Calls for new approach to digital health
Experts are calling for a fundamental new approach to digital technology that promotes equitable, affordable and universal improvements to health.
In a new report, Governing Health Futures 2030: growing up in a digital world, the Lancet and Financial Times Commission stated that digital access and literacy must be recognised as a “key determinant of health” and highlighted the need for bold action to ensure public trust. The experts pointed out that digital transformations can improve health for all people around the world, but this is only possible if digital technology is governed "in the public interest" rather than for private profit, and the health for all values of democracy, equity, solidarity, inclusion, and human rights are put at the core of its design and use.
Digital technologies are transforming all areas of life and health, a trend that has been accelerated by the COVID-19 pandemic, but the benefits of these advances are not reaching everyone equally. The authors highlighted how limited governance, together with the accumulation of data and power by the world’s big technology companies and governments for surveillance, are exacerbating health inequities, eroding trust, and compromising human rights.
The report warns that following the current path of data-extractive, commercially-driven digital transformations, will fail to deliver health benefits to all. Instead, a radical new approach is needed that redirects digital technologies to advance universal health coverage (ie, all people receiving quality health services without incurring financial hardship), ensures that the gains in digital health are equitable, and puts children and young people, who have been exposed to these technologies their entire lives, front and centre.
With access to quality health information and services increasingly reliant on digital technologies and data, the Commission also calls for digital access and digital literacy to be recognised as a key determinant of health, and to ensure that every person has safe and affordable access to the Internet by 2030.
“Digital technologies offer extraordinary potential to improve the health of all people around the world, reduce health inequities, close gender gaps, and protect the most vulnerable,” commented co-chair of the commission, Professor Ilona Kickbusch from the Global Health Centre in Switzerland. “While there is great hype and technology excitement, there has been little focus on broader societal and governance questions.
“For example, how do we protect data confidentiality while simultaneously ensuring that such data is used effectively to benefit public health? How can we address a lack of trust in technology by involving people and communities more centrally in its design and governance? This report must be a wakeup call for countries to overhaul their approach to digital health, laying out a roadmap that governments and societies can use to put essential regulation and governance in place that will result in a healthier, fairer future for all.”
She continues: “Central to the Commission’s recommendations is that the governance of digital technologies should be grounded in the established public health values of democracy equity, solidarity, inclusion, and human rights. Only then can we reach universal health coverage, improve access to quality health services, and more effectively prevent and manage public health crises.”
The Commission emphasised that digital transformations (the integration of technologies into people’s lives) shape our health both directly (via promoting health information or misinformation and the use of digital health and wellbeing tools such as wearables and telemedicine) and indirectly through a wide range of social, economic, commercial, and environmental factors that affect health. For example, social factors such as age and ethnicity, and socio-economic factors such as income and educational levels, influence people’s ability to access health services as well as their exposure to marketing and political messaging.
According to the report, the pandemic has laid bare the extent to which our societies – and their health – depend on digital technologies to function and the power of large providers and platforms.
“The health sector has been behind in leveraging digital transformations,” said co-author Dr. Jeanette Vega Morales from the Chilean National Research and Development Agency. “Only if we use them in the right way will digital technologies allow us to advance towards universal health coverage and more equitable health systems.”
To make real health gains and mitigate potential harms, the Commission is advocating widespread reform to increase public trust, rapidly strengthen the governance of digital technologies and health data, and to develop more equitable tools for healthcare.