000

The Ugly

Maurice Mars

Dept of TeleHealth University of KwaZulu-

Natal, South Africa

International Society for Telemedicine and eHealth

Reasonable Expectations

What is the Global Health Problem ?

Money

The Developed World - The Problems

The Global Health Problem : Money

• Developed world – rising health costs,

ageing population, chronic disease.

• Developing world – poverty and low

health budgets, burden of disease

The Developing World ?

Developed World ~ 1 Billion

Emerging and Developing

Nations ~ 5 Billion

The Bottom Billion

World 2010

Population Distribution (% Total Pop)

World 2010Europe 2010Africa 2010

Population Distribution %

Median Age By Region

Population Growth

1950 20102050

World 2,529 6,829 9,150

Africa 227 1,010 1,998

Asia 1,403 4,121 5,231

Europe 547 732 691

Latin America / Caribbean 167 582 729

Northern America 172 348 448

Oceania 13 35 51

Source: United Nations Population Division, World Population Prospects

2008 Revision (Medium variant)

Population Data (Millions)

Telemedicine in the Developing World

The Problem

Can one justify

spending money

on ICT solutions ?

Population Living on <US$1 /Day (PPP)

African region 42.6%

South-East Asia region 38.4

Global Average 22.7

Western Pacific region 16.0

Eastern Mediterranean 11.0

Region of the Americas 4.8

European region -WHO World Health Stats 2012

The Global Problem

Per Capita Government Health Spend US$

South-East Asia region 19

African region 41

Eastern Mediterranean 96

Western Pacific region 361

Global Average 549

Region of the Americas 1,566

European region 1,677WHO World Health Stats 2012

The Most Bang For Your Buck

The Problem

The Global Situation

Doctors per 100,000 people

African region 22

South-East Asia region 56

Eastern Mediterranean 109

Global Average 142

Western Pacific region 148

Region of the Americas 200

European region 332WHO World Health Stats 2012

Country Rank Telephone MobileCellular

Fixed Broadband

Niger 165 41.3% 73.4% 210.5%

Malawi 164 18.2 91.0 2,408.0

S Africa 99 5.2 4.8 5.7

USA 12 0.3 0.8 0.5

Monaco 1 0.1 0.3 0.3

ICT Cost

Cost of a bundle of telephone, mobile phone,broadband as a percentage of GNI per month

International Telecommunications Union 2011

Darkest Africa

Digital Divide

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011*0

10

20

30

40

50

60

70

80

90

100 Mobile-cellular telephone subscriptions

Internet users

Fixed telephone lines

Active mobile-broadband subscriptions

Fixed (wired)-broadband subscriptions

Pe

r 1

00

in

ha

bit

an

ts

Source: ITU World Telecommunication /ICT Indicators database

Global ICT Developments, 2001 - 2011

Europe The Amer-icas

CIS** World Asia & Pacific

Arab States

Africa0

5

10

15

20

25

30

35

40

4539.1

28.526.3

16.613.0

9.7

1.4

Source: ITU World Telecommunication /ICT Indicators data-base

Fixed Phone Lines /100 People 2011

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011*0

10

20

30

40

50

60

70

80

90

100Developed

World

Developing

Pe

r 1

00

in

ha

bit

an

ts

Source: ITU World Telecommunication /ICT Indicators data-base

Internet Users / 100 People, 2001-2011*

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011*0

10

20

30

40

50

60

70

80

90

100

Developed

World

Developing

%

Source: ITU World Telecommunication /ICT Indicators data-base

Proportion of Households With Internet Access 2002 - 2011

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011*0

5

10

15

20

25

30

Developed

World

Developing

Pe

r 1

00

inh

ab

ita

nts

Source: ITU World Telecommunication /ICT Indicators data-base

Fixed Broadband Subscriptions / 100 People, 2001 - 2011

2007 2008 2009 2010 2011*0

10

20

30

40

50

60

Developed

World

Developing

Pe

r 1

00

inh

ab

ita

nts

Source: ITU World Telecommunication /ICT Indicators data-base

Active mobile-broadband subscriptions / 100 People, 2007 - 2011

Digital Divide and the Health Divide

The digital divide is widening

Why is this?

Is this increasing the health divide ?

If so what do we need to do?

Population Living on <US$1 /Day (PPP)

African region 42.6%

South-East Asia region 38.4

Western Pacific region 16.0

Eastern Mediterranean 11.0

Global Average 22.7

Region of the Americas 4.8

European region -WHO World Health Stats 2012

Rethinking the Problem

Understand the problem

Prioritise young vs old?

Reduce digital divide

Reduce communication costs

Reverse the brain drain

New funding paradigm – eAid

Think Developing World in all that you do

Take Home Messages

The developing world is different

Expectations must be relevant

ICT solutions must be appropriate

National budgets are low –

sustainability

Get the most bang for the buck

Is eHealth for ageing a priority ?

The Ugly

The developing World

continues to be left behind

It

Needs

YOU