Telemedicine as a tool for improving human security - Environmental and Human Security in the Arctic - page 159

threats to human security will require unprecedented cooperation among the
public and political leaders'. The Commission therefore proposes that:
The world urgently needs primary health services and national dis-
ease surveillance systems - formally networked into a global system.
Information, data and analysis can help to identify disease outbreaks
and strengthen efforts to control their spread. So every country should
have primary health services and disease surveillance capacities … These
national systems should be linked through networks in a truly global
system, to allow for rapid knowledge sharing and rapid responses.
(CHS 2003:139)
In meeting and combating the threat that is constituted by the spread of
epidemics, telemedicine can facilitate immediate access to important infor-
mation through international early warning systems. For example, the threats
arising from the spread of tuberculosis from Russia to Europe have led to
several projects in the Arctic, including those that incorporate telemedicine.
The spread of strains of tuberculosis that are resistant to normal medication
poses a genuine threat to both the European security complex and to the
Arctic security complex. AIDS is spreading in Russia too. People are travel-
ling more widely, and the sex industry in Russia is the source of a potential
threat (Dobriansky 2003). This case illustrates how threats to health security
do not stop at borders. Further evidence of this can be found in more recent
discussions about the uses of telemedicine for potential increases in vector-
borne diseases resulting from climate and other environmental changes, such
as meningitis (UN-SPIDER 2008). An increased awareness about how to
manage disease effectively is needed, and telemedicine plays therefore a cru-
cial role in health security. These technologies and processes are relevant for
Arctic populations, as well as populations in other regions of the world, not
least in the global South where diseases such as malaria and cholera are in dire
need of management and control.
Infrastructure is needed in order to implement telemedicine in the Arctic,
where a combination of satellites and cables are required. The infrastructure
serves as a 'communication road' through which patients and health personnel
can connect with each other. They can communicate through the Internet,
by videoconferencing and by e-mail. E-mails may be accompanied by attach-
ments, which can be sound and/or picture files. A sound file could be an
ultrasound file or sound of the heart. Today the Arctic has a good coverage
of satellites. However, this infrastructure has maintenance costs, the satel-
lites are private and users must pay for access to this infrastructure. These
costs can serve as barriers to the use of telemedicine. The possibility that
increased cooperation among Arctic states can reduce costs and increase the
stability of the infrastructure is an area to be explored. Additionally, if users