A Transform Health Statement in response to the G20 Health Ministers’ Declaration
When G20 Health Ministers met on 5 and 6 of September in Rome, they must have felt the weight of history hanging on their shoulders. Never has health been higher on the public and political agenda, never has there been such a moment for Health Ministers to show leadership and stake out a pathway from the current crisis and towards a future that guarantees health for all by leveraging digital technologies and data. Never has there been such an opportunity to rethink the way we approach health, to learn from and to deepen the digital transformation of health systems and to use data in more effective ways to ensure the Sustainable Development Goal of Universal Health Coverage is met by 2030.
The G20 Health Ministers’ Declaration did make lofty references to the need for “transformative resilience” and did acknowledge the need to “foster innovative gender-responsive approaches using digital technologies and other innovations, in a way that protects personal health data, to improve access, monitoring and real-time support, and to provide better quality, more personalized, and specialized health services”.
Never has there been such an opportunity to rethink the way we approach health, to learn from and to deepen the digital transformation of health systems and to use data in more effective ways to ensure the Sustainable Development Goal of Universal Health Coverage is met by 2030.
The Declaration goes on to recognise the benefits of “further integrating digital health, including through: improving health information systems and information exchanges in a way that respects patient privacy; enhancing data analysis and reporting mechanisms; by encouraging and supporting the interoperability of digital health tools; by reinforcing the adequate training of the health workforce to strengthen health system capacity and investing more in improving health literacy to address the epidemiological vulnerability created by health and social inequities and inequalities and for supporting equitable access to health services for all people throughout the life course.”
Health Ministers also recognised the importance of data and committed to “improving rapid and transparent research, data, information and material access and sharing, in line with applicable laws and regulations at the national and international levels, necessary to prevent, detect, and respond to future potential health emergencies.” Further, Ministers recognised the regulatory barriers – a consequence of WTO rules – to the effective operation of global supply chains for essential medical goods.
Transform Health believes that the obstacles posed by nonexistent, inadequate or inappropriate regulation is one of the main stumbling blocks to the sustainable adoption at scale of digital technology and the use of data for public good that will deliver UHC by 2030, especially in low and middle income countries. Unless governments develop effective regulation, legislation and policies, as well as funding modalities to enable digital technologies to be fully integrated into health systems, then we will continue to see a widening digital divide exacerbating, rather than alleviating, persistent inequities in health. Transform Health is calling on G20 leaders to start addressing the enabling environment that will equitably deliver the transformations promised by digital technology and data, by spearheading and supporting a systematic review of the current legislative landscape, particularly in low and middle income countries.
Transform Health believes that the obstacles posed by nonexistent, inadequate or inappropriate regulation is one of the main stumbling blocks to the sustainable adoption at scale of the digital transformation of health.
Health Ministers recognise the important role of the health workers. The Declaration mentions the need for more workforce training (paragraph 23) but this needs to be accompanied by changes in the incentive structure to ensure adoption of digital technologies that will allow healthcare workers at all levels, and particularly frontline health workers to work more effectively and in a more integrated manner using digital tools. This is especially important in contexts where there are severe shortages of health workers. While digital technologies can and should never replace or be an excuse for underinvestment in the recruitment and training of health workers, they are an effective means to bridge a gap and can help extend access to, quality and affordability of care.
Transform Health urges G20 health ministers and heads of state to commit to greater investment in and support for the digital transformation of health systems and the effective use of data to achieve UHC, as well as strong and fair policies that will ensure equitable benefits for all. In a world that is increasingly digital-first we cannot ignore the risks of a growing digital divide in health which is exacerbating existing health inequities.
‘Transformative resilience’ can only be achieved through the effective use of digital technology and data. G20 countries themselves have made great progress recently in digitalising their own health systems. Examples range from India’s National Digital Health Mission, the establishment of the Digital Transformation Office (DTO) by the Indonesian Ministry of Health, Saudi Arabia’s E-Health Strategy and 5 year Roadmap, France’s Health Data Hub, Brazil’s Digital Health Strategy, and South Africa’s Health Patient Registry System.
What is needed now is a concerted effort to work together to ensure all countries and regions are able to bring their health systems into the digital age, and to develop the necessary normative frameworks that will allow these digital technologies to flourish and deliver for everyone. The first step is a global agreement on the use of health data as a means of establishing a new social contract between people and governments that will create the needed trust required for people to be willing to hand over their health data and data for health in service of the greater public good. To achieve this G20 Health Ministers need to support the creation of a global health data governance framework at next year’s World Health Assembly that will enable them to translate their recognition of an urgent need into concrete action.
What is needed now is a concerted effort to work together to ensure all countries and regions are able to bring their health systems into the digital age, and to develop the necessary normative frameworks that will allow these digital technologies to flourish and deliver for everyone.
The current G20 Health Ministers’ Declaration highlights Health Ministers’ awareness of major health issues of our age and the importance of addressing them. This is a good first start – however, awareness alone will not deliver the urgent changes we need to see to ensure the world is able to meet its UHC target by 2030. That can only be achieved by working together to ensure the accelerated adoption of digital technology and the effective use of data to enable health systems to deliver for everyone.