Reflections by Mathilde Forslund & Kirsten Mathieson at Transform Health in preparation for UNGA78

The 78th session of the UN General Assembly (UNGA78) is set to commence on Tuesday, 5th September 2023, with the high-level week kicking off on the 18th. This year’s UNGA will focus on global solidarity to accelerate action on the 2030 agenda and the Sustainable Development Goals towards peace, prosperity, progress, and sustainability for all. Concurrently, a High-Level Meeting on Universal Health Coverage (UHC) will take place on the sidelines of UNGA78 on 21st September with the theme ‘Expanding our ambition for health and well-being in a post-COVID world. 

The outbreak of COVID-19 acted as a catalyst, compelling governments across the world to intensify their usage of digital health tools, technologies, and solutions to tackle public health issues. During the pandemic, and increasingly in the post-pandemic world, we saw the immense potential offered by digital health and data-led solutions to enhance delivery of primary healthcare and accelerate progress towards UHC by 2030. 

This year’s UHC High-Level Meeting will be a pivotal moment and platform to ensure digital health is prioritised as a key driver to achieve UHC by 2030. Building political consensus and an enabling environment for digital health transformation are critical. And as we undertake this transformation, we must ensure that equity and human-rights are at the forefront of the digitisation of health systems, ensuring that we are reducing disparities and leaving no one behind, particularly the most marginalised and neglected communities.  

Transform Health – a global coalition of 150+ organisations – participated in the multi-stakeholder hearing on UHC convened by the President of the United Nations General Assembly in May. The hearing provided a platform for a diverse set of stakeholders to express their aspirations for the Political Declaration, which is set to be endorsed by world leaders at the 2023 UHC HLM. Transform Health underscored the vital role of equitable, inclusive, and sustainable digital transformation of health systems to achieve health for all. 

While the zero draft of the Political Declaration that came out following the multi-stakeholder hearing included reference to digital health, it was framed more as a vertical health intervention. The Declaration didn’t go far enough in recognising the transformative potential of digital health as an integral part of all health systems and an accelerator of UHC progress. Transform Health issued recommendations on the zero draft, stressing the need for greater prioritisation of digital health, stronger health data governance, and increased and better-coordinated funding for digital health transformation. 

We welcome the zero draft of the Political Declaration on UHC that was published in July, following negotiation by Member States. The latest draft emphasises ‘Innovation & Digital Health’, however, we feel that greater prioritisation of digital health as a key accelerator to achieve UHC by 2030 can still be strengthened, while highlighting concrete actions for Member States and other stakeholders to take this agenda forward.

As governments meet at this year’s UNGA, including the High-level meeting on UHC, we urge them to make bold commitments to deliver health for all. In the digital age, this means going beyond the status quo, recognising the transformative potential that digital and data-drive solutions offer. Transform Health is calling on governments and other stakeholder to: 

1. Prioritise digital health transformation as a cross-functional enabler and accelerator to achieving UHC by 2030, rather than a siloed vertical health issue.
2. Champion health data governance and call for the development of a global framework to establish a set of common regulatory standards (for subsequent endorsement by governments at the World Health Assembly in May 2023), to strengthen national legislation and regulation and govern health data sharing across countries.
3. Ensure a global health data governance framework is developed through a transparent and inclusive multistakeholder process (with the meaningful engagement of civil society) and underpinned by equity and rights-based Health Data Governance Principles. We call on governments to endorse the Principles, which provide a foundation for the development of a global framework and should inform national legislation, regulation and policies.
4. Increase and better target funding for digital health, to support the equitable, inclusive, sustainable digital transformation of health systems, as part of wider health system investment to deliver UHC. Ensure funding is coordinated and aligned with national priorities.
5. Develop national costed digital health strategies as an integral component of UHC and health system strengthening agendas. Strategies should be developed, implemented and monitored in an inclusive and participatory manner, with the involvement of all relevant stakeholders.
6. Establish a strong national regulatory and policy environment to guide the digital transformation of the health system so that it is inclusive, equitable and sustainable. This is important to establish what kind of digitalised health system a country needs to achieve UHC.
7. Strengthen mechanisms for meaningful multi-stakeholder engagement at all levels of planning, strategy, execution and monitoring to ensure the digital transformation is effective in improving health outcomes and accelerating UHC progress. This must include the meaningful engagement of civil society, youth, women and marginalised and hard-to-reach communities.
8. Close the divide in digital access, prioritising strategic, targeted and coordinated actions to ensure this happens. This is a prerequisite for equitable access to technology-enabled health services. This means confronting coverage gaps, affordability and digital literacy.

