Education And Debate

Digital bridges need concrete foundations: lessons from the Health InterNetwork India

BMJ 2004; 328 doi: (Published 13 May 2004) Cite this as: BMJ 2004;328:1193
  1. Shyama Kuruvilla, scientist1,
  2. Joan Dzenowagis (, project manager1,
  3. Andrew Pleasant, visiting lecturer2,
  4. Ranjan Dwivedi, project manager3,
  5. Nirmala Murthy, president4,
  6. Reuben Samuel, WHO/UN development programme health and ICT coordinator5,
  7. Michael Scholtz, special representative of the director general6
  1. 1Health InterNetwork, World Health Organization, 1211 Geneva, Switzerland
  2. 2Brown University, Providence, RI 02912, USA
  3. 3Health InterNetwork India, World Health Organization, New Delhi 110011, India
  4. 4 Foundation for Research in Health Systems, Ahmedabad 380015, India
  5. 5World Health Organization Liaison for Orissa, Orissa 751009, India
  6. 6World Health Organization, Geneva
  1. Correspondence to: J Dzenowagis, World Health Organization, EIP/HIN, 20 Avenue Appia, 1211 Geneva 27, Switzerland

    The World Health Organization's Health InterNetwork pilot project has shown that national and international partnerships can use information and communication technologies to strengthen the public health system and bridge the digital divide in health

    Information and communication technologies (ICT) are often promoted as bridges to better governance, economies, and health,13 but examples of how these bridges can be successfully built are rare.2 In this context, the United Nations' secretary general, Kofi Annan, launched in 2000 the Health InterNetwork in the Millennium Action Plan “as a concrete demonstration of how we can build bridges over digital divides.”4 The initiative proposed to install computers and internet connectivity at thousands of hospitals and health centres in developing countries. The private sector pledged to provide the millions of dollars needed, but the “dot com” bubble burst and the funding never materialised.

    The challenge of improving the flow of timely, relevant, and reliable health information remained, however. The World Health Organization (WHO), along with other United Nations agencies, technical experts, non-governmental organisations, and national governments, developed a strategy to implement and evaluate a series of pilot projects to better understand and meet those needs, as a basis for expansion.5

    An early Health InterNetwork pilot project—to improve access to scientific publications for researchers in developing countries—grew quickly as agencies and publishers formed the Health InterNetwork Access to Research Initiative (HINARI). Coordinated by WHO and the BMJ Publishing Group, HINARI now provides public and non-profit health institutions in 113 countries with free or low cost access to over 2300 biomedical journals from more than 40 of the world's major publishers.6 7

    A second pilot project, Health InterNetwork India (HIN India), aimed to show the value of integrating ICT into public health practice. This article describes the Health InterNetwork approach and …

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