Understanding the Relationship between Digital Public Goods and Global Goods in the Context of Digital Health

Abstract

With more than 95% of the global population living in areas connected by a mobile-cellular network, the opportunity for digital solutions to address health needs and accelerate the attainment of the sustainable development goals by 2030 has never been more possible. And the need is urgent. Leveraging open source oers opportunities to rapidly scale state-of-the art technologies and make relevant local adaptations of digital health solutions. Recognising this, and the urgent challenge brought on by the COVID-19 pandemic, the Community of Practice (CoP) for Health, convened by the Digital Public Goods Alliance (DPGA) and co-chaired by UNICEF Health, is seeking to support countries to identify and advocate for open source technologies that can be used for immunization delivery management. The CoP sees the highest potential impact for digital health solutions that are both digital public goods (DPGs) and global goods. This alignment is particularly important as a mechanism to complement and extend existing eorts such as COVAX, WHO ClearingHouse and Digital Square to identify digital public goods/global goods for immunization delivery management.

Full text

Paper Prepared By:
Digital Public Goods Alliance, Digital Square, UNICEF Health and
Information Communication Technology (ICT) Divisions
Understanding the Relationship
between Digital Public Goods and
Global Goods in the Context of
Digital Health
April 8, 2021

The Digital Public Goods Alliance is a multi-stakeholder initiative which aims to
accelerate the attainment of the sustainable development goals in low- and
middle-income countries by facilitating the discovery, development, use of, and
investment in digital public goods. The Secretariat of the Digital Public Goods
Alliance is co-hosted by the Norwegian Agency for Development Cooperation
(Norad) and UNICEF and governed by an Interim Strategy Group consisting of:
iSPIRT; The Government of Norway; The Government of Sierra Leone; and UNICEF.
Many sta, Community of Practice Members and allies of the DPGA generously
contributed ideas to this paper.
The paper was written by Lucy Harris and Liv Marte Nordhaug.
Special thanks to the following contributors:
Special thanks to the following contributors:
Karin Källander, UNICEF; Sean Blaschke, UNICEF; Benjamin Grubb, UNICEF; Amanda BenDor, Digital
Square/PATH; Carl Fourie, Digital Square/PATH; Michael Downey, Digital Impact Alliance at United
Nations Foundation; Jai Ganesh Udayasankaran, Asia eHealth Information Network (AeHIN); Tim
Wood, Bill & Melinda Gates Foundation; Mark Landry, World Health Organization; Peter Benjamin,
HealthEnabled, Christopher Seebregts, Jembi Health Systems NPC, South Africa.
This work is licensed under the Creative Commons Attribution 4.0 (BY) license,
which means that the text may be remixed, transformed and built upon, and be
copied and redistributed in any medium or format even commercially, provided
credit is given to the author(s). For details go to
http://creativecommons.org/licenses/by/4.0/. Creative Commons license terms for
re-use do not apply to any content (such as graphs, figures, photos, excerpts, etc.)
not original to the Open Access publication and further permission may be required
from the rights holder. The obligation to research and clear permission lies solely
with the party re-using the material.
First published in 2021 © Digital Public Goods Alliance
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Understanding the Relationship between
Digital Public Goods and Global Goods in
the Context of Digital Health
Table of Contents
Introduction 3
Defining Digital Public Goods and Global Goods 3
Digital Public Goods 3
Global Goods 3
Global Goods in Digital Health 4
Comparing Definitions 4
Conclusion 6
Resources 7
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Introduction
With more than 95% of the global population living in areas connected by a
mobile-cellular network1, the opportunity for digital solutions to address health
needs and accelerate the attainment of the sustainable development goals by 2030
has never been more possible. And the need is urgent.
Leveraging open source oers opportunities to rapidly scale state-of-the art
technologies and make relevant local adaptations of digital health solutions.
Recognising this, and the urgent challenge brought on by the COVID-19 pandemic,
the Community of Practice (CoP) for Health, convened by the Digital Public Goods
Alliance (DPGA) and co-chaired by UNICEF Health, is seeking to support countries
to identify and advocate for open source technologies that can be used for