Join us in New York by participating in our side event: Transform Health and partners are convening a high-level discussion on the Global Initiative on Digital Health and country resource portal, and how we can better optimise investment and alignment to accelerate UHC progress. Visit the event page for more details and to register your attendance by the 13th of September. Get in touch to schedule a meeting and learn more about Transform Health.

In its report Closing the digital divide: More and better funding for the digital transformation of health, Transform Health highlighted the lack of publicly available information on current funding levels and gaps in domestic and external funding for digital health, particularly for low and lower-middle income countries. 

As part of a new Global Initiative on Digital Health (GIDH), the development of a digital health resource portal is currently under consideration with the aim of optimising investment and alignment with country priorities. Working with WHO and the G20, Transform Health is facilitating a multi-stakeholder consultation to inform the development of the resource portal, including carrying out an online survey and key informant interviews to gather initial insights ahead of the final G20 Health Working Group and Health Ministers’ meeting in August 2023.

Further consultations will take place over the coming months to allow for in-depth discussions to help shape the portal, ensuring it responds to the needs of users and to build wide stakeholder buy-in. 

Key perspectives from the consultation so far:

So far, 34 organisations have shared their views on the potential uses, audience, scope and functionality of the portal. They represent civil society; implementing / technical partners; intergovernmental organisations; multilateral donor agencies; academia; and private foundations. Here is what they told us:

1. A portal to track investments in digital health will help to address several challenges

Stakeholders support the creation of a portal to track financial investments in digital health as part of the GIDH. Survey respondents and key informants felt that a portal— which must build on and align with existing tools and health investment tracking efforts—could help to address a range of challenges currently facing governments and other actors in the digital health ecosystem, including:

• Lack of transparency about current and projected levels of digital health financing.
• Missed opportunities to match available resources to funding needs and country priorities.
• Lack of knowledge about funding gaps for different areas of digital health transformation. 
• Fragmentation and duplication in donor financing.
• Inconsistencies in tracking and reporting on digital health investments.
• Weak understanding of donor priorities, grant cycles and funding processes.
• Insufficient timely information to support future strategies, budgets and assessments (e.g. on unit costs, cost effectiveness, return on investment, impact of interventions, etc).

By making information about digital health financing more accessible, stakeholders believe that a portal will assist governments, donors and the private sector to make more impactful investment decisions, fill funding gaps and increase accountability. 

2. A range of users and uses must be considered for the portal and involved in its development 

Consulted stakeholders agreed that a portal will be of particular use to governments from low and middle-income countries (LMIC) who are facing significant financial barriers to implementation of their digital health strategies. Representatives from LMIC governments and their partners should therefore play a major role in the design and testing of the portal. 

In addition to governments, other potential users of the portal identified were civil society and communities; donors (bilateral, multilateral and philanthropic); the private sector; implementing partners; and research and academic institutions. Each stakeholder group is likely to have slightly different information needs and expectations from the portal. A fully inclusive process involving each of these groups in developing the portal—and other aspects of the GIDH—will help to ensure that these are met as far as possible. Involving as many stakeholders as possible will also enable lessons to be learned from previous efforts to track investments in other areas of health. 

