Director of Political Futures Consultancy
Daniel Silke is one of South Africa’s leading Independent Political Analysts and most passionate Keynote Speakers covering South African, African and Global political and economic issues. As a renowned Futurist and commentator, his insightful, entertaining and predictive presentations on topical issues are in great demand. Silke holds a Masters Degree in South African and International Politics and has served, in a senior capacity, both as a Member of the Provincial Parliament and as a City Councillor in Cape Town He lectures and consults to major corporates, academic institutions and think-tanks both locally and overseas. He is currently the Director of Political Futures Consulting and also regularly appears in print, on the Internet and on radio & television both in South Africa and abroad. He has recently published an acclaimed new book “Tracking the Future: Top Trends that will shape South Africa and the World”.
General Practitioner / Medical Director of Dr Brauer and Associates
Marcus Brauer graduated from the University of Cape Town subsequently completing diplomas in emergency medicine, occupational health, a dive medicine course and the Wits Travel Medicine Course. He also conducts US Visa immigration medicals. He runs a general, occupational and travel medicine practice in Cape Town, and enjoys spending time with his family and doing outdoor based activities when not at work.
Head of Clinical Microbiology at Ampath National Laboratory Services
https://www.ampath.co.zaHe was the founding President of the Federation of Infectious Diseases Societies of Southern Africa (FIDSSA) and is an Executive Member of the latter council. He is currently co-chair of the South African Antibiotic Stewardship Program (SAASP) and serves on the South AfricanMinister of Health’s Ministerial Advisory Committee (MAC) on antimicrobial Resistance. He has presented at national and international congresses and has authored or co-authored more than 80 papers in peer-reviewed journals.
Gary Brunette attended the University of Cape Town where he obtained a degree in history. After serving five years in the South African Navy and a four year “walkabout” he immigrated to the United States in 1992. He attended medical school at the University of Wisconsin and subsequently completed an M.S. in epidemiology and his preventive medicine residency at the University of Maryland in Baltimore. After spending three years in the US Navy, he joined the Centers for Disease Control and Prevention in 2006. He is currently the Chief of the Travelers’ Health Branch, which is a designated WHO Collaborating Center for Travel Health. He is the Editor-in-Chief of the CDC Health Information for International Travel 2018, a Fellow of the Faculty of Travel Medicine at the Royal College of Physicians and Surgeons in Glasgow and a Captain in the US Public Health Service.
Managing Director of Travel Doctor Corporate
https://traveldoctor.co.zaAlbie de Frey graduated from the University of Pretoria in 1983, and subsequently obtained diplomas in Primary Emergency Care and Anaesthesiology from the Colleges of Medicine, South Africa. He is a Fellow of the Faculty of Travel Medicine of the Royal College of Physicians and Surgeons, Glasgow, and of the Faculty of Travel Medicine of the Australasian College of Tropical Medicine Australia. He is honorary lecturer in the School of Public Health, Faculty of Health Sciences at the University of the Witwatersrand and instrumental in the development of Wits Travel Medicine Course developed in conjunction with James Cook University, Townsville, Australia.
He is member of the WHO Expert Roster on Travel Health and is the GeoSentinel Johannesburg Site Director. He serves on several editorial boards and is currently involved in providing comprehensive travel health risk management to several multi-national companies, taking care of approximately 5 500 corporate travellers and national employees globally.
Academic Head and Chief Specialist at Clinical Microbiology and Infectious Diseases, NHLS / Wits University
Adriano Duse is currently the Academic Head and Chief Specialist of the Department of Clinical Microbiology and Infectious Diseases of the School of Pathology at the National Health Laboratory Service and the University of the Witwatersrand. He is a Fellow of the Royal Society for Tropical Medicine and Hygiene (UK) and of the faculty of Pathology, Colleges of Medicine, South Africa. He is chairman of the Microbiology Laboratory Standardisation Committee, South African Institute for Medical Research/National Health Laboratory Service. He is an Expert Consultant to the International Scientific Forum on Home Hygiene. He serves on the Gauteng Infections Control Society and was a Council member of the College of Medicine South Africa from 2011 to 2014. In 2007 he was appointed International Ambassador (South African Region) to the American Society of Microbiology. From 2008 to 2011 he was the Southern African Chair for The Global Antibiotic Resistance Partnership (GARP). He has published widely in both national and international peer reviewed journals.
