New data on fairer access to health using the internet

Event report

The session used the new research ‘Health Online Indicators LAC: Access to safe and affordable health solutions using the Internet’ as a backdrop to the discussion. The study, conducted between 2021 and 2022, aims to establish a methodology for the evaluation of health solutions using the internet across Latin America. 

As presented at the very beginning of the session, the study creates a tool to bridge internet governance and health. The study itself prompted some important research questions:

1. What is the country’s legal situation regarding telemedicine and telehealth? Who has access to telemedicine?
2. Does the country allow the purchase of medicines from other countries?
3. Does the country allow the import of medicines via the internet?
4. How do prices compare from country to country and what makes the pricing of medicines?

In reaction to the mentioned questions, an example of how it is difficult, and in some cases impossible, to buy prescribed medicines in Canada and bring them to the USA and vice versa was highlighted. It was explained as the gatekeeper’s rule and in order to overcome this, standards on the internet must be tackled first and then it can be expected that the government will follow with appropriate legislation.

Speakers approached the question of why fairer access to internet health matters. It was agreed that people seek internet medicine since they do not have adequate health care or they cannot afford it. One of the biggest issues that was also brought up at this point is the fact that 1 in 10 medical products in developing countries is inferior. However, even if people do turn to the internet for acquiring medicine, they can potentially encounter rouge pharmacies selling unapproved and dangerous drugs.

Although many countries in Latin America have recently adopted laws to regulate telemedicine, it is still a grey area in many countries, meaning that a certain framework exists, but without concrete legislation. States and governments have the power to legislate, but it was emphasised that people must be included in the conversation. It is necessary to hear the opinion of those who need medication.

The study also presented the issue of medicine importation. Although some laws allow it, the administrative difficulties and the time it takes to get approval are some of the main obstacles. However, the speakers mentioned that regulating medicine importation via the internet can be crucial, since the availability of medicines can be higher and the prices lower. The speakers mentioned that in two countries in Latin America the disparity of prices for the same medicine can be up to 171%.

The workshop presented some ways forward, and the entering point is to connect stakeholders – policymakers, health professionals, and patients. Three starting points to connect internet governance and health policy and systems research were identified:

1. fair access to telemedicine
2. sale of medicine through online pharmacies
3. exchange of medical data

The research showed that rogue pharmacies should be kept in mind. To provide safe healthcare services that can be trusted, proper legislation is needed. Since the internet is, broadly speaking, unregulated, the question prompted: where to act? Researchers provided the audience with 3 points of intervention: the seller itself, DNS/search engines/social media, and policymakers.

Although the study was based on Latin America, it can be used in different regions of the world to make the same measurements. One audience member argued that Nigeria and Latin America face similar problems, and yet each country must focus on specifically tailored frameworks and legislation. The comment was agreed upon by researchers who mentioned that the Global South is not ready for telemedicine in the same way the Global North is. 

The panellists concluded the goal of the session was not to deliver a one-stop-shop solution but bring the much-needed conversation to the table. The Internet Governance Forum (IGF) was identified as a good place to start conversations and raise issues regarding fair access to internet health.

By Ana Stankovic

The session in keywords