3. A portal should bring together information on different sources of investment in digital health transformation 

When asked what kinds of information should be included in the portal, survey respondents indicated that they would be keen to see different types of information collected and presented, including:

• Government (domestic) funding commitments and allocations for digital health transformation 
• Donor pledges / funding commitments and allocations for digital health transformation 
• Detailed information about digital health transformation investments (e.g. programme descriptions, areas of investment) 
• Compilation and summaries of costed national digital health strategies 
• Details of available resources versus total funding needs to implement national digital health strategies (funding gaps) 

Many respondents expressed a desire to have a single online portal that brings together information on financial investments with information on countries’ needs and country-enabling resources. It was suggested that a ‘one-stop shop’ would be helpful for both countries and development partners to better understand the environment and context for future investments and to learn from past investments. 

4. Tracking investments in the foundational pillars of digital health transformation must be a priority

Many stakeholders expressed their desire for the portal to support countries in moving away from a project-based approach to digital health, towards implementing a more holistic and sustainable approach to digital health transformation. In addition to tracking investments in different types of digital health interventions, the portal should support better prioritisation, reporting and analysis of investments in the foundational building blocks for digital health transformation. This will help countries and donors identify opportunities to increase investment in these critical but often underfunded areas. 

5. The portal should be designed to help to inform decision making

Respondents broadly agreed that a portal should be more than just a monitoring tool and include components to help with benchmarking, analysis and learning to inform future decision making and resource allocations. 

In addition to tracking funding flows at national and sub-national levels, potential portal users wanted to be able to see how funds were used and what impact investments had. This kind of information would help stakeholders to better understand what works and what should be scaled up. Users should be able to put a country’s financing information into context by cross referencing it with information about, for example, digital maturity and the broader health, economic and political landscape. 

6. Data collection and verification challenges will need to be addressed

Whilst stakeholders were enthusiastic about a portal, many believed that it could be challenging to populate and maintain it. The majority of organisations surveyed do not currently have a system in place to track digital health investments. Digital health transformations are often invisible within programmes and there is currently no system for governments or donors to report on investments in digital health transformation (i.e. through National Health Accounts or the OECD-DAC). 

Respondents agreed that it will be important for governments, donors and other stakeholders to agree on a set of categories for investments in digital health transformation. The WHO/ITU eHealth building blocks and WHO classifications of digital health interventions were both considered as the ideal starting point for this exercise.  

To ensure the portal is both effective and widely used, different stakeholders will need to be incentivised to share accurate and relevant information on a regular basis. Its value proposition will need to be clearly communicated and the data within it will need to be trusted and objectively verified. Respondents agreed that contributing data to the portal should not place unnecessary burden on countries or donors. 

Recommendations for the way forward

Transform Health recommends that G20 leaders, WHO and other partners incorporate the findings from this consultation into the next phase of the GIDH’s development. Further perspectives on the resource portal and other pillars of the GIDH should be sought as soon as possible, particularly from constituencies and key partners, such as LMIC governments, bilateral donors and other multilateral partners, including development banks.

Looking to the longer term, governments and development partners should explore more routine and sustainable mechanisms for reporting on both domestic and external investments in digital health transformation. For example, expenditure categories for digital health transformation could be included in the National Health Accounts and OECD-DAC reporting systems. Information from these sources could then be presented together in the digital health resource portal along with other relevant data.

READ THE FULL CONSULTATION REPORT

Read the recommendations from our earlier consultation on the GIDH

Since the virtual launch of the #MyDataOurHealth campaign on 23 January, our 28 community-based partner organisations in East and West Africa have made remarkable progress, raising awareness of the issue of health data governance among the public, the media and politicians. As a result of this engagement more people are aware of the issue and starting to value their health data, more organisations are calling for government action on this issue, there is more media coverage, and more engagements with governments across East and West Africa. This is leading to progress in getting governments to endorse the Health Data Governance Principles, and supporting a global framework on health data governance at the World Health Assembly, that can then be used as a basis for national legislation.  

Partners began their outreach by engaging their own supporters and networks, raising their awareness through social media and in workshops, and inviting them to participate in the Where’sMyData? campaign action. One hundred and five people registered for the campaign Action in the first two weeks. The impact is being felt on our partners: 

“The My Data Our Health campaign has brought new ideas in our community that build the confidence of Women living with HIV and adolescent girls and young women (AGYW) to demand their data. Previous no one, including myself was aware of the importance of accessing personal health data. It is raising the debate even to media personnel as they didn’t understand at first why it is important but now they can link this to health improvement in the country”, said Joan Chamungu, Executive Director, Tanzania Network of Women living with HIV and AIDS (TNW+).

