Project to Create a Global Service Trust Fund (GSTF) for Tele-education and Tele-health

This proposal was prepared by a working group described in the footnote at the end of this document. This paper was presented for discussion at the Founder's Conference for the Sir Arthur Clarke Institute for Telecommunications and Information (CITI) held at INTELSAT Headquarters on 5 February 2000. It has been amended to reflect suggestions and comments made at that conference as well as a meeting held at the National Telephone Cooperative Association (NTCA) on 20 June 2000 that discussed the possible holding of a summit meeting of key world leaders in order to establish the GSTF at the earliest possible opportunities.

Objective

Education and healthcare are basic needs, fundamental for human development. The main goal of the proposed Coalition is to expand educational opportunities and improve health in developing countries by enabling these countries to:

Make full use of electronic distance education and telemedicine.
Participate actively and fully in data-intensive and media-intensive exchanges with both developed countries and other developing countries.
Participate interactively and fully in joint research, professional development, and knowledge-building activities with institutions and organizations in other countries.

To do this, steps must be taken to:

Reduce the cost of broadband connectivity to a level poor countries can afford.
Create policy and regulatory frameworks conducive to the development of sustainable distance education and tele-medicine programs.
Establish high-quality applications in sufficient developing country sites to demonstrate technical feasibility, increase demand, and build support for more extensive use of such technologies in developing country contexts.

Ideally all countries would have access to free or low-cost broadband connectivity and would have the technical capacity to make use of it for improving education and healthcare. This assumes a number of favorable economic outcomes as well as changes in policy and regulatory environments supporting the effective use of these technologies.

This proposal takes a more limited objective: to make available sufficient broad bandwidth at free or highly reduced cost to enable a significant number of developing countries to undertake major new initiatives in distance learning and telemedicine. The fund might also seek to aid in the support of earth station facilities, solar power systems, local switching and local loop telecommunications facilities, and new systems of tele-education and tele-health programming. The prime objective would be to provide access to satellite or fiber bandwidth capacity and directly related equipment needed for the delivery of tele-education and tele-health information. Any activity relating to creating new programming capability would be encouraged on the basis of developing many sources of programming in many different languages on a decentralized basis rather than seeking to develop a single source of supply.

Background and Rationale

The Internet, with its rapidly expanding and improving infrastructure, will be the main telecommunication media of tomorrow. It has been extended to most countries, albeit with slow to-medium speed in most developing countries, and even in large parts of the developed world. But the full potential for achieving revolutionary advances in education and healthcare in developing countries cannot be realized with the currently available information delivery infrastructure and at currently prevailing market prices.

Improved distance education requires much better ways of presenting information and of enabling learners to interact with facilitators to enable the learners to process that information into personal knowledge.

At present most electronic distance learning takes place via rather limited programming and delivery modes. Much of the instructional programming is limited to text and simple graphics delivered over the web and/or through email and its derivatives (electronic fora, bulletin boards, chat rooms). On the other, there is "room-based" or desktop-based videoconferencing, usually with relatively small groups involved and low production values so far as the video and audio are concerned. Both techniques allow significant interaction, but the quality of instruction can suffer from the lack of high-quality audio and video.

High-quality instruction is possible by broadcast television, with multi-million dollar production budgets having been deployed to good effect in some countries, for example Annenberg/CBP in the US, BBC/Open University in the UK, and The Roberto Marinho Foundation's Telecurso 2000 and Canal Futura in Brazil. But there has been limited interactivity for these programs beyond what is possible by telephone, fax and more recently email and its derivatives.

Narrow bandwidth and high telecommunications costs limit the use of streaming video and audio on a large scale. Often telecommunications networks get clogged even with heavy Net use of more conventional kinds. Many audiences, even in developing countries, are "spoiled" by commercial television with high production values. Even for educational programming, these audiences do not easily accept jerky movement, small windows, failing connections, and low production values. The quality of tele-lectures, video inserts and the like can only approximate the high production values of commercial television. As for telemedicine, there is a proven need for high-definition moving images, or at least extremely high-resolution still images for many applications. Even with low-cost or free broadband connectivity between nations, the cost and pricing structure of telecommunications in many developing countries keep the cost of access to the Internet at prohibitive levels, and inappropriate policy and regulatory frameworks do not encourage efficient use of those public resources for education and healthcare.

