy on its website which describes how it uses and protects the personally identifiable information collected from users of the platform.  The policy states it “is not intended that the e-Government Services Online Portal can be used anonymously. But no personal information shall be collected from you, unless you provide it voluntarily.”  It adds: 

 As a general rule, we do not collect personal data about you when you visit Irembo web, unless you choose to provide such information to us. Submitting your personal data through our website is voluntary. By doing so, you are giving us your permission to use the information for the services you requested for. We collect personal data to provide you with the services you have requested, including services from third party providers. We may share the above information with Government Institutions, Ministries and Agencies in the performance of their official duties and/or providing you the services you requested for.

 The Government of Rwanda officially gazetted Law Nº 058/2021 of 13/10/2021 relating to the protection of personal data and privacy on October 15, 2021. This Law designates the National Cyber Security Authority (NCSA) as the supervisory authority of the law. On March 31, 2022, the NCSA officially launched its data protection office, which will spearhead all activities related to protecting the personal data of individuals in Rwanda. In August 2023, Irembo was accredited by the NCSA as a data controller and data processor, in accordance with the data protection law.

 The data protection law defines sensitive personal data as “information revealing a person’s race, health status, criminal records, medical records, social origin, religious or philosophical beliefs, political opinion, genetic or biometric information, sexual life or family details.” The Rwandan constitution also provides for the right to privacy under article 23 as their fundamental right and any data collected on citizens must only be done with consent.  

 mPharma (Ghana)

The Covid-19 pandemic was also a boon to Ghana’s nascent telemedicine industry. The surge in Covid-19 cases in 2020 meant that Ghana had to institute drastic measures to contain the pandemic. These included scaling up efforts to integrate telemedicine into the mainstream healthcare system.

One of the companies that took advantage of this crisis was mPharma, a Ghanaian start up originally founded to manage prescription drug inventory for pharmacies and their suppliers. The company started providing physician consultations at its network of Mutti pharmacies and also set up online patient-doctor consulting, to reach more people, just as Rocket Health did. 

mPharma now employs hundreds of people and has since expanded its operations to Gabon, Ethiopia, Nigeria, Kenya, Zambia, Malawi and Rwanda.  In 2022, the company raised USD 35 million from investors and plans to expand into more African countries. 

mPharma’s privacy policy is remarkably similar to that of Uganda’s Rocket Health except that it goes into more detail on what happens to clients’ data in case it is to enter into a merger or is acquired by third party companies, but does not state if the data subjects have a right of refusal to such potential transfer of data.

In the event of any merger, acquisition or other arrangement whereby mPharma sells or transfers all, or a portion of its business or assets (including in the event of a reorganisation, dissolution or liquidation) to third parties, you hereby consent that your personal data held with mPharma can be transferred or assigned to third parties who may become the controllers and/or processors of your personal data that was held by mPharma prior to such merger, acquisition or other arrangement. mPharma shall at all times ensure that you are notified when your personal data is intended to be transferred to third parties in the circumstances outlined in this clause.

Ghana was one the first African countries to pass a data protection law back in 2012. Its Data Protection Commission (DPC), which enforces this law, is one of the oldest on the continent. The registration of data controllers and data processors started in January 2015. The Data Protection Act places special emphasis on health data. Article 62 states that “Personal data which relates to the physical, mental health or mental condition of the data subject shall not be disclosed except where the disclosure is required by law,” among other exceptions. 

In July, 2010, the Government of Ghana launched the national e-health strategy and is planning to  launch a digital health strategy. The national ICT Sector Policy and Strategy highlights the increasing cyber threats hindering the adoption of ICT in healthcare and calls for mechanisms for the protection of patient data.

