mHealth: Can we achieve “more good by doing” than by “doing good”?

I’m ready to duck the rotten tomatoes for saying this but… there’s something that grates with me about the latest Gates Foundation Grand Challege in Global Health to “Create Low-Cost Cell Phone-Based Applications for Priority Global Health Conditions”.

A lofty goal that seeks out proposals that are ““off the beaten track,” daring in premise, and clearly different from the approaches currently being developed or employed” that can “leverage the cell phone towards innovative, high-impact, and sustainable global health solutions for the world’s poorest people“.

I’ve mentioned before how poorly researched/written these Grand Challenges are but this time maybe its just the way it seems dismissive of the fact that the cell phone is already being used to leverage help for the worlds most disadvantaged. Tomi Ahonen’s stats show how we’re at a point in time where every “economically viable” person on the planet is carrying a mobile so I think we have to be able to appreciate that this means the poorest of the poor aren’t wielding mobiles yet. Interventions may well have the effect of helping those who are a tier above the very poorest. We might like to think of a world were there’s just one digital divide but at the very bottom there are a people who are being lost and the mobiles being used by those who may be only very marginally wealthier than them may indeed be helping to keep them there. Education, very low cost mobiles and reduced barriers to ownership are key to reaching these populations.

But do we really need to look for the different? Healthcare workers I know who have or do work in these regions always tell me they need more of what we have and use here. Of course none of them deny that we need to employ smarter ways to achieve this so that it’s economically viable but replacing paper with micro SD memory cards is a game changer as far as they can all see. The Clinton Foundation supported project to map the sound of coughs against their diagnosis is a brilliant example of this as it uses similar technology to what’s being used in networked voice recognition services.

Jumping in at the deep end is great but how can you possibly rule out the potential to support “the development of technical solutions that will provide only modest or incremental improvements in health outcomes”? Surely this will probably rule out all the simple but terribly effective ideas that could have so much bearing (eg. preloading every african mobile with localised educational content so that they can learn to read or appreciate the importance of mosquito nets or dental hygiene) but just aren’t being done because there’s no economic advantage to be had by the entrepreneurs that would be needed to make it happen.

Likewise declaring no interest in supporting the “development of applications targeted to diagnostics of chronic non-infectious diseases” or the creation of “life-style guided applications” is dismissing the real potential that the 5 billion + patient owned mobiles have: to encourage and motivate behavioural change that can help prevent the onset of disease and keep citizens productive for longer.

If Bill Gates used his influence to have Microsoft create devices that made for competition in the low cost smart device sector for smartphones that were open for developers I think it would achieve more for the health of the poorest poor. Most of the things that are needed to be done are already being done in some shape or form and most of it just needs support. Doctor, Pharmacist and Nurse associations and their members the world over are getting involved in mBooks (watch Dr Ivor Kovic gives a passionate explanation of the benefits he enjoys by having his iPhone enable him to carry a whole library of textbooks with him at all times to get an idea of the opportunity). This is something that’s immediately obvious if you just look at the following picture and ask yourself where are the clinical resources (eg. the Library’s) or the CPD for these workers?

Imagine how much more powerful it would be if Microsoft got behind an initiative to give everyone in the world access to high quality medical education materials? Imagine the potential for village mobiles in the worlds poorest regions if they all could be loaded with royalty free basic Medical Textbooks, Health wiki’s and Video Educational content?

I’m willing to accept that possibly I don’t share this opinion with anyone else but when we’re talking about introducing medical interventions that are going to be “tested” on the worlds poorest and most unrepresented people I really don’t think we should be talking about things that are “off the beaten track”, “daring in premise”, “clearly different” or need to be “tested or validated”. As I’ve explained before the mHealth industry does not need to be established on such a legacy.

There are lots of really good examples of how the foundation could do good in this area eg. DataDyne, Ushahidi, Frontline SMS etc, click here for a collection of brilliant videos by Jonathan Marks capturing some of the ground swell he’s uncovering. But with the ear of Microsoft why waste your efforts on ground up initiatives when you have the potential to transform global healthcare from the top down. To my mind Nokia are leading here with the licencing of Pearson educational content (in one quick step making the former rubber boot manufacturer the biggest educator of English language in the world) so why can’t Bill Gates get involved and encourage governments to take the lead, Microsoft Windows Mobile might even be able to do something similar for health education?

Welcome to Windows Mobile 8 – the low cost smartphone OS featuring a portal for the world of carers containing all the textbooks and research articles, devices that boast antimicrobial washable casings, memory, inbuilt security etc.

About 3G Doctor

The Corporate Blog of 3G Doctor
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1 Response to mHealth: Can we achieve “more good by doing” than by “doing good”?

  1. Pingback: mHealth Challenge: Fever in rural Kenya « mHealth Insight: the blog of 3G Doctor

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