Combining the power of the Web with the ubiquity and accuracy of mobile computing, InSTEDD helps teams and organizations communicate, share and analyze information more seamlessly, make better decisions, and take more effective action in the face of a public health threat or natural disaster. The In-STEDD Collaboration Suite consists of three open-source software tools that help public health users detect anomalies, visualize clusters of potential events, predict the rate and spread of a disease out-break and provide decision makers with tools, me-thodologies and processes to investigate the event. These software tools are:
• InSTEDD Mesh4X is a light-weight synchroniza-tion platform based on cloud computing and peer-to-peer architectures. This integration platform al-lows teams to share critical information reliably, selectively, timely and securely, with anyone, using any device, regardless of network connection, sys-tems or services. Network connectivity is not a constant requirement, as Mesh4x can collect and distribute updates among users over SMS, Internet, or through other available means.
• InSTEDD Evolve is a set of integrated services (analytic, collaborative and visualization) that helps to build and sustain a community of domain experts from the local to the international level. Evolve is equipped with a machine learning algo-rithm that augment users input and accurately classifies 7 syndromes, 10 transmission modes, over 100 infectious diseases, over 180 micro-organisms, over 140 symptoms, and over 50 chemicals.
• InSTEDD GeoChat is a communications system that lets teams coordinate around events as they unfold, linking field, headquarters, and the local community in a unified effective response.
Presently, these tools are being piloted in the Mekong Basin region of Southeast Asia (Cambodia, Thailand, Laos, and Cambodia), Ushahidi in Kenya, HIV clinics in rural Tanzania, Mongolia, Ghana, and Bangladesh.
Use of mobile telephones for public health events detection and intervention in developing countries has tremendous potential due to low start-up cost and low bandwidth (e.g., SMS gateway). In 2002, mobile subscribers overtook fixed line subscribers worldwide and this occurred across geographic re-gions, socio-demographic criteria (gender, income, age) or economic criteria such as GDP per capita1. In much of sub-Saharan Africa, there are more mobile phones than fixed-line phones2 and the use of mobile phones in many Asian countries is on the rise. Addi-tionally, mobile telephone subscriptions have been growing rapidly since the 1980s in both developing and developed countries. Furthermore, the demand for mobile phones exists beyond reducing the waiting list for traditional wire-line phones 3.
However, technical, financial and regulatory barriers remain great challenges to fully adopting mobile technology as a platform in developing countries. Using mobile phones for health data exchange in developing countries has not been demonstrated giv-en the costs of data transmitted over mobile phone are greater than voice costs 2, 4, language and illitera-cy barriers2, and privacy and security issues since SMS messages can leave a trail. Other challenges include the physical components of a telephone (headset or network) are not isolated but are part of an entire business model that includes pricing plans and other incentives which can provide leverage em-ployed by public health agencies and policymakers.
1. Feldmann V: Mobile overtakes Internet: Implica-tions for Policy and Regulation. International Tele-commjunications Union 2003:1-39 [http://www.itu.int/osg/spu/ni/mobileovertakes/Resources/Mobileovertakes_Paper.pdf]. last accessed 13 March 2009.
2. Vodafone Policy Paper: Africa: The Impact of Mobile Phones. Vodafone Policy Paper Series Number 2 2005 [http://www.vodafone.com/assets/files/en/AIMP_09032005.pdf]. last accessed 13 March 2009.
3. Kundu A, Sarangi N: ICT and Human Develop-ment: Towards Bui