Join us on the 30th of November at 14:30 – 15:30 SAST for the upcoming #hcsmSA Tweetchat to share your perspective about the impact of affordable access to ICT‘s in terms of Sustainable Health Development in South Africa as well as globally. The United Nation’s Global Goals have 7 ICT indicators covering 6 targets under Goals 4, 5, 9, and 17 with the objective to significantly increase access to Information and Communications Technology and to provide universal and affordable access to the internet in the least developed countries by 2020.
As President of South Africa, Nelson Mandela was a strong supporter of ITU. Speaking on 3 October 1995 at the opening ceremony of TELECOM 95 in Geneva, he recognised ITU as a body of crucial importance for the entire African continent. Speaking not only about South Africa but also about the entire African continent, he said “We need a vast expansion of our communication and information network. ITU, as the principal driving force behind international policy, technological development, cooperation and skills transfer, is an indispensable agent in this regard.”
President Mandela then went on to add, “The value of information and communication (ICT) is felt with particular force when, as happened in South Africa for so many years, their denial is made an instrument of repression. Such measures, however, ultimately evoke inventive and innovative ways of circumventing the restrictions. For example, as prisoners on Robben Island, when we were deprived of newspapers we searched the refuse bins for the discarded sheets of newspapers which warders had used to wrap their sandwiches. We communicated with prisoners in other sections by gathering matchboxes thrown away by warders, concealing messages in false bottoms in the boxes and leaving them for other prisoners to find. We communicated with the outside world by smuggling messages in the clothing of released prisoners. Not even the most repressive regime can stop human beings from finding ways of communicating and obtaining access to information”.
“In the 21st Century, the capacity to communicate will almost certainly be a key human right.” – Nelson Mandela
A transcript of tonight’s #hcsmSA discussion will be recorded and made openly available to the public for research and development purposes by Symplur Global Health Analytics here.
T1: How do ICTs and Connectivity currently create barriers in healthcare? Can you share a personal experience?
T2: What do you think should be done to improve ICT accessibility?
(e.g. Reduce data cost, increase competition, public health funding, policy changes, improve digital literacy, fund grass root projects more actively, etc.)
T3: Without reliable, affordable access to ICT and Connectivity, what impact will that have on the future of health globally?
(e.g. Data is unavailable for clinical trials, digital divides grow between developed and developing countries, global medical education is limited, global economic competitiveness and trade is reduced, global health threats like Antimicrobial Resistance worsen with limited access to digital surveillance systems, etc.)
T4: Do you feel that access to ICT and affordable connectivity should be a human right?
CT: Closing Thoughts – What do you think is important to add to this conversation?
#hcsmSA – Community Etiquette
* Please read the blog first to familiarise yourself with the topic.
* Start your answers with T1, T2, T3, T4 or CT for transcript purposes.
* Answer only after the moderator has prompted everyone with the question.
* Please stick to the topic during the conversation.
* Lurkers, please introduce yourself, let us know you are there, we welcome you to join anytime.
* If you are not on a chat platform like Tweetchat.com, remember to use the #hcsmSA hashtag in your tweets so that they record on transcript
* Please respect members of our geo-community. Refer to the Twitter Code of Conduct to learn more.
#hcsmSA is open to all stakeholders in healthcare, both locally and globally.
We value diversity of opinion and therefore invite patient advocates, NPO’s, doctors, nurses, IT developers, marketing companies, policy-makers, event organisers, journalists, academic sector, payers, caregivers, pharma, entrepreneurs, scientists and others. We are GLOCAL.
Please support the growth of our South African hcsm community after this TweetChat by using the #hcsmSA hashtag in your health-related tweets so that we connect.
Doreen Bogdan-Martin is a strategic leader with more than 20 years of high-level experience in international and inter-governmental relations. She has a long history of success in policy and strategy development, analysis and execution.