Director of the Global Change Institute (GCI) at University of the Witwatersrand
https://www.wits.ac.za/gci/Barend Erasmus is one of South Africa’s leading experts in the field of climate change impacts, spatial ecology and land cover change. His doctoral degree was the first assessment of climate change impacts on biodiversity in South Africa. Barend has more than 80 primary publication outputs, with over 3 500 citations. He is the current Director of the Global Change Institute (GCI) at the University of the Witwatersrand, in addition to holding an industry-supported research chair, the Exxaro Chair in Global Change and Sustainability.
As the Director of GCI, he is tasked with not only aligning the Institute to reach its core objectives, but to also engage with various key role-players such as government, industry, researchers and business to address global change challenges. The GCI focuses on evidence-based decision support for climate action, and plays a leading role in various local, regional, national and international engagement platforms. These platforms provide an opportunity for the >30 GCI postgraduate students to gain first-hand experience of the science-policy interface. As the Exxaro Chair in Global Change and Sustainability, Barend’s own research focuses on long-term patterns of landscape change and climate change, and how to ensure that ongoing- and future changes take us closer to sustainability. Passionate about research and imparting knowledge, Barend has supervised over 50 Honours, MSc and PhD students. Barend contributes as a member of board level committees to the National Business Initiative, the Endangered Wildlife Trust and the Africa Climate Reality Project.
Professor and Chair of the Department of Anthropology at Baylor University, Texas, United States
Michael Muehlenbein is Professor and Chair of the Department of Anthropology at Baylor University in Texas, United States. Trained in tropical medicine, travel medicine, and conservation medicine, he leads regional efforts in One Health and Medical Anthropology, having also been at the University of Wisconsin, Indiana University, and the University of Texas. He has helped lead the ISTM and SASTM in both One Health and ecotourism, as he now specializes in emerging infectious diseases associated with human contact with wildlife, monkeys and apes in particular. He has published over 60 peer-reviewed papers, including two books, has taught over 3000 university students, and offers annual field schools in One Health in South Africa, Mexico, and Thailand.
General Practitioner at Private Practice
Salim Parker is a general practitioner based in Cape Town and immediate Past-President of the South African Society of Travel Medicine. He is the co-director of the Cape Town GeoSentinel site and currently serves on the Liaison Committee of the International Society of Travel Medicine (ISTM) as well as on the editorial board of the Journal of Travel Medicine. In collaboration with the Global Centre for Mass Gathering Medicine, he is involved in Hajj pilgrimage related research. Original research has been presented at the last five ISTM conferences. He has authored book chapters, including co-authoring the 2018 Hajj chapter in the CDC Health Information for International Travel.
Wardlaw Professor of Psychology at University of St. Andrews
Stephen Reicher is Wardlaw Professor of Psychology at the University of St. Andrews. He is a Fellow of the British Academy, a Fellow of the Royal Society of Edinburgh and a Fellow of the Academy of Social Sciences. He has been a consultant to Scientific American Mind and an Editor of the British Journal of Social Psychology. He has won multiple international honours, including the Nevitt Sanford and Harold Lasswell awards from the International Society for Political Psychology.
Professor Reicher’s work is in the area of social identity and group processes. He has written some 300 books, book chapters and journal articles covering such topics as crowd behaviour, leadership and social influence, intergroup hatred and conflict, conformity and obedience and the psychology of tyranny.
In addition to his impact on academia, Professor Reicher’s work has had considerable social impact. He has advised the UK and Scottish governments on behaviour in emergencies and community resilience. His work has transformed public order policing in the UK, Europe and beyond. He has served as consultant to the UK Equalities and Human Rights Commission on social inclusion.
Travel Medicine Practitioner
David R. Shlim first visited Nepal in 1979 to work as a volunteer doctor for the Himalayan Rescue Association, at an aid post at 14,000 feet. After three stints near the base of Mt. Everest, he moved to Kathmandu in 1983 to begin what became a fifteen-year career as the Medical Director of the CIWEC Clinic Travel Medicine Center in Kathmandu, the world’s busiest destination travel medicine clinic. He is the author of more than forty-five original research papers, numerous chapters in textbooks, an editor of the Center for Disease Control’s Yellow Book and is a recent past-president of the International Society of Travel Medicine.
