How more inclusive ICT policy and infrastructure could stem the spread of COVID-19

Epidemiological evidence has shown that the spread of pandemics across regions and nations follows patterns of underlying social and economic inequalities, among them digital exclusion. But how does digital exclusion impact the effectiveness of public health policies created in response to those pandemics? And how can more digitally inclusive policies be crafted in ways that could curb the spread of pandemics such as COVID-19?

Such were the questions driving an ITU public webinar on the impact of unequal access to ICT infrastructure on COVID-19  held on 29 July 2020. Organized as part of ITU-D Study Group 1 Question 4/1 work on economic policies and methods of determining the costs of services related to national telecommunication/ICT networks, the webinar was opened by ITU Telecommunication Development Bureau Director Doreen Bogdan-Martin.

How digital exclusion hinders public health policy

In her opening remarks, Ms. Bogdan-Martin emphasized how ICT infrastructure and universal connectivity can reduce the pandemic’s disproportionate effects on the digitally excluded. “As the Internet becomes the primary information channel on the pandemic for those lucky enough to have a connection, inequality in access to services and ICT infrastructures results in increased information asymmetry between users and non-users,” she said. “This compromises the development potential of this transformative technology.”

After a welcome by Rapporteur for Question 4/1 Arseny Plossky, I followed up on Ms. Bogdan-Martin’s global picture by highlighting the impact of digital exclusion on COVID-19 diffusion, whereby digital exclusion is captured through the multiple dimensions of soft and hard ICT infrastructures. These include access, affordability, digital skills and cybersecurity. The more complex public health information needs to be, especially when targeting specific localities or demographics, the more digital exclusion impacts policy effectiveness. Hence, unequal access, use, affordability, and skills to ICTs form new barriers to policy effectiveness, that materialise whenever we observe low quality and costly connectivity, coupled with a lack of digital skills.

Granular digital exclusion data needed

Since digital exclusion is linked to hard and soft infrastructure, its distribution can be very fine-grained. Areas of disconnection often overlap with well-connected ones. Hence, policy effectiveness needs fine-grained data collection and data sources, on both soft and hard ICT infrastructure barriers.

Panelists Jane Coffin of Internet Society and Andrea Pirrone of OFCOM UK presented combined perspectives on policies, projects, interventions and regulatory experiences from their organisations. Based on the real experiences and cases, they stressed the relevance of collecting of individual user data through dedicated surveys, and of facilitating licencing, and tariffs regimes for speedy implementation of infrastructure expansion based on cooperative models.

Prof. Jon Crowcroft, of the University of Cambridge, shared different data sources and affordable connectivity technologies that can be used to limit the extent of the pandemic while improving the effectiveness of public health policies. Only If large part of the population has devices with Bluetooth, for instance, it is then possible to obtain data and understand the formation of social networks and implement contract tracing by using data on mobile phones needs coverage.

The affordability barrier

The trouble is, in many places, Bluetooth-enabled devices are simply unaffordable. According to Prof. Alison Gillwald of Research ICT Africa, affordability and diffusion are key issues affecting African countries and represent high barriers to successful public policies. The cost of a device is a main barrier to use the internet, even more so than data costs, said Prof. Gillwald. Often, signal and infrastructures are available, but people cannot afford access.

Cultural differences, language barriers and digital literacy are critical elements when it comes to mobile phone usage. In the context of a pandemic, they can also become factors of success or failure of public health-oriented apps. For example, ‘phone sharing’ is a widespread practice where smartphone affordability is low and where data bundles are expensive. According to Prof. Crowcroft a pure app-based approach to public health would be of limited use in such places and would need to be accompanied by community involvement and word of mouth. Further, mapping symptoms hotpots using mobile data would be affected by variable coverage limits the accuracy required to build a precise social network. Moreover, this approach rarely works where people need to save battery and often switch off their phones.

Infodemics: a growing public health policy concern

Cyberthreat vulnerability and infodemics should be considered as additional dimensions of digital exclusion that exacerbate existing inequalities. Weak cybersecurity measures can negatively impact the effectiveness of ICT infrastructure, said Dr. Enrico Calandro of the University of Cape Town. Focusing on infodemics as one of the possible factors compromising Africa’s COVID-19 responses, Dr. Calandro explained how infodemics affect both behaviour and the effectiveness of countermeasures. Similarly, disinformation is specifically affecting first-time internet users while social media use may amplify rumours through algorithms and profiling. This, in turn, distorts public health communication strategies and public debate, often leading to the formation of polarised groups around competing narratives. 

Beyond ‘business as usual’

Webinar participants agreed that a “business as usual” approach does not solve the problem in a market failure framework. We need to overturn old models and paradigms for network expansion and find new solutions based on collaboration and infrastructure sharing, through multi-stakeholder partnerships for instance.

Context-based approaches to access, affordability and cybersecurity are necessary. Since many COVID-19 contract tracing and immunity passport apps largely do not work in Africa as many people lack Bluetooth enabled phones, policies should also focus on SMS-based apps.

Simple ways of reporting symptoms can be then used statistically, rather than individually, for mapping hotspots. Public health authorities can leverage this data to advise citizens about risks, and people can share data informing each other by word of mouth. 

When it comes to cybersecurity, we need collaborative models on cyberspace governance to create greater resilience among users, since many countries do not have enough network capacity or sufficiently strong legal frameworks to counter infodemics or cyberattacks.

In conclusion, since public health policies need to affect individual and collective behaviours and decisions, it is essential that these are both understood and shared. No matter how easy the policy messages, images or narratives can seem, digital inclusion must be an essential mediating element if public health policies are to be understood, followed and ultimately successful.

Image credit: Negative Space via Pexels