| 20 April 2021
A conversation about the NDHM sandbox, innovation, last-mile access, and more with Kiran Anandampill
India is rapidly digitising. For many of us, our digital lives are as important as our physical lives. Digital infrastructure adds a new foundation that complements physical infrastructure in addressing India’s economic and social development needs — and it can do so faster, better, cheaper and at population scale. Today, with digital platforms, technology infrastructure can be shared by both government and private sector entities, which can leverage it to create new solutions and enhance citizens’ experience.
The National Digital Health Mission announced by the Prime Minister envisions an open digital ecosystem for healthcare. Telemedicine, e-pharmacy and hospital services can be delivered with an inter-operable tech platform using personal health records and health facilities information.
The Open Digital Ecosystems (ODE) framework is an approach to designing digital infrastructure to realise the full potential of the infrastructure while minimising risks and possible harms. The framework has three layers, and they are analogous to how we think about physical infrastructure too. The first is the tech layer or the actual infrastructure itself. In digital infrastructure, our ‘highways’ are the tech platforms. In India, we are now coalescing around the shared understanding that tech platforms need to be modular, open API, open source and interoperable.
The second layer is governance: the “rules of the game” and the institutions that uphold them. Here too the issues are similar to physical infrastructure. Who is responsible for creating and maintaining infrastructure — government, private sector or PPP mechanisms? Who should own it? Who pays for the services — governments or users? Do we need a regulator? What is the recourse in case of harms? Like we have speed limits for road safety, and aviation security norms, issues related to data privacy and security in the digital world need addressing.
The third layer is community engagement. Community refers to entrepreneurs and other builders who ensure that the infrastructure actually gets used and solutions are built on top. It also refers to tech developers and civil society organisations who engage to ensure continuous improvements and hold government to account. We saw the crucial role civil society and the media played in Aadhaar. The healthy debates of democracy led to a fundamental right to privacy enshrined in the Constitution, and legal guardrails on where and how Aadhaar may be used.
India has been a pioneer in the first layer — digital infrastructure. Aadhaar and the India Stack are powerful examples of ‘digital highways’ with a vision to enable traffic of all kinds of services that can ride atop. We were one of the first developing countries to have a population scale digital identity, and have built a low cost digital payments infrastructure.
The Covid pandemic has made us more dependent than ever before on this digital infrastructure and the services and applications on top. And during this pandemic, the government was able to transfer ₹37,000 crore directly to the bank accounts of 16 crore citizens using India’s digital infrastructure.
India is in the initial phase of the journey on the governance and community layers. But they are as important as the tech layer. The pandemic has starkly revealed the limitations of digital platforms, with many sections of the population excluded.
The world has also realised the potential harms of concentration of data, and hence, power, in ‘Big Tech’ platforms. Critical issues like privacy and individual’s control over their personal data, as well as the security and sovereignty of data are being hotly debated both globally and in India.
Such issues are even more critical for state owned digital platforms, since many more people are depend on them for basic services. For example, a registry of digital health records for every individual can be a powerful tool for accessing the right healthcare. However, without stringent measures to protect individual agency over use of these records, they can also be exploited. Decentralised architecture for data registries is an important mitigation measure. Privacy and security measures like purpose limitation, tokenisation, encryption, and transparency to protect users can help build trust in the digital ecosystem.
We estimate that by 2030, 10 high potential national ODEs in sectors like health, agriculture, justice, etc., can collectively create new value of around $500 billion ( ₹35 lakh crore) or about 5.5 per cent of GDP, and savings of around $200 billion ( ₹15 lakh crore).
With Covid-19, the ODE approach becomes even more relevant, not just in healthcare but also in areas such as employment, education, and social protection.
This article was originally published in HinduBusinessLine on 23rd Sep 2020, and can be accessed here.