* Information and communication technologies have not been harnessed systematically to improve the health of populations in developing countries * These technologies empower those who use information by providing them with a choice of information to be accessed in their own time and by allowing them to put their own information on the web * The current digital divide is more dramatic than any other inequity in health or income * The quality of health information available on the web is inconsistent, and the visibility of research from developing countries is limited * The way forward is to exploit the full interactivity of the internet, which allows rapid feedback and change to continuously mould information into useful knowledge Go to:
Sources for this paper were obtained by searching Medline using the term dissemination and from visits to websites and links to related organisations known to be working in the areas of health research and information and communication technologies in developing countries. Information was also provided by key informants working in international health research. Go to:
The digital divide: knowledge as power
Knowledge has been portrayed as a good that is available to the global public and as something that is not diminished after being used by an individual, and once provided it has been seen as difficult to restrict to a single individual or a group.2 Advances in information and communication technologies make the global distribution of this good seem effortless. The technology, specifically the world wide web, enables information to be made available to multiple users the instant it is produced. Anyone can use it, whether an ordinary woman living in a village or a high ranking policymaker. More importantly, users are not passive recipients. They can choose the type of information they wish to access. They can even produce or package the information themselves. As technology reporter John Markoff has said: “For very little money, and with a modicum of computer skills, virtually anyone can create his or her own website. Anyone with a modem is potentially a global pamphleteer.”3 The vision that this conjures is both anarchic and democratising, and it emphasises freedom of expression and access to information. The power of technology has been described as revolutionary, and the Organisation for Economic Cooperation and Development has written of a new, knowledge based economy.4 However, it is rare for a woman in a developing country to have access to the internet. In Africa, which has a population of 700 million, fewer than one million people had access to the internet in 1998, and of this number 80% were in South Africa. Among the other 20% the ratio of people who have access to the internet to those who do not is 1 to 5000, in the United States or Europe the ratio is 1 to 6.5 According to the United Nations Development Programme: “There are more [internet] hosts in New York...