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Almost since the very beginning of Telecentres/public access centres the nagging from funders – mostly governments but major NGO’s as well – has been directed towards making sure that these would somehow/sometime become financially self-sustaining i.e. "sustainable". The idea was that once the initial investment had been made – mostly in providing hardware/software and some period of supported connectivity – that Telecentres would somehow magically be able to transform themselves into "social enterprises" which could get enough revenue from their local communities to:

1. Pay salaries (and benefits) to staff
2. Pay rent on buildings
3. Cover access charges
4. Cover charges for maintenance and replacement

Given that the Telecentres were established in the first place and located where they were precisely because the local population was for the most part poor, isolated, and other wise marginalized i.e. not in a position to pay for their own computers, Internet access etc. seems to have escaped the attention of those leading the demands for “sustainability”. That this sustainability was a more or less complete pipedream which any realistic assessment of the circumstances of Telecentres would have determined seems to have been overlooked as both funders and Telecentres themselves chose to hope somehow that the future reckoning in terms of funder expectations/Telecentre commitments would never arrive.

And so Telecentres have limped along without realistic plans for the future or sufficient funding to achieve even their modest goals and funders have turned to consultant study after consultant study to find the magic formula that would take off their hands/budgets this unwelcome dependency of providing internet and computer access to those on the other side of the “Digital Divide” i.e. those who for whatever reason were unable or unwilling to provide it for themselves.

To be very clear: certainly there are publicly accessible Internet centres in very many communities in all parts of the world. The most common name for them is Cybercafes. Cybercafes provide computer/Internet access primarily to young males to fulfill various fantasies via more or less violent games and other such pursuits. That it is widely headlined that these private enterprises have little or no redeeming social value (I won’t argue this at the moment) and certainly no value from a social or economic development perspective let alone resolving issues of a Digital or a Service Divide is almost unarguable.

The broader purpose of Telecentres was and remains to add value as social initiatives by governments or others by providing free or very low cost Internet access to low income populations, in remote regions, or for those with other forms of social disability that prevent broad participation in an increasingly digital society. If governments (or others) choose to de-fund existing Telecentres on the basis that they are saving them from the evil of “dependency” (or whatever) they should know that they are choosing to penalize precisely those whom they have otherwise identified as requiring support because of their social and economic circumstances.

Governments are not only unrealistic but they are deeply hypocritical in requiring communities in which they previously made these investments because of their overall lack of resources, to somehow now come up with the resources to support these facilities. One additional observation, Telecentre funders repeatedly confuse the issue of Telecentre utilization rates with the issue of funding and sustainability.

Cybercafes have high utilization rates (or they don’t survive) precisely because they are market driven and thus provide the kinds of services on which those without significant financial responsibilities are prepared to spend their money—i.e. entertainment. Telecentres have or at least should have the mission of providing Internet enabled services and opportunities for access and use to those otherwise unable to obtain such access, make such use and thus achieve a degree of digital inclusion.

These services (which of course, will vary from locations to location) are responsibilities and goals for which government funds have been budgeted. Attempting to download responsibility and cost for the delivery of these services onto the poor and marginalized themselves – which the continuing chants for “sustainability” in fact are, is both the height of irresponsibility and the height of cynicism.

The challenge is to design and develop Telecentres which are embedded (“owned”) by local communities and which provide those communities with among other capabilities the variety of services and supports (as for example e-government, e-health, small business development and support) which they require and which otherwise, in the absence of the Telecentre, would be much less accessible and much more costly and difficult to obtain (and to deliver).

These are notes for a talk to be given by Mike Gurstein to an ITU sponsored workshop on Telecentre sustainability in Bangkok, May 23-25, 2011 and were published originally as Telecentres are not “Sustainable”: Get Over It!

Whenever we talk about mHealth, there is always much hand-wringing around sustainability. And by that we usually mean we want to find the mHealth model that can be like mobile phones - paid by users and funded by deep-pocketed, aggressive private firms. That way, we can escape the limitations of donor funding and move past the many mHealth pilots that never seem to scale, to truly global healthcare solutions.

I would like to be a heretic and put forth an idea that's be brewing since last week's Technology Salon sustainability discussion where our comments even suggested that all ICT4D efforts are sustainability failures:

Do we expect her to pay? (Data Dyne)

mHealth isn't sustainable

International development efforts in mHealth focus on bringing resources and solutions to communities who are unable to provide their own. This can mean remotely checking on patients in rural areas miles from the nearest clinic, or delivering health PSA's to urban youth in Nairobi nightclubs, to even educating affluent women in India on their menstrual cycle.

But in all these instances and more, the recipient is either unwilling or unable to pay for the service. So why do we keep looking for ways to have them fund mHealth initiatives? Why do we think private payment is the sole sustainable model? Let's look at who has the will to pay for such services and expect them to underwrite mHealth initiatives.

mHealth is fundable

Public health is a high priority for governments. A healthy population is a happy, productive one, and therefore every government has a keen interest in providing healthcare solutions to its populace. Some of these solutions are government funded without question - in the USA we don't expect the Centers for Disease Control or Medicaid to be self-funded in a pay-for-service model. Some solutions are a public-private hybrid - general healthcare services are almost always a mix of public, business, insurance, and private funds. And other solutions can be either - HIV testing and treatment varies by country and even by client.

But in any of these scenarios, do we hear talk about sustainability? Outside arguments about the cost of these programs, no one is advocating that governments stop funding for CDC's or HIV treatments. So why then, when we talk of mHealth, do we try to force a fully private-payer model?

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