it will be important to think about their design and uses as well.1 In 2009 the number of smartphones imported to Africa was equal to the number of SMS-only phones. Citing Cisco’s estimates that by 2020 there will be more than 50 billion things connected to the Internet, Dr. Ranck spoke of the coming of an “Internet of Things.” These things may be, for example, sensors looking at air and water, and connected through a smartphone. Dr. Ranck noted that access to the Web is becoming more mobile, with most connections to the Web now being made by mobile phones. Because smartphones are also designed to collect data, this increasing connectivity raises the question of who is collecting data, what data are being collected, and who owns the data.

The proliferation of social media platforms is changing culture. Small numbers of people can raise the profile of the issues they care about by generating content for social media platforms and connecting to more people. There are a large number of mHealth deployments worldwide, ranging from HIV prevention messages and information via text to diagnostic tools and peripherals that can attach via Bluetooth wireless for remote diagnostics, acute treatment, and drug adherence. Dr. Ranck predicted that more democratic engagement in public health will result from the growth of peer-to-peer mHealth implementation, making it imperative to address “technological citizenship” in greater detail.

Dr. Ranck also cautioned that an intervention that worked well in one setting may not work in the same way in another cultural context. The issue of power often may be ignored in the development of mobile applications. He mentioned that there are some examples of domestic violence applications, successful in one area, that actually increased the level of domestic violence in other areas because of gender and control issues over the mobile phone.


Security is a growing issue for ICTs, and tools are being developed to anonymize data that are sent through mobile devices—for example, to ensure the safety of human rights workers. Dr. Ranck noted that the potential for de-anonymizing large datasets could raise privacy concerns. Many participants and speakers felt that innovations in ICT are ahead of current policies regarding privacy.

One workshop participant expressed concern over the implications of citizen reporting, vigilantism, and “trial by publicity.” Speaker Erik


1 Short Message Service (SMS) is a text messaging data application for phone, Web, or mobile communication systems, using standardized communications protocols that allow the exchange of short text messages between fixed line or mobile phone devices.

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