Unlocking health equity in every byte

A joint op-ed from UHC2030, Digital Transformations for Health Lab (DTH-Lab) and the Organisation for Economic Co-operation and Development (OECD)

The rapid rise of digital technologies - from mobile phones to digitally connected devices to artificial intelligence - is transforming daily life, reshaping how we interact, work and access essential services. In an increasingly connected world, access to health services should be universal, yet inequalities continue to be a fundamental challenge for achieving progress towards universal health coverage (UHC).

Today, 4.5 billion of the world’s population lack access to essential health services, and over 2 billion face financial hardship due to the health care costs they have to pay out of their own pockets.¹ These statistics alone do not present the full story. Average figures disguise the deep inequalities in health care between and within countries; with people in vulnerable and marginalized situations, particularly those living in low- and middle-income countries, being affected the most severely. With over 300 million people who are living in extreme poverty being driven even deeper into poverty due to healthcare costs,² a significant number of people who are already in vulnerable situations are being forced to choose between essential healthcare and other basic needs. The evidence shows that true equity cannot be achieved when billions are left behind.

The digital revolution presents an unprecedented opportunity to transform the health landscape. Digital health is an enabler of accelerating progress towards UHC by strengthening health systems, including through more inclusive, equitable and efficient health financing, service delivery and health governance. It also can strengthen the resilience of health systems by expanding access to care, enabling real-time data-driven decision-making, and enhancing coordination, making healthcare systems more adaptive and better equipped to meet challenges head-on. Digital health has the power to act as a bridge, connecting underserved communities to services, information and resources that may otherwise be out of reach. For underserved regions and populations in vulnerable situations, digital health has the potential to make health services more accessible, affordable and efficient.

In September 2023, political leaders from UN Member States met for a second UN High- level meeting on UHC to reaffirm their commitment to achieving UHC by the Sustainable Development Goals (SDGs) date of 2030. As countries now strive to get back on track towards SDG Target 3.8 - ensuring that everyone, everywhere, has access to essential health services without financial hardship - there is a significant opportunity to harness digital transformations to drive equity gaps and accelerate progress towards UHC.

With the midpoint to the 2030 Agenda on Sustainable Development now behind us, the world must seize the lessons learned from the COVID-19 pandemic to strengthen health systems through a primary health care approach, thereby improving the health, safety and well-being of people everywhere. Digital health technologies are central to this effort, offering tools to meet the biggest challenges for UHC: bridging gaps on equitable access, patient-centered care, affordability, and resilient health systems.

However, to ensure no one is left behind, we must complement digital health advancements with measures for stronger digital and data governance, enhanced privacy protections, and infrastructure to bridge the digital divide. Approximately 2.9 billion people in the world remain offline, with access shaped by intersecting inequalities like gender, race, class and geography.³ Weak governance of digital ecosystems and artificial intelligence (AI) puts people who are connected at risk of unregulated digital health tools, health misinformation and exposure to health-harming content and digital practices. Putting communities at the centre of digital and data governance is key to ensuring that digital health solutions are not only innovative but also inclusive, responsive to populations' needs, and aligned with equitable, patient-centered care for all, so that no one is left or pushed behind. Expanding digital literacy and accessibility, while fostering political will and funding, is essential to ensure digital health benefits reach everyone.

With Digital Health Week (4-10 November 2024) now behind us, UHC2030, OECD and DTH-Lab are working together to mobilize support for continued action to harness the momentum and potential of digital health technologies in our journey toward UHC.

To support these efforts, we are excited to announce the development of a UHC2030 strategic narrative to guide advocacy and action on digital health for accelerating progress towards universal health coverage. This forthcoming advocacy brief will outline concrete actions for advocates to engage policy and decision-makers on using digital health to build bridges for health equity and accelerate progress toward UHC.

Consultations for this paper have been underway and will continue into early 2025, with publication anticipated soon after. We invite stakeholders to engage with this narrative and join our calls for continued actions on the paper’s key advocacy areas:

• Building secure, accessible, affordable and connected digital infrastructure in all communities and health facilities to enable telemedicine and other digital health services
• Prioritizing investments in digital health solutions that strengthen health systems to ensure equitable and affordable access to quality health services and provide protection from financial hardship due to health care costs, including for vulnerable and marginalized groups
• Putting communities at the center of digital health by developing inclusive and sustainable mechanisms to involve diverse stakeholder groups, including for the design, governance and delivery of digital health systems and solutions
• Establishing national health data governance frameworks to enable data uses that improve equitable health outcomes while protecting individual and community data rights
• Placing UHC and health equity at the core of digital and AI governance
• Ensuring sufficient health workforce capacity and population-wide digital health literacy and skills for sustained digital transformation
• Fostering trust in digital health with the public and with health providers

For updates on the development of the advocacy narrative, subscribe to the UHC2030 newsletter or email info@uhc2030.org. 

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References:

1. Tracking universal health coverage: 2023 global monitoring report. Geneva: World Health Organization and International Bank for Reconstruction and Development / The World Bank; 2023.
2. Tracking universal health coverage: 2023 global monitoring report. Geneva: World Health Organization and International Bank for Reconstruction and Development / The World Bank; 2023.
3. Facts and Figures 2021: 2.9 billion people still offline, The UN Agency for Digital Technologies