6.3 DIGITAL TRANSFORMATION OF HEALTH
Seamless, simple and speedy Early digital efforts have been piecemeal, fragmented and siloed, but if harnessed correctly, digital technology and data can accelerate a new era of improved health care for everyone I n the quest to achieve Health For All, health systems aim to deliver everything needed to prevent and treat ill health, affordably and for everyone. But it has become harder to deliver on these aspirations. First, we know more about the factors that influence health and well-being: the determinants of health are not only biological, behavioural and social, but also digital and commercial. Furthermore, awareness about the environmental determinants of health keeps growing (and changing) as we learn more about the health effects of heavy metals, microplastics, per- and polyfluoroalkyl substances, and other types of pollution, and as the world’s climate changes. The World Bank estimates the total cost of lead exposure at 6.9% of global gross domestic product (due to IQ losses and increased cardiovascular disease), higher than the combined cost of ambient and household air
pollution with disproportionate effects in low- and middle-income countries. Over 60% of infectious diseases will likely be exacerbated by climatic hazards. The intractable inequities in health are exacerbated by these determinants, which are more prevalent among vulnerable populations and for which services to address them are less accessible – creating a vicious circle where these determinants perniciously grow. Second, Covid-19 has affected national economies. Its wide-ranging impacts have impeded governments’ ability – especially in low-income countries and countries in fragile and conflict situations that need to invest the most in strengthening their health systems – to return to pre-Covid levels of health spending. The efficient use of every cent spent on health is a great priority, especially as governments must – simultaneously – make up lost ground and strengthen health systems to be more resilient to future health emergencies. Third, the health workforce is struggling. Health workers have suffered immeasurably during the Covid-19 pandemic, resulting in burnout, mental health concerns and high attrition. This has exacerbated staff shortages that were already of concern: the World Health Organization estimates that in just six years, there will be a shortage of 10 million health workers, mainly in low- and middle-income countries. Fourth, emerging evidence shows the extent to which human systems are linked and integrated. Research has exploded on the human microbiome and its effects on immune function, neurotransmitter production,
By Marelize Görgens, lead, Digital Health
Flagship Program, World Bank
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Health: A Political Choice – from fragmentation to integration
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