In sum, what is ultimately needed is both high quality audio/video delivery and high quality interactivity. At the outset of the GSTF it may be possible to obtain services that involve only high quality audio or limited amounts of interactivity. From these beginnings, however, the longer term goals can be achieved.

A true revolution in distance learning and telemedicine requires access to the World Wide Web, allowing the flexibility to offer a variety of media. These might include two-way audio, one-way audio supplemented with broadcast multi-media, full-motion video-conferencing up to MPEG 2 quality, television-quality netcasting, and high-resolution image transfer for tele-medicine. Such capabilities require medium to broad bandwidth downstream and low to medium bandwidth upstream. Ultimately developing countries need broadband Internet via international satellite and fiber-optic cable and this should remain a goal, even if the initial services are at lower data rates.

The revolution in education and healthcare in developing countries also requires a more favorable policy environment, not just for telecommunications but also for education and healthcare. A key to bringing down prices to affordable levels is to establish national and international competition or at least flexibility in the provision of telecommunications, education, and healthcare services. Also rapid transfer of knowledge from developed to developing countries needs to be possible.

Finance and Organization

Deployment of this high-speed Internet for education and health applications in developing countries would be financed with a Global Service Trust Fund(GSTF) for tele-education and tele-health. The Fund might be modeled on the Universal Service Fund of the U.S. Federal Communications Commission, which provides for discounts of 20-90% on a variety of telecommunications services and equipment for schools and libraries.

Ideally, funding would be sufficient to eliminate or greatly reduce the telecommunications cost for qualified education and healthcare applications. A second solution might be a subsidized International E-Rate akin to the "E-Rate" now benefiting schools in the United States. A third option could be to begin with free bandwidth, but raise it toward (expected to be declining) market prices in gradual steps using the International E-Rate model.

Two separate contribution "funds" or "sources" would be established an in-kind bandwidth transmission source and a financial assistance source. Ideally the GSTF would include a broad coalition of commercial and governmental sources. These might include key international organizations such as the International Telecommunications Union (ITU), the United Nations Educational, Cultural, and Scientific Organization (UNESCO), and the World Health Organization (WHO) plus commercial satellite system providers, equipment manufacturers, and providers of tele-education and tele-health. The Coalition would also include international development banks, bilateral aid agencies, foundations, and various types of companies contributing to the Fund as well as organizations contributing education and healthcare knowledge. The Fund could be administered in a variety of ways, but it must have a well organized, credible and financially scrupulous entity of significant international standing in charge in the disbursement of funds.

The proposed Fund would be financed from a variety of public and private sources, which could include:

Overseas Development Assistance funds of countries belonging to the Organization for Economic Cooperation and Development.
Cash contributions from the profits of international financial institutions such as the World Bank and the regional development banks.
Cash contributions from foundations and companies.
Contributions in kind from companies owning underused satellite transponders and/or fiber optic cable. For these companies, the marginal cost of making available underused existing bandwidth is near zero, but providing it may build future markets for sale at (declining) commercial prices.

The Fund's bandwidth source might be allocated through a variety of means that might even include an auction process to organizers of distance education and telemedicine projects in qualifying countries. Providers of services might be required to make some commitments of resources and in-kind participation to qualify to use the GSTF's assets. The cash source might be used for grants to such projects, with rules favoring poorer countries and end-beneficiaries, assuring a certain geographical distribution of benefits among regions, and so forth. Grants might also favor international knowledge sharing. All grants would be made through an open competitive process. These are only some preliminary ideas. The details, including the establishment of a pilot version of the Fund to test operational principles, need to be worked out during the next stage in proposal development.

Next Steps – Recommendations of the Working Group

Establishing the Fund and Coalition requires a critical mass of global support for these new organizations. The ability to mobilize financial and in-kind resources for the Fund depends on the credibility of the membership of the Coalition. That credibility would be furthered by early support from such key international entities as commercial satellite and fiber optic service providers, multi-national businesses, national governmental aid agencies, foundations, and agencies of the United Nations such as the ITU, UNESCO, WHO, the World Bank Group (including the International Finance Corporation), and the regional development banks (African Development Bank, Asian Development Bank, European Bank for Reconstruction and Development, and the Inter-American Development Bank). No legitimate agency of standing would be excluded from participating. Creation of a preliminary coalition of participants to support the "source for bandwidth and key equipment" as well as the "financial aid source" would be critical to the initial testing of this concept. The example established by the WorldSpace organization to provide access to 5% of their total system capacity by means of the WorldSpace Foundation is one model that seems to have special promise.

