USAID is Cutting Edge When It Comes to mHealth. Really? Really.

USAID is Cutting Edge When It Comes to mHealth. Really? Really.

Last year, the mHealth Alliance and the National Institute of Health (NIH) sponsored their first mobile health (mHealth) “Summit,” at the Ronald Reagan building in Washington, DC. The location was telling: it is the home of the US Agency for International Development (USAID). This year’s mHealth Summit has nearly doubled in size, moved its location to the Convention Center, and is being keynoted by Bill Gates and Ted Turner. It is safe to say that mHealth is certainly a topic de jour. The problem is that the big names---the global mobile phone network providers, manufacturers, pharma companies, and global consulting firms---are all jumping on the bandwagon, but they are late to the game. And the conversations in the plenary sessions highlight the fact that there’s a huge disconnect between the global companies and the on-the-ground implementers.

While US-focused agencies and global telecommunication companies lament the fact that there is “no evidence base” yet for implementing mHealth projects and that we “still don’t know the right business models,” small, nimble, international NGOs working in the least developed countries of the world---often sponsored by the oft-criticized USAID---are actually producing results and saving lives.

Several times on the first day of the conference, from the wide stage in the massive ballroom of DC’s modern Convention Center, the speakers tried to draw the parallel between the internet’s growth and the promise of mHealth. But they failed to remember that the internet model was not one in which experts sat around and first figured out business models and how everything would fit efficiently together. Rather, the boom of the internet took place on the backs of innovators working out of their garages on innovative ideas on a small scale (pilots, anyone?), and then, once the models were proven, made the case for additional funding.

It is also critical to remember that we are not talking about trying to find the “best,” most robust business model for delivery of a consumer product. We are first talking about health, which primarily needs to be about saving lives rather than saving money; and second, in most of the world, mobile delivery of information, collection of data, and collaboration among health workers is the only way. There often are no alternatives, unless one is willing to continue to rely on a tiny workforce in rural villages with no electricity walking or biking dozens of miles to get help, supplies or information.

While global telecommunication companies and academicians argue about business cases and how to evaluate impact, USAID is sponsoring successful, results-oriented mHealth projects. The innovators for mHealth are not pharma or mobile phone providers; they are USAID implementing partners like MSH, John Snow Inc., Johns Hopkins, FHI, Jhpiego, Abt Associates, AED and others.

The innovators are not HP, Microsoft or Apple; they are the developing world-focused mHealth solution developers like Frontline SMS, DataDyne, D-Tree and others. The visionary funders are not the venture capitalists; they are the donors such as USAID, and foundations such as The Bill and Melinda Gates Foundation, the mHealth Alliance and the United Nations Foundation.

This conference, I believe, is being dominated by the ivory towers of academia and health institutes, and ignoring the real innovators---the health care providers on the front lines of the world’s poorest communities who themselves are finding new ways to use mobile phones to save lives and improve health.

Several months ago, I spent an afternoon in a rural village with no electricity talking to community health workers who had been provided mobile phones from a USAID project.  They took 10 minutes to draw, on a piece of newsprint, a very clear business model that would help these industry captains here to “get it”: health workers with phones save time, money, and lives by being connected via a new technology where before there was none.

Perhaps next year, we should hold this conference in Africa, led by USAID and other donors.  Presentations could come from the front lines, and I believe that very quickly we’d stop talking about making the business case and spend more time on funding the innovations that are saving lives today.

Piers Bocock is MSH’s Senior Director of Communications & Knowledge Exchange.

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