How to ensure patient privacy and data protection 

There are significant gaps in current data protection and privacy policies of eHealth service providers in Africa regarding patient data collected. For example,

  •   Some startups in their privacy policies do not provide for protections in case of mergers or acquisitions, a common occurrence in startup ecosystems; or what the rights of the data subjects are in this situation and what privacy implications such mergers might have on clients’ data rights. 
  •     Secondly, most of the policies are written in such a careful and calibrated way to reduce as much as possible the burden of responsibility and duty of care for patient data protection, away from the company. This is the reason for multiple indemnifications and disclaimers written in the company policies. 
  •   Thirdly, the regulatory environment in terms of national data protection laws is not robust enough as it does not provide sector-specific guidance especially for very sensitive sectors such as healthcare. While the general legal regime on data protection appears strong, there is a need for specific guidelines to ensure patient privacy and data protection in the digital health context. Entire sections need to be added in National Data Protection Laws that focus on health data governance especially in digitally provided healthcare services. 
  •   There is also limited collaboration between Ministries of Health and Data Protection Authorities. There is thus far little evidence of any sanctions that have been borne by health startups that have not adhered to some of the requirements of the Data Protection Authorities, such as registering their operations with the data protection authorities and hiring data protection officers in their companies.

Data protection offices need to work more closely with ministries of health and private digital health providers to design strong regulatory frameworks that guarantee patient privacy and data safety while facilitating the growth of the telemedicine industry. 

Countries could model their digital health data protection policies on the WHO guideline recommendations on telemedicine, which calls for client-to-provider telemedicine to complement, rather than replace, the delivery of health services and in settings where patient safety, privacy, traceability, accountability and security can be monitored. In this context, WHO further states that monitoring should include the “establishment of standard operating procedures (SOPs) that describe protocols for ensuring patient consent, data protection and storage, and verifying provider licensing and credentials.”With many startup companies increasingly venturing into health services, the data protection laws need to be updated accordingly to provide more robust health data protection. 

Companies could, among other measures, take the following actions:

  •   Update their clients with information of any mergers or takeovers of their companies in case they happen, appraise them of the implications of such mergers and what role the clientele has to play, or their rights and obligations. 
  •   Any app updates or system upgrades with implications on patient data, new demands for, or changes in their data protections protocols, should be swiftly and transparently communicated to users, as well as what implications that might have on the use of these apps on their devices.
  • Conduct ongoing, consistent education of their clients on their data rights and the measures being taken to ensure the protection, privacy and integrity of medical records.
  •     Beyond just bland privacy policies and Terms of Use documents on their websites, companies need to have robust engagement and communication strategies to guide their constant interfaces with clients to ensure consistent safety and privacy of their data.

Shifting the Burden: Online Violence Against Women

By Evelyn Lirri |

Across Africa, the use of Information and Communications Technology (ICT) by women and girls remains low. Yet amidst the low access to digital tools, women, particularly those in public and political spaces, such as human rights defenders (HRDs), bloggers, and journalists, continue to be the primary target of various forms of online violence such as cyberstalking, sexual harassment, trolling, body shaming and blackmail.

 According to a 2021 global survey by UNESCO, nearly three-quarters of female journalists have experienced online harassment in the course of their work, forcing many to self-censor. Furthermore, a 2020 report by UN Women found that women in politics and the media were more likely to be victims of technology-based violence as a consequence of their work and public profiles.

Over the years, the Collaboration on International ICT Policy for East and Southern Africa (CIPESA) has documented and pursued interventions aimed at addressing the significant obstacles hindering an increase in women’s participation not only in online spaces but also in the political sphere. A concerning and recurring trend is that, oftentimes, responses to violence against women have prioritised an individual’s responsibility for self-protection rather than systematic or policy actions. 

 At the Forum on Internet Freedom in Africa 2023 (FIFAfrica23), the National Democratic Institute (NDI), Pollicy, Africtivites, the Women of Uganda Network (WOUGNET), Internews and the Solidarity Centre shared lessons learned from their work implementing multi-stakeholder interventions to address online violence against women. During a panel discussion, it was noted that applying multi-stakeholder interventions that include governments, civil society, technology platforms and media was critical in promoting safe and meaningful participation of women in online spaces. Internews and WOUGNET highlighted the work they have been jointly engaged in through the FemTech project in various African countries, aimed at empowering women human rights defenders to safely participate in digital spaces while promoting equitable access to technology. Through trainings of women human rights defenders, CSOs, policy makers and law enforcers, the project is raining awareness on how women are often impacted by cyber crimes legislations. 

