Blockchain and the governance of pandemics
New blockchain projects fighting COVID-19 are emerging at a fast pace, showing the potential of this disruptive technology to mitigate the multi-systemic threats that the pandemic is posing in all phases of the emergency management and generating value for the economy and society as a whole.
This post inspired a scientific article published on IEEE Access: link
Significant difficulties in managing the supply chain, lack of coordination, and sharing of information between healthcare structures, suspension of the fundamental rights of citizens, enormous damage to global economies: these are some of the side effects of COVID-19. It is a health crisis first, however, it is producing collateral, multi-systemic consequences on healthcare, economic, social, and information systems (Figure 1). After the pandemic, the world is undoubtedly going to be a very different place and we will need new approaches and tools to face this reality.
The effects on the efficiency of the healthcare system, as reported by the World Trade Organization, has materialized in problems at the medical supply chain level, with the shortage of medical equipment due to panic buying, and evident difficulties of governments and national healthcare services to provide medical staff and population with the minimum medical facilities necessary to face the pandemic and reduce the contagion. Moreover, the national systems are struggling in performing an accurate prediction of the pandemic course, mainly due to the total lack of automation in data sharing between different healthcare structures (source: European COVID-19 Data Platform Initiative).
Concerning the stability of the social system, the social distancing directives imposed by some of the national states to protect the health of individuals and minimize contagion, has, however, posed doubts on the protection of some of the fundamental rights of citizens and the possible “Big brother” effect generated by the introduction of contact tracing practices by the authorities (source: European Union Agency for Fundamental Rights). The education system is suffering a severe blow, with the abrupt interruption of the growth and learning paths of young people, a problem which, according to the United Nations, is involving more than 68% of the school-age population in the world. Finally, the philanthropic area, which remains a primary social aid in many nations, is revealing some significant flaws, evidencing areas of unfairness, opacity, and inefficiency in the distribution of public and charity funds (sources: U4 Anti-corruption Research Center).
Considering the health of the economic system, according to the report published by OECD, companies, and in particular SMEs, are significantly struggling to offset the financial losses caused by the pandemic. The credit lines are insufficient to cover the expected liquidity shortage of all affected SMEs during the first lock-down, and this could precipitate in the case of a second wave. This situation will inevitably lead to the closure of many companies and the consequent loss of jobs. Another collateral problem is connected to the high use of cash, especially in the small real economy: studies have found that COVID-19 can survive on surfaces for over three days, and touching banknotes and coins may turn out to be unsafe.
Finally, according to a study of the United Nations, there is a real risk of “Infodemic” of misinformation associated with a lack of transparency of the information/media system, evidencing the urgent need to fight against the proliferation of fake news about the virus.
This bird’ s-eye view on the issues caused by the pandemic poses new questions on the use we could do of exponential technologies — such as blockchain — evidencing some areas of intervention where a new technology paradigm could be adopted: supply chain management, healthcare data sharing, fundamental rights, education, welfare and philanthropy, access to credit, cashless payments, and misinformation. In the next part of the post, we will discuss how blockchain has been leveraged to face the problems mentioned above through experimental projects aimed at exploring innovative approaches to solving systemic issues.
As shown in Figure 2, from the existing academic and grey literature analysis, we have identified around 30 relevant initiatives and filtered a shortlist of blockchain applications to face COVID-19 (and pandemics more in general). As a result, 19 projects have been put under the lens, and a cross-case analysis has been performed considering four dimensions: the type of blockchain involved, the maturity level of the proposed application, the value generated by the use of blockchain, and the targeted emergency phases. With particular reference to the fourth dimension, we mapped each application to the standard five stages of emergency management (prevention, preparedness, response, recovery, and mitigation) to understand if, during pandemics, the emergency management process may benefit from blockchain in one or more specific phases.
This analysis helps us paving the way to respond to the following research questions concretely:
1. For what kind of problems may blockchain be leveraged to offset the impact of COVID19-like pandemics?
2. Which is the level of maturity of existing solutions on the market?
3. What kind of value can this technology offer?
4. Is there a phase in the management of emergency that may specifically benefit from the use of blockchain?
Shortlist of selected projects
In this section of the post, we are going to answer to the first question, “For what kind of problems may blockchain be leveraged to offset the impact of COVID19-like pandemics?” by exploring the shortlist of 19 identified projects and describing how they are dealing with the issues of COVID-19 pandemic. In Figure 3, the projects are grouped considering the impact areas (see Figure 1) they mostly refer to.
