This is the last keynote address I made at the International Medical Informatics Conference (MEDINFO).The speech presented the areas in which eHealth can contributed to health and well-being, the emerging trend of using big data in health and examples of how big data from mobile phones, social media and internet have been used.

1. MEDINFO 2015: eHealth-enabled Health
| 15 August 2015
MEDINFO 2015:
eHealth-enabled Health
Sao Paulo, Brazil
19-23 August 2015

2. MEDINFO 2015: eHealth-enabled Health
| 15 August 2015
Convergence of health
information technologies to
achieve the post 2015 Sustainable
Development Goals
Najeeb Al-Shorbaji, Director
Knowledge, Ethics and Research
World Health organization

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From the MDGs to the SDGs
• The Millennium Development Goals (MDGs)
were adopted in 2000 by the UN General
assembly;
• The MDGs included eight goals and 18 targets;
• The MDGs included health, education, well-being
and environment targets;
• Goal 8 " In cooperation with the private sector,
make available benefits of new technologies,
especially information and communication".

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From the MDGs to the SDGs
• The MDGs have served as a tool to monitor and measure
progress;
• Many of the targets will not be achieved by end of 2015;
• The United Nations Conference on Sustainable
Development (UNCSD), also known as Rio 2012, Rio+20
came 20 years after the first Summit in 1992 in Rio, Brazil;
• Outcome of Rio+20 "The Future We Want," renewed the
political commitment to sustainable development and
declared the commitment to the promotion of a sustainable
future;
• It gave the mandate that the SDGs should be coherent with
and integrated into the UN development agenda beyond
2015.

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From the MDGs to the SDGs
• The SDGs build on the learning from the MDGs and address
the multiple interlinked global challenges and defined 17
goals: End poverty, end hunger, ensure healthy lives and
wellbeing, gender equality and women and girls
empowerment, availability and sustainability of water and
sanitation, energy for all, economic growth, employment
and decent work, reduce inequality, safe human
settlements, sustainable consumption and production
patterns, climate change, oceans, seas and marine
resources, terrestrial ecosystems, forests, peaceful and
inclusive societies, global partnership.
• Target # 9: Build resilient infrastructure, promote
inclusive and sustainable industrialization and foster
innovation;

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ICT in the SDGs
Target 9c: Significantly increase access to
information and communications technology and
strive to provide universal and affordable access to
the Internet in least developed countries by 2020;
Innovation and ICT empowering individuals and
civil society on a large scale; social media have
changed business, personal relations, political
movements; have transformed risk communication;
connectivity disruption has risks.

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Role of Science and Technology
• Scientific and evidence-based approaches are
essential for defining the goals and targets;
• Scientific research and innovation are the only way to
introduce new ways of work and improve on existing
practices;
• Monitoring progress and assessing results require
scientific methods;
• Technological advancements offer efficient and cost-
effective tools and platforms for achieving SDGs;
• SDGs benefit from existing and scientifically approved
inter-linkages and interdependencies between natural
and social systems.

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ICT for Development
• Information and communication technologies
for development (ICT4D) refers to the use of
information and communication technologies
(ICTs) in the fields of socioeconomic
development, international development and
human rights. The theory behind this is that more
and better information and communication
furthers the development of a society. (Wikipedia:
http://en.wikipedia.org/wiki/Information_and_communication_
technologies_for_development

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What is health?
Health is a state of complete physical, mental and
social well-being and not merely the absence of
disease or infirmity. WHO Constitution, 1948;
Tackling Social Determinants of Health is
recognized as being a fundamental approach to the
work of WHO and a priority area in the draft 12th
WHO General Programme of Work 2014–2019;
The social determinants of health are the conditions
in which people are born, grow, live, work and age.
These circumstances are shaped by the distribution
of money, power and resources at global, national
and local levels.

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Health and ICTs
• Health care is data driven knowledge intensive
sector;
• Information and communication technologies
are essential to the delivery of health services,
building health systems, and ensuring effective
public health action. Every field mission,
country office, health ministry, partnership and
program depends on reliable and timely
information to do their work. WSIS 2105

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Health in the SDGs
• Health is presented in SDG # 3: "Ensure healthy
lives and promote well-being for all at all ages"
• Transitioning from the MDGs to the SDGs
(maternal and child health, Malaria, HIV, etc.)
• Health is a contributor to the achievement of and
is benefitting from other SDGs;
• Universal Health Coverage is central to the Goal
and encompasses health promotion/education,
prevention/protection, treatment and palliative
care.

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Goal 1: End poverty
Target 1.3: Implement
social protection systems
for all
Goal 2: End hunger, achieve
food security and improved
nutrition
Target 2.2: end malnutrition,
achieve targets for reductions
child stunting and wasting
Goal 6: Ensure availability
and sustainable
management of water and
sanitation for all
Target 6.1: achieve
universal and equitable
access to safe and
affordable drinking water
Goal 5: Achieve gender equality and empower
all women and girls
Target 5.2: end all forms of violence against
all women and girls ….
Goal 4: Ensure inclusive and
equitable education ………..
Target 4.2: ensure access to early
childhood development, care and
pre-primary education …
Goal 16: Promote peaceful and inclusive
societies for sustainable development,
……..
Target 16.1: reduce all forms of violence and
related death rates everywhere
Health
Health is linked to many other SDGs and targets
Other goals and targets e.g. 10 (inequality), 11 (cities), 13 (climate change)

