During a Q&A session that followed the keynotes on the second day of the GSMA-mHA Mobile Health Summit 2012 in Cape Town, a number of audience members quizzed speakers on whether mobile health services could be deployed globally. The argument made by the first speaker was a classic one: Rolling out a service globally will rapidly deliver the benefits of scale.

A second member of the audience argued that much health information was actually globally applicable, even allowing for linguistic and cultural variations. The speaker, who was from an NGO, said 80 percent of advice in their service for pregnant women was the same for separate services deployed in India and Africa. The remaining 20 percent was a specific “cultural and social overlay” that could be added by a local NGO, the questioner said. Again this pointed to global deployments being a realistic proposition.

These sound like persuasive arguments when so much of the mobile health sector is waiting on mass deployments that will prove the viability of services and business models. Let’s ramp up from those endless trials with 50 participants and roll out on a massive scale, goes the argument. Even better, let’s look at simple app-based services that can be easily offered across multiple markets.  

But the keynote speakers were sceptical, or at best ambivalent, about global deployments. Thierry Zylberberg, Orange EVP and general manager of its healthcare business, argued that health is national, not global, and that the latter did not offer an easy answer some had hoped for. The corollary of being a country-specific “is not just one business model exists,” he said. In the developing world mobile technology improves access to healthcare, which creates value for the beneficiaries, said Zylberberg. The question then is “how to get revenue from that”.  

A keynote speaker from the previous day, Axel Nemetx, Head of mHealth Solutions, Vodafone Global Enterprise, had made a similar point.  He argued that mobile operators were all for scale. The problem is that healthcare systems themselves operate at a national, regional or even local level, said Nemetz.

Zylberberg went further. He pointed out that global giants Microsoft, Google and Intel had all either closed or sold their (global) healthcare businesses. The Microsoft and Intel businesses had been sold to GE. Although itself a global business, GE does not run its health business as such, argued Zylberberg. "Health is national, even regional,” he said.

He also showed his own preference for B2B or even B2B2C services (meaning a mobile operator providing a M2M-type service for a vendor who delivers a retail service to a healthcare provider), as opposed to B2C services. There has yet to be a global deployment of a consumer wellness service, he pointed out. The suggestion here is that more complex business models are needed if mobile operators want to succeed in health.

Among the other speakers, Zachary Katz, the director of diagnostic services with the Clinton Health Access Initiative, said that “health messages are global but delivery is national”.  And Olivier Deuffic, the head of innovation with Saudi operator Mobily, urged mobile operators to think small. Or more precisely he argued mobile operators should make small, practical moves to establish a presence in mobile health. The means to do this was by working with private health providers rather than government where partnerships can suffer from “big expectations,” said Deuffic. “Big plans can fail because of budget restrictions and short term political views…,” he said.

In other words, governments prefer solutions that can deliver results within a short political cycle rather than those that lay the groundwork for a gradualist policy that might provide benefits over the longer term, which appears to be the operator’s preference.  Have mobile operators become sceptics on mobile health? Or are they just becoming more grounded? That all depends on whether one thinks the mobile industry has become world-weary and lost its faith in mobile health, or it has reached the stage of realism that will actually produce some firm results.

The editorial views expressed in this article are solely those of the author(s) and will not necessarily reflect the views of the GSMA, its Members or Associate Members.