immunization delivery management.
The CoP sees the highest potential impact for digital health solutions that are both
digital public goods (DPGs) and global goods. This alignment is particularly
important as a mechanism to complement and extend existing eorts such as
COVAX, WHO ClearingHouse and Digital Square to identify digital public
goods/global goods for immunization delivery management.
Defining Digital Public Goods and Global Goods
Digital Public Goods
Digital public goods (DPGs) are defined by the UN Secretary-General, in the
Roadmap for Digital Cooperation, as “open source software, open data, open AI
models, open standards and open content that adhere to privacy and other
applicable laws and best practices, do no harm, and help attain the Sustainable
Development Goals.”
This definition has been translated into a 9-indicator open standard by the DPGA.
This standard requires DPGs to demonstrate: relevance to the SDGs; use of an
approved license; clear ownership; platform independence; documentation; a
mechanism for the extraction of non personally identifiable information; adherence
to privacy and applicable laws; adherence to standards and best practices; and a
commitment to do no harm. The DPG Standard has been designed to be relevant
for all DPGs, regardless of sector.
Global Goods
While there is no authoritative definition of global goods, the traditional usage2is
an extension of an established economic definition of global public goods, “a good
that has the three following properties:
2Global public good,Wikipedia.
1ICT Facts and Figures 2016, International Telecommunications Union.
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●It is non-rivalrous. Consumption of this good by anyone does not reduce the
quantity available to other agents.
●It is non-excludable. It is impossible to prevent anyone from consuming that
good.
●It is available more-or-less worldwide.”3
Global Goods in Digital Health
Looking at global goods within the health context, two prominent definitions are:
Digital Square’s What Are Global Goods Wiki which defines global goods as “A
mature digital health software [that] is software that is Free and Open Source
Software (FOSS), is supported by a strong community, has a clear governance
structure, is funded by multiple sources, has been deployed at significant scale, is
used across multiple countries, has demonstrated eectiveness, is designed to be
interoperable, and is an emergent standard application.”4
USAID’s A Vision for Action in Digital Health describes global goods as “including
content (knowledge products) and software tools, which frequently are open-source,
adaptable, and reusable to meet the diverging needs of various geographic or
thematic contexts.”5
Comparing Definitions
Relevance to the SDGs
Each of these definitions addresses the three core properties of global goods:
non-rivalry, non-excludability, and worldwide availability, with some variation in the
specific requirements. However, digital public goods (DPGs) also require relevance
to the attainment of the Sustainable Development Goals (SDG).
By looking exclusively at global goods in the context of health we can see health
global goods as relevant to the attainment of SDG Goal 3: Ensure healthy lives and
promote well-being for all at all ages 6, and therefore addressing the SDG
requirement of DPGs.
Incorporating Best Practices and Doing No Harm
The DPG definition explicitly addresses questions related to doing no harm and
incorporating best practices. Within the DPG Standard, “do no harm” is divided into
three sub-categories with corresponding criteria that are assessed. These include:
1) data privacy & security; 2) inappropriate and illegal content; and 3) protection
from harassment.
While “do no harm” is not explicitly mentioned in the definitions of global goods,
adherence to the Principles for Digital Development and security best practices are
a part of the evaluation frameworks for Digital Square Global Goods and include
“do no harm” components.
6Goal 3: Good Health and Well-being, the United Nations Sustainable Development Goals.
5A Vision for Action in Digital Health, USAID.
4What are Global Goods,Digital Square.
3Defining Global Goods Kaul, Inge, Isabelle Grunberg and Marc A. Stern.
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Digital Health Global Goods as a Subset of Global Goods
Unlike DPGs, global goods are not inherently digital. However, digital goods
(software) are prominently represented amongst global goods due to their potential
for global scale. Since digital technologies tend to be non-rivalrous by nature, one