He was the Director of the Himalayan Rescue Association for ten years. He also provided free medical care for a Tibetan Buddhist monastery for fourteen years and developed a close relationship with the head of the monastery, Chokyi Nyima Rinpoche, and his father, Tulku Urgyen Rinpoche, who was recognized as one of the greatest meditation teachers of the twentieth century. He also offered free medical care to all newly arrived Tibetan refugees who came over the Himalayan passes from Tibet.
He is the co-author, with Chokyi Nyima Rinpoche, of Medicine and Compassion: An American Doctor and a Tibetan Lama on How to Provide Care with Compassion and Wisdom. The book has been translated into four other languages. He resides in Jackson Hole, Wyoming, where he practices travel medicine.
Immediate Past President at Nigerian Academy of Science
Oyewale Tomori is the immediate past President of the Nigerian Academy of Science with experience in virology, disease prevention, and control. He was at the University of Ibadan from 1971 to 1994. He later served as the pioneer Vice Chancellor of the Redeemer’s University in Nigeria from 2004 to 2011. From 1994 to 2004, he was the virologist for the World Health Organization (WHO)’s Africa Region, establishing the African Regional Polio Laboratory Network. In 1981, he was recognized by the U.S. Centers for Disease Control and Prevention (CDC) for contributions to Lassa fever research. In 2002, he received the Nigerian National Order of Merit, the country’s highest award for academic and intellectual attainment and national development.
He has authored over 140 scientific publications and has served or continues to serve on numerous advisory committees, including: WHO Africa Regional Polio Certification Committee, WHO Group of Experts on Yellow Fever Disease, Chairman WHO Yellow Fever Emergency Committee on International Health Regulations, Vice Chair of U.S. National Academy of Medicine Global Health Risk Framework Commission, and World Bank Interagency Working Group on Financing Preparedness and Response.
He is an international member of the U.S. National Academy of Medicine and a member of the Board of Gavi Alliance.
President at International Society of Travel Medicine
https://www.istm.orgLeo Visser studied medicine at the Catholic University of Leuven in Belgium. He specialized in Infectious Diseases at the Leiden University Medical Center, where he obtained his PhD (1997).
He was appointed as Professor in Infectious Diseases and Travel Medicine in 2014.
He is involved in clinical care, research, teaching and training in internal medicine and infectious diseases, with the emphasis on vaccinology, vaccine-preventable and tropical diseases, travel medicine and global health.
He is head, Department of Infectious Diseases at LUMC as well as head, LUMC travel clinic, which is a reference centre for travel medicine and vaccination in The Netherlands.
He is the President of the International Society of Travel Medicine and member of the European Expert Committee for Travel Medicine. In the past he was, amongst others, member of the steering committee of TropNet, the European Network on the Surveillance of Imported Infectious Diseases (www.tropnet.eu) and chairman of the National Coordination Centre for Travellers' Health Advice (LCR).
His current research activities involve vaccination responses in immunosuppressed hosts, immune response to yellow fever vaccine in the elderly, alternative vaccination routes, and immunogenicity and safety of intradermally administered rabies vaccines. Malaria vaccine research is performed in close collaboration with the Department of Parasitology (LUMC) and Radboud University of Nijmegen with special emphasis on the search for biomarkers of protection in the controlled human malaria infection model.
Head of Department at Department of Paediatrics at Kalafong Provincial Tertiary Hospital
Theunis Avenant heads the Department of Paediatrics at Kalafong Provincial Tertiary Hospital, a teaching hospital of the University of Pretoria, where he also acts as assistant to the Dean. He is a registered sub-specialist in Paediatric Infectious Diseases and regularly lectures at conferences on diverse topics in this field. In addition to serving on several University and Hospital committees has served on the executive committees of the South African Paediatric Association (SAPA) and the Southern African Society of Paediatric Infectious Diseases. Other interests include travel medicine, undergraduate and postgraduate medical training.
Lee Baker qualified as a pharmacist at Witwatersrand College for Advanced Technical Education in 1975 and has worked as a medicine information pharmacist for the past 33 years and is owner of the Amayeza Info Centre.