Since 2008, Doreen has been Chief of Strategic Planning & Membership for the International Telecommunication Union (ITU), a specialised agency of the United Nations located in Geneva, Switzerland. The ITU is dedicated to bringing connectivity to all the world’s people through development assistance, standardisation, and coordination of radio communications.
Doreen leads the organisation’s strategic initiatives and directs the Corporate Communications and External Affairs divisions. She serves as Secretary to the ITU Board of Directors, and Coordinator of UN Affairs for the ITU. Doreen has more than 15 years of experience working with developing countries, advising governments from around the world on policy and regulatory reform measures. She has organised global conferences with thousands of participants from 150+ countries, and brokered international consensus on many critical issues, and is a regular presenter at high-level international forums and summits.
With a Master’s degree in International Communications Policy from American University in Washington, DC, Doreen completed post-graduate certification in Strategies for Leadership at the Institute for Management Development in Lausanne, Switzerland. She is also certified in Accountability and Ethics by the United Nations Leaders Programme. Doreen is an affiliate of Harvard University Berkman Center for Internet and Society and a member the Swiss Network for International Studies Academic Council.
Taryn Springhall is co-founder and editor at eHealthNews. A recognised journalist and global traveller, Taryn is using her skills and experience to build a platform that supports the adoption of eHealth in Africa through sharing ideas, news stories and knowledge. She is passionate about healthcare & technology and its collective power to deliver social change and make a difference to the lives of individuals, communities and whole populations.
Professor Natalie Schellack
Associate Professor/Course Coordinator Clinical Pharmacy
Department of Pharmacy
Sefako Makgatho Health Sciences University
Founder of the South African Monthly TweetChat #clinpharm (Analytics c/o Symplur)
Professor Natalie Schellack is currently working as an Associate Professor and Course Leader: Post Graduate Programmes in Clinical Pharmacy in the Department of Pharmacy, Sefako Makgatho Health Sciences University.
She holds three degrees, two bachelor degrees (nursing and pharmacy) and a PhD in pharmacy. She is part of the editorial team of three international journals, serves on the Gauteng Provincial Pharmacy and Therapeutics Committee Paediatric Essential Medicine List of the National Department of Health of South Africa. She further serves on the Sefako Makgatho Health Sciences Research and Ethics Committee and assists in different projects for the World Health Organisation.
Professor Schellack is also the chairperson of the South African Society of Clinical Pharmacy (SASOCP). She has supervised of 39 master’s degree students to completion over the last five years. She has served as an external examiner to the Universities of Witwatersrand, Kwazulu-Natal, North-West, Western Cape University and Nelson Mandela Metropolitan. She has written over 95 publications (research, review and textbooks) in the last six years. Her special interest is paediatrics, including dosing according to pharmacokinetic and pharmacodynamics principles in pharmacotherapy.
Egide is a General Practitioner (GP) registrar and soon to be PhD. graduate at Burundi University. He is a community and innovative project leader. He has been working with the U.S mission in Bujumbura to help students access to ICT by training them about basic computer science.
He has worked with more than 300 students on elementary computer science as well as professionals in a Chronic Diseases Network (YP-CDN) based in Boston, recently also participating in their NextGen Leaders Summit. He is a co-founder and deputy leader of a Burundian Medical Fellowship. Egide’s prominent interests are in advancing global health, access to resources for community empowerment, advocacy, improving ICT, in connectivity, equipment and infrastructure. His vision encompasses collaborative and disruptive change to strengthen global data collection and in his words says, “No one deserves to live through a debilitating illness alone. Humanity has to act together to combat our global health crises because diseases are not isolated to specific countries, they never understand the same borders.”
Manish is a digital health entrepreneur and found of HCITexperts in India. He has experience in various health IT companies offering services such as EHR, Patient Portals, Patient Kiosks, Mobility solutions for doctors, nurses and patients and remote monitoring frameworks. He has trained and lead teams to build digital health solutions for clients in India, South-East Asia, Africa, the Middle East & America.
