May is a month filled with several international gatherings in Geneva, but 2024 was an unprecedented year that surely challenged the city’s hospitality industry. With the usual hosts like the Geneva Health Forum, WSIS+20 Forum, AI For Good and the World Health Assembly (WHA) to new convenings such as Geneva Digital Health Day – health enthusiasts were faced with a plethora of events, convenings and roundtables focused on advancing health in a digital era.
From these convenings, I have compiled a list of the habitual offenders or points that need remembering now that you may be back to business as usual and as we look towards the next convening in September at the Summit of the Future.
1. The digital transformation of health is improving the accessibility of health services but this must be coupled with initiatives that support digital, health and civic literacy
Improving accessibility to health services through digital technologies is well accepted but throughout different discussions, more experts at the global and grassroots level alike pushed for strengthened literacy alongside the uptake of digital solutions. This need for improved literacy spans from users and patients to healthcare providers. In an event hosted by UHC2030 entitled, Accelerating progress towards universal health coverage: dialogue between Parliamentarians, youth and civil society, panellists agreed that digital is a powerful tool that can improve accessibility to health information and services but if these services are not well known nor do the tools and skills exist to appropriately use them then services will not be utilised to their full potential.
In October 2021 The Lancet and Financial Times Commission on Governing health futures 2030’s report highlighted the interconnections between digital literacy, health literacy and the broader democratic and civic literacy skills arguing that none of these skill sets can be expressed effectively without the other in a digital age. In the partnering document to the Commission report, the Youth Statement and Call for Action, young people alike called on stakeholders to build and expand youth’s resources, skills and opportunities to foster innovation, trust and equitable uptake of digital health skills.
The DTH-Lab is co-designing a toolkit with young people that aims to improve the digital, health and civic literacy of young people based on their asks. The DTH-Lab recently launched a brief on digital health citizenship and a survey to assess young people’s perception of digital health citizenship to support the co-creation of desired health outcomes, promote youth leadership and support a generation of informed and enfranchised digital health citizens. Through a series of intergenerational dialogues, data gathering and youth led workshops, the toolkit will aim to meet young people where they are to improve the knowledge and skills needed to ultimately improve their health and well-being.
2. The digital transformation for health depends on the contextualisation of solutions
In an interesting intervention shared during the Geneva Digital Health Day, ICRC shared a key message of the need to contextualise digital health solutions to the country and community level to uphold ethical considerations. In the example shared, telemedicine services were established to connect physicians to patients living in crisis situations. However, the established VPN was not secure enough to provide services without putting patient data at risk. By contextualising a digital solution they were able to avoid risk and potential harm. Elaborating on a successful digital health activity that promotes equity through strengthened contextualisation, Javier Elkin, Head of Digital Health at ICRC shared the impact of the Digital Center Management System and what can be possible when adhering to strict protocols and contextualising digital solutions, particularly in the context of conflict areas.
Currently, the DTH-Lab is rolling out a series of regional and country level workshops with young people to gain more concrete asks and proposed solutions on how digital first health systems should be designed while accounting for the diverse contexts of young people. This process aims to improve the representation of diverse asks from young people but also to inform a blueprint that will set out young people’s vision for digital first health systems and guide different actors—from policy makers to technology companies—on the steps required to make this vision a reality.
3. From physicians to community health workers - the health workforce has a role to play in the uptake of digital in health
The health workforce does have a role to play in rolling out digital health solutions but to what extent and in what capacity made for interesting debate at this year’s youth pre-WHA hosted by the International Federation Medical Students Association (IFMSA). Molly Pugh-Jones from the Digital Health and Rights Project (DHRP) and myself co-led an interactive discussion with the future health workforce on, “Health in the Digital Era: A human rights-based approach to digital technologies to achieve UHC”. A key takeaway was that medical students have a shared excitement yet lingering concern about applying digital health solutions in achieving health for all. Due to the vast spectrum of digital health solutions that currently exist some medical students are still grappling with digitising medical records whereas others are considering AI approaches to improving the mental health and well-being of future patients.
The digital transformation for health must first meet the communities and providers where they are. The range of diverse concerns health care providers face poses different barriers and challenges in rolling out solutions that need to be better accounted for.
Furthermore, other members of the health workforce must be considered when designing and deploying these digital solutions for health. Several references were shared this year in relation to the importance of the community health worker (CHW)- often women and oftentimes youth.
In an interesting presentation during the Geneva Digital Health Day, Kushi Baby shared the importance of empowering CHW with digital tools and knowledge to improve community level health and health promotion. This was also echoed in a presentation by Kelin during a Transform Health’s session on, “Optimising digital health investment to deliver UHC”. There is often a strong reliance on CHW but their training and pool of resources are not always matched nor is the financial backing from the government properly reflected.
Currently, the DTH-Lab is working with various partners including IFMSA, the International Pharmaceutical Students Federation (IPSF), the Global Health Workforce Network Youth Hub at the WHO and PATH to ensure the diverse needs of the health workforce are reflected in its thinking and included in its work. Activities aim to support improved skills, capacity and leadership in working within digital first health systems.
