Telepreventive Medicine

as the Grand Challenge

Supercourse's Front Page 


What is the Grand Challenge?

CALL FOR IDEAS: Identifying Grand Challenges in Global Health 2003

The Bill & Melinda Gates Foundation, in collaboration with the National Institutes of Health, and the Foundation for the National Institutes of Health, has established an initiative to support scientific and technological research that addresses Grand Challenges in Global Health. The Grand Challenges in Global Health initiative, led by an international Scientific Board, seeks the participation of the global scientific community in articulating the "Grand Challenges" for scientific exploration that will ultimately increase research attention to the most critical health problems in the developing world. Although there are enormous challenges that relate to poverty, access to health interventions, and delivery systems in developing countries, this initiative is focused on the grand scientific and technological research challenges in health.

After approval of the full list of selected Grand Challenges by the Scientific Board in August, 2003, the list will be widely published and advertised to solicit research grant proposals from the global research community for funding by the Grand Challenges in Global Health initiative. The Scientific Board intends to conduct an entirely open competition for research funding, with no advantages accorded to those whose ideas are selected as Grand Challenges.

Testimonials from supporters of the Supercourse from around the world

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Prof. Fengsheng He, Director, WHO Collaborating Centre in Occupational Health, P.R. China

Dear Sirs,
          Dr Ronald LaPorte from the Pittsburg University, USA, initiated a "Supercourse". In which, over 1300 lectures have been provided from leaders such as nobel prize winners, Ministers of Health, Directors of WHO institutes and top academics. The lectures are contributed voluntarily, and open to all with no copyright restrictions. The supercourse is now being developed and used by close to 10,000 people in 151 countries. The Supercourse is the first global open source model for training in prevention.
          Because the human resources in preventive medicine is extremely weak and insufficient in all developing countries, and people in developing nations are lack of access to good education in preventive medicine, the training and education in public health, epidemiology, occupational health and safety etc. with the use of Supercourse would be highly efficient and most useful to the public health scientists in the developing world, leading to a cost-effective upgrading of global preventive medicine.
          Learning the criteria to be used to select the Grand Challenges,:
 * The magnitude of the health problem being addressed and its alignment with the scope of the program.
 * The identification of the scientific or technical roadblock to achieving a solution and why this roadblock is limiting on a critical path to achieving the solution.
 * The soundness of the scientific and technical foundation for the proposed Grand Challenge, not merely the ease or likelihood of success. (Novel and innovative ideas that may be risky, but nonetheless scientifically and technically well founded, will be valued.)
 * The impact of solving the Grand Challenge on the health problem, including indirect benefits such as those on income or environment.
 * The feasibility of widely implementing any solution to the Grand Challenge in the context of the developing world.
           I would like to strongly recommend this telepreventive medicine programe to become a Grand Challenge.

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Dr Denish Moorthy, Consultant, ICCIDD, All India Institute of Medical Sciences, India

My dear friends and colleagues,
          I seem to have been only like a small boy playing on the sea shore, diverting myself in now and then, finding a smoother pebble or a prettier shell than the ordinary, whilst the great ocean of truth lay all undiscovered before me
     Sir Issac Newton, Physicist, Mathematician, philosopher, above all a “Scientist”
          True ignorance is not the absence of knowledge, but the refusal to acquire it
Sir Karl Popper, Assistant cabinet maker, School teacher, Physicist, philosopher, and a “Scientist”
          "As we enter the digital decade, the opportunities before us to drive innovations are immense. This presents a unique role for the government of India to create a vibrant knowledge based economy that encourages innovation and is built on deep partnership…”
William (Bill) H. Gates