individual's use of a digital product does not limit its utility to someone else.
Additionally the use of open source licensing can ensure that no one is excluded
from using/reusing a good.
Open Source as a Fundamental Requirement
The definitions of DPGs and Digital Square’s definition of global goods explicitly
requires projects be open source defined as use of an approved license7, clear
ownership, documentation, platform independence, and extractable
(non-personally identifiable) data. While the USAID definition of global goods uses
the term “frequently” in front of open source, we can understand that given the
additional requirements it would be functionally impossible for a digital health
global good to be proprietary and meet this definition. Therefore, digital health
global goods can be expected to meet the digital public good requirement for being
open source.
Digital Health Global Goods as Mature Digital Public Goods
If we consider digital health global goods as a subset of global goods, we can
further classify digital health global goods as mature digital public goods. Within
definitions of global goods for digital health there is broad alignment on the need
for global goods to demonstrate maturity through indicators such as:
●Scale: Implemented by a large number of parties/deployed at scale/used by
multiple countries.
●Funding: By multiple parties/sustainable.
●Evidence of Eectiveness: Demonstrated eectiveness/evidence
based/emergent standard.
This concept of maturity is further detailed in the Digital Square - Global Goods
Maturity Model which was developed with input from the digital health community.
In contrast, the DPG definition, by design, has no maturity requirement. Therefore,
any solutions that otherwise address the DPG Standard may be considered DPGs.
This dierence creates an opportunity to describe digital health global goods as a
mature subset of digital public goods.
Conclusion
Having a clear, shared articulation of the relationship between global goods in the
digital health context and mature digital public goods is extremely useful. Not only
does it allow for clarity and consistency in communication, it also facilitates
7Projects must demonstrate the use of an approved open license. For Open Source Software, we only accept OSI approved licenses. For Open Content we require the
use of a Creative Commons license while we encourage projects to use a license which allows for both derivatives and commercial reuse (CC-BY and CC-BY-SA), or
dedicate content to the public domain (CC0); we also accept licenses which do not allow for commercial reuse (CC-BY-NC and CC-BY-NC-SA). For data we require an
Open Data Commons approved license.You can find the full license list here.
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alignment and collaboration within and across digital health and digital public
goods initiatives.
In future iterations of the Global Goods Guidebook, Digital Square will note which
global goods are DPGs, and which use cases have been approved through the WHO
Clearinghouse. The DPG Registry will also note which DPGs are Digital Square
approved global goods.
We imagine in the future, those wishing to fund8or otherwise support digital health
global goods, may be able to use the DPG Standard as a practical prerequisite.
Leveraging the DPG screening process could eliminate the need for multiple
programs to check licenses or review documentation on the same project. This
approach allows programs to extend, rather than duplicate, one another.
In recognition of this opportunity, the Digital Health CoP, convened by the Digital
Public Goods Alliance, is working to apply the combined standards for DPGs and
global goods to assess promising short-listed projects of high relevance for
immunization delivery management. At the outset of this assessment these health
solutions will be digital public goods and global goods, shared through multiple
catalogues and systems with governments who are requesting open solutions to
immunization delivery challenges.
Resources
●Digital Public Goods Alliance DPG Standard, digitalpublicgoods.net/standard
●Digital Public Goods Alliance DPG Registry, digitalpublicgoods.net/registry
●Digital Square Global Goods Guidebook, digitalsquare.org/global-goods-guidebook
●Digital Square Global Goods Maturity Model,
wiki.digitalsquare.io/index.php/Global_Goods_Maturity
●Principles for Digital Development, digitalprinciples.org
●The Principles of Donor Alignment for Digital Health digitalinvestmentprinciples.org
●WHO Clearinghouse, innovate.who.int
8The Principles of Donor Alignment for Digital Health, Digital Investment Principles.
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