The digitalisation of health care is putting Health For All within reach, but additional technical and socio-political investment is required to bring it firmly into the world’s hands
As with other aspects of digitalisation, the transformation of health care is well under way, and has been turbocharged by the Covid-19 pandemic. Data-driven approaches are increasingly being introduced or aspired to in operating health systems in developed and developing countries alike, increasing the availability of health data.
The potential benefits are exciting – from improving medical research to informing effective policymaking and budgetary allocations for more efficient health response systems. But the risks and dangers are just as important to reflect upon and mitigate right from the start. These are not only technological, but also political.
To illustrate, although scientists were able to sequence the genetic code of the SARS-COV-2 virus at an unprecedented speed thanks to the technical abilities to share the data, the benefits of this technological feat have not been equitably distributed, despite citizens in developing countries participating in the clinical trials that made the vaccine rollout possible. As well, the emerging technologies applied in health care are already driving discrimination and inequities in health outcomes, right from the information realm where misinformation and disinformation have been runaway challenges to the nascent digital health infrastructure in which, for instance, algorithms trained to use health-related expenditure as a proxy for health needs concluded that Black patients are healthier than white patients because white patients spent less on health care.
These are not mere exceptions; they are a timely reflection on the need to bypass technological solutionism and situate digital transformation within the complexities of a politically, economically, socially and culturally unequal world.
Health data governance
Thus, to further realise the transformative potential of digital technologies for healthcare systems, and the resulting data generated, it is imperative that stakeholders centre policy and governance, along with technological innovation and requisite investments, on influencing the determinants of success and minimising harms. How health data are generated, processed, analysed, stored and reused is both a technological and political challenge. This is why health data governance ought to be on the international policy agenda. The guardrails required to govern the collection and use of health data must be updated to keep pace with the digital innovations that will inevitably demand and generate more data. However, this health data economy will need to protect the rights of individuals and communities, even as the data are used for public health. In an age of digital interdependence, health data governance frameworks must reflect the diversity of norms the world over. They must buck the trend of global governance approaches taking a ‘West to rest’ model, where decisions are made in Western capitals and focused on Western contexts, and then exported to the rest of the world.
Building new solutions
The digitalisation of health care has excited many people, especially since the Covid-19 pandemic began. In developing markets such as Africa, digital technologies present an opportunity to not only digitise health systems, but also to build new solutions that benefit from the potential of digital tools. Innovation is often invoked; indeed, we need innovations to drive the achievement of universal health coverage by 2030, and in a digital age. However, innovation is needed on both the technical and the socio-political front. To fully leverage the potential of digital technologies towards universal health coverage, the investments needed for health systems is an equally important innovation as any emerging technology. Be it the mobilisation of domestic or international funding, investments into providing health care in a digital age need to be coordinated, and they must factor in how to ensure the equitable, inclusive and sustainable digital transformation of health systems, aligned with the national plans and policies of countries.
The prospects of Health For All in a digital age are within reach. We will do well to invest both technically and socio-politically to ensure that we inch closer to universal, equitable and sustainable health systems everywhere in the world.