‘Empowering young people and their communities to control their health data is pivotal in shaping a future where they are active in their healthcare and can access digital services and information to enable them to enjoy their rights. At the heart of the digital transformation of health is the question of data. If we, as young people, don’t even have control over our own health data, then we will play no part in this digital transformation, and many of us will be ignored and left behind when governments make their decisions around health priorities. This is why the My Data Our Health campaign is important to us,” said Edmond Magara, Head of Programs for Youth Alive! Kenya.

A short film on the experiences of those who took part in the ‘Where’s My Data?’ action and tried to find their health data was produced. This film has been used online and during different events. In addition we asked people to fill in a survey on their perceptions and understanding of health data. To date over 2000 people have done so. Results of the survey are being used as a benchmark for the campaign.

Partners have also been promoting two Instagram and TikTok filters we developed aimed at raising awareness of the issue in a fun and interactive way. So far the filters have been viewed by over 13 thousand people.  We’ve developed a user guide here on how to use the filters.  

EANNASO and Girls First Initiative collaborated on a Twitter Space event to consider the issue of health data governance across the East Africa region and to explore the role of civil society organisations in advocating for a global health data governance framework. These online discussions add to the broader set of conversations taking place on this issue and raises its profile. 

In May our partner, VIA -ME organised a Youth-Summit to raise awareness of the issue of health data governance among youth-led organisations in the run up to the World Health Assembly. The 41 young people who attended developed a manifesto on health data governance that called on the government to take action. The event was covered on national television. At the summit  37 organisations endorse the Health Data Governance Principles. Participating organisations also promoted the event and the manifesto among their supporters and networks. 

An important aspect of the campaign is to broaden understanding and support for the issue. To achieve this, partners have been reaching out to civil society organisations working on the issue of health and UHC to ensure they integrate calls for more effective health data governance into their priorities. In June  our partners FENOS-CI, OSEFF and AFPROEX in Côte d’Ivoire conducted a successful civil society workshop in which  the National Federation of Health Organisations endorsed the campaign. This event was also covered in the national media. 

To raise public awareness our partners have been working with journalists across the two regions. Partners in Uganda and Tanzania organised workshops with journalists in April to raise their awareness of the issue and its importance. Engendering Gender Uganda has also hosted a workshop with journalists in Uganda who have begun to publish media stories; 2 stories have been published so far. In Côte d’Ivoir, FENOS-CI held a media training with journalists on the issue of health data governance that was covered on national television. Coalition partners were provided with a Communications Toolkit in English and French to encourage them to create their own content and assets. Partners in Tanzania used these assets in their press statement in celebration of World Health Day calling for a global health data governance framework. Other partners have been using these materials in their own communications products and on their own websites.

All these engagements serve to raise the profile of the issue of health data governance among the public and politicians and build political support for the campaign. The collective engagement under the banner of MyDataOurHealth also creates a sense of sale that one organisation alone would not be able to achieve, and is more likely to come to the attention of decision makers in government.  

Our partners have been engaging politicians directly to raise their awareness of the issue and to get the government to endorse the Health Data Governance Principles and support calls for the creation of a global framework at the World Health Assembly.    

In Benin, One World and other partners hosted the  ‘Data For Health’ symposium that was attended by almost 60 participants, including representatives from the Ministry of Health, the National Statistics Office, the Ministry of Digital Technology civil society, youth representatives, among many others. The symposium aimed to generate awareness and inspire action for stronger health data governance and a global regulatory framework to achieve greater health equity. The event was covered on national television and in the newspapers. One World followed up this event with a meeting with the Director of the Department of Data Management at the Ministry of Health who expressed her support for the objectives of the campaign. Partners in Côte d’Ivoire met representatives from the Department of Digital Health and Data from the Ministry of Health to discuss issues related to the campaign. This meeting was very positive and our colleagues are now aiming to have further meetings to explore the government’s endorsement of the Health Data Government Principles and support for a global framework. 

