Healing technology for the Commonwealth

Amidst all the inequalities of this world, advances in information and communication technology (ICT) are one area which can offer a fast-track development opportunity for the poor.

At first, this may appear to be a contradiction. It would seem right and moral that precious resources and the allocation of budgets should focus on basic needs. It’s not hard to envisage the positive and dramatic impact of interventions such as the mass immunisation of children, the provision of mosquito nets to prevent malaria and the benefits of clean water.

Yet e-health addresses the reality that the whole world is becoming digitalised – not just the wealthy, developed world. And we had better all help each other to get on board.

It is also useful to remember that within each and every country, no matter what its GDP, there exist pockets of poor, marginalised people.

It is a known fact that there is a link between information, communications and economic growth. But there is a misconception that harnessing this technology for health is the preserve of a privileged few nations. Despite the so-called ‘digital divide’, the communications boom in some developing countries has far exceeded even the most optimistic predictions.

Africa for the past five years has had the fastest-growing mobile phone market in the world – in fact, twice as fast as the global market. In 2007, there were 260 million mobile phone subscribers on the continent.

And there is still massive network potential for this to develop further. In Nigeria, for example, there are around 40 million mobile cellular subscribers out of a population of 150 million. Sixty per cent of the population was covered by mobile signal in 2006.

For many governments, the infrastructure needed for landlines to reach remote or impoverished areas is simply unaffordable. This is a demand-led revolution and not dependent on supply. Private companies have taken the lead, and competition is forcing prices down.

Just four years ago, Africa became the first continent to have more mobile phone users than landline users. Mobile phones now make up 90 per cent of telephone subscriptions in Africa.

This used to be the boast of technologically sophisticated nations such as Finland, the birthplace of Nokia. Now we are talking about countries whose citizens are some of the poorest, most deprived on Earth.

As a journalist recently observed, in Africa a mobile phone can be a passport out of poverty.

Why does this matter to health? Because as you read this, mobile phones are being used to help people living in remote or inaccessible areas get medical advice. And doctors and nurses in regional hospitals are consulting specialist colleagues in bigger cities, both in their own countries, and abroad.

Across the world, governments are recognising the importance of integrating ICT into their health systems.

Consider the benefits of co-ordinating emergency medical relief after a disaster, or famine. Or of sharing information when there is a public health crisis involving a contagious disease such as the Ebola Virus.

And what about using ICT to educate health workers, or to keep them up to date with developments? In the absence of new information, old procedures will continue to be used, unless nurses and doctors can have access to the latest medical advances.

Ordinary people, too, can gain a lot from basic information.

In Bangladesh, a rural helpline has been set up, alongside an initiative called ‘Mobile Ladies’. These women go from house to house with a cell phone hearing about villagers’ problems and helping them find solutions. The facility means that no one is excluded, even illiterate people, disabled people, old people, or sick people.

Almost half the queries concern health issues.

The impact of the ‘brain-drain’ of health workers, which has been a big problem for many Commonwealth governments, could be lessened if specialised learning opportunities were easily available via the internet. And valuable expertise could be resourced readily, across borders and despite distance.

Imagine the benefits of e-health to mobile clinics moving from village to village. Using technology to store health records can be critical to the diagnosis and treatment of a sick person.

E-health offers us all the chance to address long-standing inequalities, reaching populations, and sections of populations which have been ignored, or are inaccessible or marginalised because of geography, ethnicity or poverty.

While access to the internet, and particularly broadband, remains limited in many places, new advances in wireless technology and in cellular phones – now offering email and access to news and internet services - mean that poorer countries are in an especially good position to take advantage. The process of digitalising is taking place much faster than ever before and with newer, more efficient technology, less compromised by erratic electricity supplies.

Health is a human right which has long been denied to many. It is also an integral part of social policy, and a cornerstone of socio-economic development. E-health is one of the tools that we now have to redress this, to aid governments in reaching the Millennium Development Goals.

The Commonwealth is a unique organisation. Perhaps we don’t appreciate how unique it is. Not only is its geographical, racial and religious span considerable, but its economic diversity embraces some of the richest nations in the world, some of the fastest developing nations, emerging economies, economies with massive markets, technologically sophisticated economies and highly dependent or vulnerable economies.

The sharing of knowledge, expertise and ‘best practice’ is something the Commonwealth knows how to do well. The achievements and models of some countries in the field of e-health could readily be duplicated by others.

The mobile phone, the computer, and the digital camera are already changing how we organise, manage, finance and strengthen health systems. The technology is available and increasingly accessible in most Commonwealth countries. The challenge is harnessing its potential to support the health sector and acknowledging that the delivery of health care is not a static practice.

The future of the world’s health will be determined more and more by technological advances, and e-health is central to this transition.

Nobel peace laureate Archbishop Emeritus Desmond Tutu, keynote speaker at the Commonwealth Health Ministers Meeting in Geneva on 18 May 2008 on e-health. The civil rights leader is also a co-author of ‘Third World Health: Hostage to First World Wealth’ (2005) and ‘Health, Trade and Human Rights’ (2006).