She is a member of the South African Malaria Elimination Committee (SAMEC) that is working towards eliminating malaria in South Africa and is involved in compiling the current malaria guidelines on treatment and prevention. She is the South African representative and chairperson for the Pharmacy Professional Group of ISTM and is President of the SASTM. She is the editor of two books; Beyond Childhood Vaccinationand Guide to the Practice of Travel Medicine in South Africaand co-editor of The Older Traveller – a guide for the health professional.
Deputy Director of National Institute for Communicable Diseases
https://www.nicd.ac.zaLucille Blumberg is employed at the National Institute for Communicable Diseases, of the National Health Laboratory Service in the Public Health Surveillance and Response Division. She is also medical consultant to the Emerging Pathogens Centre on rabies and viral haemorrhagic fevers. She has specialist qualifications in clinical microbiology, travel medicine, and infectious diseases. Her special interests are in tropical diseases, travel medicine, malaria, the viral haemorrhagic fevers, and rabies. She is a member of a number of South African expert groups on Ebola, rabies, malaria and serves on various WHO Advisory Groups.
Senior Specialist at Division of Endocrinology and Diabetic Medicine
Professor Joel Dave, MBChB (UCT) PhD (UCT) FCP (SA) Cert Endocrinology (SA)
Joel Dave completed his training as a Physician and Endocrinologist at Groote Schuur Hospital in 2003 and 2006, respectively. He spent 8 years in private practice but maintained his links with Groote Schuur Hospital and the University of Cape Town with an appointment as a part-time Senior Specialist and Senior Lecturer in the Division of Endocrinology and Diabetic Medicine. During this time he was actively involved in research and was also involved in the examining of undergraduate and postgraduate students. In September 2016 he returned to Groote Schuur Hospital and the University of Cape Town in a full-time position as a Senior Specialist in the Division of Endocrinology and Diabetic Medicine. Prof Dave enjoys participating in continuing medical education activities with undergraduate and postgraduate students as well as with other healthcare professionals.
Head of Parasitology at National Institute for Communicable Diseases
https://www.nicd.ac.zaJohn Frean is Head, Parasitology Reference Laboratory, Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases and is affiliated to the Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand. He holds South African, United Kingdom and Australian qualifications in medicine, pathology (microbiology and parasitology), tropical and travel medicine. His areas of interest are clinical and diagnostic microbiology and tropical medicine, especially parasitic and zoonotic diseases.
Specialist Emergency Physician and Principal Specialist at ER Consulting
Sean Gotschalk is a specialist Emergency Physician and is the Principal Specialist, ER Consulting, for the KwaZulu-Natal region. He was the lead expedition doctor for the High Altitude Cold Swim in Chile, 2015 and, in 2010, the expedition doctor on the Mount Everest Cold Water Swim. He has participated in many congresses and has several publications to his credit. He is a faculty lecturer in emergency medicine at the University of KwaZulu-Natal, a founder member of the Wilderness Emergency Medicine Society of South Africa (WEMSSA), member of the African Federation for Emergency Medicine and the Emergency Medicine Society of South Africa. His sports interests include cycling, trekking (Tres Cruces, Chile; Kala Patthar, Nepal) and participating in triathlons.
Consultant Cardiologist at Melomed Private Hospital
Chevaan Hendrickse is a consultant cardiologist at Melomed Private Hospital. He completed his basic medical training at the University of Cape Town, subsequently specialising in cardiology. He spent time as a radiation oncology registrar which provided valuables skills in the principles of nuclear physics. He has a particular interest in interventional cardiology and has been involved in several trials and is currently a participant in the Pan African Pulmonary Hypertension Cohort Study (PAPUCO), which is a multicentre epidemiological study exploring pulmonary hypertension in Africa. He has presented at numerous national and international conferences.
Regional Medical Director of International SOS
https://www.inernationalsos.comDr Fanie Jute is currently employed as Regional Medical Director with International SOS based in Dubai. He joined International SOS in 2008 as Regional Medical Director based in Jakarta, Indonesia. Prior to joining International SOS Dr Jute was employed by an international mining company in 2003 as a health services manager to remote mining projects based in Mali and Tanzania. During this period he managed all aspects of remote health care delivery including Public and Occupational Health.
