Africa may lead the way with mHealth

I'm guessing that Africa is where we'll see the most exciting breakthroughs in mHealth. Need some evidence? Take a look at the latest Pew data on cell phone adoption.

Landline use is almost non-existent (and importantly, were really never used):


Cell phone use is surging.


Importantly, people are using their phones for texting. This is critical. We have dozens of evidence-based texting interventions for a wide range of conditions.


And we'll see rapid penetration, because people smartphone penetration is lagging. This may seem disadvantageous, but we've shown that you can deliver highly personalized, fully automated, health system linked interventions through regular old feature phones (who came up with that name). This means that there are no pesky [expensive, time intensive, expertise-demanding] visual interface issues to get in the way.


It's hard to overestimate how important these changes could be. When have we seen such rapid changes in infrastructure that can revolutionize the health system in low income countries?

This might deal the death blow to the digital divide

There's good evidence that, during the past half decade, mobile has become the "digital onramp to the Internet". The digital divide in Internet access dissipates greatly when you consider mobile access.

That's what makes announcements like these so exciting. Google's Project Loon would launch balloon access points into the sky, providing easy (and hopefully cheap) Internet access in areas that are challenging to wire.

A single “Project Loon” balloon can now remain in the air for more than six months and provide 4G LTE cellular service to an area the size of Rhode Island, according to Google. Company officials have taken to calling Loon balloons “cell towers in the sky.”

Google plans to launch Project Loon in global locations abroad:

As for where pilot projects will begin, Jabbari said, “given that we have an established launch site in New Zealand and an established recovery zone in Latin America and other places, that's where you're most likely to see us, somewhere around there.” However, “we've had conversations with countries elsewhere and telcos elsewhere, those have all gone really well.” Jabbari said Google wants to create a “ring around the world” with its balloons.

Here's my suggestion: start at home, too.

The proliferation of cheap mobile devices and now, pervasive [and potentially cheap] Internet access could deal the death blow to our domestic digital divide. We need a Marshall Plan of sorts to support the coordination of initiatives like Loon (as well as competing projects from Facebook and some of the telcos). The goal: extend the digital revolution to all Americans.

Going global

Sure, we got it a bit backwards. First, you saw the blooper reel.

Now, here’s the real thing.

Beginning Fall 2013, we’re starting one of the first liberal arts global health majors in the country. Learn from and work alongside the best faculty at Duke and expand your classroom experience with real-world fieldwork and research in the world. Learn more.