Guest editorial: Digital health – The public health view
Dear reader,
While in the moment, it is difficult to know that mankind is undergoing a revolution. When a new technology is first introduced, it is challenging to predict the exact magnitude to which it will impact the structures and systems of society. It is most likely that this determination will be left for future historians, who, with the help of hindsight, will be better equipped to make these evaluations and analyses.
We talk about the arrival of digital technologies with a lot of enthusiasm, especially in regards to their potential impact on health and healthcare. However, this enthusiasm is coupled with notable anxiety as well. This is because, while the introduction of new technologies has the potential to bring revolutionary benefits to humankind, it also has the potential to do more harm than good, or to exacerbate an already existing problem. This pattern of reactions towards new technologies is well established in sociology. Understanding how technology is designed, produced, implemented and regarded by society is fundamental to our progression and improvement. This is why the relationship between technology and humankind has been a relevant topic in disciplines like sociology and anthropology.
Digital technology has already brought revolutionary changes to many areas of life today. When assessing its relevance and potential application to health and health care, some have very high expectations for the “digital era”. Others claim that new technologies offer “only” a gain in time, money and human resources. For sure, there are limits on the problem-solving capabilities of technology. For example, several technological mechanisms have been developed to improve maternal and child health in various settings, especially for low and middle income countries. It has been found that women are very receptive to health information, and this has frequently made them the target of health promotion and prevention initiatives. Thus, the status of the health of a population depends to an important extent on the women of the community. However, in many LMIC, the legal and societal status of women is very low. This has negative consequences for the health outcomes of women, and subsequently limits the level of health in the community as a whole. No matter the benefits that a new technology offers, it will not give women the fundamental rights that they desperately need to lead safe and health lives. Rather, in some instances, the technological “fix” is actually distracting from the actual cause of the health problem.
It is also important to consider the role of digital technologies in global business. Health is a major industry in the business sector globally. The health and life sciences sector often accounts for a substantial percentage of a country’s GDP. For example, in 2016 the pharmaceutical industry alone accounted for 7.8% of Switzerland’s GDP. Digital technologies in health are sure to be incorporated into the business models of these health corporations, and are likely to be a profitable addition. Seeing as the interplay between business and digital health has the potential to increase or decrease existing inequities in society, it is the duty of Public Health to have clear, defined values that it can effectively communicate to the public. Public health is devoted to the vision of an equal society, without discrimination, and is based on the value of solidarity.
All technology will have to be measured by the impact it has on our societal model; they may well increase or decrease existing inequities and injustice. It is our task to use them in the way we want to live as communities. For the time being, all public health professionals should be fully aware of the potential impacts of health technologies and should always consider the pressures that indirectly influence their basic values. It is our responsibility as engaged participants in the realm of Public Health to take a pro-active role and express the views for the society that we want.
Bettina Borisch, Institute for Global Health, University of Geneva
Executive Director, World Federation of Public Health Associations
Contact: Bettina.Borisch@unige.ch
References:
- Cerqui, D. (2006) Humans, Machines, Cyborgs: Le Paradigme Informationnel dans l’Imaginaire Technicien. Labor et Fides, Geneva
- Borisch B., Iloegbu C.A., Wells N. (2018) Data, technology and public health. Public Health Genomics, citation online: 10.1159/000488703
Bettina Borisch kindly agreed to publish her keynote at the MMI/MMS workshop “Digital health, eHealth, mHealth: Breakthrough for public health or creating new dependency? A critical look at the current hype” as a guest editorial to these Network News. More Network meetings on digital health will take place later on this week! See the announcements below. (TS)
MMI Network: Events
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Network event: Medicus Mundi Switzerland
Clinical Decision Support and Health Information Systems – Potential and Pitfalls of New Technologies
Basel, 25 April 2018
Swiss TPH Spring Symposium. “New technologies are progressively transforming health care delivery. In health facilities, point-of-care devices can support clinical personnel in the diagnosis and care of patients. At system level, health information tools help aggregate and visualise data thereby facilitating decision-making for managers and policy makers. The Spring Symposium 2018 invites health system professionals and students to share and review experiences of technology-enabled healthcare with a particular focus on low- and middle-income countries.”
> https://www.swisstph.ch/en/about/events/spring-symposium-2018/
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Network event: Medicus Mundi Switzerland
Governing Digital Health: Beyond ownership and regulation
Geneva, 26 April 2018
“What policies and decisions are needed to govern digital health? How can we ensure that the advancements in digital health and artificial intelligence will improve the quality of health care delivery and foster health equity?” This lunch event at the Global Health Centre (member of Medicus Mundi Switzerland) is part of the GHC Executive Course on Engaging in Multi-Stakeholder Diplomacy for Health.