To that end, the working group recommends that:

A more polished and developed draft of the proposal be put before major international conferences in 2000. Further it would be highly desirable for the Clarke Institute for Telecommunications and Information to undertake in partnership with others around the world to organize a Summit of World Leaders Concerning the Establishment of the GSTF.
An intensive effort be made to enlist the support of the leadership of the key international institutions mentioned above, facilitating the mobilization of bilateral aid agencies, foundations, and multinational corporations and to bring them together at a World Summit in Washington, D.C. in mid-2001.
Working groups on the various aspects to be funded and supported by the GSTF should be organized prior to this World Summit Meeting. These working groups would include representatives of other interested international organizations, bilateral aid agencies, companies, foundations, and other NGOs, as well as of relevant information and telecommunications industry organizations, e.g. the Global Information Infrastructure Commission.

Note: It is further hoped that providers of satellite or fiber optic system capacity would be willing to join in further working group discussions to shape the framework for the "pilot version" of the GSTF for tele-education and tele-health.

		Project to Create a Global Service Trust Fund (GSTF) for Tele-education and Tele-health (Version 5-3 October 2000) Click here for the original of this version created by Peter T. Knight of Knight & Moore, Washington, DC., and click "special version" under the footnote.
	This proposal was prepared by a working group described in the footnote at the end of this document. This paper was presented for discussion at the Founder's Conference for the Sir Arthur Clarke Institute for Telecommunications and Information (CITI) held at INTELSAT Headquarters on 5 February 2000. It has been amended to reflect suggestions and comments made at that conference as well as a meeting held at the National Telephone Cooperative Association (NTCA) on 20 June 2000 that discussed the possible holding of a summit meeting of key world leaders in order to establish the GSTF at the earliest possible opportunities. Objective Education and healthcare are basic needs, fundamental for human development. The main goal of the proposed Coalition is to expand educational opportunities and improve health in developing countries by enabling these countries to: Make full use of electronic distance education and telemedicine. Participate actively and fully in data-intensive and media-intensive exchanges with both developed countries and other developing countries. Participate interactively and fully in joint research, professional development, and knowledge-building activities with institutions and organizations in other countries. To do this, steps must be taken to: Reduce the cost of broadband connectivity to a level poor countries can afford. Create policy and regulatory frameworks conducive to the development of sustainable distance education and tele-medicine programs. Establish high-quality applications in sufficient developing country sites to demonstrate technical feasibility, increase demand, and build support for more extensive use of such technologies in developing country contexts. Ideally all countries would have access to free or low-cost broadband connectivity and would have the technical capacity to make use of it for improving education and healthcare. This assumes a number of favorable economic outcomes as well as changes in policy and regulatory environments supporting the effective use of these technologies. This proposal takes a more limited objective: to make available sufficient broad bandwidth at free or highly reduced cost to enable a significant number of developing countries to undertake major new initiatives in distance learning and telemedicine. The fund might also seek to aid in the support of earth station facilities, solar power systems, local switching and local loop telecommunications facilities, and new systems of tele-education and tele-health programming. The prime objective would be to provide access to satellite or fiber bandwidth capacity and directly related equipment needed for the delivery of tele-education and tele-health information. Any activity relating to creating new programming capability would be encouraged on the basis of developing many sources of programming in many different languages on a decentralized basis rather than seeking to develop a single source of supply. Background and Rationale The Internet, with its rapidly expanding and improving infrastructure, will be the main telecommunication media of tomorrow. It has been extended to most countries, albeit with slow to-medium speed in most developing countries, and even in large parts of the developed world. But the full potential for achieving revolutionary advances in education and healthcare in developing countries cannot be realized with the currently available information delivery infrastructure and at currently prevailing market prices. Improved distance education requires much better ways of presenting information and of enabling learners to interact with facilitators to enable the learners to process that information into personal knowledge. At present most electronic distance learning takes place via rather limited programming and delivery modes. Much of the instructional programming is limited to text and simple graphics delivered over the web and/or through email and its derivatives (electronic fora, bulletin boards, chat rooms). On the