Dr Jute is a South African citizen and has more than 25 years of professional experience. He completed his Masters in Family Medicine from University of Orange Free State, South Africa in 2000 and attained postgraduate qualifications in Tropical Medicine & Hygiene and Travel Medicine. He is a member of various professional bodies including the South African Society of Travel Medicine, International Society of Travel Medicine and South African Academy of Family Practice/Primary Care.
Medical Practitioner at Dr Brauer & Associates
Dr Sameer Kauchali is an occupational medical practitioner who is currently an associate at Dr Brauer & Associates, Cape Town. He graduated from UCT in 2001 and completed his internship & community service at Chris Hani Baragwanath, and Polokwane Hospital respectively. He then spent 2 years in the UK working at different emergency units as well as spending some time in Forensic Psychiatry. He currently consults with organizations and companies in assisting in the provision of Comprehensive Organisational Workplace Programmes. He has background experience in mental health, which is often not addressed sufficiently at the workplace. His special interests include uncovering hidden causes of common chronic medical conditions and addressing common, but undiscovered deficiency states that in the background, slowly contribute in the manifestation of mental and physical disease if not addressed early. His aim is to assist companies, individuals and organizations in reducing their burden of disease and by extension slash the huge economic costs associated with these conditions. He has recently established an educational and preventative medicine Wellness Company, The Vitamin D - Hormone Foundation of South Africa whose objective is the dissemination of the latest research on the role vitamin D plays in many chronic diseases including heart disease, cancers, autoimmune conditions, chronic pain and mental illnesses and addiction. He also conducts educational Wellness Workshops on multiple health topics. His special interests include the use of ear acupuncture in the management of smoking cessation and drug & alcohol addictions, as well as the management of multiple physical conditions with ear acupuncture. He also has certification as a travel medicine and maritime medicine practitioner.
Managing Director of Thom Kight & Co
https://www.thomkightfuneraldirectors.co.zaNeil Keight has over 30 years' experience in the funeral industry. after ten years in the industry he was in charge of the International Repatriation division which resulted one extensive worldwide travelling. The company has built up business relations and contracted to many local and international business organisations such as ISOS, Europe Assistance and Mears International. He is the Founder Member and Chairman of the International Funeral Directors' Association.
Specialist/Emergency Physician and Senior Consultatnt at Thelle Mogoerane Regional Hospital Emergency Department
Efraim Kramer is currently Specialist/Emergency Physician and Senior Consultant at the Thelle Mogoerane Regional Hospital Emergency Department, and formerly Head, Division of Emergency Medicine, Wits Medical School.
He is Adjunct Professor of the Division of Emergency Medicine, Wits Medical School; Extraordinary Professor, Sports Medicine, Pretoria University. He was appointed as the Tournament Medical Officer, FIFA World Cup Russia 2018 and Special Advisor Medical Services, FIFA Medical Committee. He is the former Medical Director of Rescue South Africa, Disaster Response.
C.E.O at The African Snakebite Institute
https://www.africansnakebiteinstitute.comJohan Marais is the C.E.O of The African Snakebite Institute and is affiliated with the University of the Witwatersrand. His interest is venomous snakes and snakebite. He lectures widely on snakes of Africa as well as snake handling and first aid in snake bite.
He has two publications: A Complete Guide to snakes of Southern Africa and Snakes & Snakebite in Southern Africa.
Executive Director of International Association for Medical Assistance to Travellers (IAMAT)
https://www.iamat.orgTullia Marcolongo is the Executive Director of the International Association for Medical Assistance to Travellers (IAMAT). With a focus on responsible travel, Tullia helps travellers plan a healthy trip. She has published guides on how to stay well abroad, travel health insurance, and navigating medical care in another country. Tullia is the Chair of the Psychological Health of Travellers Interest Group of the International Society of Travel Medicine and a member of the American Society of Tropical Medicine and Hygiene.She holds a Certificate in Travel Health®.
Assistant Professor of Paediatrics at University of Arizona
https://www.arizona.eduMelissa Moore is Assistant Professor of Paediatrics, University of Arizona, College of Medicine and is Co-Director of Global Health in the College. In 2009 and 2010 she was the attending paediatrician at the Commonwealth Health Centre (Saipan, Northern Mariana Islands) in the Paediatric Clinic, Inpatient Ward, New-born Nursery, NICU, and PICU and was involved in the air transport of critically ill patients to the Philippines and San Diego.
