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Experts call for a moratorium on use of new internet domain .health

As the Internet Corporation for Assigned Names and Numbers (ICANN) moves forward with plans to launch health-related generic top-level domains (gTLD), such as .health and .doctor, a coalition of health policy academics and clinicians are raising concerns about a process they say “favor[s] business interests and the generation of profits over the future integrity of the Health Internet.”

In a commentary published in the open access journal Globalization and Health, the authors - led by Tim Mackey of the Global Health Policy Institute – call for a moratorium on use of the new internet gTLD domain .health. They argue that ICANN’s “lack of adequate stakeholder participation and…transparency” has fueled an awards process that disregards the public’s interest in reliable health information in the interest of “contracting .health to the highest bidder.” They note the six-figure application costs and bidding award system make participation in the domain delegation process unfeasible for health care non-profits and that the oversight body has failed to acknowledge concerns submitted by organizations such as the World Medical Organization, the World Health Organization and Save the Children among others.

“Yet while ICANN has chosen to disregard these cautions, it has favored applicants from other sectors including larger corporations,” the commentary explains. “As an example, when ICANN’s Governmental Advisory Committee protested that certain new gTLDs (.wtf, .fail, .gripe and .sucks) could be wielded against businesses by angry customers – no corporation ever wants to see – ICANN singled these out for “special safeguards” and suspended further plans.”

Tim Mackey says: “Despite the growing importance of health information online, little is known about the characteristics of health-related generic top-level domain applicants. What is clear, however, is that several privately held, for-profit businesses, many of which are completely unknown to the public health field and have no such expertise, are actively seeking or have already been awarded these new health domains and propose few if any needed restrictions on future use.”

As the commentary explains, the decisions ICANN is making today will determine the future of the “Health Internet.” Putting health-related gTLDs into the hands of domain registrars whose only incentive will be to maximize profits by auctioning sites to the highest bidder, means the future web could easily see:, owned and administered by tobacco companies and unscrupulous vendors operating to lure vulnerable patients.

As a way of addressing these issues, the authors call for an immediate moratorium on the use of .health and other health-related generic top-level domains. They also encourage ICANN to enter into active consultation with members of the global public health community.

“Were ICANN to agree to this moratorium, we would recommend the formation of an expert working panel comprised of a diverse set of eHealth stakeholders to constructively discuss the appropriate role and governance of generic top-level domains to ensure universal access to quality health information online. This includes discussion on consumer privacy and protection, methods of assurance and verification of quality/trusted health information, proactive prevention of online fraud and abuse.”

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Notes to Editor 

1. Commentary

A Call for a Moratorium on the .health Generic Top-Level Domain: Preventing the Commercialization and Exclusive Control of Online Health Information
Tim K Mackey, Gunther Eysenbach, Bryan A Liang, Jillian C Kohler, Antoine Geissbuhler and Amir Attaran
Globalization and Health 2014, 10:62

Article available at journal website here.

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