Global Digital Health Forum 2023: A changing tide for more localized digital health
By: Laura Kallen, Digital Square Communications Officer
From December 4–6, 2023, 31 staff from 9 countries representing projects across PATH’s digital health portfolio attended the 2023 Global Digital Health Forum (GDHF) in Washington, DC. Over 2,500 in-person and virtual participants attended more than 270 sessions in a variety of formats, including panel discussions, interactive workshops, lightning talks, and poster presentations. PATH staff presented in more than 20 different GDHF sessions.
The forum showcased the breadth and depth of work happening in global digital health—as well as some major shifts taking place to help realign the sector for country ownership and sustainability. Here are some of the themes that emerged throughout the week.
Photo: A selection of the 31 PATH staff in attendance at the 2023 Global Digital Health Forum.
Increasing calls for localization
When countries are in the driver’s seat of their own digital health journeys, digital health systems and solutions are fit for purpose and more sustainable.
“The job is not to just implement and provide global goods. The job is to organize the country for digital transformation.”
Digital Square supports the sustainability of national digital health systems through technical assistance with enterprise architecture adoption, a business-like approach to holistic digital health system planning. Jean Thierry Kalombo, Director of the Democratic Republic of the Congo’s National Agency for Clinical Engineering and Digital Health (ANICNS - DRC), presented a session on the DRC’s digital transformation journey. “Currently, we are working with Digital Square on the enterprise architecture, and this has really been a successful journey so far,” he noted.
Photo: Jean Thierry Kalombo, Director of ANICNS - DRC, presents on the agency’s work with Digital Square to advance DRC’s digital transformation journey.
Public-private partnerships with local service providers will also play a key role in localization. In a workshop hosted by Digital Square, facilitators shared research into firsthand experiences of in-country organizations and local service providers sustaining open-source digital solutions after donor funding ends. Key takeaways from the workshop centered on how the global community can support national health services to better understand the total cost of ownership and advocate for government funding to keep systems operational.
Photo: Vivian Korir, Digital Square Program Manager, presents on DHALP at GDHF 2023.
Prioritizing capacity strengthening
Another crucial piece of localizing digital health systems is capacity strengthening. By connecting ministry staff and IT entrepreneurs in countries with digital health systems training, resources, and networks, ministries of health can help ensure local capacity to build and maintain their digital health systems.
One panel looked at three successful, interlinked capacity strengthening initiatives: the World Health Organization (WHO) Digital Health: Planning National Systems course, the Asia eHealth Information Network (AeHIN) training network, and Digital Square’s Digital Health Applied Leadership Program (DHALP) pilot.
Held in 2022–2023 with 50 participants from five countries, DHALP saw a significant impact on graduates’ digital health leadership skills and confidence. Planning for the next iteration is underway.
Mitigating and adapting to climate change
The climate crisis will touch all aspects of health care. While the urgency of the climate crisis and its impact on global health was the focus of 15 different sessions, speakers pointed out the need for the digital health sector to be more proactive in its involvement. In one panel session, HealthEnabled Director Peter Benjamin noted, “We all realize the climate crisis is a priority, but only about ten percent of us are actually working on projects that are framed around the climate crisis.”
Sessions highlighted how digital health can help with both climate change mitigation (lessening the carbon footprint of digital systems to “do no harm”), and climate change adaptation and resilience. Digital health can implement forecasting systems for diseases affected by climate change and can help strengthen immunization systems to be more resilient against future pandemics.
Image: Dr. Gabrielle Samuel, lecturer at King’s College London, shared a framework for digital health and the climate crisis.
Realizing the promise and risks of AI for health—and the need for regulation
In the past few years, government leaders started to incorporate artificial intelligence (AI) and machine learning into national health systems. These powerful tools have the potential to bridge critical gaps in health coverage, support health workers to make better decisions, and enhance systems such as disease surveillance and supply chains. But, if not carefully implemented, AI could also exacerbate existing health disparities.
In a World Bank–hosted panel, speakers emphasized the need for early warning systems and the importance of codesigning AI regulations with low- and middle-income country stakeholders. Discussion elevated the fact that there are existing health care standards and regulations that AI could fit into. “In medicine, the regulatory bodies that allow medicines to have access to markets are a well-designed system. We need the same for digital systems and especially for AI,” noted Ricardo Baptista Leite, CEO of HealthAI.
Note: Digital Square is committed to careful and ethical implementation of AI in health care. Read more about PATH’s ethical approach to AI.
Smashing the digital gender divide
Photo: Lauren Wall, Digital Square Deputy Director of Capacity Strengthening, led a session using a board game to illustrate decision points, costs and benefits, and long-term implications of gender-inclusive digital health programs.
While tech is a traditionally male-dominated field, the forum made evident that women in global digital health are leading the development of new technologies, driving implementation, and forging connections to further innovation and partnership. Several sessions also emphasized and illustrated the pervasive impact of the gender digital divide—the fact that globally, women are less likely than men to have access to digital tools and technologies.
“Broadband internet access is a social determinant of health. Layer on top of that the gender digital divide—there is this intersection,” noted Dr. Stephanie Watson-Grant, Country Health Information Systems and Data Use (CHISU) Program, at a panel discussion organized by African Women in Digital Health on removing barriers for women’s digital health engagement and leadership. “If we’re not careful and deliberate about diversity and inclusion in digital health systems, we will have a serious problem.”
Ensuring gender diversity, equity, and inclusion in digital health programs requires deliberate planning and funding. Lauren Wall, Digital Square Deputy Director for Capacity Strengthening, led an engaging workshop utilizing a self-designed, interactive board game to illustrate the crucial importance—along with costs and challenges—of explicitly including gender in project goals, planning, stakeholder engagement, and monitoring and evaluation.
Increasing global coordination and normative guidelines for digital health solutions
In 2019, WHO established its Department of Digital Health and Innovation (DDHI) as the global normative body for digital health. In the past few years, the department has launched several new initiatives in partnership with the global digital health community—including Digital Square and PATH—to help drive effective and equitable digital transformation in countries by providing global guidelines, alignment, consolidation, and verification of digital health solutions and investments. These initiatives and their impacts were showcased across several GDHF sessions.
One example of a coordinating resource is the Global Initiative on Digital Health—a WHO-managed network that will consolidate, streamline, and amplify investments in digital health to address challenges, such as “products-focused” digital health transformation. Another example is the WHO SMART Guidelines, a comprehensive set of reusable digital health components—such as Digital Adaptation Kits, which Digital Square helped create—that transform guideline adaptation and implementation to preserve fidelity and accelerate uptake.
These pivotal resources are helping achieve better alignment among country leaders, digital health investors, and innovators. Digital Square is excited to continue working with partners to further develop and disseminate them.
An inspiring week
It was a week of inspiration and new ideas, learning from others and from past failures, frank discussions around needed directional changes, and—most importantly—partnership. Many other important topics in digital health were discussed at GDHF that are not covered here but can be explored on the online platform.
Digital Square remains committed to the enormous possibilities of global digital transformation—for health equity, gender equity, climate change adaptation, and universal health coverage. We look forward to another year of working with and learning from our partners to help realize our shared goal of sustainable, locally driven digital transformation of health systems.