At the regional level in East Africa, Transform Health held an event on health data governance and promoted the campaign at the Africa Health Agenda International Conference (AHAIC 2023). The high-level event sought to address the critical need for a set of global standards on health data governance. The session highlighted the lived experiences of youth, women and other marginalised communities who participated in the Where’sMyData? action and invited panellists to consider actions governments need to take to address the issue of health data governance. 

In the coming  months partners plan to step up their engagement and convince governments in East and West Africa to take a lead in endorsing the Health Data Governance Principles and in calling for a set of common standards. Through their engagement they will be contributing to a reframing of the issue of health data and a renewed appreciation and understanding of its importance to us as individuals (it does contain our most intimate details after all!) and as societies. 

Background

Transform Health is calling for a global health data governance framework, underpinned by equity and human rights based principles, to be developed and adopted by governments (guided by the coalition’s Health Data Governance Advocacy strategy). To ensure this happens, we need governments to support and adopt a World Health Assembly resolution mandating the WHO to develop a global framework. It is important that such a framework is developed through an inclusive, multistakeholder process. A global framework (endorsed by governments through the World Health Assembly) would establish an agreement between nations around a set of common regulatory standards for the governance of health data. Once adopted, we ultimately want to see a global framework adapted at regional and national levels, to guide and inform the development/strengthening of national health data governance legislation/regulation and regional frameworks.

Earlier this year, Transform Health launched the #MyDataOurHealth, a global campaign led by community based organisations, to raise awareness and galvanise action on the issue of health data, and to encourage a public and political conversation around questions of health data collection and use. The campaign aims to build up public and political support for stronger health data governance and for the need for a set of global standards to inform national legislation.  

About Transform Health 

Transform Health is a global coalition of more than 130 organisations advocating for the equitable digital transformation of health systems, to achieve health for all.

This is an anonymous account of a Transgender Woman seeking healthcare in Mbale city. This represents the dire conditions that are sometimes faced by members of the LGBTQ+ community while exercising their fundamental right to accessing quality healthcare. 

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I am a transgender woman living in Masanda cell, Musoto in Mbale city in Uganda. I have been seeking health care services including on my sexual and reproductive health in a government health hospital because I cannot afford care in a private health facility. They charge a lot. 

On 29 May 2023,  I went to seek medication from the hospital and I regretted going there. I was treated badly.  It was the worst day of my life. When I entered the medication room, I found a nurse. She looked at me for some minutes. She then asked me …how can I help you… I told her about the pain I was having, discharge and the discomfort. Her face just changed. She started asking me ..why did you get the infection… why don’t you be normal like other people instead of trying so hard to be what you are not. I became confused. But because I was in pain, I did not have money to go to a private health facility, I tried to remain calm and humble so that she could help me. 

She then asked… are you aware of the confusion you people have brought? We are now being hated by the community members, members of parliament and family members because of your acts. She told me…. my job is my security… it supports me and my children and I cannot loose it because of you. Look for someone else to help you.  

I left heart broken, confused and in pain. I went out and sat on a bench outside. I kept looking at the health workers passing in their white jackets. I feared to open up to another medical worker there, so I just left. But I just wondered why did she treated me that way because I had received health care in that very hospital. 

I went to report my case to the NGO which supports transgender people in Mbale. I wanted them to ask that nurse why she humiliated me especially after listening to my private matters, which she was recording and later she did not even help me. The NGO told me the climate was not good. They advised me to seek medical support from a private clinic. They gave me names of two private clinics and a contact phone of one person. 

I am worried that the hospital staff have my health information now, they recorded and kept it and rather than help me with my pain they drove me away. I don’t even know what information was recorded and I am afraid to go and ask for my health record. I am also afraid this information could now be used against me, especially given the attitude of the nurse and the current climate in the country. I need medical care and I can’t afford a private clinic, but I am now afraid of going back to the public hospital. I am feeling desperate.   