A Part of living history
          India has a population of over 1000 million. It was always thought that the mass media of television and radio was the best means to reach a population of that considerable size. In the field of public health, apart from the mass media of television and the radio, we now have an added power to reach a part of the 1000 million population. The Internet. Even though the Indian net penetration is only about 3 million, there lies ahead of us a challenge - how to combine the tools of the communications revolution and innovations in learning with the dramatic expansion in knowledge resources to improve the health of all people, particularly the world's poor. The answer lies not in the curative services, but in prevention. Combining the best of prevention information with the Information technology revolution and the traditional networks of information dissemination in India, and the world, to equitably reach out to everyone, is THE CHALLENGE.
          I work in the field of Iodine Deficiency Disorders elimination. For the last 41 years, the Government of India has been implementing a Salt Iodization program. We had a simple solution to eliminate a serious problem like iodine deficiency – iodised salt; we had the capacity to produce iodised salt for the whole country, and more; still, we now only have an adequately iodized salt coverage of 49%. Why hasn’t Universal salt Iodization worked? Our recent surveys all over the country found that one of the key reasons that it was not working was the lack of information about the benefits of the consumption of iodised salt in the general population; What we have growing here, and in many places around the world, is an epidemic of ignorance; an epidemic that threatens to undermine the sustainability of public health programs. Ignorance arises not because the people refuse to accept health education; the ignorance is due to the non-availability of the latest practical simple prevention information.
          This is where the field of telepreventive medicine will play a major role in the not so distant future. Traditionally, didactic teaching in the classroom has always been a part and parcel of transmission of prevention information in the developing countries. What telepreventive medicine adds to this is in terms of connectivity; the traditional networks will be infused with the latest in prevention from experts all around the world who have gained this knowledge through experience. There is no greater teacher then experience. Soon, drawing on my experience in India, the Ministry of Health in Timor Leste will be able to develop a Salt Iodization program, suited for their country, avoiding the drawbacks that occurred in India’s program. A health worker in Benin will be able to implement the latest intervention to alleviate the burden of non-communicable diseases, working on information obtained from Thailand. The business world is turning into one global marketplace and it is only fair that the public health world meet together in one place – cyberspace.
          Sir Karl Popper’s work in the philosophy of science brought to the fore the need to account for and to promote the growth of knowledge. He believed that men like Sir Issac Newton (vide above) made possible a tremendous growth of knowledge by championing bold ideas and subjecting them to severe attempts at refutation, an attempt at charting “the great ocean of truth”. It is a theory’s openness to empirical refutation that makes it scientific. If a refutation is avoided at all costs then one gives up science. On the other hand, if a theory is abandoned too easily in the face of apparent refutation, then the theory has no opportunity to show its strengths, which may only become apparent in the course of debate. Telepreventive Medicine is a bold scientific idea that can be implemented globally, regardless of the level of technological advance in any country. That is because the success of Telepreventive Medicine is in the hands of the people, reaching out to touch others with knowledge.
          Bill Gates in one of his speeches mentions - “Part of the idea of the role of technology is to allow people to pursue curiosity and allow people to work together in very individualized ways. Depending on the topic, the way that someone is motivated to be interested in that topic, the things that really bring it to life for them, or make it understandable to them vary a lot from student to student. And so having all of the information out there on the Web, the latest information, and new ways of collaborating around that really can make a huge difference. Part of the vision, of course, in education is connecting everybody together.”
          In India, the people exposed to the concept of “Telepreventive Medicine” currently number around 200. These key people are mainly placed in Academia and non-governmental organizations. As we are writing to each other, these 200 people, with access to Telepreventive Medicine, and an ideology rooted in preventive health, are each teaching 100 other people about the Supercourse lectures and Telepreventive Medicine. That’ amounts to 20000 people being inoculated against the epidemic of ignorance!! The greatest advantage that Telepreventive medicine gives us is that it is a low cost, high output technology; the greatest investment is in an area that India has no lack of – human resources. People connected, working together, people telling other people about prevention – imagine if the power of the Internet technology were harnessed to combine with the power of empowered humans – the outcome in measurable terms would be immense. Prevention information can reach more than the 100 million, which is the current estimate of Internet users in India by the end of the current decade.
          Now that is your Grand Challenge!
          Thank you for your time!

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Prof. Andrei Troufanov, Irkutsk State Technical University, Russia

To: Scientific Board, Grand Challenges in Global Health

Dear Mr./Mrs. Chairman and Board Members :
          I am pleased to forward my reference of Telepreventive Medicine as a Grand Challenge.