The HCITExperts‘ blog is an effort to form a collective of multi-disciplinary experts who share their expertise with startups in India to enable innovative solutions that improve enable healthcare delivery. It also offers the doorway to network with global experts to improve knowledge and solutions that can be implemented in India.
Thank you to everyone joining us in this discussion. Your unique perspective is important to understanding how to implement effective digital solutions for Sustainable change.
Access to ICT for Sustainable Health Systems in Developing Countries
ICT is the backbone of Sustainable Health Development globally. Basic access to a reliable internet connection and equipment such as computers and smartphones will transform our lives in coming years. Without ICT access, developing economies in Africa, such as South Africa won’t achieve any of the global goals. It’s a critical situation for everyone as we move towards the fourth industrial revolution and health 3.0, because our continent will be left behind.
From a citizen’s perspective, moderating a geographic hcsm community and researching to advance our health sector can be a cumbersome task. I pay close to ZAR 800 p/m for ADSL because Fibre is not available in my area yet. I use two dominant Telecoms and Internet Service Providers (ISP) and have limited choices. If I report a slow connection I sometimes also pay for the call-out so I tend to avoid it. I pay for a 10 Mbps line speed and a 20 GB capped data package but on most occasions due to heavy congestion only receive about 1.5 – 3.0 Mbps according to Speedcheck.org and I work from a so-called developed Johannesburg business district called Fourways. Because of the instability of my connection, I pay an additional ZAR 500 for a 4G device which offers similar results and a virtual office subscription for ZAR 580, just in case there is load-shedding or both options fail simultaneously and I am desperate to get my work done. The total cost for a reliable connection is ZAR 1880 p/m, (i.e: $135.00), to put that into perspective, that is equivalent to a third of my mortgage payment. That doesn’t include my mobile data at an additional ZAR 300 p/m for a depressing 2GB and roaming mobile data which costs me more than my flight. I find myself questioning how on earth the underprivileged community must feel when they try to use this so-called “freely” available resource called the internet. (World Bank Extreme Poverty Statistics). South African middle-class can hardly afford the liberty of reliable connectivity, nevermind the poorest of the poor. Surely if this continues, smart and holistic data in Africa will become a luxury for the very wealthy and rule out any possibility of precision medicine and genomics by 2030? Global health data is critical to everyone.
According to a recent article about connectivity as a human right, most people in the world don’t have much disposable income to spend on data access and any plan to make internet access broadly available will require making significant technology and business model improvements that enable some access to be either very cheap or free for people who can’t otherwise afford it. Another issue is access to equipment such as smartphones and digital literacy education. There is a concern that the longer these citizens are unable to access the internet, the wider the digital divide will grow and impact on a global economic level.
In a recent ONE campaign article, it was also emphasised that “Internet access is a catalyst for creating a world of greater freedom, fairness and dignity for all peoples, everywhere and that every country must now agree on an urgent plan to implement the Global Goals, and mission-critical within those strategies is connectivity for all. The Pope and Malala have spoken eloquently about the one world and one family we’re all a part of, and the internet, at its best, facilitates that unity. But when three-billion are left beyond the internet, they are left behind and left out of that family. That must change and fast.”
The Connectivity Declaration was signed by many global leaders which included: Charlize Theron for Africa Outreach Project, Bill and Melinda Gates for the Bill & Melinda Gates Foundation, Richard Branson, Hans Vestberg for Ericsson, Mark Zuckerberg for Facebook, Hugh Evans for Global Citizen, Bono for ONE, Shakira, George Takei and Chris Anderson for TED.
As a Global Citizen, you can sign it here too – LET’S CONNECT AFRICA HEALTH TOGETHER
YouTube Video courtesy of ITU
In 2016, is it still unreasonable for citizens to consider connectivity as a human right? Especially in an emerging economy like South Africa which has the resources but a lack of interest and awareness?
