This work closely aligns with the DPGA’s Health Community of Practice (CoP) which brings experts, including representatives from DICE, together to support the discovery, assessment and advancement of open source technologies with relevance to immunization delivery management. Through these convenings it became even more clear how critical access to digital health  global goods are in addressing Covid-19.

Well before the pandemic, countries were making significant strides in their digital transformations. COVID-19 has provided a galvanizing moment to support these efforts, but pandemic responses should utilise the immediate opportunity but with a long-term goal. We must support digital transformations not just for vaccine roll outs, but far beyond COVID-19. DICE accounts for this by providing technical assistance for countries to operationalise their national COVID-19 pandemic response plans, including vaccine deployments, in a way that improves service delivery more broadly, and enables data-based decision making which will strengthen health and immunization information systems.

We are pleased to support DPGA co-host, UNICEF, and the organisations behind DICE as they provide technical assistance that builds strong global digital systems. Read more on DICE below.

A multi-agency COVID Digital Health Centre of Excellence (DICE) co-led by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) launched on April 29th, to provide coordinated technical assistance to national governments and partners on digital health interventions that address health priorities in the context of the COVID-19 pandemic, as well as post-pandemic health system needs. 

The COVID DICE is a consortium of partners, including the Bill & Melinda Gates Foundation (BMGF), GIZ, the US Centre for Disease Control, the European Commission, The Global Fund, The Foreign, Commonwealth & Development Office (FCDO), the Gavi Alliance, USAID, and the World Bank. It is co-hosted by a UNICEF-WHO virtual secretariat that will be managing day-to-day activities, including coordination with technical partners like Digital Square.

The COVID DICE is currently funded by a donation from the BMGF, and is designed to provide coordinated technical assistance to low- and middle income countries (LMICs) to support sustainable and scalable deployment of carefully chosen mature digital global goods for planning distribution of commodities and vaccines, tracking patients and supplies, surveillance and case detection, monitoring coverage of services, training health workers, and communicating with the general population to generate demand and reduce misinformation. 

Although the initiative is currently focused on addressing the immediate needs of the countries in the context of the COVID-19 response, the COVID DICE will also aim to fast track WHO’s Global Digital Health Strategy, thereby laying the foundation for a more comprehensive mechanism for harnessing the power of digital health technologies for overall health systems strengthening, in response to COVID-19 and beyond.

“UNICEF, WHO, and DICE partners are receiving a steady stream of requests for technical support for establishing digital solutions from governments, as they grapple with the unprecedented challenges brought by the COVID-19 pandemic,” said Aboubacar Kampo, UNICEF’s Director of Health. He continued, “the DICE will provide critical coordination and technical assistance to support the pandemic response and vaccine delivery, while balancing this with countries’ long-term vision for strengthening of health systems more broadly.”

As countries are operationalizing their national COVID-19 pandemic response plans, including deployment plans for the COVID-19 vaccines, they are turning to digital health interventions to amplify efforts to improve service delivery, make decisions based on actionable data, and strengthen health and immunization information systems more broadly. 

“Countries have already made significant investments in digital health systems, and many of these platforms can be expanded to provide substantial support to COVID-19 vaccine delivery and beyond,” said Bernardo Mariano Junior, Chief Information Officer and the Director of Digital Health and Innovation at WHO. “However, the enabling digital environment in Lower Middle Income Countries is often fragmented and not geared towards the support of large-scale vaccination delivery to the population.”

Carine Gachen from the Gavi Alliance shares this concern: “Poorly designed or inappropriate digital interventions, as well as vertical approaches geared only for COVID-19 vaccines, risk undermining and weakening national health systems. Countries must rapidly assess, identify, adopt, cost, and deploy robust and ready-to-scale digital health solutions to meet the demands as a pivotal preparation step for successful COVID-19 vaccine delivery.”

DICE will initially leverage existing partner capabilities so that it is operational immediately, and will seek additional funding and partnership support to coordinate and scale its ability to meet rapidly growing demand for assistance to select and deploy global goods for the COVID-19 response. 

DICE is creating a roster of consultants, volunteers and partner agencies to respond to country requests. Apply to the consultant roster before May 21st 2021. If you would like to get involved or support in other ways, write to: contact@digitalhealthcoe.org with the subject line “SUPPORT” with what services you are able to offer.

The Digital Public Goods Alliance looks forward to working closely with DICE on advancing relevant digital global goods via this exciting initiative.

Globally, significant progress has been made to harness the momentum of digital innovation and translate it to the healthcare sector. We’ve seen this, for example, in the unprecedented global cooperation on vaccine development. While these advancements are considerable, more must be done to support countries in their transition to digital health beyond the pandemic. COVID-19 has underscored the need for innovative solutions that have the ability to not only help countries respond, but also to strengthen digital cooperation and promote equitable access to health solutions. 

In recognition of this need, in 2020 the Digital Public Goods Alliance (DPGA) convened a Health Community of Practice (CoP) with UNICEF Health which focused on identifying DPGs for immunization delivery management. 

