BMJ 1994;309:736-737 (17 September)



Global health network university proposed

EDITOR, - Recently we pointed out the potential of the information superhighway to become a critical factor in improving global health in the next century.1 One important aspect of the telecommunications revolution is to enable distance education. We believe that it is time to establish a global training programme in public health through the capabilities that the internet provides and are enlisting faculty and students to join this effort.

Developing countries are facing the twin burdens of chronic disease and infectious disease. As the result of increased longevity, chronic diseases have emerged, yet infectious diseases have not been eliminated. Recently a World Bank report argued that cost effective public health measures represent a primary means for disease prevention and a reduction of the enormous cost of disease.2

The establishment of public health measures requires trained public health staff. Many developing countries have no choice but to send students abroad for training. This is enormously expensive - tuition, fees, and stipends at an American school of public health for a two year MPH degree cost over $80 000, but unfortunately the costs are higher as more than 50% of students do not return home after completing their degree. Thus, increasing the number of foreign trained MPH staff in a country requires an investment of over $160 000. In addition, we are in a global community of health, yet our students in developing and developed countries alike have little international experience.

Until now, a student could acquire the public health tools of access to information, the network of students, the availability of leading scientists, and international experience by few means other than through foreign training. Now, however, potentially equivalent international expertise and public health care education can be provided through the internet, which can reach broad audiences and avoid relocation and other unnecessary expenses.

We are in the process of establishing a telecommunications based public health training program. This program will grant degrees in public health, as well as provide internationally recognised certificates for those students receiving their public health degrees from their home institutions. Students can also take courses to gain international experience. We are seeking expert members of faculty of public health in schools, ministries of health, and other areas who could serve as mentors and instructors for a new "metaschool" of public health that could train students through the internet on the basis of how we learn through networks.3

The first step of this is to identify potential faculty in epidemiology and other disciplines from schools of public health who are facile on the internet who would like to teach in this metaschool. The second step is to network, across country boundaries, young people starting their training in public health so as to start a global training dialogue among students themselves and the faculty. The third step is to begin the degree granting programme.

Students and faculty interested in forming a global health network university (GHNet-U), please contact one of us below.

R E LaPorte, S Akazawa, E Boostrom, M Campos, T Gamboa, R Gooch, H Lee, I Libman, E Marler, K Roko, F Sauer, N Tajima, W Wiebe 

  1. LaPorte RE, Akazawa S, Hellmonds P, Boostrom E, Gamboa C, Gooch T, et al. Global public health and the information superhighway. BMJ 1994;308:1651-2. (25 June.) [Full Text]
  2. World Bank. Development report, 1993: investing in health. Oxford: Oxford University Press, 1993.
  3. Riel M. Global education through learning circles. In: Harasim L, ed. Global networks. London: MIT Press, 1993: 221-6.

Global public health and the information superhighway Epidemiologists are using the internet

EDITOR, - Ronald LaPorte and colleagues presented an impressive, though not unrealistic vision of an electronic future for public health.1 Many of us in public health have used Internet in some of the ways suggested.

In 1990 an electronic network for research and teaching in public health was established among epidemiologists in Hungary, Canada, Norway, Israel, and Australia.2 In 1991, to facilitate a European Community funded TEMPUS (Trans European Mobility Programme for University Studies) project aimed at developing education for a new public health in Hungary, we set up a listserver at the University of Western Ontario, Canada, linking 16 partners in six countries.3 This electronic mailing list has provided a mode of communication between partners, enabling rapid transfer of information and discussion of the project, as well as development of presentations and publications.

More recently, in Newcastle, a listserver has been set up as a part of the Mailbase system open to academics in public health.4 This list facilitates the sharing of information (on workshops, seminars, conferences, research grants, new ideas, etc) and promotes links, collaborative working, joint problem solving, and mutual support. It was initially intended for those working in the United Kingdom, but the membership has grown rapidly over 18 months and has spread to the rest of Europe and North America. At the outset the list was easily accessible only to academics, but the opening up of the information superhighway1 heralds the possibility of a much wider membership for the list, including those working in health services (such as public health physicians in Britain) and others in public sector and non- governmental organisations.

Electronic communication, especially computer conferencing, has also been used as a tool for distance education in epidemiology and biostatistics,5 breaking the isolation that is often felt by students at remote sites.

As LaPorte and colleagues have indicated, the possibilities are many. The advantages are also great. For example, preparing a joint publication with international authorship takes considerably longer without electronic mail (e-mail); we prepared this letter by shutteing the draft back and forth across the Atlantic in a matter of seconds for each transfer. We could even have e-mailed it to the BMJ if the journal had its own e-mail address, enabling direct editing and typesetting. Could this be a future for rapid communication in medical journals?

The Mailbase system operates from Newcastle University Computing Centre and provides a national resource for the support of academic e- mail discussion lists. To join the public health list, send an e-mail message with the single line: join public-health firstname lastname to, substituting your first and last names as appropriate. There is no cost and you will receive full information on the list and on using Mailbase when you join.

M White, T Ostbye


  1. LaPorte RE, Akazawa S, Hellmonds P, Boostrom E, Gamboa C, Gooch T, et al. Global public health and the information superhighway. BMJ 1994;308:1651-2. (25 June.) [Full Text]
  2. Ostbye T, Bojan F, Rennert G, Hurlen P, Garner B. Establishing an international computer network for research and teaching in public health and epidemiology. European J Epidemiol 1991;7:34-8.
  3. TEMPUS Consortium for a New Public Health in Hungary. Computer communication for international collaboration in public health. Ann NY Acad Sci 1992;670:43-9. [Medline]
  4. Parkin D, White M. New electronic mailing list for public health and epidemiology. Public Health Physician 1993;4(1):10.
  5. Ostbye T. An "electronic" extramural course in epidemiology and medical statistics. Int J Epidemiol 1989;18:275-9. [Abstract]