Here are a few examples of how access to affordable ICT directly impacts on our health sector both locally and globally:
One Health: Antibiotic and Antimicrobial Resistance
In 2014, the White House Strategy recognised the importance of One Health (#OneHealth). Antibiotic Resistance (#AntibioticResistance) and Antimicrobial Resistance (#AMR) can arise in bacterial pathogens affecting humans, animals, and the environment. Strengthening detection and control of resistance requires the adoption of a “One-Health” approach that promotes the integration of public health and veterinary disease, food, and environmental surveillance. Improved detection can be achieved through appropriate data collection and sharing, enhancement, expansion, and coordination of existing surveillance systems, and the creation of a regional laboratory network that provides a standardised platform for resistance testing and advanced capacity for genetic characterization of bacteria including whole genome sequencing.
IT Surveillance Systems and Mobile Apps for Emerging Diseases like Zika and Ebola
The use of mobile phones, text messaging and video can be incredibly cost-effective and essential in healthcare work, particularly in developing countries. These tools can not only impact on patients, but also on healthcare workers themselves. Currently, health systems in developing countries are overstretched and overburdened. There is a massive global health worker shortage – estimated to grow to 12.9 million by 2035, from the current deficit of 7.2 million – making it even more imperative to support front-line health workers through ICT and mobile technologies that provide education, improve efficiency and enable deliverable health services.
Currently, in Ireland and Europe, healthcare workers such as GPs and hospital doctors continue their training using online platforms and materials sent to their mobile devices. However, health workers in developing countries may not necessarily have these tools to improve their knowledge. Therefore, we must act to address this imbalance. To do so requires strategic collaboration and partnership throughout the entire training ecosystem. The importance of this is now even greater, with the growing Ebola epidemic and the imbalance it is causing to health systems in Africa and beyond.
AIDS, TB and ARV’s
Technologically, although South Africa has the most advanced ICT platform in Africa there is a digital divide between urban and rural settings and between the rich and poor (Akinsola, Herselman & Jacobs 2005; Sikhakhane & Lubbe 2005; World Economic Forum 2012). There are also different levels of eHealth maturity across and within provinces with a wide range of legacy information systems, which leads to little or no interoperability and communication between these systems (DOH 2012a, 2012b).
Thus far, research has shown that education alone is not adequate to effect the desired behavioural change amongst most individuals (Rachel 1999). ICTs have the potential to accelerate the development and implementation of productive HIV prevention programmes and interventions, by building a capable health system, thereby reducing barriers in accessing quality services (Scheibe, Brown & Bekker 2012).
Mobile devices and broadband connectivity will be a vital link in allowing the disabled to participate fully in work and social activities. In addition, the advent of the Internet of Things (IOT) and the explosion in wearables also have major sensory replacement and enhancement implications for consumers with disabilities.
In the past, ICTs for disabled people were developed separately and at great expense. With mobile devices, tablets, TVs, wearables and sensors now available as a platform for everyone, access to specialist equipment, apps and services are much easier and certainly much more affordable. Now disabled people can join many online activities such as retail, banking and entertainment, whilst having the opportunity to get into the workforce, leveraging those more accessible devices and exposing their individual skill set.
Developments in computing, storage and network capabilities combined with a range of means of interacting with devices and applications such as touch, gesture, speech – and brainwave, coming soon – all mean that senses can be enhanced or content adapted to suit an impairment.
These are the key components falling into place to make all this possible:
• Devices are getting more accessible with adaptation to screens and input assisted by speech, touch or gesture
• Smart homes mean that devices and functions are easily adapted to different conditions. For example, lighting that changes colour to announce a phone call or someone at the door.
• Wearables & IoT allow consumer electronics such as high-powered cameras, microphones and sensors to help disabled individuals communicate.
• Smart city services can help disabled people better navigate their way through the village, town or city with assistive services based on iBeacons and information about accessible routes and buildings
• Applications help seeing, interpreting, speech and learning.