The DPGA Community of Practice Model

The DPGA convenes expert CoPs to support the discovery, assessment and advancement of digital public goods (DPGs) with high potential for addressing critical development needs in low- and middle-income countries. Currently, there are ongoing CoPs for climate change adaptation, health, and financial inclusion. Within these broad topics, each CoP narrows in on particular focus areas by considering relevance and potential impact of DPGs.

Aligning Initiatives for Digital Health

Several organisations within the development sector have been working to identify and support digital health technologies including WHO’s ClearingHouse and Digital Square’s Global Goods Guidebook. Though there are differences in criteria across these initiatives (discussed in the paper), in the health context, global goods can be considered mature digital public goods, and there are considerable opportunities for alignment that have the potential to accelerate the discovery and adoption of global goods.

In the coming weeks, the DPGA will be releasing a list of solutions identified by this CoP that meet all of the criteria to be recognized as both digital public goods and global goods of high relevance for immunization delivery management.

For more information, continue reading the full paper Understanding the Relationship between Digital Public Goods and Global Goods in the Context of Digital Health. 

COVID-19 has turned the world upside down. Globally, there have been devastating effects on healthcare systems and economies. The residual effect on human welfare will be felt for years to come. While vaccines have provided a light at the end of the tunnel for many, vaccine ubiquity is far from worldwide. The tools for effective management of immunization information are not equally available or accessible. 

There is a need to look at opportunities for new digital cooperation and openness.

Ensuring that everyone is able to be vaccinated is in the interest of all. Guaranteeing that the digital solutions necessary for effectively managing immunization delivery are digital public goods will strengthen digital cooperation and promote equitable distribution of vaccines across the globe. 

In order to be a digital public good, projects must be open source, adhere to applicable laws and best practices, do no harm, and help attain the sustainable development goals.(2) Many of the tools used for managing vaccine delivery meet most of these requirements but are not yet open source, limiting countries ability to freely adopt them.

For this reason, the Digital Public Goods Alliance is calling on all digital solutions that are relevant for immunization delivery management to be open source. 

We consider tools to be relevant for immunization delivery management when they address the following dimensions from the WHO-UNICEF COVAX Vaccine Delivery Innovation Team: infodemic management; micro planning; counterfeit detection; communication for demand generation; health worker training; vaccination status tracking; vaccination monitoring; and safety monitoring within a health context.

We urge relevant technologies to follow the lead of solutions like DIVOC, DHIS2, CommCare, mHero and other health technologies to take the following steps to become open source: use an approved open source license(3), clearly define their ownership, document the source code, use cases, and/or functional requirements of the project, and ensure a mechanism for extracting or importing non-personally identifiable data from the system in a non-proprietary format. 

Open source solutions can accelerate vaccine delivery and set countries up for long-term success. 

In Sri Lanka the first suspected case of the novel coronavirus was registered on 27 January 2020. Within just two days, following a request from the country’s Ministry of Health, a DHIS2 tracker for COVID-19 was created by local developers that focused on the registration and tracking of travellers arriving from regions with a high risk of COVID-19 infection. It was deployed at Sri Lanka’s airports just days later.  

Sri Lanka is using DHIS2, an open source health information management system and a digital public good.(4) Globally, DHIS2 is used in 73 countries which account for 30% of the world’s population.

After developing the DHIS2 tracker Sri Lanka shared their user guides with the global DHIS2 COVID-19 response team. The tracker is now integrated into openly licensed training material publically available for worldwide use. An application version of the tracker has since been released for global adoption allowing other countries using DHIS2 to more adequately track the virus.(5) It is now operational in 38 countries and under development in 14 more.(6)  

In the case of immunization delivery management, this is just one example of why open source is preferable to proprietary systems. When the code is open source, systems and platforms can be adapted for new circumstances by creating tools that can aptly respond to diverse challenges beyond just pandemics. As in Sri Lanka, these adaptations can then be shared widely, allowing for other countries to benefit from innovative solutions while strengthening global cooperation between and amongst countries. 

Outside of increasing accessibility and cooperation, open source technologies provide short- and long-term benefits, not only in regards to vaccinations, by assisting countries to build their digital infrastructure.

In the short term, open source solutions: 

• Can be easily adopted by national governments without fear of vendor lock-in, which can bind countries to rigid technologies at a high cost;
• Can be adapted to meet unique local needs and contexts specific to their country or region; and
• Allow countries to leverage multiple partners and vendors to quickly deploy solutions at the speed which pandemic response requires.

In the long term, open source solutions: 

• Help foster robust digital governance, by providing countries with sustainable tools that can be adapted for other use cases, even across sectors;(7)
• Build country capacity by increasing the skills of government staff who learn to manage, and adapt open source solutions. This opportunity to learn from, and build off of, existing open source code can aid efforts to create sustainable, local digital capacity;
• Allow researchers and academics to more easily find and review non-personally identifiable data and extract lessons learned for future scenarios;(8) and
• By virtue of their transparency, foster public trust which helps strengthen government institutions.(9) 

The global community must make strong commitments to support quick, equal and open access to digital public goods that enable governments to fight COVID-19. 