In Senegal, AfricTivistes, a network organisation made up of journalists, bloggers and HRDs, has spearheaded public advocacy campaigns on responsible use of the internet. The organisation has conducted gender-inclusive training and capacity-building workshops for journalists, bloggers, public officials and political leaders on how to respond to cyber violence. Aisha Dabo, a Programme Coordinator at AfricTivistes, noted that since 2017, over 700 people in 15 African countries have been reached with these trainings. The organisation also conducts media monitoring of online violence on social media platforms. 

Sarah Moulton, NDI’s Deputy Director for Democracy and Technology, highlighted the negative impact that online violence continues to have on women who are actively engaged in politics and political spaces. In Uganda, for instance, a joint report by Pollicy and NDI documented cases of gender-based online violence during the 2021 general elections and found that women and men politicians experienced online violence differently, with women candidates likely to be trolled and body shamed while men were more likely to experience hate speech. This echoed research by CIPESA which analysed the gender dynamics of politics in online spaces in Uganda, including campaigns for presidential, parliamentary, mayoral, and other local government seats during the same elections. The CIPESA research also explored the legal landscape and in similarity to Pollicy and NDI found that although Uganda has enacted a number of laws aimed at improving digital access and rights such as the Computer Misuse Act 2011, the Anti Pornography Act 2014, the Excise Duty (Amendment) Act 2018, most do not address the gender dynamics of the internet such as targeted online gender-based violence, affordability, and the lack of digital skills among women.  

Like Africvistes, NDI has engaged in a number of campaigns to document these various forms of violence and make recommendations to address the problem. In 2022, it released a  list of interventions that could be adopted globally by technology platforms, governments, civil society and the media to mitigate the impact of online violence against women in politics and hold perpetrators to account.  

“Often, the expectation is that the individual is responsible for addressing the issue or for advocating on behalf of themselves. It really needs to involve a lot of actors,” said Moulton. 

On its part, the Solidarity Centre has been spearheading a global campaign to end gender-based violence and harassment in the world of work. With the advent of Covid-19, a growing number of women shifted online for employment opportunities, access to services and education, among others. It was highlighted that female platform workers, including influencers, content creators and women who run online retail businesses, continue to face various violations such as sexual harassment and cyberbullying. 

Panelists called on governments to ratify the International Labour Organisation (ILO) Convention No. 190 on violence and harassment in the world of work. This global treaty recognises the impact of domestic violence in the workplace, and how women are often disproportionately affected.  Currently, the convention has been ratified by 32 countries globally, of which only eight are African.

Journalists attending FIFAfrica23 also shared their encounters with online violence and called for regular digital literacy skills to stay safe online. Alongside the need for enhanced digital literacy, participants also noted the lack of effective reporting mechanisms for cases. Ultimately, it was noted that efforts that shift the burden of blame from victims of online violence against women in Africa need to be more actively pursued, alongside more actionable, collaborative and systematic interventions by governments, law enforcement, and platforms.

Addressing The Gender Dynamics of Media Freedom and Journalists’ Safety in Africa

By Juliet Nanfuka |

November 2 marked the International Day to End Impunity for Crimes against Journalists, a  United Nations (UN) recognised day observed annually that serves to draw attention to the level of impunity for crimes against journalists. While impunity for crimes against journalists is high and is a global reality, there is a concerning and continued gender-biased undercurrent that shapes and informs the media landscape in many African countries. As such, some cases of crimes especially against women journalists go unrecognised. The safety of African women journalists is therefore an urgent concern and a key cornerstone of press freedom..

As such, the Collaboration on International ICT Policy in East and Southern Africa (CIPESA) in partnership with the United Nations Educational, Scientific and Cultural Organization (UNESCO) has embarked on a multi-country project centred on implementing some of the recommendations of the 2022 report on the State of Media Freedom and Safety of Journalists in Africa

According to the report, while both men and women journalists in Africa are likely to experience trolling, more women have been sexually harassed and threatened. Further, online attacks against women journalists appear to be increasing exponentially and have also moved offline – with potentially deadly consequences. Yet women journalists who experience abuse online rarely seek justice and often struggle to have their complaints taken seriously and properly investigated. 