> http://graduateinstitute.ch/lang/en/pid/8646-1/_/events/globalhealth/governing-digital-health
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Network event: Medicus Mundi Switzerland
Gender Based Violence: Approaches and challenges at community and advocacy level
Berne, 2 May 2018
“Gender Based Violence (GBV) is a main issue in international health cooperation. GBV is not only a human rights violation, but it also has a great social and economic impact and hampers health, education and poverty reduction programs. The aidsfocus.ch conference will discuss approaches and challenges of how to address GBV at different levels.
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Network event: EPN
Promoting Patient Safety – Medications without Harm
Kampala, 15-18 May 2018
EPN Forum 2018. “The biennial EPN Forum is an opportunity for EPN members to meet in one place, learn, share knowledge, exchange experiences and best practices from their home countries. The theme for the EPN Forum 2018 is ‘Promoting Patient Safety – Medication without Harm’. The Forum taps into the third WHO Global Patient Safety Challenge. The goal of the challenge is to propose solutions that address the many obstacles the world faces to ensure the safety of medication practices. Medication harm to patients is an ongoing problem in many countries and not unique to lower and middle income countries (LMICs). Faith-based health facilities should take up the challenge to improve their patient’s safety through learning and knowledge sharing. The first step is attending the EPN Forum 2018.”
> http://www.epnetwork.org/index.php/en/the-forum-2018
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Network event: MMI Network and members
71st World Health Assembly and related events – MMI participation and contributions
Geneva, 21-26 May 2018
This year’s World Health Assembly (WHA) will again a week full of intensive debates on key global health issues, both within the formal Committee meetings and in a never ending series of formal and informal side events (an overview will soon be provided by G2H2).
The MMI delegation will include Network and project representatives, in particular from our Global Health Governance team, our working groups on Human Resources for Health and Effective Health Cooperation and the joint PHM/MMI WHO Watch project.
As an organization in official relations with WHO, the Medicus Mundi International Network will submit a number of statements under items concerning technical issues.
- Join the MMI Delegation
Registration for the MMI delegation at the WHA will be possible until 5 May. To know more, Network members (only) are invited to get in touch with our Secretariat. - Civil society meetings before the WHA
The meetings will take place on Friday and Saturday 18-19 May 2018. The global health governance team of the MMI Network was a co-organizer of civil society strategy meetings for some years. Two years ago we handed over this role of a convenor to the “Geneva Global Health Hub” (G2H2) project hosted by the MMI Geneva office. G2H2 will also have its second Annual General Meeting on the weekend before the World Health Assembly.
http://g2h2.org/posts/event/may2018/ - Moving health cooperation beyond aid. MMI Assembly
An invitation to the MMI Annual General Assembly will be sent out later on this week. The Assembly will take place on Saturday 26 May 2017, 9:30-11:30 hrs at the Graduate Institute. - #AidToo: Sexual exploitation in international cooperation: Prevent, respond adequately – and most of all: address the root causes. MMI Workshop
The public lunch event as side event to the MMI Assembly, on Saturday 26 May 2017, 12:30-14:30 hrs, will be co-hosted by the Global Health Centre and take place at the Graduate Institute. Thanks to Cordaid, the Institute of Tropical Medicine Antwerp and Medicus Mundi Switzerland for their engagement in the preparation of the workshop.
Save the dates! Detailed information on these meetings and a list of WHA side events will be available soon on the MMI website and sent to MMI key contacts.
MMI Network: News, reports, resources
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Network news: EPN
EPN: Fight against Antimicrobial Resistance
EPN News, April 2018 “What exactly does EPN do and how do they work with Action on Antibiotic Resistance (ReAct)? In an interview with Jamie Wagner, Advocacy and Communications Intern at Christian Connections for International Health – CCIH and a student at Pepperdine University, USA, Dr. Mirfin Mpundu, Executive Director EPN and Head of ReAct Africa Node, talks about EPN, its efforts in the fight against Antimicrobial Resistance and how we partner with ReAct in combating AMR and Infectious Diseases.”