Not surprisingly, with so many contributing components coming from so many diverse sources, there is a lack of consistency when it comes to standards. This is true for the consumer electronics components as well as the operating systems and applications environments being used.
Data from UN Women indicates the Digital Divide isn’t just about economic access to technology but is also constrained by gender. Globally, 250 million fewer women are online than men and the Internet user gap between the sexes has increased to 12 percent in 2016. In the developing world, the figure is even more daunting for women with a 31 percent difference.
The telecoms and technology industry also recognises that women and girls play a vital part in sustainable global development. On September 18, at the annual Broadband Commission meeting in New York City, ITU and UN Women teamed up with partners from Silicon Valley to Mexico to launch EQUALS: The Global Partnership for Gender Equality in the Digital Age. EQUALS will collaborate with every programme, whether run by a foundation, corporation, ministry, or NGO, attempting to bring digital literacy and savvy to all women and girls in the world.
ICT’s are transforming old market sectors including farming, manufacturing and the health sector, and creating new market sectors that didn’t exist even a few years ago, like social media management, gaming and the mobile apps economy. The demand for both basic and more advanced ICT skills cuts across all sectors, from agriculture and construction to education and service industries to ICT jobs themselves, in both developing and developed countries. Basic digital literacy is increasingly required just to find job listings and apply for a job.
ITU’s Telecommunication Development Sector (BDT) has created a new Youth Employment and Entrepreneurship Resources Database to assist young people to find and use these digital opportunities. This database contains resources for finding employment, becoming an entrepreneur, learning technical and soft skills, finding a mentor, searching for funding, networking, and many other valuable services.
Rare Disease global registries represent a fundamental research effort upon which a number of critical activities are based. They constitute key instruments for increasing knowledge on Rare Diseases (RD) by pooling data for fundamental and clinical research, epidemiological research, and real-life post-marketing observational studies1. They broadly support health and social service planning by playing a pivotal role in healthcare organisations. They also represent a necessary infrastructure for the implementation of the European Reference Networks for rare diseases, and as
They also represent a necessary infrastructure for the implementation of the European Reference Networks for rare diseases, and as such they represent a top priority2 for the RD community at a National, European and International level. Furthermore, Patient Registries are one of the main pillars of the current EU policy framework on National Plans for RD3. EURORDIS holds Patient Registries as an advocacy priority and is actively participating in the major EU projects4, 5, 6. In the field, shaping and implementing an EU coordinated strategy on registries that will be patient-centred.
Outside the rare disease field, a number of major research infrastructures have shown that tools for large-scale data and sample sharing across multiple research projects can succeed. RD-Connect aims to unite the multiple existing infrastructures and integrate the latest tools in order to create a robust and comprehensive platform that combines biobanking, data analysis and patient registries that can be used by rare disease researchers worldwide.
Precision Medicine is a medical model that proposes the customisation of healthcare, with medical decisions, practices, and/or products being tailored to the individual patient. Essentially it is a combination of biological, physical, engineering, computer, and health sciences to set the stage for a transformative leap towards a targeted, data-driven, healthcare mechanism for patients.
On his April 2016 trip to the Vatican, Vice President Biden issued a call for an international commitment of all nations for the Moonshot initiative to consider renewed and focused cancer investments in ways that improve patient outcomes by creating publicly accessible sets of research and patient data, including those data sets that can represent the global diversity of populations, people, and cancers.
Imperial College in London adds that Non-Communicable Diseases (NCDs), such as cancer and diabetes, are the world’s number one killer, bringing hardship across both economically rich and poor nations. The largest burden – 80% (28 million) – occurs in LMICs, making NCDs a major cause of poverty and an urgent development issue.
Join the next #hcsmSA TweetChat in December when we discuss cybersecurity and digital health in Africa. Follow @hcsmSA on Twitter to learn more. Use the #hcsmSA hashtag in your health-related tweets to keep the conversation going afterwards and to grow our geo-community.