It is a particular pleasure to be addressing our colleagues from both the Ministries of Health and the Ministries of Telecommunications at this Eastern Mediterranean Meeting on Telemedicine. This meeting of Ministries on the use of telecommunications for health represents major progress for the delivery of health information, education and services around the world.

A century ago, people were amazed to see the ghostlike images of the bones of the hand in the first x-ray ever taken. Since that time the creativity of researchers and clinicians has pushed the use of x-ray technology far beyond anything dreamed of 100 years ago.

Today, there is another revolution. We are redefining the boundaries of health. Now we can exchange health information and provide services across geographic, time and social boundaries.

Today telecommunications technology routinely beams medical advice and information between countries. The military uses it to treat their sick and injured on board ships and aeroplanes. It helps ambulance medics hook up patients to hospital emergency rooms for pre-arrival treatment.

With the development of international fiberoptic networks, satellite communications, and the ever-expanding Internet, technology is now going from revolutionary to routine, from unimaginable to indispensable.

One of the most important trends is that of integration of applications over one or more networks, as in national or community health information systems. Such a network, delivering updated, clinically relevant, valid and integrated health information over the Internet is feasible. Its successful development depends on technical and economic cooperation in countries and regions.

I am here today to reaffirm WHO's commitment to using telecommunications for health. They will play an essential role in health care systems. By weaving together the threads of prevention, primary care and patient management into our health care tapestry, telecommunications can help us create a seamless system of care.

And that's exactly why this meeting - this partnership - is so crucial. Because we know it takes a comprehensive strategy to build and manage a telecommunications infrastructure and ensure equitable, affordable, universal access to its benefits. We must use these technologies to reach those who need health care. We must get the most from every dollar.

What can countries do?

Rural telecommunications rates, which tend to be much higher than those in urban areas, are a barrier to the expansion of telemedicine. We need to revise policies and rate structures, and support lower rates for rural and high-cost areas, as well as those for lower income groups. We need to build universal service provisions to make sure all providers can pay for a high enough level of bandwidth to support telemedicine.

For these technologies to truly benefit health, we need reliable telephone lines, a stable electric supply and skilled staff. We need strong and consistent policies to encourage private investment. We need access to bandwidth to allow experimentation with telecentres and other ways of reaching out.

Through institutions such as the World Trade Organization and the International Telecommunications Union, countries are working to promote liberalization, security and predictability through a clear set of rules. This is particularly valuable at a time when technological growth is changing the face of the telecom industry. From a longer-term perspective, this goes beyond trade and economics. It makes access to knowledge easier and gives nations large and small better opportunities.

We must seize the opportunity to use these technologies, not only to ensure quality care, but to extend and improve it.

It is a challenge for every nation. But let me say this: This is a great time to be addressing these challenges. The millennium sets an important milestone - it motivates and incites us. We have high expectations for improving world health and reaching the most vulnerable populations. We need to ensure that public policy in all sectors can help us succeed.

How do we as a community of nations meet these - and other challenges - during a time when we face serious limits on our resources? We must set clear priorities. We must create partnerships such as the one you represent. Together, we must develop health information networks - to link national health ministries, WHO Collaborating Centres, laboratories, practitioners and others around the world. We must develop the right infrastructure and policies to promote and sustain telecommunications for health. Together, we can create a blueprint for regional cooperation in telehealth, and set a plan for implementation.

WHO will continue to work with governments to help create frameworks for integrating telecommunications into health.

We need an emphasis on education. The use of telemedicine will result in our health workers being very different people than they are today; their training must reflect this.

We need an emphasis on coordination. We must ensure that the systems we create will operate across networks, that systems can interact and that what is developed for use in one scenario can be transported to another. Vertical systems, built to satisfy narrow interests, impede real progress toward health information infrastructure in our nations and regions.

We need an emphasis on incorporating new technologies. Together with distance learning, simulation in the training of our health care personnel will enhance their abilities while offering access to previously unavailable educators.

We need an emphasis on networks. The ability to communicate around the world was made possible via the Internet. Everywhere, scientists must have the ability to share results, discuss theories and utilize data bases.

We need an emphasis on policies and standards. The WHO and its regional offices have a vital interest in the health status of the world. There is significant work to be done in developing policies and standards for systems that will involve worldwide partners and public and private ventures.

We need an emphasis on evaluation. There is a vast array of independent projects arising everyday. No one yet has a great deal of experience with telemedicine to guide the development of evaluation criteria. In this, we are depending on regions and countries to be active partners.

I see the overarching telemedicine challenge as achieving a global, interactive system that contributes to the improved health of all people of the world.

It is vitally important to look ten and twenty years into the future and to think about what we must do today to be prepared for tomorrow. We must analyse, reflect and take action.

As your presence here today demonstrates, this process must involve sectoral partners, as well as national and local government agencies and academia. The revolution in which we are now immersed cannot be tackled independently. We must work together to build the architecture for tomorrow.

We are moving from the industrial revolution to the information revolution. I am a promoter of telemedicine, but even more so a promoter of equitable, quality health services to all people. Telemedicine is merely a way to achieve that. For many countries, getting set for this new opportunity is expensive. We need to encourage support systems so that all groups of countries can have access to this technology. If not, the poor will lag even further behind. That works against the core value of equity.

A few years ago we would not have had this video conference. Today, we all can reach across the world. Imagine where that can bring us.

In closing, I would like to express my appreciation to our host, Saudi Arabia for providing the facilities for this meeting. Your commitment to advancing telemedicine is demonstrated by your National Telemedicine Network, which will help to ensure an even and fair distribution of health services irrespective of location.

I would like to recognize the Regional Office of the Eastern Mediterranean for carrying out a survey on the status of telemedicine in the Region in preparation for this meeting. I wish also to commend your initiative in the field of telemedicine, including the partnership you have established with the International Telecommunications Union.

A century ago, at the dawn of the industrial age, the first x-rays opened the eyes of health care professionals to the human body. Today we stand poised to enter another new century, with the information age unfolding before us, helping us fundamentally to promote health and to alleviate human suffering.