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A window of opportunity for Africa's health information
Editorial
abolition of corporal punishment across Europe. In 2002, the UN Committee on the Rights of the Child renewed its attack on UK law, which constitutes “a serious violation of the dignity of the child”, and called for reform to comply with the Convention. In June, 2003, even the House of Commons and House of Lords Joint Committee on Human Rights called for full compliance with the Convention. In 2003, Scotland became the first region in the UK to make it illegal to punish children by shaking, hitting on the head, or using implements such as a belt, cane, slipper, or wooden spoon. England, Wales, and Northern Ireland now lag behind 12 European countries, beginning with Sweden in 1979, and Israel, all of which have
introduced legislation to prohibit parents from using corporal punishment on their children. Article 24 of the Convention on the Rights of the Child spells out “the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health”. Signatory or not, American children should be able to expect more from their health care. Children worldwide have the right to be brought up free from fear of physical abuse, psychological harm, or loss of dignity, and to receive the best health care attainable. There is no excuse for British and American children to number among the exceptions. ■ The Lancet
Panos Pictures
A window of opportunity for Africa’s health information Rights were not granted to include this image in electronic media. Please refer to the printed journal.
See Public Health page 295 and Comment page 223
See Telematics and Informatics 2004; 21: 67–81
See http://www3.sn.apc.org/ africa
222
July 12 saw the launch of a new initiative, the Global Review on Access to Health Information in Developing Countries. This 2-year project is drawing together partners worldwide, including The Lancet, to consolidate knowledge and experience on improving developing-world access to health information. The reason such a review is needed is simple: most of the developing world’s health professionals cannot access the information they need to manage their patients. In this issue of The Lancet, Fiona Godlee and colleagues discuss potential strategies to tackle this knowledge gap and note that “Clinicians may still generally prefer paper, but among currently available technologies only the internet has the potential to deliver universal access to up-to-date health-care information.” Yet internet availablility in the developing world, especially in sub-Saharan Africa, is low and, when available, prohibitively expensive. Health professionals in Africa, particularly those working in isolated communities, had great hopes when the internet arrived on the continent more than two decades ago. By 2002, all capital cities in Africa had direct internet access, serving around 7 million of the continent’s estimated 816 million population. But African users accounted for only 1% of the world’s internet traffic that year and 80% of that use was in South Africa. Health professionals are estimated to account for only 0·001% of Africa’s internet use, and this is almost entirely in capital cities. Those who face major public-
health problems in Africa’s non-urban populations are therefore kept very much outside the boundaries of the global digital village. Internet penetration in Africa has been hindered by factors such as irregular or non-existent electricity supplies, the expense of equipment, and lack of technical skills. A recent study showed that the high initial cost of personal-computer equipment compels academics in Kenya and Nigeria to use cyber cafes and other public facilities to communicate with colleagues, access e-publications, and the like—a situation that their peers in the affluent parts of the world would find extremely challenging. Some progress has been made. For example, tariffs on the importation of computer hardware have been abolished in several African countries, making more computers available in the health sector. But African governments could do much more and currently have an unparalleled opportunity to ensure expansion of internet access as the continent’s stateowned telecom networks are currently being deregulated. We call upon the governments of the sub-Saharan African countries to ensure that their telecom networks are sold to the private sector if—and only if—the commercial companies make a binding commitment to improve services beyond the capital cities. Regional urban hubs could then be points of dissemination of health information to the district level. ■ The Lancet www.thelancet.com Vol 364 July 17, 2004
abolition of corporal punishment across Europe. In 2002, the UN Committee on the Rights of the Child renewed its attack on UK law, which constitutes “a serious violation of the dignity of the child”, and called for reform to comply with the Convention. In June, 2003, even the House of Commons and House of Lords Joint Committee on Human Rights called for full compliance with the Convention. In 2003, Scotland became the first region in the UK to make it illegal to punish children by shaking, hitting on the head, or using implements such as a belt, cane, slipper, or wooden spoon. England, Wales, and Northern Ireland now lag behind 12 European countries, beginning with Sweden in 1979, and Israel, all of which have
introduced legislation to prohibit parents from using corporal punishment on their children. Article 24 of the Convention on the Rights of the Child spells out “the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health”. Signatory or not, American children should be able to expect more from their health care. Children worldwide have the right to be brought up free from fear of physical abuse, psychological harm, or loss of dignity, and to receive the best health care attainable. There is no excuse for British and American children to number among the exceptions. ■ The Lancet
Panos Pictures
A window of opportunity for Africa’s health information Rights were not granted to include this image in electronic media. Please refer to the printed journal.
See Public Health page 295 and Comment page 223
See Telematics and Informatics 2004; 21: 67–81
See http://www3.sn.apc.org/ africa
222
July 12 saw the launch of a new initiative, the Global Review on Access to Health Information in Developing Countries. This 2-year project is drawing together partners worldwide, including The Lancet, to consolidate knowledge and experience on improving developing-world access to health information. The reason such a review is needed is simple: most of the developing world’s health professionals cannot access the information they need to manage their patients. In this issue of The Lancet, Fiona Godlee and colleagues discuss potential strategies to tackle this knowledge gap and note that “Clinicians may still generally prefer paper, but among currently available technologies only the internet has the potential to deliver universal access to up-to-date health-care information.” Yet internet availablility in the developing world, especially in sub-Saharan Africa, is low and, when available, prohibitively expensive. Health professionals in Africa, particularly those working in isolated communities, had great hopes when the internet arrived on the continent more than two decades ago. By 2002, all capital cities in Africa had direct internet access, serving around 7 million of the continent’s estimated 816 million population. But African users accounted for only 1% of the world’s internet traffic that year and 80% of that use was in South Africa. Health professionals are estimated to account for only 0·001% of Africa’s internet use, and this is almost entirely in capital cities. Those who face major public-
health problems in Africa’s non-urban populations are therefore kept very much outside the boundaries of the global digital village. Internet penetration in Africa has been hindered by factors such as irregular or non-existent electricity supplies, the expense of equipment, and lack of technical skills. A recent study showed that the high initial cost of personal-computer equipment compels academics in Kenya and Nigeria to use cyber cafes and other public facilities to communicate with colleagues, access e-publications, and the like—a situation that their peers in the affluent parts of the world would find extremely challenging. Some progress has been made. For example, tariffs on the importation of computer hardware have been abolished in several African countries, making more computers available in the health sector. But African governments could do much more and currently have an unparalleled opportunity to ensure expansion of internet access as the continent’s stateowned telecom networks are currently being deregulated. We call upon the governments of the sub-Saharan African countries to ensure that their telecom networks are sold to the private sector if—and only if—the commercial companies make a binding commitment to improve services beyond the capital cities. Regional urban hubs could then be points of dissemination of health information to the district level. ■ The Lancet www.thelancet.com Vol 364 July 17, 2004