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