~ Mathilde Forslund, Executive Director, Transform Health

Transform Health recently participated in the multi-stakeholder hearing on universal health coverage (UHC) organised at the UN headquarters from 8-9 May in New York. The hearing was part of UN’s high-level meetings on UHC, TB and pandemic prevention and preparedness in 2023 and was attended by representatives and advocates from a diverse range of non-state actors, including civil society, communities, youth groups, health and care workers, parliamentarians and local government networks, foundations, academia and the private sector. The hearing allowed a range of partners to make statements about their hopes and ambitions for the outcomes of the UN High-Level Meeting on UHC, which will be held on the sidelines of the United Nations General Assembly in September. The one and a half day hearing aimed to inform and shape the themes of the multi-stakeholder panels of the High-Level Meeting.

Transform Health was invited to share perspectives during the meeting – on behalf of more than 130+ coalition partners – calling for digital health and health data governance to be prioritised, as key components of achieving the Sustainable Development Goal on UHC. Innovative approaches are urgently needed to get back on track to achieve UHC by 2030. This includes unlocking the potential of digital technologies and data to strengthen health systems, and scale up access to primary health care services.

Digital health is already an important and growing part of most health systems and offers a huge opportunity to accelerate progress towards UHC. As we harness this opportunity, we must ensure that equity and human rights are central to the digital transformation of health systems, to ensure that we are closing, rather than widening, health equity gaps.

Promising outlook

During the hearing, we were encouraged by the statement of the Government of Indonesia, which highlighted that ‘digitalisation of the health sector is the key driver to achieve UHC’. We also heard from the private sector constituency, represented by Olseya Struck from Royal Philips, who emphasised the need for primary care to be co-designed and co-invested in to achieve UHC at scale. She called for stakeholders across different sectors to partner faster at scale, identifying investable solutions and to cover investment needs through blended finance. 

What is missing?

The multi-stakeholder hearing emphasised that UHC is not just about health, but critical also to drive broader socio-economic development and reduce inequities. However, there was a lack of sufficient emphasis on the transformative role that digital technology and innovation can play in achieving UHC. The recently launched Action Agenda on UHC by the UHC2030 Movement, mentions digital health and highlights the importance of adopting enabling laws and regulations that create an enabling environment for use of health technologies and innovations that will strengthen future economic and social resilience. 

Whilst this is important, we are missing a stronger focus on digital health transformation as an accelerator of UHC. Transform Health is calling on Member States and the UN to prioritise investments in digital health and health data governance to strengthen health systems and scale up access to primary healthcare. Specifically, we want to see action to:

1. Prioritise digital health transformation as an accelerator to UHC, rather than a siloed health issue. 
2. Close the divide in digital access, including coverage gaps, affordability and digital literacy. We need a digitally-enabled workforce that can keep up with innovation in health and deliver care that reaches even the most marginalised groups.
3. Increase, and better target and coordinate funding for digital health as part of wider investment to deliver UHC.
4. Establish a strong national regulatory and policy environment to ensure the digital transformation of the health system and use of data are inclusive, equitable, sustainable and promote human rights. 
5. Develop and endorse a global health data governance framework that governs how data is used, owned, managed and shared within- and across borders. Transform Health calls on governments to formally endorse the Health Data Governance Principles (already endorsed by more than 140 organisations and governments), which lay the foundation for a global framework. 
6. Strengthen mechanisms for meaningful multi-stakeholder engagement at all levels of planning, strategy, execution and monitoring, and particularly ensuring the inclusion of especially youth, women and marginalised communities . 

Prioritising digital health and health data governance in the High-level meeting Political Declaration

A Political Declaration will be endorsed by Member States at the High Level Meeting in September. We must ensure that the declaration addresses  the critical role that digital health and health data governance play in accelerating progress towards Universal Health Coverage 2030. A draft declaration is currently being negotiated by governments, with the zero draft recently shared for feedback. This is an important window of opportunity to ensure these issues are prioritised. 