In the first impact area — healthcare system — MiPasa, ProCredEx, GenoBank.io, and Digital Health Passport aim at solving the problem of data sharing across the different healthcare systems. MiPasa is based on the IBM blockchain platform and aims to help to monitor and to foresee local and global epidemiological trends and to detect likely asymptomatic carriers by feeding big data on infection routes and occurrences to powerful AI processors around the world. ProCredEx is based on the Algorand blockchain and offers a credentialing system to speed up verification of healthcare workers, connecting with the existing healthcare credentialing systems. This could prove beneficial to onboard staff and retired doctors for combatting the coronavirus as well as doctors that move across state lines. GenoBank is based on the Telos Foundation blockchain, an EOS-based blockchain, and offers a mobile app for users, a processing interface for laboratories, a privacy-ensuring blockchain architecture, and sourcing and logistics solutions for low-cost COVID-19 tests and processing. Their mobile app, named Agerona, will allow users to source low-cost COVID-19 testing securely. The Bournemouth University Digital Health Passport (DHP) project is based on a private blockchain and a proof-of-authority consensus mechanism, offering a framework to provide a distributed infrastructure supporting the issuance of a DHP by foreign health systems and their verification by relevant stakeholders, such as airline companies and border control authorities. The other two projects, Tymlez and MediLedger, aim at improving the medical supply chain management: Tymlez is based on the Deloitte “Blockchain-In-A-Box” (BIAB) platform and offers the technology for modelling the medical goods ecosystem through a platform that meets supply and demand. MediLedger is based on a custom permissioned DLT and provides a tool for the traceability of pharmaceuticals, including relevant wholesalers such as Pfizer, McKesson, Genentech, Gilead, and AmerisourceBergen, among others.
Within the second impact area — Social System — SafeTrace, Pronto C2, BeepTrace, and CovidChain are targeting the issue of contract tracing and related fundamental rights. SafeTrace is based on the Enigma blockchain and is aimed at providing a platform to facilitate privacy-preserving contact tracing. SafeTrace lets users share sensitive location and health data with other users and officials, without compromising the privacy of that data. Pronto C2 is a contact tracing project based on the Hyperledger private blockchain developed by the University of Salerno, which provides a fully decentralized automatic contact tracing system offering complete transparency and resilience through full decentralization, therefore being more appealing for citizens. BeepTrace is a contact tracing application based on a Direct Acyclic Graph (DAG) distributed ledger promoted by the University of Glasgow, which offers a timely framework for authorities, companies, software developers, and researchers to fast develop and deploy useful digital contact tracing applications, to conquer COVID-19 pandemic soon. CovidChain is a mobile app developed by Cotton University that aims at assisting people in following social and physical distancing norms in public places. It offers an anonymity-preserving blockchain-based framework allowing people, through the use of their smartphones and other communication devices, to protect themselves from infections as they conduct their daily business activities. The solution is based on a public custom blockchain.
Two projects, HelperBit, and Red Cross, aim at helping the charity and philanthropy sector to face the challenges of a pandemic. HelperBit is using the Bitcoin blockchain to provide a crypto platform that enables charities to accept Bitcoin and other cryptocurrencies most safely and efficiently, in order to reduce the lack of transparency, inefficiency, and unfair redistribution of funds of the charity sector and bringing people to trust non-profit organizations and increase donations. Red Cross, instead, is using the Bitcoin blockchain to start accepting donations through its website. Finally, Sony Global Education and Fujitsu Research Institute are trying to address the educational issues by initiating a field trial to evaluate the usefulness of blockchain technology in the management of course records and grade data. The trial is based on the Hyperledger private blockchain and will be conducted in collaboration with Human Academy Co., Ltd., an educational institution that accepts and teaches international students.
In the third impact area — economic system — initiatives like Debitum Network and Blockchers are trying to address the problems related to the access to credit for SMEs and startups. Debitum, offers a platform to help companies getting financial support. While, in the traditional financing world, all steps of this process are carried out by a single financial institution in a centralized manner, Debitum aims at creating a direct link between businesses and institutional investors by decentralizing the process that is needed to successfully and efficiently fund small and medium enterprises. Blockchers is an initiative funded by the European Commission aiming to sustain European startups in creating new DLT-based business model through financial and training support, also providing a hybrid (permissioned and permissionless) blockchain infrastructure for new ideas piloting. Projects like Wirex are working to overcome the use of cash, a possible source of transmission of the virus, through a mobile app based on a public blockchain enabling P2P and B2B payment networks.
