An Open Standard for Global Health?

Global health advocates need to pay more attention to issues of net neutrality, open-source standards and the growing movement to create a global commons.

Over the past several months at Harvard, I’ve started to delve much deeper into some fundamental questions about who owns the Internet and the information we are accumulating in the various computers sprinkled about the globe. Thanks to the ongoing exploration of these issues at the Berkman Center for Internet and Society, I now realize these issues have major implications for how we address some of the world’s pressing health and development needs as well.

Once upon a time, whenever pundits worried about a “digital divide” between rich and poor or the developed and developing worlds, they focused on the physical tools—like computers and broadband connections—for accessing the Internet. If we aren’t careful, however, an even greater divide may be written into the very backbone that makes the Internet possible, allowing powerful companies and countries a greater voice because they can pay for faster access to their websites while the rest of us languish in slow download hell. The many injustices of the real world would then be faithfully recreated in the virtual world as well.

The global health community has long argued that everyone should enjoy equal access to basic health care—regardless of income or social standing. But does that noble goal extend to access to information—in all its many forms as news, data or research results? When first-world consultants help a developing country create an electronic medical records system, for example, do they advise their clients to use a proprietary software program or an open source one? Is it possible to access international and national health and development databases, use the information gained and distribute the results without incurring monetary fees? (These are just two examples. The more you dig, the more you find.)

Why does this matter? Open source software is, of course, no panacea. But the tech support is worldwide, sustainable and typically comes at the right price. Too often, on the other hand, proprietary software leads to digital servitude and a stranglehold on innovation.

As for databases, I’ve learned quite a lot about them from reading Yochai Benkler’s The Wealth of Networks. (I found it easier to read the book but there’s also a complete version of Benkler’s tome on the web.) Apparently, since 1991 the U.S. government has not considered databases to be copyrightable. Access to them is free—although you may want to pay a subscription service to provide the information in a more user-friendly format.

By contrast, Benkler writes, the European Union passed a Database Directive in 1996, “which created a discrete and expansive right in raw data compilation.” As a result, “government agencies are required to charge what the market will bear for access to data they collect.” So where is the database industry thriving and growing faster? In the U.S., where databases are not encumbered by copyright restrictions.

Hmmm. An open standard leads to greater innovation and growth in business. Sounds like something the global health community ought to take to heart.