Can a Global NGO Make Digital Contact Tracing Work?

By Maria Carnovale, Maurizio Arseni, Augusto Gesualdi, Laura Murphy

In the Geneva train station, Giovanni checked his pockets for the traveler’s three essentials: ID, wallet, and phone. Glancing at his phone, he noticed that the icon of his newly downloaded Italian contact tracing app was right next to SwissCOVID, the Swiss app. He looked up at the rush of masked passengers boarding the train bound for Italy. “I bet the virus is going on vacation too,” he joked to his wife as they stepped aboard.

Like many other jurisdictions in Europe and around the world, Switzerland and Italy deployed national contact tracing apps to speed the identification and isolation of COVID-positive individuals. But the two apps do not talk to each other; they lack what is technically called interoperability. Even though most national contact tracing apps are based on the same technology—namely, the Google and Apple Bluetooth system—they all run independently of each other.

In today’s hyperconnected world, thinking about contact tracing solely as a local effort is an outdated model that is not up to mitigating the spread of COVID-19.

In today’s hyperconnected world, thinking about contact tracing solely as a local effort is an outdated model that is not up to mitigating the spread of COVID-19. The European Commission already recognized that fragmentation of the digital contact tracing infrastructure makes these solutions ineffective when citizens (and viruses) travel across borders. In fact, it is now testing a new interoperable system. Until that launches, travelers need to download a new app for every country they visit in order to maintain a record of contacts and receive exposure notification.

More troubling, none of these apps have been blockbusters. Except for a few countries whose national contact tracing apps have reached around 20% adoption levels, most countries are hovering around 5% adoption rates. All fall short of the much more ambitious threshold of adoption needed to effectively support detecting and breaking contagion chains—estimated at 60%.

To have a shot at mitigating the current crisis while allowing travel across borders, what’s needed is a global contact tracing infrastructure with apps that can communicate with each other. The best way to do this is to form a global nongovernmental organization to provide a contact tracing system that preserves privacy, competition, and interoperability, while credibly acting in the public interest.

An NGO could be key to boosting adoption rates. In the current system, the main concerns (effectiveness, safety, and privacy) are not met by the two groups actually developing apps: governments and technology companies. At a time when consumers’ trust in tech companies and governments is wavering, many people see contact tracing apps as another attempt by big tech or governments to profile users and abuse the data collected. After all, they have already seen their personal data routinely harvested and resold to an ecosystem of third-party data brokers.

An NGO could be key to boosting adoption rates. In the current system, the main concerns are not met by the two groups actually developing apps: governments and technology companies.

Governments’ responses to the pandemic, meanwhile, have been hesitant and politicized. To many potential users, digital contact tracing replicates the same script, especially as significant financial resources are invested in developing contact tracing solutions despite experts voicing discordant opinions about their effectiveness.

By contrast, a mission-oriented global NGO—with members from governments, technology companies, and civil society organizations—could reassure users that digital contact tracing is an integral part of a broader, coordinated strategy. In addition, an NGO could safeguard users’ personal data so that they are never to be used for commercial purposes, and any potential harm would be monitored and compensated. The NGO might also promote innovation and act as a catalyst to share best practices—and denounce abuses—among stakeholders.

The idea of a nonprofit taking a lead role in setting standards for global technology infrastructure is far from new. For example, the interoperability of the telecommunication infrastructure across countries is ensured by two organizations: a nonprofit telecommunications consortium called 3GPP; and the United Nations’ International Telecommunications Union. These organizations ensure that phones and other communication devices work in different parts of the world, and that people can communicate across national borders with the same device they use for domestic calls.

Of course, for all their promise, global NGO’s can still fail if they are improperly implemented. When Facebook used a Swiss-based nonprofit to launch Libra, its global cryptocurrency, with members such as Visa, Uber, and Spotify, the experiment failed quickly after financial regulators and policy-makers raised concerns about currency sovereignty and the potential for Libra to conceal money laundering.

Facebook’s experience should serve as a warning: any effort that does not successfully engage all meaningful stakeholders will be short-lived. To achieve credibility, the NGO must allow representatives of different countries and jurisdictions, local public health authorities, private companies, and civil society groups to negotiate solutions that are politically feasible, technically realistic, socially acceptable, and inclusive.

Credibility can be achieved only through high levels of organizational transparency. Making documentation public is useful, but only scratches the surface. What is needed is openness at every stage of the internal decision-making process: its inputs, outputs, and process. One of the key tasks of the NGO will be tofoster and coordinate independent research and data sharing on effective uses of digital solutions.