Within the last impact area, focusing on information systems projects like iReportCovid, AnsaCheck, and The News Provenance Project of The New York Times aimed at mitigating misinformation issues. iReportCovid is an app launched by the Algorand Foundation and built on the Algorand public blockchain that enables individuals to report their COVID-19 information anonymously directly. AnsaCheck is based on the Ernest&Young OpsChain (an Ethereum based blockchain) and aims at providing a certified and transparent source of information avoiding fake news. The News Provenance Project is an initiative of the NYT based on Hyperledger aiming at diminishing the spread of misinformation by empowering readers to make more informed, confident judgments about the news they read online.
Figure 4 shows the projects grouped by the eight application areas emerging from this preliminary exploration of the use cases: health data sharing, fundamental rights, information, medical supply chain, welfare & philanthropy, education, and cashless payments.
Cross-case analysis
After introducing the selected projects, we now present a cross-case analysis aiming at offering the elements to answer the three-remaining research questions: What is the level of maturity of existing solutions on the market? What kind of value can this technology offer? Is there a phase in the management of emergency that may specifically benefit from the use of blockchain?
Concerning the level of maturity of existing solutions on the market, as shown in Figure 5, the cross-case analysis highlights an adequate level of maturity of the proposed solution, the most of which ranks between the product and the Minimum Value Product (MVP) levels (14 over 19). We can also notice a fair distribution of the projects across the different impact areas, with a higher concentration of the most mature projects in the Healthcare and Social areas.
As per the value offered by blockchain across the different impact areas (Figure 6), features like increased transparency, ease of sharing information securely, and protection of digital identity are the most relevant advantages of using blockchain in the healthcare system. Regarding the social system, enhanced privacy, the anonymity of personal data for contact tracing, and the improvements to the traditional educational practices represent a strength stemming from the use of blockchain. The Economic system can benefit from higher levels of trust, automation, and disintermediation, as well as to develop new business models aimed at a greater alignment of incentives among the involved actors. Finally, immutability and accountability of data stored in a blockchain can help to build a more trustable information system, also relying on the “wisdom of the crowd” to fight fake news through peer-to-peer communication.
Finally, is there a phase in the management of emergency that may specifically benefit from the use of blockchain? To answer this question, we briefly introduce the five stages of emergency management:
1. Prevention: includes any activities that prevent an emergency and reduce the chance of an emergency happening. Prevention activities take place before emergencies.
2. Preparedness: includes plans or preparations made to save lives and to help response and rescue operations. Preparedness activities take place before an emergency occurs.
3. Response: includes actions taken to save lives and prevent further property damage in an emergency. The response is putting your preparedness plans into action. Response activities take place during an emergency.
4. Recovery: includes actions taken to return to a normal or an even safer situation following an emergency. Recovery activities take place after an emergency.
5. Mitigation: includes activities to reduce the loss of lives by lessening the impact of disasters and emergencies. Mitigation activities take place after emergencies.
The cross-case analysis unveils a broad coverage of all phases of emergency management spanning from a minimum number of 9 projects covering the prevention phase to a maximum of 18 projects offering a blockchain-based solution for managing the pandemic in the response phase of the emergency management (Figure 7).
It is also very interesting to notice that most of the projects analyzed make use of permissionless blockchains, which show a good predisposition to the adoption of public blockchains in relevant sectors of the economy and society (Figure 8).
Conclusions
Both blockchain and pandemics are fairly new and uncharted territories. The presence of many projects and initiatives, with different levels of maturity, that aim to face the challenges of COVID-19 through the use of DLTs highlights that the blockchain ecosystem is a vibrant one and a community of entrepreneurs and developers who are very receptive to new social challenges and willing to demonstrate how this exponential technology can change the future.
This technology has been applied to address a wide range of problems, mostly requiring coordination as it represents a trust enabler for sharing and collaboration activities. It has been fruitfully applied along most of the emergency management process, from tracking to the reduction of information asymmetries, certification, privacy preservation, trust.
We want to end this post with a reflection that may fuel our next research endeavour: if COVID19 brought us together as a single population, can blockchain bring us together in the creation and management of a new breed of global commons?
Please cite this post as follows: Favenza, A., Ferro, E., Ricci, L., (2020), “Blockchain and the governance of pandemics.” Overtheblock Innovation Observatory. https://medium.com/overtheblock/blockchain-and-the-governance-of-pandemics-54e804cb0ec6
OverTheBlock is a LINKS Foundation’s initiative carried out by a team of innovation researchers under the directorship of Enrico Ferro. The aim is to promote a broader awareness of the opportunities offered by the advent of exponential technologies in reshaping the way we conduct business and govern society.
We are chain agnostic, value-oriented, and open to discussion.
