On 31 January 2020, more than 20 people from 16 international organisations and NGOs convened at The Graduate Institute, Geneva for a two-hour dialogue about digital health moderated by Ilona Kickbusch, Co-chair of The Lancet and Financial Times Commission Governing health futures 2030: Growing up in a digital world.
This dialogue is the second of its kind – a follow-up to a meeting with international actors in Sept. 2019 — and provided an opportunity for participating organisations to discuss how their digital strategies incorporate health and well-being. Organisations included FIND, Foraus, ICRC, I-DAIR, IFRC, ITU, NCD Alliance, OECD, PATH, PMNCH, UNAIDS, UNDP, UNICEF, WEF, WHO, and the World Bank.
Commissioner Andrew Wyckoff, Director for Science, Technology, and Innovation, and Health Policy Analyst Tiago Cravo Oliveira Hashiguchi from OECD opened the dialogue with a presentation of work in 36 member countries, highlighting how OECD considers digital transformation across sectors, from tax and public affairs to education and health.
“Enhancing access to digital systems requires coherent and self-reinforcing strategies across many policy areas,” said Wyckoff. “As time progresses, the dominance of ‘digital natives’ will resolve some issues that plague effective use, but, given the speed of change, we will still face a training and upskilling challenge.”
OECD identified big data as the thread running across all sectors, as both a source for good and a risk to privacy, human rights, and equity. While there is interest in how data and digital technologies can support patients and policymakers, there are substantial limitations for health budgets and information management, coupled with regulatory uncertainty, issues of access and digital literacy, and concerns about possible stigmatisation or marginalisation of certain populations.
“Health is data rich, but information poor,” said Cravo Oliveira Hashiguchi. “This should not be read as discouragement; it’s a measured reading of where the richest countries in the world stand today, despite the high expectations surrounding digital health. Political leadership and bold policy reform, including an overarching strategy, governance framework, and human and institutional capacity, are necessary to overcome key barriers.”
OECD’s presentation kicked off a roundtable discussion on how international organisations can collaborate across their projects, with Member States, and with partners to identify and shape a vision and maturity model on which entities can plan and track their digital transformation progress. Participants indicated that governance, standard setting, interoperability, data sharing, sustainability, and the preservation of intellectual property were of high importance. However, the political economy and industry-led response to these areas pose challenges.
All participating organisations signalled a call for streamlined negotiation of these challenges, stressing the importance of person-centred design that takes into account human rights, dignity, and equity, and includes the contribution of multilateral stakeholders with stake in good health and well-being outcomes.
“We are all working with the same communities and partners on the ground to support the provision of quality healthcare services,” said BP Panwar, Technology for Development Business Analyst with UNICEF. “With many existing digital health systems operating independently, with different standards and frameworks, we are missing opportunities for collaboration and interoperability. It is advisable to make it mandatory to register all initiatives to avoid duplication. It is better to have one complete modular solution for multiple problems than multiple ad hoc solutions for the same problem. We need to have core system strengthening approach in place.”
The Commission plans to convene international organisations biannually to continue to share knowledge and inform a cohesive response to the digital transformation.