Remarks as Prepared for Keynote Address at the mHealth Summit, Ambassador Eric Goosby, U.S. Global AIDS Coordinator

October 30, 2009

October 30, 2009

Thank you to the host of the mHealth Summit, the Foundation for the National Institutes of Health, and all of the corporate sponsors for convening us around this important, and very relevant, topic.

Ambassador Bagley already covered the value of public-private partnerships, particularly with the information and communication technology sector. From the beginning, PPPs have been an integral part of PEPFAR's approach, bringing in both innovation and the core competencies of the private sector to the fight against HIV/AIDS.

Through over 90 partnerships around the world, PEPFAR has engaged the private sector to enhance sustainability of programs, facilitate scale-up of interventions, and make programs more efficient. The PEPFAR/ICT Working Group has been convening for three years now, bringing together many of the leading ICT firms to discuss how their technology solutions can improve public health.

The next phase of PEPFAR presents new challenges – how do we build on the successes of our first phase, shifting from emergency mode to a long-term solution? In the past few months and in the years ahead, we will look to increasingly empower and build the capacity of local governments; train 140,000 new health care workers to strengthen the most vital part of a health system – its people on the front lines; and leverage our HIV/AIDS investments to strengthen overall health systems.

Shifting towards a long-term solution means taking advantage of the resources that are already in place, and the perfect illustration of this would be in mHealth. With over 2 million mobile phones sold in the developing world every day and substantial network coverage in Africa, there has been a paradigm shift in the communications infrastructure on the continent that we are just beginning to take advantage of. So much of what we must do is communicate – whether it's reminding a patient to take their anti-retroviral drugs, educating the public about the facts and myths of HIV infection, or simply bringing patients back for a follow-up appointment. Utilizing the mobile phone technology backbone of the continent is crucial. PEPFAR has piloted projects that:

  • Provide community health workers with cell phones and mobile applications to track and report vital events in a village (such as births, maternal and child deaths);
  • Encourage and track pregnant women seeking antenatal care and prevention of mother-to-child transmission services;
  • Monitor orphans and vulnerable children and patients receiving home-based care; and
  • Improve distribution of medicines, bed nets, and contraceptives.

PEPFAR is a partner in an existing mHealth PPP—Phones for Health with Accenture Development Partners, GSM Association, Motorola, MTN, and Voxiva. Phones for Health was initiated in 2007 and is currently operational in Kenya, Tanzania, and Rwanda, leveraging over $3 million in public and private resources annually to support HIV monitoring, Infectious Disease Surveillance and Response, blood transfusion services, and other multi-channel health data collection and reporting services.

Just Wednesday, PEPFAR convened a working session on mHealth here in the Ronald Reagan Building on the eve of this Summit, to further engagement with potential mHealth partners, map current and prospective mHealth solutions, and help prepare our field operations for this new opportunity to leverage the mHealth Alliance.

So there are many examples of PEPFAR dipping its toe in the mHealth waters. But PEPFAR as a program needs to find out what works and what doesn't, and actively scale what does. That is why I'm thrilled to announce today that PEPFAR has signed an MOU to join the mHealth Alliance. We will cooperate with the Alliance and its members to enable better access to cost-effective mHealth solutions and service providers. By aligning ourselves with the UN, Vodafone and Rockefeller Foundations and others, we hope to: First, assist in the growth of the mHealth Alliance, and thus enable scalable and sustainable mobile technology innovation and impact through leadership, global advocacy and coordination, and implementation activities; and secondly, strengthen country ownership and address PEPFAR priorities using mobile technology-enhanced solutions in emerging markets.

We plan to start our collaboration with the mHealth Alliance immediately. My office and the Alliance will work in close consultation with the PEPFAR country teams, implementing partners, host country counterparts—including Ministry of Health and Ministry of Telecommunications officials, mHealth Alliance donors, partners and affiliates in four concrete ways: One, we will share Project Reference Materials and Designs. PEPFAR has a wealth of country-level experience with developing, operating, and maintaining mobile ICT infrastructure building projects. We will share reference materials like landscape analyses, training curricula, regulatory standards, and local partnering agreement templates so that other members of the Alliance and the broader global health community may benefit from our existing investments.

Two, we will laser focus on Implementation and Capacity Building. PEPFAR's strength is in our programs and people on the ground, and we will work with the Alliance to provide PEPFAR country teams a platform and collaborative means to engage with the Alliance's stakeholder base with any eye toward strengthening our projects and services. This will happen through networking, local coordination, and support across multi-lateral initiatives to scale successful pilot projects. Together, we will also convene and host targeted meetings and workshops to promote utilization of appropriate mHealth solutions tailored to country-specific environments. Three, we will align our current Phones for Health PPP with the mHealth Alliance. After extracting lessons learned, we will encourage building upon the Phones for Health PPP implementation activities where appropriate through expansion of mobile technology for health solutions and offerings. Where it is practical and in alignment with host country government priorities, we will encourage Alliance affiliates to plan and implement cost-effective prescribed solutions to address PEPFAR programmatic challenges, on everything from HIV prevention messaging to health records access, health workforce support services to survey implementation and data collection. We will also include HIV/AIDS components in at least one partnership initiative in Africa, ideally leveraging the initiative with other Alliance-supported uses of mHealth to encourage adoption and sustainability.

Finally, we will create an open technology platform for mHealth programs, communications, and partnerships. This platform will promote the use of globally applicable mobile technology, open standards and standards-based approaches, and access to wide array of mHealth solution providers and support services to benefit public health.

So with the mHealth Alliance and our country programs, PEPFAR intends to maximize the use of cost-effective mobile solutions for health. Our reason for doing this is not based on the next new development fad or a shiny new technology, but rather a desire to use the powerful mobile technology infrastructure that is already paid for to deliver effective programs. With cell phones in use in even the most difficult environments we work in, mobile technology allows us to be more nimble, reach targeted groups more effectively, and better meet the needs of underserved or “hard to reach” populations with mobile tools and services that can truly transform healthcare – anywhere in the world. Thank you.

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