4. The digital transformation of health for action and solutions - meeting the unmet needs
Digital technologies and AI alike must strive to meet the unmet needs of public health if they are to contribute to achieving Universal Health Coverage (UHC). In a High-level Strategic Roundtable on AI at the WHA, the Director General’s analogy of a knife and AI were memorable. AI is a tool similar to a knife and we don’t stop using knives because they can do harm but what matters is how we use them. Dr Tedros went on to say that digital health and AI are strategic priorities for the WHO as they are committed to supporting member states to highlight its benefits and protect people from its risks.
Launched in 2023, the Global Initiative on Digital Health is a network of networks dedicated to supporting digital health transformation in countries worldwide. The DTH-Lab and the GIDH Secretariat at the World Health Organisation co-hosted a stakeholder meeting in advance of the WHA for Geneva-based partners working at the intersection of health and digital governance. In the meeting statement launched in April of this year, attendees urged heads of governments that digital transformations intentionally contribute to, and do not undermine, health futures for all.
The DTH-Lab with the Digital Health and Rights Project co-hosted a side event to the WHA entitled, Achieving UHC through an inclusive and rights-based digital transformation. In a series of fireside chats, stakeholders in the global health governance ecosystem discussed key issues impeding the achievement of the Sustainable Development Goals (SDGs) including digital divides, meaningful participation of young people and the governance of AI and digital technologies for health. Members of the DTH-Lab Regional Youth Champion cohort and DHRP youth network shared a video calling on policy makers to address their health priorities through improved action.
Using technology for the sake of using it is long in the past. These tools must have a vision of meeting the unmet needs of the population if they are to create a positive impact.
5. Intergenerational and cross sectoral partnerships and financing
Although a usual suspect at such convenings, the call for partnerships and collaborations that span sectors and generations was seen more than just heard. Representation from the private sector to civil society organisations (CSOs) was witnessed on most panels with a big win for the noticeable attempts of young people being meaningfully included. There were 16 youth delegates from the country level attending this year’s WHA, double since 2022. Coupled with delegates from youth-led organisations including members of the WHO Youth Council, the Palais felt more generationally balanced than it had previously.
In addition to a more inclusive spirit in and around the WHA, the WHO investment case launch sat centre stage of this year’s WHA. To fundraise a gap of $7.1 billion in advance of implementing the WHO’s strategy for global health 2025-2028, the General Programme of Work (GPW 14), WHO’s member states made several pledges including Ireland’s Minister of Health Stephen Donnelly’s commitment to additional flexible funds.
In Ireland’s statement to the WHA, the country is expanding services in physical and mental health and is concerned about the “profound harm” being caused to so many young people by social media platforms. With Ireland’s recent launch of “Digital for Care – A Digital Health Framework for Ireland” coupled with their financial pledges and commitments to young people’s health and well-being in the digital space, hope for a possible resolution on the impacts of young people’s use of digital technologies at the WHA in 2025 doesn’t seem too far off.
The DTH-Lab is currently conducting research on the digital determinants of health (DDoH), a relatively new concept that refers to the direct and indirect ways in which digital transformations impact equity in health and well-being. With a particular focus on exploring the benefits and risks of digital, the Lab is also generating new knowledge and evidence on how digital determinants intersect with other determinants to impact health and well-being and why they ultimately require new forms of governance. To address critical evidence gaps, the DTH-Lab is partnering with organizations in India and Nigeria to study young people’s experiences of digital determinants in different contexts. Currently, the Lab is facilitating research and thought leadership on this issue through a Lancet series on the DDoH and a special issue in Health Promotion International.
Final thoughts
Although digital was not on the WHA agenda this year, it was far from absent. As we look to the next global convening of states at the Summit for the Future in September, I am hopeful that the discussions will be a better reflection of the relationship between the digital transformation and health than what has so far been shared in the current zero drafts.
Below are five proposed recommendations to inform the Summit of the Future in creating shared action to achieve health for all in a digital age:
As we make our way to 2025, just five years away from the SDGs, a lingering reflection of what next May could bring is a challenge to the traditionalist perspective of achieving UHC – what does health for all look like when the digital transformation offers many promises but transcends borders? Possible food for thought until the global health community reconvenes in Geneva next time.
Whitney Gray is the Youth Engagement Coordinator at the Digital Transformations for Health Lab. She has a degree in pre-medical biology and medical ethics and holds two Masters degrees in Public Health and International Affairs.
Whitney Gray is the Youth Engagement Coordinator at the Digital Transformations for Health Lab. She has a degree in pre-medical biology and medical ethics and holds two Masters degrees in Public Health and International Affairs. Ms Gray’s experience includes biomedical research, health systems strengthening, global health governance and civil society engagement. With a longstanding desire to advance the health and wellbeing of all, she works to improve the inclusivity of actors in the design and implementation of research, policy and solutions for health.
