TELEMEDICINE AND DEVELOPING-COUNTRIES - A REPORT OF STUDY-GROUP 2 OF THE ITU DEVELOPMENT SECTOR

While there are significant potential advantages and benefits from tel emedicine, the evidence of its cost-effectiveness and sustainability i s meagre. This is because much of the telemedicine activity so far has been in the form of pilot projects or demonstrations in universities and hospitals with subsidized funding from government or other sources . The number of self-sustaining, commercial applications of telemedici ne is still very small. Telemedicine undoubtedly yields cost savings i n certain circumstances, but often the savings and benefits accrue to those who do not have to pay for the service. Thus, few service provid ers have found a way to recover their costs (and make a profit) from t hose to whom they provide their service. Even fewer countries have act ually budgeted for the provision of telemedicine as a service widely a vailable to their citizens. Nevertheless, with the rapidly declining c ost in hardware and telecommunications, the level of interest and the corresponding activity in telemedicine is rising rapidly. Most of the telemedicine experience to date has been in the industrialized world. It is apparent that the first requirement of developing countries is f or more information about telemedicine, what it is, and how it might b e able to help solve some of the shortages in medical and health care. Given the potential of telemedicine to facilitate the provision of me dical information and health care in rural areas, it seems useful for developing countries to undertake pilot projects in order to evaluate its potential and cost-benefits. The results of such pilot projects co uld be part of the development of a national health for all policy whi ch takes telemedicine into account. In view of the other priorities of developing countries, especially those of the least developed countri es, financing telemedicine activity is likely to remain a challenge fo r some time to come. Funding from external donor agencies may well be necessary, but local commitment and participation in pilot projects is essential if the project is to have a chance,of success. As telemedic ine requires a multidisciplinary approach, the active participation of telecommunication operators must be assured. Despite some false start s in the deployment of telemedicine as a continuing service to the gen eral population-as opposed to a few well-to-do clients-telemedicine ha s great potential to improve access to health care and to contain cost s in developing countries.