Illustrative cases include some from Kenya, where in 2018, several women in the media were the target of smear campaigns on social media platforms, through hashtags, photos, and video-edited graphics depicting nude characters. In 2019, a  female journalist’s phone number was publicly shared on Twitter by Julius Malema, the leader of the Economic Freedom Fighters (EFF) political party in South Africa, which resulted in “an avalanche of racialised and sexist abuse, including rape and death threats.” Although the EFF was sued, and the court found that the party had violated the electoral code by failing to “instruct and take reasonable steps to ensure that their supporters do not harass, intimidate, threaten or abuse journalists and especially women”, the case is a microcosm of what women journalists across the continent experience particularly when reporting on politics.    

More broadly, the media landscape in Africa has become rife with arbitrary censorship, especially on the internet, arrests of journalists on the grounds of combating cybercrime, fake news or terrorism, and acts of violence against media personnel that usually go completely unpunished. Although media plurality has improved dramatically on the continent, the gender dynamics remain ever-present, such as few women holding executive positions in media companies. Meanwhile, the increased reliance on technology has seen the affronts experienced by female journalists transferred online with a bigger impact on the profession, which is forcing some out entirely, silencing others from reporting on critical concerns or encouraging a culture of self-censorship. 

Accordingly, the CIPESA/UNESCO collaboration seeks to create avenues of engagement on these concerns and how they undermine the practice of journalism by women. These will be pursued by a series of inperson meetings revolving around recommendations that emerged from the documentation of media freedom and journalist’s safety in Africa. 

This work builds on earlier interventions by CIPESA including the 2020 Women At Web Uganda (#WomenAtWebUg) Masterclass and Reporting Grant which served to increase the visibility of the dynamics faced by Ugandan women online and improve balance, quality and regularity of reporting. Through the Africa Digital Rights Fund (ADRF), CIPESA supported the Women In Media Initiative Somalia (WIMISOM) in building the digital security skills and knowledge of women journalists (print, broadcast and online) and women-led media organisations in Puntland, Somalia and Somaliland as a means of combating threats against female journalists and their sources. 

In 2022, CIPESA joined the Uganda Media Sector Working Group (UMSWG) in the commemoration of World Press Freedom Day where the theme “Journalism Under Digital Siege” was the focus of deliberation. Discussion at the UMSWF meeting resonated with insights that emerged from research in Namibia. In 2022, the ADRF provided support to the Internet Society – Namibia Chapter to develop a country situational assessment on the state of online violence against girls and women in Namibia. The assessment reaffirmed the experiences of Namibian journalists as similar to those worldwide. It noted that, “where online attacks against women journalists have political motives, where political

actors, extremist networks and partisan media are identified as instigators and amplifiers of online violence against women journalists.”

In May 2023, in recognition of International Women’s Day (IWD), CIPESA hosted a regional webinar titled “Tech4Equality: Advocating for Gender Inclusive ICT Policy and governance” that assembled gender experts from a host of countries including Namibia, Tanzania, Uganda, and Zambia. This was complemented by efforts in Cameroon where CIPESA alongside Civic Watch and DefyHateNow engaged women journalists at a workshop on the opportunities for embracing technology while also being alive to the challenges inherent to journalism in the digital space. 

Meanwhile, gender inequalities, bias and the media have been key points of deliberation at the annual Forum on Internet Freedom in Africa (FIFAfrica) which this year marked a decade. It entailed a workshop in which partners including the National Democratic Institute (NDI), Women of Uganda Network (WOUGNET), Pollicy, AfricTivistes, and Internews presented insights from their work and recommended multi-stakeholder interventions to address online violence against women.

As more women in the media operate in environments rifled with gender-based challenges and threats that stem from deeply ingrained societal norms, collaborative efforts are required for more impactful responses to be reached. This is fundamental as the role of women journalists in shaping narratives and advancing social progress in Africa should be prioritised.

African Perspectives on Operationalising UNESCO’s Guidelines for Regulating Digital Platforms

By Juliet Nanfuka |

Across the world, governments are introducing laws to regulate online content. Many of these laws contain provisions that may lead to the increasing removal of legitimate expression as opposed to harmful and illegal content. In turn, the global community continues to grapple with the question of how harmful online content should best be moderated in a manner that does not undermine citizens’ right of access to information and freedom of expression.

