The fourth industrial revolution has arrived[1].

The world is transforming at a rapid pace with innovative technologies, impacting the way we live. The health sector is no exception and is in fact an active participant in the changes that could herald a new era for provision of health care. Novel technologies such as Artificial Intelligence (AI) and next generation sequencing offer an opportunity to reimagine provision of healthcare[2],[3]. Telehealth, which had been practiced in one form or another, received a boost during the COVID-19 pandemic, when social distancing measures meant a dramatic reduction in mobility and availability of technological platforms facilitated its use at scale and at a reduced cost[4]. Strengthening information systems and better data protection regimes has also created a greater space for use of Big Data analytics that can improve patient experiences and provision of care[5]. Mobile health has the potential to revolutionise public health and also offers opportunities to increase access to health services and encourage self-management of health, thus empowering people[6]. Social media is a powerful tool and can not only increase awareness on issues related to health among the general public but also create a movement for better health and improve accountability[7]. These technologies can be employed across the spectrum of healthcare, prevention, diagnostics and treatment. Technology’s promise to increase access and reduce inequities in health speaks to the overarching goal of the global health community to achieve Universal Health Coverage (UHC) has been enshrined in the Sustainable Development Goals (SDGs). Recent analyses show that the world is off-track in achieving its goal by 2030 and that there is a need to rethink approaches which can be enabled by innovative technologies[8].

Yet, barriers remain in harnessing the potential that these technologies have to offer and risks that must be recognised when embracing them. The “Coming Wave” of technology could not only change the way we operate but, also threaten our existence[9]. There are concerns around who uses these technologies and for what[10]. Many of the world’s poorest people lack access to technologies such as mobile phones and the internet. Data privacy and security remains a matter of concern and the implementation of interoperable systems is still a challenge. There is a risk of these technologies exacerbating existing inequities rather than diminishing them. Bias in AI algorithms could perpetuate biases and limit access to care. This is the case, both within and across countries, with low-and-middle income countries facing unique challenges on how to develop and utilise these emerging technologies effectively. There is a need for technology transfer from high income to middle and low-income countries, as was amply demonstrated in the development and distribution of COVID-19 vaccines. Acceptability and applicability of novel technologies among users also needs to be considered closely.

The world is at a turning point and there is an urgent need for an accelerated response to reach the goal of achieving UHC within the expected timeframe, and having healthier populations through improved public health by embracing technological innovations, which has been identified as one of the mega-trends impacting the health sector. It will be important to consider how to safeguard individual rights and privacy, while harnessing the benefits of shared data, diagnostic algorithms and computational insights. The global health community has begun discussions on how to better govern AI and this is a welcome step[11]. This field is being shaped by other mega-trends on planetary health, security and demographics, including the role of gender, which will be relevant considerations in forging the path ahead. The Prince Mahidol Award Conference (PMAC) provides a unique platform for global health practitioners to debate and discuss this topic and articulate potential areas for collaboration in the future.

References

[1] The term refers to the fundamental change in the way the world operates, driven by technological advancements. Fourth Industrial Revolution | World Economic Forum (weforum.org)

[2] Top 10 health care innovations | Deloitte US

[3] WEF_Top_10_Emerging_Technologies_of_2023.pdf (weforum.org)

[4] Implementing telemedicine services during COVID-19 : guiding principles and considerations for a stepwise approach (who.int) ; The State of Telehealth Before and After the COVID-19 Pandemic - PMC (nih.gov)

[5] The use of Big Data Analytics in healthcare - PMC (nih.gov)

[6] mHealth (who.int) ; Mobile Health: making the leap to research and clinics | npj Digital Medicine (nature.com)

[7] The role of media in supporting health (who.int)

[8] Tracking universal health coverage 2023 global monitoring report (who.int)

[9] The Coming Wave by Mustafa Suleyman review – a tech tsunami | Science and nature books | The Guardian

[10] MIT Solve | Ethical Innovation: A Conversation Between Yuval Noah Harari and Serhii Plokhy | Ethical Innovation with Yuval Harari & Serhii Plokhy

[11] AI Advisory Body | United Nations