She is a member of the International Society of Travel Medicine and of the Pediatric, Migrant/Refugee Health and Student Travel Abroad Interest Groups.
Honorary Professor at University of the Witwatersrand
Mary Ross is an Occupational Medicine and Public Health Medicine specialist and an honorary professor at the University of the Witwatersrand, holding fellowships from the South African Colleges of Medicine, Faculties of Occupational Medicine, Public Health and Travel Medicine (UK), and Australasian College of Tropical Medicine. She has had a career in her fields of specialisation in the academic, public and private sector.
Mary initiated the first African travel medicine course in 2000 and was the Scientific Chair for the first ISTM regional conference held in Africa. Mary was also Scientific Chair for the International Commission for Occupational Health congress in 2009 and served as an ICOH Board member (2009-2015). She is currently Chair of the Working Group on Occupational Infectious Agents with a focus on those who travel for work.
Professor Emeritus at University of Zurich
Robert Steffen is Professor Emeritus at the University of Zurich and Adjunct Professor of the University of Texas School of Public Health in Houston. The Australasian College of Tropical Medicine and the International Society of Travel Medicine — which he co-founded — both elected him as Honorary Fellow. His research primarily focused on travel related epidemiology and prevention resulting in almost 400 publications. In Switzerland he presided the Travel Health Expert and the Influenza Pandemic Planning committees and he was Vice-President of the Federal Commission on Vaccination. The WHO Headquarters in Geneva often invite him to serve as chairman to advisory boards, including the Emergency Committee on Ebola.
Industrial Psychologist at Professional Private Consulting
Dr. Marius van Aswegen is a registered Industrial Psychologist with 20 years’ experience in providing professional consulting services in the following areas:
• Expatriate selection, preparation and management during all the phases of the international career life cycle
• Expatriate cross-cultural preparation and in-country expatriate versus local national conflict resolution
• Host-country-specific strategic planning and team building facilitation
• Expatriate and host country national leadership development
Marius provides professional consulting services to various companies such as Standard Bank, the First Rand Group, Vodacom, Goldfields, Accenture, John Deere and WorleyParsonsin the areas of expatriate selection and preparation, expatriate versus local national cross-cultural interactions, and cross-border organisational development. He is contracted with International SOS and Worldwide Travel Medical Consultants (WTMC) in providing psychological support relating to trauma situations.
Marius travels extensively across Africa, and is actively involved with clients operating in countries such as South Africa (inbound expatriates), Nigeria, Uganda, the Democratic Republic of Congo, Tanzania, Mozambique, Cameroon, Angola, and Botswana. Internationally, he also works with clients operating in China, the Middle East, Europe, and Australia.
Infectious Disease Physician at Life Vincent Pallotti Hospital
Helen van der Plas is an Infectious Disease Physician in private practice based at Life Vincent Pallotti hospital for the past six years. After receiving her medical degree from the University of Stellenbosch she specialised in Internal Medicine at the University of Cape Town and subsequently sub-specialised in Infectious Diseases. She obtained a diploma in Tropical Medicine and Hygiene from the University of Witwatersrand. Prior to full time private practice, she worked as an Infectious Diseases consultant for the Division of Infectious Diseases and HIV Medicine at Groote Schuur Hospital and was a senior lecturer at the University of Cape Town. Dr van der Plas has a broad interest in infectious diseases, tropical and travel-related infections and HIV medicine.
General Practitioner at Hout Bay Family Medical Centre
https://www.houtbaymedicalcentre.co.zaMax Winkler graduated from the University of Cape Town and is a general practitioner at the Hout Bay Family Medical Centre in Hout Bay, Cape Town, South Africa, offering travel medicine related advice to travellers in the travel clinic as well as general clinical duties. His fields of interest include infectious diseases, wilderness medicine and occupational health. He is President-elect, the South African Society of Travel Medicine.
Inneke Laenen obtained her MBChB from the University of Cape Town (UCT) and has a background working in primary health care and emergency medicine. She is currently the product manager of Essential Medical Guidance (EMGuidance) where she works with a dedicated team of software developers, designers and medical professionals to craft a product that brings together technological innovation and clinical utility. Inneke is currently also pursuing a Masters degree in Public Health (Health Systems) at UCT. Her fields of interest include health information technology and health systems