The promises and perils of digital health

February 6, 2020


From health apps that record blood sugar or air quality, to drones that deliver vaccines, technology is increasingly shaping nearly every aspect of our lives. The potential for technology to transform health care is tremendous, especially for poor, hard-to-reach, and marginalized communities. But advances in digital health can bring privacy and data security challenges that threaten human rights and exacerbate inequalities.

When developing countries have technology, it can be deployed to address longstanding health challenges. In Guinea-Bissau, health workers record malaria data by hand and then send it by public transport for analysis, a process which can take up to three weeks. This makes it difficult to track where outbreaks are occurring or make informed, timely decisions about where to direct resources. UNDP, the Global Fund, and the World Bank are working with the government to disseminate mobile tablets to health facilities across the country, allowing health workers to monitor malaria data electronically. This has contributed to a 16 percent decrease in the number of malaria-related deaths since 2017.

Marginalized groups

However, technological advances aren’t necessarily reaching those with the greatest need. Well over half the world’s population still don’t have the internet, and they are overwhelmingly from marginalized groups such as women, the elderly, people with disabilities and those who live in poor, remote or rural areas.

Where digital technologies are reaching these communities, security and privacy issues can exacerbate stigma and discrimination. Between 2016 and 2017, there were over 1,300 recorded incidents of protected health information data breaches in 27 countries. Leaking this type of information can threaten the safety and wellbeing of vulnerable groups, such as people living with HIV, especially in the 75 countries around the world that criminalize HIV non-disclosure.

Even if data is collected for altruistic purposes, it can be misused or shared with others who may use it for other than what was intended. Data-sharing agreements can give governments personal information that could be used to target or monitor marginalized groups. This can lead to a breach of trust in the confidential doctor-patient relationship and discourage vulnerable people from seeking care.

Pushing back for privacy

In some places there is push back against these potential breaches of patient privacy. Kenyan civil society opposed the health authorities’ plan to use biometric data, such as fingerprints or eye scans, in a study on HIV. They argued that this data could be used by police to target groups such as sex workers, men who have sex with men, transgender persons and people who inject drugs, for arrest and prosecution. Other countries are following suit. The Supreme Courts of IndiaJamaica and Mauritius all affirmed the need for strong safeguards when collecting biometric data to ensure privacy.

Countries must take action to enable vulnerable communities to benefit from advances in digital health while respecting their privacy. First, all people—not just a select privileged few—should be able to enjoy the benefits of innovation and technology. The goal of digital health must universal health coverage which reduces inequalities, rather than deepens them.

Second, strong rights-based legal and ethical frameworks are critical for digital health. They must be accompanied by laws and policies that protect the privacy and dignity of patients, particularly those who risk further stigmatization and discrimination.

Equal distribution

Finally, greater efforts are needed to ensure advances in technology are distributed equally, so that communities most in need can benefit. Partnerships across sectors can help accelerate the introduction of new technologies in poor, marginalized or remote communities.

Technology offers new opportunities to tackle some of the world’s most challenging diseases, and ultimately, save lives. The digital health revolution has happened. It’s time to close the digital divide and for global and national governance, laws and safeguards to catch up.

This article was originally published here.