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Back To Vidyya WHO Proposal Would Raise Quality Of Internet Health Information

Dot Health Could Soon Be As Well Known As Dot Com

People seeking health information on the Internet will get a higher standard and faster results under a bold new World Health Organization (WHO) proposal. The initiative aims to cut a direct path through the Internet maze, making it much easier for users to find the accurate and reliable health information they need.

WHO has proposed the creation of ".health" to join the small group of Internet top-level domains (TLDs) such as ".com" and ".org" that currently help users locate websites in their chosen field of interest.

The Internet Corporation for Assigned Names and Numbers (ICANN) says that more TLDs are needed urgently to cope with the Web’s rapid expansion, and has recently invited all interested parties to submit new TLD proposals for consideration.

ICANN has the authority to prescribe the means by which TLDs are added to the system which allows users to locate computers on the Internet by a name.

This week ICANN meets in Los Angeles to review a host of such submissions. Many national and international health groups have expressed support for the WHO proposal and are hopeful that ".health" will be approved.

"The Internet has become a vital tool for individuals, families, the health profession and the health industry. WHO is the safe pair of hands that Internet users need to help them navigate their way through a mass of often complex and sometimes conflicting health information," says Dr Joan Dzenowagis, the main formulator of the WHO proposal.

"We want – and need - to raise the standard of information about health that gets placed on the Internet, and improve people’s trust in it. As the recognized leading international agency in health, and with over 50 years’ experience in setting standards, WHO is uniquely qualified to do this. Moreover, we also want to draw on the expertise of the many other groups already active in health," Dr Dzenowagis says.

At present there are more than 10,000 health sites on the Internet. Users have no easy way of finding their way through them, nor can they be sure about the accuracy or reliability of the information. There has been no way of making information providers adhere to any code of practice. If the proposal is accepted, WHO, as the sponsoring organization, would have the responsibility to set policy on how the ".health" TLD - is distributed and used.

WHO’s intention is that ".health" will immediately identify the domain-name holder as adhering to agreed quality and ethical standards, thereby instilling confidence and security in the information provided. Such standards would emerge from international consultations WHO would initiate with governments, medical associations, consumer groups, the health industry and others.

WHO Top-level Domain Proposal Overview

This overview summarizes the main elements of the detailed technical proposal.

The Internet Corporation for Assigned Names and Numbers (ICANN) adopted a policy for the introduction of new Internet top-level domains (TLDs) in July 2000. The World Health Organization (WHO) has proposed that a sponsored, restricted top-level domain called ".health" be created, to improve and promote health information quality on the Internet.


Recent years have seen explosive growth in public health and medical information on the Internet. Finding useful and valid information on the Internet can be difficult because of the speed and lack of structure of the accumulating body of information. While filtering tools such as directories, indexes and search engines are widely used, locating information is only a starting point, after which users must decide on its quality and utility.

Many users rely on resources that rate web sites that provide information and products. Others rely on "trust-marks" or a seal designating that the site abides by a given standard. Problems with these approaches have been that 1) ratings can never be complete nor comprehensive and depend heavily on the tools used, and 2) adherence to trust-mark standards cannot be enforced.

Various national and international groups, including WHO, have been struggling to find a way to ensure the quality of health information given the problems of sheer information volume as well as the undesirability and impossibility of regulating Internet content. Holding information providers to any standard has not been an option until now, when the possibility arises of restricting the use of ".health" to content providers who will voluntarily abide by established quality and/or ethical standards.

Top-level domains

The Internet Corporation for Assigned Names and Numbers is a private sector, not-for-profit corporation with the authority to prescribe the means by which new TLDs are added to the Internet Domain Name System (DNS), the system which allows users to locate computers on the Internet by a name. The DNS, which was introduced in the mid-1980s, is a distributed database containing resource records that allow mapping between computer names and numerical addresses.

The DNS has a hierarchical structure, with each name composed of a series of "labels" separated by dots. The last label in a name refers to the top-level domain (eg ".int"); each top-level domain can be subdivided into second-level domains (eg "") and so on. For technical reasons, the operation of each TLD is delegated to a single organization.

For the first time since the 1980s, new TLDs will be introduced, according to a careful process designed to maintain the stability of the Internet. The process is intended to be a well-controlled, small-scale introduction as "proof of concept" to evaluate the feasiblity and utility of a range of different types of TLDs and their impact on the DNS. ICANN has accepted proposals from organizations and individuals for new TLDs. These proposals will be subject to a technical review and public comment, after which TLDs will be selected for more detailed negotiation and implementation.

New TLDs may be restricted or unrestricted. A restricted TLD refers to a TLD with rules on who may apply for a registration within the domain, and what uses may be made of those registrations, or both. The Sponsoring Organization for a restricted TLD has the responsibility to set policy regarding how the TLD is distributed and used. The Sponsoring Organization also chooses the Registry Operator, the entity that is responsible for the actual operation of the registry for the TLD.

Based on consultation and feedback received over the past few years and WHO's own experience, it is clear that a sponsored, restricted ".health" TLD, rather than an open and generic TLD, could enhance the credibility of information provided for public and personal health. Policies governing the TLD distribution and use could ensure that information providers using this TLD abide by specific standards.

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Editor: Susan K. Boyer, RN
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