The Digital Public Goods Alliance (DPGA) is committed to increasing the discoverability, investment and use of these digital public goods. In the coming weeks, the DPGA will be releasing a list of solutions that are digital public goods and global goods of high relevance for immunization delivery management as part of the Community of Practice (CoP) for Health convened by the DPGA and co-chaired by UNICEF Health.

Open source immunization delivery management solutions can save tens of thousands of lives while giving a chance for already fragile states to return to normalcy. That is why digital public goods for immunization delivery management should be prioritized and tools for immunization delivery management that are currently proprietary should become open source.(10)

1. UN Secretary-General António Guterres’ opening remarks to the Africa Dialogue Series on COVID-19 and Silencing the Guns in Africa: Challenges and Opportunities, United Nations
2. Digital Public Goods Standard, Digital Public Goods Alliance
3. Licenses & Standards, Open Source Initiative
4. DHIS2 – Digital Public Goods Case Study, Digital Public Goods Alliance
5. Innovating DHIS2 Tracker and Apps for COVID-19 Surveillance in Sri Lanka, DHIS2
6. COVID-19 Surveillance, Response & Vaccine Delivery Toolkit, DHIS2 
7. DHIS2 – Digital Public Goods Case Study, Digital Public Goods Alliance
8. Digital Solutions for COVID-19, Johns Hopkins
9. Building and Reusing Open Source Tools for Government, New America 
10. How to Become an Open Source Enterprise, GitHub

The DPGA Community of Practice Model

The DPGA convenes expert Communities of Practice (CoPs) to support the discovery, assessment and advancement of digital public goods with high potential for addressing critical development needs in low- and middle-income countries. Currently, there are ongoing CoPs for climate change adaptation, digital health, and financial inclusion. Within these broad topics, each CoP narrows in on particular focus areas by considering relevance and potential impact. 

Digitalisation, financial inclusion and COVID-19

The last years have seen growing international consensus around the need to accelerate digitalisation of public financing as a driver of financial inclusion and the broader 2030-agenda. The value of digitalising government payments in developing countries is estimated at US$220-$320 billion annually by the IMF.

The COVID-19 pandemic has accentuated this need, as governments with robust systems in place were better equipped to respond to the outbreak not only in their direct health response, but also by targeting vulnerable populations and delivering payments into people’s accounts to mitigate the economic hardships caused by the outbreak.

The Financial Inclusion CoP has therefore spent the last few months working to identify and shortlist technologies that, in a given country, can be used by a range of service providers and innovators. These technologies can be built on across sectors and have features that can allow countries to freely adopt and iterate them to meet local needs. Projects that were at this particular intersection of digital public goods (DPGs) and digital public infrastructures (DPIs) stood out as meeting all of these criteria.

Below, we share a snapshot of our thinking, but encourage you to read the full paper for more detail. 

Defining digital public goods and digital public infrastructures

Digital public goods are defined by the UN Secretary-General’s Roadmap for Digital Cooperation as “open-source software, open data, open artificial intelligence models, open standards and open content that adhere to privacy and other applicable international and domestic laws, standards and best practices and do no harm.” Encompassing the UN’s shared goals, DPGs should also be relevant for attainment of the Sustainable Development Goals. 

There is no similarly authoritative definition of DPIs, but they are often referred to as the rails that other solutions “run on top of” and their implementation typically enables many other solutions and business models to flourish. It is furthermore meaningful to divide them into foundational and functional categories, referring to the extent to which they are horizontal enablers.

Narrowing in on the DPIs that can drive financial inclusion at scale 

Discussions within the CoP on which technologies could have the most potential impact on financial inclusion and would be most horizontally enabling led to an initial shortlist of technologies for further assessment.

The DPGA Secretariat is now in the final stages of verifying these technologies against the 9-criteria open standard that the Alliance has developed to operationalise the definition of DPGs. Key transformative features of DPGs include their adoptability and adaptability, and their resulting potential to help form new models for international digital cooperation. DPGs can be foundations for multi-stakeholder cooperation and can help transcend geographical, institutional, sectoral and expertise boundaries. Local adaptations and iterations can be shared back with the core project and help ensure long term sustainability. DPGs can also help safeguard human rights through relevant minimum standards and through providing transparency and accountability around how technologies have been designed.

Of particular importance for driving financial inclusion at scale is that, due to their open source licensing, DPGs can offer more control and independence and reduce the risk of vendor lock-in, making it easier for countries to make strategic decisions and have a long-term and holistic perspective when building out their digital foundations.

The shortlist

The table below depicts key features of digital public goods compared to digital public infrastructures and shows the technologies (highlighted section) that have been identified by the CoP as both foundational DPIs and likely DPGs. 

Next steps

Once DPG Standard compliance is verified, the DPGA Secretariat will work with the CoP to conduct a deeper assessment of these technologies in order to compile and highlight information of key relevance to governments, donors and other stakeholders working to accelerate financial inclusion through digitalisation. 

Also, the transformative potential of DPGs can not be fully realized unless we simultaneously transform the systems, structures and practices in which these technologies are embedded. As one important step in this direction, the DPGA Secretariat is therefore working with philanthropic and government donors to align on a common global approach to resource mobilisation and coordination.

To learn more about the relationship between DPIs and DPGs we encourage you to read the full paper.