On September 28, the United Nations Educational, Scientific and Cultural Organization (UNESCO) held a high-level panel discussion on unpacking African perspectives on the operationalisation of UNESCO’s Guidelines for regulating digital platforms. The session was among the discussions held at the 2023 edition of the Forum on Internet Freedom in Africa (FIFAfrica) which assembled organisations from across Africa and beyond to deliberate on reigning concerns in the internet governance and digital rights landscape.

The UNESCO Guidelines (in full referred to as Guidelines for regulating digital platforms: a multistakeholder approach to safeguarding freedom of expression and access to information) aim to safeguard  freedom  of  expression,  access  to information,  and  other  human  rights in the context of the development and implementation of digital platform regulatory  processes. The guidelines outline rights-respecting regulatory processes and promote risk   and system-based processes for content moderation and curation. Following a series of multistakeholder consultations and contributions that started in September 2022 the guidelines have been under review with a launch of the final document yet to be announced. 

The panel featured at FIFAfrica comprised John Bosco Mayiga, Programme Specialist at UNESCO, who moderated the discussion, Hon. Neema Lugangira, Chairperson of the African Parliamentary Network on Internet Governance (APNIG), Grace Githaiga, Convenor of the Kenya ICT Action Network (KICTANet), Dr. Simon-Peter Kafui Aheto from the University of Ghana, and Samira Danburam, New Media and Security Manager at the Nigerian Communications Commission.

Mayiga noted that there are growing shared concerns by many actors in the digital society on how to better harness the benefits of information platforms while also addressing the challenges that come with it. “There is much to gain with digital transformation. However, amidst hate speech and disinformation, there is also much to lose,” he said.  “How do we move forward leveraging the advantages of the platforms, but also take care of the excesses that happen to be part and parcel of platforms?”

Githaiga noted that there are no fast and easy answers in dealing with the current challenges of content moderation. She further noted that the guidelines will be invaluable in serving as a basis for individual countries, especially as different countries are at different levels of digital regulation while socio-cultural contexts also vary across borders. 

Indeed, various countries, particularly in Africa, are still grappling with navigating issues such as hate speech, disinformation, protecting legitimate online freedom of expression, content moderation, and data privacy. Dr. Kafui-Aheto added that the Internet Universality Indicators (IUI’s) are a great complementary tool to the guidelines. He also stressed that digital literacy, including on regulatory frameworks, is fundamental in the realisation and utilisation of the indicators and the UNESCO guidelines by more stakeholders. 

The speakers discussed the potential paths that the operationalisation of the guidelines in Africa could take. There was consensus amongst panelists on the need to create regional and national multi-stakeholder networks that enable the active participation of diverse groups in the implementation of digital platform regulation. This consensus was reached as the challenge of ensuring that online platforms serve as places where individuals can seek factual information but without fear was a recurring theme across FIFAfrica. 

Ultimately, the session stressed that the creation of an internet of trust cannot be the preserve of any particular group however specialised they are; it should be a collaborative effort that includes all stake-holders.

The guidelines are designed to inform regulatory processes under development or review for digital platforms, in a manner that is consistent with international human rights standards. According to UNESCO, the Guidelines may serve as a resource for policymakers in identifying legitimate objectives, human rights principles, and inclusive and participatory processes that could be considered in policymaking. The guidelines could also inform the policies and practices of digital platforms; and provide an advocacy and accountability tool for civil society.

CIPESA Conducts Digital Rights Training for Ethiopian Human Rights Commission Staff

By CIPESA Writer |

The Collaboration on International ICT Policy for East and Southern Africa (CIPESA) has conducted a digital rights training for staff of the Ethiopian Human Rights Commission (EHRC) in a programme that benefitted 22 experts from various departments of the statutory entity. 

The training was a response to the desire by the commission to build its organisational capacity in understanding and defending digital rights and CIPESA’s vision to grow the ability of African national human rights institutions (NHRIs) to monitor, protect and promote digital freedoms.

Conducted in the Ethiopian capital Addis Ababa on October 11-12, 2023, the programme aimed to build the EHRC staff’s understanding of digital rights issues and the link with traditional rights. Participants went on to brainstorm how the EHRC should strengthen human rights protection in the digital space and through the use of technology.