Already, some models of inclusive and bottom-up approaches are emerging. For instance, in launching its contact tracing app in September, Belgium started an open consultation. Anybody could submit comments and feedback on the functional design of the app and the policies guiding its deployment. Within just a few weeks after its launch, nearly 1 million users had downloaded the app.

Volunteers also play a crucial role in providing external accountability and transparency. By powering many nonprofits, they witness the organizations’ internal decision-making processes and gauge their adherence to the stated mission. In order to gain this benefit, volunteering roles need to be distributed across the whole organizational structure, rather than concentrated in a small subset of mundane tasks. Most importantly, volunteers cannot be limited by nondisclosure agreements that would impede their ability to speak up if confronted with abuses of power.

This process of engaging civil society might seem tedious and bureaucratic, and it is certainly less agile than the swift decision-making of a private company. But the private interests of corporations are simply unfit to defend the public interest with the level of credibility needed in the fight against this pandemic.

An NGO can foster innovation in contact tracing by promoting the most effective technical standards developed by competing private entities, simply because it has no direct financial interest in these standards. A private company, by contrast, would be easily tempted to make decisions that allow it to quickly accumulate market power. That same market power could limit smaller competitors’ ability to market potentially more effective solutions, which would be a loss for society at large.

What is needed is openness at every stage of the internal decision-making process: its inputs, outputs, and process.

Google and Apple have already positioned themselves as the gatekeepers of global contact tracing, and are influencing key policy decisions in the space from their position as a global standard. When the two companies recently launched their own exposure notification solution, built into their smartphone operating systems by default, they de facto became the standard for exposure notification, a key component of contact tracing. They started by providing the backbone of the Bluetooth-based exposure notification technology that is currently powering most digital contact tracing solutions issued by national governments. In what seems like a paradoxical role reversal, Google and Apple then issue permissions to countries and jurisdictions (the same entities that usually regulate tech companies) to use their contact tracing technology. These permissions avoid fragmentation and unethical features. In order to be added to app stores, national contact tracing apps then go through an additional review. It seems a perfectly oiled machine; why should we ever seek an alternative?

For a start, epidemiologists are already warning that these apps might be ineffective in combating the pandemic, and the apps do not provide public health officials with the information they need to respond to outbreaks. Still, Google and Apple are automatically adding exposure notification to their operating systems, overriding users, researchers, and local public health authorities rather than involving them in the development of the tool. This insular decision-making process is reminiscent of the problems that contributed to the failure of Facebook’s Libra. And these mistakes are things that a global NGO with a commitment to an inclusive, deliberative process could avoid.

At the same time, there is no simple pathway to an effective global contact tracing app without Google and Apple, whose operating systems (Android and iOS, respectively) collectively control over 99% of the smartphone market. These companies appear to be the only ones that can deploy a widespread and interoperable solution that could get wider adoption at the necessary scale.

A global NGO’s role will ultimately be that of mediating between the interests of the public, governments, and the necessary tech giants. Even if the 60% target adoption rate is reached, it will take trust and collaboration among the parties involved.

Thus, a global NGO’s role will ultimately be that of mediating between the interests of the public, governments, and the necessary tech giants. Even if the 60% target adoption rate is reached, it will take trust and collaboration among the parties involved; users will still need to engage with the app once it’s on their smartphones, and public health authorities will have to use it to inform their responses. The thing that will make digital contract tracing effective is coordination, not unrealistic adoption objectives.

But coordinating various disparate parties is not something technology companies do well, if at all. Apple and Google’s response has been unilateral and has shown limitations in bringing together different stakeholders. The International Telecommunications Union and the World Health Organization are taking steps in that direction. They have set up a focus group comprising experts in artificial intelligence and digital health technologies to share best practices and analyze the effectiveness of technological approaches to health emergencies. But such large intergovernmental organizations frequently consult grassroots and civil society organizations only at the early stages of the decision-making process, and their outcomes ultimately reflect the countries and lobbies that have flexed their muscles.

Thus, in the current situation, such a coordinating role would be most effectively led by nonprofit and nongovernmental organizations that have a clear mandate to involve many parties and be transparent.

Unless the world collectively agrees to return to its pre-globalized status, countries will eventually reopen their borders. As that happens, they will need to coordinate contact tracing efforts, both manual and digital. Libra’s failure at launching a global currency shows the flaws of a top-down, overbearing, business-led approach to policy-making that did not align with nations’ needs. To create a transparent, inclusive, and interoperable public health initiative on a global scale, an appropriately structured nongovernmental organization must take the lead in this political vacuum.