Are Technological Innovations in Healthcare a Reason to be Hopeful about Overall Health Inequality?

A guest post by Miriam Namakanda

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The intersection of health and technology sounds like something out of a fantastical utopian future. eHealth only came into our vocabulary in the year 2000, to describe the crossroads of technological innovation with health care. eHealth is a more general term covering anything from health websites to tools such as the one being developed at the University of Calgary to help people in intensive care communicate their decisions. Mobile health, on the other hand, refers to the use of mobile phone technology in particular for healthcare, for example apps for smartphones like the one being developed at Dalhousie to help diabetics manage sugar levels. Taking a survey of the ongoing innovations and experiments taking place around the world, one might conclude that these new technologies can provide a solution to the global health crisis. There are pioneers of eHealth in Brazil, Uganda, and even here in Canada. In Brazil, a study found that mobile health technology was able to improve the treatment of some 100 elderly Favela residents. Not only were health workers able to monitor the patients” health over some distance, cutting trips also cut costs along the way. In lower income countries with failing infrastructures, mobile health offers a solution for people who cannot easily be reached, or can”t afford to make the journey to the clinic. If these projects are successful then we wouldn”t need as many health workers as we do now to personally visit patients.

However, Tina Rosenberg of the New York Times blog “Fixes” reported a mixed bag of results with similar sorts of pilots in Uganda. In fact, though some pilots seemed to yield somewhat positive results, because of the lack of evidence and chaos resulting from so many projects, they have been officially banned in the country. Meanwhile, in Canada, the Harper administration recently invested over a million dollars in eHealth innovation projects. There is plenty of space for eHealth applications in rural Canada.

Though they seem like promising solutions for people needing care in hard to reach places, their genius can”t be put to use until the overall global health system has undergone some huge changes. We have to ask how, once these innovations have been proven to be beneficial, shall we fund them. We should also be wary of the possibility that in some situations eHealth could potentially work around failing infrastructures. If this was the case then larger issues that effect global health will remain unresolved. The most obvious question being the fact that poverty is a major hurdle when it comes to health equality. Before we get excited about these innovations we need to face the hard facts about health inequality. The solution to these problems won”t come in the form of new technologies here and there. Instead we will need to look at solutions and indicators that are more broad in their scope.

A recent Research and Design resolution reached by the Consultative Expert Working Group (CEWG) at the World Health Assembly last week is a sign of hope. This treaty could possibly mean that more research will go into developing medicines for diseases that have been neglected. Currently, major pharmaceutical companies research and design medicines that are in demand by paying consumers. So they are likely to spend more money on solutions for aliments such as baldness or erectile dysfunction instead of developing solutions to diseases like Nodding Syndrome, or Chagas. The latter won”t be consumed by a wealthy population and therefore hold no relevance for these profit-driven companies. You may think this isn”t a big deal, but aside from intense suffering resulting from these diseases, many of the medicines are developed at publicly funded universities before they are patented to be sold. As Dr. Marcia Angell pointed out in a talk at Brown, taxpayers pay twice, once for the universities and then again for the medicine. Not to mention other misdeeds by these companies including treating animals horribly to even testing very harmful medicines on human beings in . The treaty may be the start of a new dynamic. Delinkage means that these major pharmaceutical companies will be given grants to make medicines that are needed.

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