Dr. Abdi Jibril, the Commissioner for Civil and Political and Socio-Economic Rights at the EHRC, noted that the proliferation of digital technology has contributed positively to human rights protection. It was therefore necessary to maximise the benefits of digital technology and to expand its usage for the promotion and enforcement of human rights.

The importance of growing the capacity of NHRIs was underscored by Line Gamrath Rasmussen, Senior Adviser, Human Rights, Tech and Business at the Danish Institute for Human Rights and CIPESA Executive Director Dr. Wairagala Wakabi. African NHRIs are not always well versed with the opportunities and challenges which technology presents, which creates a need for capacity development and developing partnerships with stakeholders such as civil society. 

As legislation governing the technology domain is fast-evolving, NHRIs in many countries are playing catch up. As such, these institutions need to constantly keep updating themselves on new legislation and implications of these laws on human rights in the digital domain. The NHRIs need to  enhance their capacity to document, investigate and report on digital rights. 

The NHRIs also need to pay specific attention to the vices such as hate speech, disinformation, and technology-facilitated gender-based violence (TF GBV), that are being perpetuated with the aid of technology.

Dr. Daniel Bekele, the Chief Commissioner at EHRC, stated that social media companies and messaging platforms are not doing enough to moderate harmful content in Africa yet in other geographical regions they have invested more resources and efforts in content moderation. He said African countries need to work together in order to build a strong force against the powerful platforms. The official proposed that the African Union (AU), working with relevant governments and other stakeholders, should spearhead the development of regulations which African countries can jointly use in their engagements with the tech giants on issues such as content moderation. 

 The two-day training discussed the positive and negative effects of digital technology on human rights and how the commission’s work to enforce human rights can be strengthened through the use of digital technology.

Among other topics, the training also addressed the human rights, governance and technology landscape in Sub-Saharan Africa; public and private sector digitalisation and challenges for human rights; the link between online and offline rights; transparency and accountability of the private sector in upholding human rights; and opportunities for NHRIs to advance online rights at national, regional and international levels. It also featured deep dives into key digital rights concerns such as surveillance, online violence against women, disinformation, and network disruptions. 

At the end of the training, the EHRC staff identified key actions the commission could integrate in its annual work plans, such as digital rights monitoring, advocacy for enabling laws to be enacted, and developing tools for follow up on implementation of recommendations on digital rights by treaty bodies and the Human Rights Council. Others were collaborations with local and regional actors including media, fact-checkers, civil society organisations, and platforms; working with the police and other national mechanisms to tackle hate speech and disinformation while protecting human rights; and conducting digital literacy.

Trainers in the programme were drawn from CIPESA, the Centre for the Advancement of Rights and Democracy (CARD), the Danish Institute for Human Rights, the Centre for International Private Enterprise (CIPE), the African Centre for Media Excellence (ACME), Inform Africa, and the Kenya National Cohesion and Integration Commission (NCIC).

Meanwhile, after the aforementioned training, CIPESA teamed up with Ethiopian civil society partners to conduct a training on disinformation and hate speech for journalists, bloggers and digital rights activists. Like many African countries, Ethiopia is grappling with a significant and alarming rise in hate speech and disinformation, particularly on social media platforms. This surge in disinformation is undermining social cohesion, promoting conflict, and leading to a concerning number of threats against journalists and human rights defenders.

The proliferation of disinformation is to citizens’ fundamental rights as studies have shown that many Ethiopians feel their right to freedom of expression is compromised. The prevalence of disinformation also means that many Ethiopians lack access to impartial and diverse information.

Disinformation has been directly fueling conflict in several regions of Ethiopia. According to workshop participants and reports, both pro-government and anti-government actors have perpetuated this vice, whose real-world consequences are severe, including the loss of life and large-scale violent events.

Whereas Ethiopia in 2020 enacted legislation to curb hate speech and disinformation, the effectiveness of this law has been called into question. Some critics argue that it has not been effectively implemented and could be used to undermine citizens’ rights.

The training equipped 21 journalists, bloggers and activists with knowledge to navigate this law and with skills to call out and fight disinformation and hate speech. The efforts of the trained journalists, and those which the human rights commission could implement, are expected to boost the fight against online harms and contribute to the advancement of digital rights in Ethiopia.