          Telepreventive Medicine (TelPreMed) is a new science based on a interdisciplinary approach at least of three fulcra: Medicine, Information and Telecommunication Technologies (ITT), and Public Management. Why is it a new science? The point is that TelPreMed comprises its own goal and target of exploration (Personal Health Provision by Preventive Measures on the Global Scale ), its own issues , huge value of pertinent data, and specific methods of research and solving problem, and technologies of information processing. The new science has a new language with pertinent unambiguous vocabulary .
          The critical point of the idea bases on feasibility of global sharing of Accurate, Reliable, Formatted and Opportune Information on Medicine. One shouldn't confuse TelPreMed as an ITT branch. ITT 's instruments measure processes in bytes, bauds and GHz , contrary TelPreMed possesses its own criteria and indicators expressed in life expectancy, mortality and so on. As any science this new one gives a foundation for a great advance in life quality. Also one can expect that Telepreventive Medicine will exert an influence on other disciplines as Medicine, ITT, System Theory, Information Security, Law and human rights. Even TelPreMed is now in its cradle and only starting positions are marked near 10 000 scientists have been involved in the issue. It will embrace diverse actors more and more. No doubt the initiative will demand the building of a unique supporting infrastructure and a unique Information Security Policy. Myriad of sorts and nuances of conflicts require non-traditional scope to Information Security issues.
          The five components of the science of Telepreventive Medicine have been called :
1) Create a global health network
2) Establish an Internet backbone to monitor all diseases
3) Prevention knowledge on demand
4) Develop an open source Internet library for free prevention knowledge
5) Reach the unreached.
          Practically since the core of prevention is sharing knowledge I would like to emphasize the value of Data Reliability. Moreover TelPreMed will be in contradiction and competition with shady health business and shady health management. Thus I dare say it has to comprise such a component as Information Security which implies: confidentiality, integrity and accessibility.
Another component of the science one should mark out is Standardization as knowledge to be shared must have standard quality and format.
          I suspect some users might be bewitched by cheapness of yield that the Telepreventive Medicine provides and thus deceived with the outer simplicity of the latter. On the contrary the final product requires thorough research and academic activity. The TelPreMed needs in Awareness, Education and Training component to adjust the science to the society. Telepreventive Medicine is also of National value for Russian Federation. The science is developing in the country fast. It comprises near 100 lectures and more than 500 actors. It makes great sense for Russia to pay attention to the fact of first-hand information distribution ( Preventionist to Person ) on health for free . There are two crucial affects I may presume: elimination of low qualified intermediaries and development of national health culture. Indirectly the former and the latter will help to forge new democratic relations in contemporary Russia.
          The Role of the innovation for mankind none can overestimate but to compare with such cornerstone advances as literacy . The TelPreMed will play a key role in future Knowledge Society. It will make a contribution not only into Medicine field but into international and interdisciplinary development . Contrary to curative telemedicine which arms the limited circle of medical experts with new tools, TelPreMed has retailored human consciousness of national and global scales.
          In whole the construction of Telepreventive Medicine is brilliant in its courage and absolutely matches the entity of a Grand Challenge.

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Prof. Nicolas Padilla, University of Guanajuato, Mexico

          I found very useful the supercourse in my training as epidemiologist; also, I can write lectures on important issue in my country(Mexico).
          My students ( I am professor of pediatrics in School of Nursing and Obstetrics of Celaya, University of Guanajuato, typical classroom and Asesor in Pediatrics, Biostatistics and Epidemiology in Bachelor in Nursing and Obstetrics in the same School, open and to distance) used this supercourse as support material in my courses and they found it very friendly and easily to use. We make a evaluation of each lecture. In general, they are useful in their training.

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Dr Selena F Gray, University of the West of England, UK

Dear sir/madam
          I should like to express my support for the designation and recognition of telepreventive medicine as a Grand Challenge. The internet as a powerful tool for prevention must be harnessed in developing countries. The pioneering work done by the "supercourse" lecture internet programmme is absolutely remarkable, and represents a real global pooling of skills and talents that can be accessed free of charge by those who most need it.
          Experiments have shown that within a week young children given access to computers in a "hole in the wall" in India can find and use information with no training demonstrating the power of IT to promote health education and information I hope that you  will give very serious consideration to supporting this as a grand challenge.

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Professor Khor Geok Lin, Malaysia

          I wish there were more health professionals who are as forward thinking and quick to act as you and your team. Reading your proposal for the grand challenge is mind expanding and if implemented (and it deserves to be funded), will break down not only mental barriers but also socio-cultural and bureaucratic walls. I just have one suggestion to add -providing knowledge is the key as you rightly emphasized, and developing or strengthening institution capacity is critical, as institutions, be they universities or ministries, play a major role in disseminating knowledge, formal or otherwise.

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Prof. Luiza Gharibyan, Yerevan State Medical University, Armenia

          I am writing to thank all of you very much indeed for this extremely important for our Country lecture of Supercourse. It 's so helpful not only for professors of our University .Our students also like to study and use the information of this program. It allows to prepare qualified, competent, and dedicated specialists. Thanks to this program, we could get acquainted with many achievements in the field of Public Health.
          Supercourse is the international educational program which allows students and professors of all Universities in the field of prevention to share educational lectures through the Internet free-of-charge.
          In this internet library, it is possible to find lectures of the best professors from leading Universities not only U.S.A. ,but also other countries of the world.