How can blockchain improve health systems in LMICs?

The first half of this session will provide participants with insights into what Blockchain is and what it is not. It will highlight when a global health solution will need a blockchain solution. It was give the key distinguishing features of blockchain and how it relates to traditional applications. The session will detail the difference between Blockchain and Cryptocurrencies and how they relate to one another. The first half will end with the potential that Facebook backed Libra blockchain could have in financial inclusion and global health. The session will also show participants use cases where Blockchain are already being proposed and implemented. During the second half, participants will through a hands-on exercise learn how to convert a real-world contract between two healthcare organization into Blockchain smart contract. The Blockchain of choice for this exercise will be Ethereum with a simple Integrated Development Environment. Participants will: • understand the concept of Blockchain and possible areas of application in global health • understand what digital assets are and how they relate to global health • through a hands-on exercise code their first smart contract.

Blockchain Technology enables distributed public ledgers that hold immutable data in a secure and encrypted way and ensure that transactions can never be altered. While Bitcoin and other cryptocurrencies are the most popular examples of blockchain usage, this “distributed ledger technology” (DLT) is finding a broad range of uses. Data storage, financial transactions, real estate, asset management and many more uses are being explored. The 17 Sustainable Development Goals (SDGs) are a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity by 2030. This presentation will focus on how could Blockchain Technologies assist in faster attainment of the 17 SDGs with a focus on Health and Well-being (Goal #3). My experience as the lead author of two chapters on Blockchain for SDGs' attainment of the United Nations recent Whitepapers on Blockchain will be drawn for presenting this panel. The presentation will highlight a framework developed for implementing Blockchain-based projects in Global Public Health aimed at enhancing SDG 3 and for measuring impact according to SDG 3 targets and indicators. Use cases (beyond proof of concept) from 4 countries (Israel, Slovenia, UK and USA) targeting Low-Middle Income Countries (LMICs) will provide concrete examples for discussion.

Performance-based Financing (PBF) has been implemented many developing countries to strengthen the health system and improve health service provision and quality. PBF provides financial incentives to health providers based on the delivery of specified priority outputs, upon verification that the results have actually been delivered. The verification process is the cornerstone of PBF as it ensures that the health services being claimed have actually been provided. However, verification is extremely costly (20-30% of the total program costs) and time consuming, contributing to payment delays to health providers. In recent years blockchain (BC) has gained prominence in the healthcare sector with use cases focusing on privacy, security, tracking, and access to patient health records. If BC networks can automate manual processes of verification, it would speed up processing times and dramatically cut operating costs. It would also allow the purchaser of health services to create an immutable ledger that will serve as a permanent record of all transactions conducted at each consultation, in all health facilities under a performance contract. Patients (or their designated representative) would be asked to verify via SMS that a service has actually been delivered, with the response being stored on the BC for payment or further follow-up. The same approach could be used to reduce leakages in supply chain for pharmaceutical goods, while improving the assurance that drugs are actually being used by/delivered to patients. The World Bank’s Health Nutrition and Population Global Practice, in cooperation with its Technology and Innovation Lab, has developed a working prototype of this system, called “Real-Time-Results-Based Financing Verification”, which is being piloted in Cote D’Ivoire as the next step in beta-testing this system. This presentation highlights the results of this piloting process and provides conclusions on potential scale-up costs and benefits.