> http://www.ccih.org/the-fight-against-amr/
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Network news: Doctor with Africa CUAMM
Doctors with Africa CUAMM in the front line to fight NCDs“
Cuamm, April 2018. Doctors with Africa CUAMM has taken part in the WHO Global Dialogue on Partnerships for Sustainable Financing of Noncommunicable Disease (NCD) Prevention and Control, held in Copenhagen, Denmark. Andrea Atzori, Head of International Relations, on behalf of CUAMM, presented best practices to tackle NCDs in Mozambique, Ethiopia, Sierra Leone and Angola.”
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Network paper and video: Health Poverty Action
The Alternatives: Global perspectives for healthier lives
Health Poverty Action, April 2018. “The scale of the global health challenges we face can make it easy to forget that alternatives are possible. But not only are they possible – they are being implemented right now! From the strong welfare of the Nordic countries to the promotion of technology and research and development in South Korea. From Ecuador’s focus on the Good Life to Cuba’s agro-ecology which has made it the most sustainable country on the planet! Around the world, there are a range of approaches that in different ways are delivering healthier environments and healthier lives.”
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Network paper: Cordaid
Addressing Teenage Pregnancy in Sierra Leone
Cordaid, April 2018. “Sierra Leone has one of the highest rates of Teenage Pregnancy in the world. 3 in every 10 teenage Sierra Leonean girls are pregnant, according to UNICEF (2015 figures). This is why Cordaid’s Teenage Pregnancy Prevention Program supports the Government of Sierra Leone in preventing and reducing teenage pregnancies and pregnancy-related mortality and morbidity.”
> https://www.cordaid.org/en/news/preventing-teenage-pregnancy-sierra-leone/
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Network paper: Wemos
Development assistance for health workers and equity – is a Global Fund for Health the answer?
Wemos, April 2018. “The shortages and unequitable distribution of health workers have been well known for many years. So are the challenges facing Official Development Assistance (ODA), including ODA for Health and in particular for health workers’ salaries. We need long-term sustainable funding for health.” (Blog by Mariska Meurs)
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Network paper: Wemos
Employers and employees in Health Care: We too advocate fair health worker policy
Wemos, April 2018. “”Wemos and the European Public Service Union (EPSU) are collaborating to draw the principles of ethical recruitment of migrant health workers within and to Europe to the attention of stakeholders involved in sustainable health workforce policy. Two years after the adoption of the European Code of Conduct of EPSU-HOSPEEM in 2008, all WHO Member States signed the WHO Global Code of Practice on the International Recruitment of Health Personnel.”
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Network video: Cordaid
Sexual and Reproductive Health and Rights. A Jeune S3 video
Cordaid, March 2018. “Talking about sexuality and rights is not easy for young people. Talking about it in fragile and conflict-affected areas is even harder! Come meet some of the inspiring young people who want to change this.”
> http://stichtingcordaid.m9.mailplus.nl/nct8020574/vNHe2iDHa22XjI2
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Network paper: Medicus Mundi Switzerland
No ‘Business as Usual’ against Non-Communicable Diseases
The Symposium 2017 of the Medicus Mundi Switzerland Network highlighted the complexity of the NCD epidemic. Determinants of NCDs are of social, economic, political and environmental nature, resulting in a growing burden – especially in LMICs – that can no longer be out of priority. Only with a multidimensional approach this epidemic can be tackled. The symposium reader is available now as online bulletin.
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Network paper: Wemos
Imagine, then, having to rely on your mobile telephone for light while attending a mother giving birth
“Imagine working at a health clinic for a week on the run. Imagine finding out that your only colleague has left and will not be replaced. Imagine, then, having to rely on your mobile telephone for light while attending a mother giving birth. Does this sound extreme? It is. It is also the reality of health workers in Malawi.” A great blog by Elisa Veini, Wemos, published in March 2018. We used a picture and quote for the announcement of the MMI workshop on “Digital health, eHealth, mHealth: Breakthrough for public health or creating new dependency?
> https://www.wemos.nl/en/24-7/
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Network Resource: ITM IHP
Switching the poles
Have a look at the great weekly newsletter produced by our new Network member, the ITM IHP Network. It might help you switching your poles, too.
> http://www.internationalhealthpolicies.org/
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Network Resource: MMI
mmi-cooperate: New tool for horizontal communication within the MMI Network
The mailing list set up by the MMI secretariat is intended to facilitate horizontal communication among the members of the Medicus Mundi International Network engaged in international health cooperation. All MMI Network members are invited to use “mmi-cooperate” to inform their colleagues about current activities and events, to enquire about opportunities for collaboration, to share key publications and resources, or to launch a conversation on a particular technical or political topic. Instructions needed how to do it? Please get in touch with our Secretariat