1. 000 The Ugly Maurice Mars Dept of TeleHealth University of KwaZulu- Natal, South Africa International Society for Telemedicine and eHealth

2. Reasonable Expectations

3. What is the Global Health Problem ? Money

4. The Developed World - The Problems

5. The Global Health Problem : Money Developed world – rising health costs, ageing population, chronic disease. Developing world – poverty and low health budgets, burden of disease

6. The Developing World ? Developed World ~ 1 Billion Emerging and Developing Nations ~ 5 Billion The Bottom Billion

7. World 2010 Population Distribution (% Total Pop)

8. World 2010 Europe 2010 Africa 2010 Population Distribution %

9. Median Age By Region

10. Population Growth

11. 195020102050 World2,5296,8299,150 Africa2271,0101,998 Asia1,4034,1215,231 Europe547732691 Latin America / Caribbean167582729 Northern America172348448 Oceania133551 Source: United Nations Population Division, World Population Prospects 2008 Revision (Medium variant) Population Data ( Millions )

12. Telemedicine in the Developing World

13. The Problem Can one justify spending money on ICT solutions ?

14. Population Living on <US$1 /Day (PPP) African region42.6% South-East Asia region38.4 Global Average22.7 Western Pacific region16.0 Eastern Mediterranean11.0 Region of the Americas4.8 European region- WHO World Health Stats 2012

15. The Global Problem Per Capita Government Health Spend US$ South-East Asia region19 African region41 Eastern Mediterranean96 Western Pacific region361 Global Average549 Region of the Americas1,566 European region1,677 WHO World Health Stats 2012

16. The Most Bang For Your Buck

17. The Problem

18. The Global Situation Doctors per 100,000 people African region22 South-East Asia region56 Eastern Mediterranean109 Global Average142 Western Pacific region148 Region of the Americas200 European region332 WHO World Health Stats 2012

19. CountryRankTelephoneMobile Cellular Fixed Broadband Niger16541.3%73.4%210.5% Malawi16418.291.02,408.0 S Africa995.24.85.7 USA120.30.80.5 Monaco10.10.3 ICT Cost Cost of a bundle of telephone, mobile phone, broadband as a percentage of GNI per month International Telecommunications Union 2011

20. Darkest Africa

21. Digital Divide

22. Global ICT Developments, 2001 - 2011

23. Fixed Phone Lines /100 People 2011

24. Internet Users / 100 People, 2001-2011*

25. Proportion of Households With Internet Access 2002 - 2011

26. Fixed Broadband Subscriptions / 100 People, 2001 - 2011

27. Active mobile-broadband subscriptions / 100 People, 2007 - 2011

28. Digital Divide and the Health Divide The digital divide is widening Why is this? Is this increasing the health divide ? If so what do we need to do?

29. Population Living on <US$1 /Day (PPP) African region42.6% South-East Asia region38.4 Western Pacific region16.0 Eastern Mediterranean11.0 Global Average22.7 Region of the Americas4.8 European region- WHO World Health Stats 2012

30. Rethinking the Problem Understand the problem Prioritise young vs old? Reduce digital divide Reduce communication costs Reverse the brain drain New funding paradigm – eAid Think Developing World in all that you do

31. Take Home Messages The developing world is different Expectations must be relevant ICT solutions must be appropriate National budgets are low – sustainability Get the most bang for the buck Is eHealth for ageing a priority ?

32. The Ugly The developing World continues to be left behind It Needs YOU