other, there is "room-based" or desktop-based videoconferencing, usually with relatively small groups involved and low production values so far as the video and audio are concerned. Both techniques allow significant interaction, but the quality of instruction can suffer from the lack of high-quality audio and video. High-quality instruction is possible by broadcast television, with multi-million dollar production budgets having been deployed to good effect in some countries, for example Annenberg/CBP in the US, BBC/Open University in the UK, and The Roberto Marinho Foundation's Telecurso 2000 and Canal Futura in Brazil. But there has been limited interactivity for these programs beyond what is possible by telephone, fax and more recently email and its derivatives. Narrow bandwidth and high telecommunications costs limit the use of streaming video and audio on a large scale. Often telecommunications networks get clogged even with heavy Net use of more conventional kinds. Many audiences, even in developing countries, are "spoiled" by commercial television with high production values. Even for educational programming, these audiences do not easily accept jerky movement, small windows, failing connections, and low production values. The quality of tele-lectures, video inserts and the like can only approximate the high production values of commercial television. As for telemedicine, there is a proven need for high-definition moving images, or at least extremely high-resolution still images for many applications. Even with low-cost or free broadband connectivity between nations, the cost and pricing structure of telecommunications in many developing countries keep the cost of access to the Internet at prohibitive levels, and inappropriate policy and regulatory frameworks do not encourage efficient use of those public resources for education and healthcare. In sum, *what is ultimately needed is both* high quality audio/video delivery and high quality interactivity. At the outset of the GSTF it may be possible to obtain services that involve only high quality audio or limited amounts of interactivity. From these beginnings, however, the longer term goals can be achieved. A true revolution in distance learning and telemedicine requires access to the World Wide Web, allowing the flexibility to offer a variety of media. These might include two-way audio, one-way audio supplemented with broadcast multi-media, full-motion video-conferencing up to MPEG 2 quality, television-quality netcasting, and high-resolution image transfer for tele-medicine. Such capabilities require medium to broad bandwidth downstream and low to medium bandwidth upstream. Ultimately developing countries need broadband Internet via international satellite and fiber-optic cable and this should remain a goal, even if the initial services are at lower data rates. The revolution in education and healthcare in developing countries also requires a more favorable policy environment, not just for telecommunications but also for education and healthcare. A key to bringing down prices to affordable levels is to establish national and international competition or at least flexibility in the provision of telecommunications, education, and healthcare services. Also rapid transfer of knowledge from developed to developing countries needs to be possible. Finance and Organization** Deployment of this high-speed Internet for education and health applications in developing countries would be financed with a Global Service Trust Fund(GSTF) for tele-education and tele-health. The Fund might be modeled on the Universal Service Fund of the U.S. Federal Communications Commission, which provides for discounts of 20-90% on a variety of telecommunications services and equipment for schools and libraries. Ideally, funding would be sufficient to eliminate or greatly reduce the telecommunications cost for qualified education and healthcare applications. A second solution might be a subsidized International E-Rate akin to the "E-Rate" now benefiting schools in the United States. A third option could be to begin with free bandwidth, but raise it toward (expected to be declining) market prices in gradual steps using the International E-Rate model. Two separate contribution "funds" or "sources" would be established an in-kind bandwidth transmission source and a financial assistance source. Ideally the GSTF would include a broad coalition of commercial and governmental sources. These might include key international organizations such as the International Telecommunications Union (ITU), the United Nations Educational, Cultural, and Scientific Organization (UNESCO), and the World Health Organization (WHO) plus commercial satellite system providers, equipment manufacturers, and providers of tele-education and tele-health. The Coalition would also include international development banks, bilateral aid agencies, foundations, and various types of companies contributing to the Fund as well as organizations contributing education and healthcare knowledge. The Fund could be administered in a variety of ways, but it must have a well organized, credible and financially scrupulous entity of significant international standing in charge in the disbursement of funds. The proposed Fund would be financed from a variety of public and private sources, which could include: Overseas Development Assistance funds of countries belonging to the Organization for Economic Cooperation and Development. Cash contributions from the profits of international financial institutions such as the World Bank and the regional development banks. Cash contributions from