In the most recent episodes of the Global Health Matters podcast, host Dr Garry Aslanyan and his guests reflect on the forces and factors that shape the economic, social, and physical landscape affecting health for all.

“The global policy landscape is changing more rapidly than ever due to the influence of pandemics, regional conflicts and technology,” Aslanyan says during part I of “Geopolitics of Global Health,” on which he hosts Dr Ricardo Baptista Leite, CEO of Health AI.

Health AI, a non-profit foundation headquartered in Geneva, is dedicated to establishing a global regulatory framework. Its mission is to ensure equitable mitigation of risks associated with artificial intelligence while promoting investment and innovation. Through these efforts, it aims to facilitate the adoption of responsible AI to enhance health outcomes worldwide.

“There are social factors that actually ensure that someone is sick or not sick,” Baptista Leite says. “In most places around the world, not to say everywhere, we do not have health systems, we have disease systems. We have models that are broken and that are driving more and more cost and more and more disease.

“All of these health care workers that are burning out, they’re in a rat race, they’re like a hamster on a wheel, just running and running but not going anywhere, or actually taking steps backwards because the system is rigged in a way that it actually gets more and more people sick.”

Global Cooperation & Surveillance

Aslanyan, Baptista Leite and Yodi Alakija, co-chair of the African Union’s African Vaccine Delivery Alliance in part II, ask:

• What lessons have we learnt during and after the pandemic that could guide us forward?
• What critical skills and understandings should global health professionals have to understand better and navigate the geopolitical environment impacting their programs or research?
• Has progress been made to give Global South actors a more influential role at the table, and do current geopolitical tensions help or hinder this process?

Baptista Leite emphasises the critical need for global cooperation in pandemic prevention, stressing the importance of learning from past failures and improving coordination. He highlights initiatives like COVAX and the ACT Accelerator as significant but flawed attempts at equitable vaccine distribution. Still, he says the focus should be on learning from these experiences and implementing better procedures to prevent future pandemics.

He says the key to this effort is agreeing on fundamental concepts and strengthening surveillance mechanisms, with independent oversight to support organisations like the WHO.

“It’s not a question of taking away rights or sovereign leadership from any country; it’s working together,” Baptista Leite says. “We do need some strong surveillance mechanisms, possibly independent mechanisms, that will reinforce the role of organisations like WHO, which are instrumental as the main normative agency for health at the global level.”

Baptista Leite also advocates for an early warning system akin to that for pandemics, but for AI, to detect and address adverse impacts globally. He says Health AI could help certify regulatory bodies so that they can validate AI tools and keep surveillance of their impact in their own communities.

“If something goes wrong, if there’s an adverse effect, if there’s an unintended impact of artificial intelligence in one country, we want everyone to get a red flag immediately,” Baptista Leite says. “We are living in a time of algorithmic colonisation, or some call it digital colonisation, in the sense that many Global North organisations are basically deploying their AI-driven or AI-generated technologies into low- and middle-income countries; they’re extracting data with no oversight. In some countries, governments are paying these companies to do this, and they’re basically taking away this goldmine from the countries.

“So it is a new form of colonisation that I think will end up leading to social unrest if we do not address it quickly, particularly in the sensitive field of health and health data,” he continues. “The studies are showing that if we have a symbiotic relationship between machines and humans, we can leverage the health outcomes in ways that we’ve never done before, towards that vision of health and well-being for communities, including those that today live in low resources settings.”

Geopolitical Literacy

For her part, African Union’s Alakija is a staunch advocate championing women’s equity and African voices in decision-making. She and Aslanyan touch on three critical points related to the geopolitics of health: The importance of investing in building alliances and shared understanding, that even alliances born out of adversity can build global health unity, and that the “decolonisation” rhetoric should be reframed as efforts to rebalance power.

Alakija stresses that everyone in the health sector must also have a basic understanding and training in geopolitics.

“We need to speak more practically about the aspects required to implement policies, and many of these often involve complex political considerations,” Alakija says. “This understanding is essential, really, for effectively advocating for and implementing health interventions, education development in good dimensions, in different geopolitical contexts.

“We also need to understand that the geopolitical landscape is constantly changing, and so global health professionals ourselves must be adaptable and flexible,” she continues. “We have to be prepared to modify our voice and our strategies and our approaches in response to shifting political dynamics.”

Listen to previous episodes of Dialogues on Health Policy Watch.

Image Credits: Global Health Matters Podcast.