One world one health

Imagine a world without the internet today, where computer networks didn’t talk to each other. People in one country might continue to reinvent the wheel in use for years in another part of the world. Without a standardised internet protocol, our version of reality would have looked radically different – one with many local area networks but no common internet to plug into.

This alternate reality is similar to the flux in the digital health space today. On the edge of disruptive technologies, it awaits direction, standardised framework and a decisive nudge from the international leadership to ensure innovations can be scaled up to benefit billions in the Global South.

The exciting world of digital health is brimming with small but powerful pilots and innovations across subsectors. Some of these are smart wearables, internet of things, virtual care, remote monitoring, artificial intelligence, big data analytics, blockchain, tools enabling data exchange, storage and remote data capture.

But without a unified global vision, all of it is stuck in a fragmented ecosystem. This, when the pandemic has shown the enormous potential of digital healthcare tools.

Digital tools, public good

India has experienced transformative digital tools in public health. During the Covid pandemic, platforms like CoWIN and eSanjeevani were game-changers in the delivery of vaccines and healthcare services.

CoWIN, Covid vaccination programme’s digital backbone, tracked the logistics of vaccines. It registered people to be vaccinated and generated digital certificates as proof of vaccination.

By reducing the information asymmetry between people and the system, CoWIN democratised the vaccination drive. Rich or poor, everyone had the same access. Realising the potential of the open-source tool, PM Modi offered it to the world as a digital public good. Similarly, eSanjeevani, the telemedicine platform allowed online consultations with doctors from home. It has handled over 10 crore consultations. At its peak, it handled over 5 lakh consultations a day.
A digitally enabled Covid war room helped make real-timepolicy decisions. A specialised surveillance system tracked the disease by geography and monitored inventories for essential supplies, predicting demand at national, state and district levels based on caseloads. Aarogya Setu, RT-PCR app and other digital tools allowed for data to inform policy that strengthened India’s Covid response by an order of magnitude.

To exploit the potential of digital tools in public health, India is building a national digital health ecosystem – Ayushman Bharat Digital Mission (ABDM). It empowers patients to store and access medical records, share these with healthcare providers and ensure treatment.

It helps patients access accurate information on health facilities and service providers. India under PM Modi is willing to share its learnings and resources to build similar digital health ecosystems for the world, particularly lowand middle-income countries. Here, vulnerable people can derive benefits of cutting-edge digital solutions. The dream of universal healthcare coverage can come true.

Open access, remove barriers

Access to digital solutions is blocked by copyright regimes and proprietary systems. Most transformative digital solutions are not easily accessible because they are unevenly distributed in terms of language, content, and infrastructure.

Even where digital public goods or open-source solutions exist, their utility is limited as they’re bound toa platform, data and logic, for which no global standards exist. There is no global governance framework for digital health that can ensure interoperability across systems and address concerns around data security and privacy.
Independent efforts to create global standards around digital health exist but operate in silos, and are largely uncoordinated without any support for their enforcement.

If the global community resolves to converge its efforts under one umbrella, G20 is the platform to build a future-ready vision for digital health.

Consolidate efforts, ensure coverage

Imagine the tremendous potential that can be unlocked if we build and implement a global blueprint for digital health. For that we need to:

1. Converge the many scattered ongoing efforts into a global initiative on digital health, institutionalise a governance framework.
2. Collaborate on a protocol as had been done for the internet decades ago.
3. Identify and scale up promising digital solutions as digital public goods.
4. Bring on board all stakeholders.
5. Build trust for global exchange of health data and find ways to fund such initiatives.

With the presidency of G20, India will strive to build consensus on some of these issues with mechanisms to operationalise them. All it takes to script a breakthrough in digital health is to place collective good over narrow interests; to grasp that the ‘universe’ in Universal Healthcare Coverage extends beyond own countries.
What must drive intention and action in G20 is Vasudhaiva Kutumbakam: the universe is a family. And it is our responsibility to secure the health of that family. Whatever the cost.