foundations and companies. Contributions in kind from companies owning underused satellite transponders and/or fiber optic cable. For these companies, the marginal cost of making available underused existing bandwidth is near zero, but providing it may build future markets for sale at (declining) commercial prices. The Fund's bandwidth source might be allocated through a variety of means that might even include an auction process to organizers of distance education and telemedicine projects in qualifying countries. Providers of services might be required to make some commitments of resources and in-kind participation to qualify to use the GSTF's assets. The cash source might be used for grants to such projects, with rules favoring poorer countries and end-beneficiaries, assuring a certain geographical distribution of benefits among regions, and so forth. Grants might also favor international knowledge sharing. All grants would be made through an open competitive process. These are only some preliminary ideas. The details, including the establishment of a pilot version of the Fund to test operational principles, need to be worked out during the next stage in proposal development. Next Steps – Recommendations of the Working Group Establishing the Fund and Coalition requires a critical mass of global support for these new organizations. The ability to mobilize financial and in-kind resources for the Fund depends on the credibility of the membership of the Coalition. That credibility would be furthered by early support from such key international entities as commercial satellite and fiber optic service providers, multi-national businesses, national governmental aid agencies, foundations, and agencies of the United Nations such as the ITU, UNESCO, WHO, the World Bank Group (including the International Finance Corporation), and the regional development banks (African Development Bank, Asian Development Bank, European Bank for Reconstruction and Development, and the Inter-American Development Bank). No legitimate agency of standing would be excluded from participating. Creation of a preliminary coalition of participants to support the "source for bandwidth and key equipment" as well as the "financial aid source" would be critical to the initial testing of this concept. The example established by the WorldSpace organization to provide access to 5% of their total system capacity by means of the WorldSpace Foundation is one model that seems to have special promise. To that end, the working group recommends that: A more polished and developed draft of the proposal be put before major international conferences in 2000. Further it would be highly desirable for the Clarke Institute for Telecommunications and Information to undertake in partnership with others around the world to organize a Summit of World Leaders Concerning the Establishment of the GSTF. An intensive effort be made to enlist the support of the leadership of the key international institutions mentioned above, facilitating the mobilization of bilateral aid agencies, foundations, and multinational corporations and to bring them together at a World Summit in Washington, D.C. in mid-2001. Working groups on the various aspects to be funded and supported by the GSTF should be organized prior to this World Summit Meeting. These working groups would include representatives of other interested international organizations, bilateral aid agencies, companies, foundations, and other NGOs, as well as of relevant information and telecommunications industry organizations, e.g. the Global Information Infrastructure Commission. Note: It is further hoped that providers of satellite or fiber optic system capacity would be willing to join in further working group discussions to shape the framework for the "pilot version" of the GSTF for tele-education and tele-health. ________________________________________ * The first draft of this proposal was developed by Dr. Takeshi Utsumi, Chairman of the GLOSAS/USA and presented at the International Workshop and Conference on Emerging Global Electronic Distance Learning (EGEDL'99) held August 9th - 13th, 1999 at the University of Tampere, Finland. EGEDL was sponsored by Alprint, the British Council, Finnair, Finnish Broadcasting Company, Foundation for The Support of The United Nations (FSUN), Japanese Medical Society of America, Ministry of Education Finland, Pan American Health Organization (PAHO), PictureTel, Sonera, Soros Foundation/Open Society Institute, United States Information Agency (USIA), United States National Science Foundation, and the Information and Development Program (infoDev) administered by the World Bank. The conference conclusions included a recommendation to work for the establishment of the Fund and the Coalition. Subsequently a working group was formed at a meeting held at the Pan American Health Organization to further develop the proposal and include policy conditionality. This proposal was prepared by that working group composed of Peter Knight (Knight-Moore Telematics/CDI), Frank Method (UNESCO), and Lane Smith (USAID). Helpful comments were received from Carlos Braga and Michael Moore. Joseph Pelton and Bruce Ross-Larson provided editorial assistance and revisions to adapt this paper to a format common to the project proposals being considered by the Founder’s Conference of the Clarke Institute for Telecommunications and Information. ________________________________________ Comments concerning this paper should be sent either to Tak Utsumi, Peter Knight or Joseph Pelton at the following e-mail addresses; utsumi@columbia.edu, ptknight@attglobal.net, ecjpelton@aol.com.