World Health Decision Makers Should Consider GIS

By Daniel J. Carucci, MD, PhD, President, Global Health Consulting, Inc.

Over the past decade, development assistance for health (DAH), including that targeting malaria control across Africa, has increased significantly from $7 billion a year to $27 billion a year in 2007. Those investments have resulted in millions of lives saved, including a nearly 50 percent reduction in deaths due to malaria in some countries. Continued progress toward reaching the audacious goals established by the United Nations—to reduce childhood mortality by two-thirds and the maternal mortality ratio by 75 percent and halt the advance of the HIV epidemic—will require not only additional funds but also smarter approaches to delivering lifesaving resources to those who need them most.

The populations who are affected by these health concerns are not distributed evenly across countries, and, unfortunately, neither are the resources, commodities, and services that they need. Malaria rates are highest near areas of stagnant water that come about during periods of heavy rain or as a result of man-made irrigation and are lowest at higher elevations and in arid conditions. Similarly, HIV rates may be higher in certain urban populations sometimes associated with commercial transportation routes. Tuberculosis can be found in hot-spot areas, where crowded conditions and remote location can increase transmission and hinder detection and treatment. Maternal and neonatal mortality are highest in rural populations that have little access to preventive services and emergency care.

Health ministers are faced with the enormous challenges of providing health care products and services, such as insecticide-treated bed nets to prevent and kill malaria-carrying mosquitoes, anti-retroviral drugs to prevent and treat HIV infection, condoms to prevent sexually transmitted diseases and unwanted pregnancies, drugs to treat tuberculosis, family planning services, and childhood vaccines. Existing health systems and the supply chain infrastructure are fragile and poorly distributed throughout the country, meaning that more effort is required to get goods and services to those most affected. Decision makers must have better tools and knowledge to ensure that the substantial but limited resources that are available are allocated where they are needed most. They also have to be able to evaluate the impact that their policies and resource allocation decisions are having on vulnerable populations. Finally, donor governments need greater transparency from recipient countries to determine the impact and outcomes of their investments, particularly as funding for international assistance comes under greater scrutiny.

By harnessing geospatial information with the vast quantities of data that have been generated over the past decade; encouraging newly collected data to be geopositioned; and combining disparate datasets from satellite imagery, weather, environment, elevation, transportation corridors, epidemiology, resource allocation, training programs, and others, health ministers and donors will be able to evaluate the effectiveness and efficiency of their health strategies. Importantly, it will allow them to make near real-time adjustments in their strategies and more effectively deploy their resources to those most in need, as the authors of the above article have done.

The GIS community needs to work to close the gap between the technical staff that are fully immersed in GIS for health and the policy and decision makers who may not yet fully appreciate the importance and power of GIS in their decision making or for strengthening their advocacy for continued resources from donor governments.

For more information, contact Daniel Carucci, president, Global Health Consulting, Inc. (e-mail:

See also "Can GIS Help Fight the Spread of Malaria?."

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