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Opening statement: The 2019 District Health Information System (DHIS2) Annual Conference

Opening statement held by State Secretary Aksel Jakobsen at the 2019 Distric Health Information System (DHIS2) Annual Conference

Ladies, Gentlemen, Colleagues, representatives of international agencies and digital development experts.

What an exciting forum – over 300 digital health experts from around the world and representatives from all the major international health donors, funds and UN health agencies.

I would like to start out by giving a brief overview of our engagement in health.

Norway is a relatively small country but a major donor to global health. In order to maximize the effect of what we do in aid we have chosen to concentrate on a small number of critical problems where we think we can contribute.  Health is one of these areas. 

Most of our financial support to health flows through large multi-lateral funds such as Gavi-the vaccine alliance, the Global Fund, The Global Financing Facility and CEPI - that fund development of new vaccines. 

We are also proud to host the District Health Information System expertice at the University of Oslo.

DHIS2 represents a truly global public good – and it has been created through global cooperation.  The strength of DHIS2 is the fact that this is an action research programme – based on learning and continued development.  However, the efforts to define problems and imagine solutions – together and over time -  is what underpins the success in this field.

Norway has supported this project since its inception. We are proud to have been part from the very beginning. After a decade of intensive, and I would also like to add- impressive and tireless work of innovative experts, understanding cross cultural aspects as well as highly intricate technical issues, the projects are now yielding impressive results! Norway will continue to support this great initiative. 

The programme has now reached an impressive 2.1 billion users world wide, in more than 70 developing nations. What is so exceptional about this programme?

It is the ability to truly address the real challenges of ordinary people, many of which - without this programme- would be left behind. The most vulnerable among us. And that is where you all come in. You are the experts. It is the involvement of national experts that makes this programme truly stand out.

Because as you all know:

In order to meet the health challenges a nation faces – to establish priorities, monitor implementation of key interventions and evaluate impact, health data is imperative. Increased national use of quality health data is a core requisite to improve national performance, legitimacy and accountability. 

Health is one of five priority areas for the Norwegian development programme and is one of the prioritized sectors for increased utilization of digital technologies in development cooperation. We strongly support the continued focus to support countries to develop and use better health data in order to effectively tackle the public health challenges facing their people.

Luckily, we are not alone in this endeavor.  The partnership behind This system has grown. More and more health agencies recognize that national systems are often based on DHIS2 and their data needs are dependent on further development of national systems. 

We have been working in excellent cooperation since 2012 with Pepfar and The Global Fund  – and more recently with the Global Financing Facility, The US Center for Disease control, UNICEF, WHO, Gavi and Gates. We value this partnership and co-creation.  We think this is a excellent way to support development – together.

We have seen great results In the area of global health the past 20 years. Increased efforts and financing from the international community has Been crucial.

But, national health care systems cannot be seen as the responsibility of international financiers – while domestic authorities focus on more important challenges. 

This government firmly supports the SDG emphasis on Universal Health Coverage – And the notion that it is the national authorities that are responsible for national health and effective and equitable health services .

Our government wishes to continue to invest in health and to partner domestic authorities to develop and pay for the health systems they need.  In this agenda, health information is absolutely crucial.

Technology and social organization can change the prospects for development radically - and within current resource constraints.  With good innovation we can do more for less. 

This government places a strong emphasis on innovation and digitalization as part of its development strategy, and we will present a White Paper to Parliament on Digital Transformation in Development Cooperation in October.  We look to this programme as a model for discovery; for how to dynamically evolve effective solutions; and for how to build a community of users and contributors to ensure a good tool is put to use where it is needed.  And we know other digital development specialists are also looking at DHIS2 as a way of doing digital development (not as a product) to inform how we progress with systemic digital development.

However, DHIS2 was initially developed by students from Asia, Africa and Norway studying at UiO, working part time, as part of their degree.  While I am proud that UiO is the host to this essential global public good, I have to acknowledge it has been developed with the hearts and minds of all of you here today and many others.  This is a truly global project – that drives higher education programmes and job creation around the world.

Norway is financing several new experiments in using DHIS2 for education system management.  Other agencies and countries have used DHIS2 for a range of other sector based programmes - including water, nutrition, social security, education etc.  We can only imagine the power of using a single open source software for a wide range of government functions – reducing costs and enhancing feasibility of cross government led digital development. DHIS2 is really an important contribution to digital public goods.

DHIS2 is an open source software, in line with best practice standards in digital health and the principles for digital development. This enables anyone to freely adapt the generic core to their contextual needs, and also to share back suggested improvements to the core.  However, maintaining and further developing a hugely successful open source platform also comes with challenges – how do you finance a successful open source software that grows and grows and needs exponentially more support?

In previous decades, giants like Yahoo and Google had to work out how to make their businesses profitable.  This has largely been done through advertising and uses of data.  Neither is appropriate when we are talking about public sector software and private health data.

But think of the costs of every country developing their own software for each sector  - if development is also about making technology appropriate, cheaper and more robust – allowing higher levels of development for the same resource envelope then the global development of HISP is a very good investment. I am a strong supporter of the Principles for Digital Cooperation and the idea of promoting Digital Public Goods in all areas relevant for attaining the Sustainable Development Goals.

Finally, together we face new challenges ahead – such as how to ensure stable financing for digital public goods like DHIS2 – how to develop effective governance etc. But for now – you are blazing the trail and we are eagerly following. Thank you, for listening and I wish you fruitful discussions and knowledge-sharing!

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