article · Bulletin of the World Health Organization
Low- and middle-income countries face severe health burdens from noncommunicable diseases, climate change, debt, and conflict, while having the lowest health-care spending. Digitalisation of healthcare, powered by artificial intelligence software and quantum computing hardware, provides a viable way to address these challenges. Effective implementation depends on three essential enablers: governance, infrastructure, and security. Critical examination of these pillars highlights the importance of public-private partnerships, sovereign artificial intelligence, and embedded human security to ensure health systems remain safe, affordable, equitable, and sustainable. When guided by practical cross-sector insights, artificial intelligence can advance human-centred global health through managed strategic competition. Targeted guidance helps public health decision-makers in developing regions lead local digital health adoption, while assisting partners in wealthier nations to provide appropriate technologies, funding, and knowledge sharing.
Global crises threaten healthcare delivery in developing countries where resources are most constrained. Demonstrating how artificial intelligence and advanced computing can be responsibly integrated through solid governance, infrastructure, and security offers a structured route for international partners and local leaders to build resilient, cost-effective health services.
The work outlines policy and strategic frameworks rather than a direct commercial product, positioning it at a conceptual and strategic guidance level. It identifies applications in public-private partnerships, sovereign artificial intelligence platforms, and secure digital health infrastructure. The primary users are public health decision-makers, technology suppliers, and international funding bodies seeking to deploy and support digital health systems in low- and middle-income countries.
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The rising incidence of noncommunicable diseases, combined with the costs of mitigating climate change, sovereign debt and regional conflicts, is undermining global health security and threatening progress towards achieving the sustainable development goals of the United Nations. The negative impact of these polycrises is disproportionately borne by low- and middle-income countries, which have the highest disease burden and lowest health-care spending. Health digitalization is emerging as a promising countermeasure, accelerated by artificial intelligence (AI) software and quantum computing hardware. We provide a multisector critical analysis of the three key enablers - governance, infrastructure and security - of the responsible AI-enabled digitalization for safe, affordable, equitable and sustainable health-care systems in low- and middle-income countries. We consider leading use cases in public-private partnerships, democratized sovereign AI and embedded human security. Our analysis proposes that these use cases demonstrate how digital AI-accelerated global health may be advanced as human-centred managed strategic competition. We conducted our analysis through an inclusive range of theoretical perspectives and practical experience spanning academia, industry and practice across the world. We provide recommendations for the responsible management of the key enablers to accelerate global health for all. We anticipate that this paper will be useful for public health decision-makers, both in low- and middle-income countries leading local health digitalization, and in high-income countries supporting this transaction through their technologies, funding and knowledge exchange.
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DOI: 10.2471/blt.24.291643
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