We believe that digital health should not be viewed only as a health vertical, but rather very much as an accelerator to achieve health for all. Digital health and data-led solutions, governed under a global health data governance framework, have far-reaching impacts and can play a transformative role to enable more equitable health systems – towards achieving Universal Health Coverage. 

What is next?

In order to sustain political commitments and encourage greater investments in digitally-transformed health systems, it is critical that the final political declaration recognises the role of digital health transformation in driving UHC progress and sets out concrete actions for Member States and other stakeholders to take this forward. 

In the lead up to UNGA77, as the political declaration is getting finalised, it is important that partners and stakeholders strongly advocate for digital health transformation to be given a more salient position to help achieve UHC 2030.

Relevant resources

• Recording of the full multi-stakholder hearing. 

Ahead of the 2nd meeting of the G20 Health Working Group, Transform Health was invited to organise a multi-stakeholder consultation on a new global initiative to accelerate the digital transformation of health systems, proposed by India’s G20 Presidency. The consultation brought together more than 80 participants to provide inputs on various aspects of the initiative.

Stakeholders welcomed the initiative and its potential to help close existing funding gaps and accelerate the equitable digital transformation of health systems, particularly in low and middle-income countries (LMICs), while also sharing recommendations to guide its development and implementation.

Digital health prioritised by Indian G20 Presidency

‘Digital health innovations and solutions to aid universal health coverage and improve healthcare service delivery’ has been identified as a priority for India’s Presidency of the G20 this year. Under this priority area, the Indian government is championing the establishment of a Global Initiative on Digital Health (GIDH). The proposed initiative seeks to harmonise the current fragmented global digital health landscape and address barriers to scaling and sustaining the digital transformation of health in all parts of the world.

Transform Health coalition partners and other stakeholders were invited to share their feedback on the GIDH during a virtual consultation on 24th March and through an online survey. Stakeholders were asked to share their feedback on six aspects of the GIDH: its scope; how it should align with other initiatives and principles; how it should be governed; the role of different stakeholders; how funding should be mobilised and distributed; and how the success of the initiative should be measured.

At the opening of the virtual consultation, Transform Health’s Executive Director Mathilde Forslund welcomed the G20’s prioritisation of digital health and the huge opportunity for this to help take forward recommendations in the coalition’s digital health investment report that was launched last year. The report looks at the challenges within the current funding landscape for digital health and lays out six key recommendations for national governments, international donors, and the private sector to increase and improve investments towards building digitally-enabled health systems that improve health outcomes for all. 

Key stakeholder recommendations from the consultation

More than 80 individuals from over 50 organisations provided feedback on the GIDH. Contributions came from across the globe and represented a diverse range of sectors, including civil society, bilateral donors, multilateral agencies, health implementing organisations, regional digital health networks, youth networks, academic institutions and technical agencies.

Stakeholders recommended that the initiative should:

• Set a bold, global vision for the digital transformation of health, and also deliver tangible outcomes for LMICs in areas such as:
  • Increasing the capacity of governments and their partners to build stronger and more equitable digitally-enabled health systems;
  • Strengthening global governance and regulatory frameworks for digital technologies and data; and
  • Establishing sustainable investment models to support the development and implementation of digital health strategies.

• Align with existing initiatives – notably the WHO’s digital health strategy – and help improve coordination and alignment between different initiatives and networks.
• Be grounded in existing principles for digital development, data governance and donor alignment, as well as human rights.
• Leverage existing organisational structures and funding instruments to reduce costs and further fragmentation of the global health architecture. An independent and inclusive governance and oversight mechanism should however be created.

• Reflect the diverse ecosystem of global, regional and national stakeholders involved in digital health, including end users, in the initiative and its governance. 

• Prioritise funding to support the development and implementation of national digital health strategies. Funding streams could also be made available for other organisations to deliver activities that support national digital health strategies and/or cross-border goals. 
• Focus on LMICs who are most off-track to achieve UHC and with lowest levels of digital health maturity.

READ THE FULL CONSULTATION REPORT