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SDG health goal 3 and its 13
targets
To ensure
healthy lives and
promote
wellbeing for all
at all ages
3.1 Reduce
maternal mortality
3.2 Reduce
child and neonatal
mortality
3.3 End epidemics of HIV, TB, malaria
and NTD, and combat hepatitis,
water-borne diseases and other
communicable diseases
3.4 Reduce
mortality due to NCD and
improve mental health
3.8 Achieve
universal health
coverage
3.7 Universal access to
sexual and reproductive
health-care services
3.6 Reduce mortality
due to road traffic
injuries
3.5 Strengthen prevention
and treatment of substance
abuse (narcotics, alcohol)
3.d Enhance capacity for early
warning, risk reduction and
management of national and global
health risks
3.c Increased health financing
and health workforce in
developing countries
3.a Strengthen
implementation FCTC
(tobacco)
3.9 Reduce deaths and illness
due to pollution and
contamination
3.b Access to affordable essential
medicines and technologies

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Data integration
a) Using the tools of public health informatics, medical
informatics, bioinformatics and medical imaging to
integrate different types of data (patient/personal,
public, diseases, molecular);
b) Big data and analytics bring together:
a) data on people and from people, the environment (land,
forestry, water, seas, oceans, air, soil), natural resources,
animals, space, etc.
b)Data on social, economic, behavioral, political, habitat, etc.
aspects of people

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Data revolution
• Problems to be addressed mainly in
LMICs:
• Lack of demand and use of data for policy and decision-making
• Inadequate availability of data for public health action due to
major data gaps, quality problems, timeliness issues, including
public health emergencies, and poor dissemination and use;
• Inadequate data to maximize health care, quality and safety;
• Lack of knowledge about major public health issues;
• Improve global, regional and country monitoring of the health-
related SDG.

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Key components of a data
revolution
• A considerable investment in national statistical capacity, both
technical and institutional, including a major strengthening of national
statistical offices
• Redesign of traditional statistical processes to become more
integrated and efficient and yield more timely and disaggregated
data;
• Leverage of new sources of data and metadata, including big data;
• An approach to data collection that protects human rights in line with
fundamental principles of official statistics;
• Open data, i.e. open access to data respectful of national and
international data policies, promoting transparency and supporting
accountability;
• Effective public and private collaboration.

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Taxonomy of types of new, digital data
sources relevant to global development
• Data Exhaust;
• Online Information;
• Physical Sensors;
• Citizen Reporting or Crowd-sourced Data.

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Main areas for health
• Active diseases surveillance and response systems;
• Electronic facility / district health information systems;
• Electronic tracking systems for health expenditure and resource
flows, and electronic health workforce registries with individual level
data;
• Electronic registers and databases with individual level patient data;
• Electronic health records for individuals with patient data based
aggregate systems;
• Comprehensive health examination surveys;
• Longitudinal patient based tracking systems for specific populations;
• Interoperable databases for medical care, including logistics, lab,
patient care etc.
• Big data analytics.

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Big data
• Improve understanding of human behaviour
• Offer policy making support for global development;
• Early warning, through analytics;
• Real time monitoring of impact of policies and
programmes;
• Correlations versus causation and evidence based
medicine;
• Critical issues:
• Ethical guidelines, legal frameworks, and technological solutions
for protected data sharing;
• Privacy and security as well as data linkages in health.

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Mobile phone data (as an example)
• mHealth: data collection being crowd sourcing,
registered individuals or health workers using
mobile devices, including mobile phones,
represent a major part of mobile health . This can
provide good understanding of:
• population health,
• disease outbreaks,
• migration and movement of people,
• geospatial links as to who is located in which place,
• health statistics on illness, death, hospital use, etc.,
• Clinical data in mobile electronic health records,

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Mobile phone data (as an example)
• Educational data generated based on the use
of mobile value-added services can be used
to improve public-sector understanding of
educational needs and knowledge gaps,
allowing more targeted and timely initiatives
to disseminate critical information. This may
include extent of access to m-Learning
platforms, download of educational videos
(MOOCS, for example), searching Open
Access sites and journals, registration to
specific APPs, etc. Language orientation
(English vs. other languages).

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Mobile phone data (as an example)
• Agriculture through:
• Mobile payments for agricultural products,
• Input purchases and subsidies may help
governments better predict food production trends
and incentives,
• Exchanging data on rain fall, water availability,
insecticides, pesticides, etc.
• Crop storage situation,
• Financial services available for farmers,
• Mapping of regional situations and identify areas
of strength and weakness,
• Early detection of problems for better decsions.

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Mobile phone data (as an example)
• Financial data harvested from mobile money
services (m-Pesa: mobile-phone based money
transfer and micro-financing, for example) can
provide deep insight into spending and saving
habits across sectors and regions. Electronic
transaction history can contribute to building credit
histories, making them candidates for loans and
other credit-based financial services. Extent of use
and cost of mobile phone (subscription, prepaid,
postpaid, data transfer, etc.) can paint a picture of
financial status of an individual.

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Mobile phone data (as an example)
• Women and girls empowerment through:
• Delivering education, learning and training
content;
• Connecting individuals and building communities,
• Access to job and employment opportunities,
prices, availability of goods and services,
• Access to development, health, development and
safety information,
• Ability to report and inform on abuse by others
and violation of human and women's rights.

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Mobile phone data (as an example)
• Environmental data, water, air and soil
pollution through:
• Data recording on changes and emerging
trends,
• Capturing and exchanges images, video
recordings,
• Reporting by individuals and linking with
geospatial data,
• Linking mobile data with Internet access for
monitoring and observation on on-goewing
basis.

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Mobile phone data (as an example)
• Food and nutrition through:
• Barcode reading of nutrition values and
additives on food cans and containers,
• Immediate informing of food poisoning and
reporting on abuse,
• Exchanging experience of individual and
advice by specialists on food and nutrition
issues.

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‫شكرا‬
obrigado
Gracias
谢谢谢谢谢谢谢谢
Thank you
Merci
спасибо