A stark debate over who owns the data in the future of AI and digital health emerged at the World Health Organization (WHO) Executive Board on Wednesday.

Low and middle-income countries warned that the rapid deployment of new technologies risks accelerating data extraction and increasing inequality, cautioning that – without strict AI governance, sustainable financing and equitable guardrails – the implementation of AI in health systems would compromise “data sovereignty”.

The debate centred on a WHO report outlining the framework for a digital transformation strategy spanning 2028 to 2033. Highlighting the profound shifts driven by AI and genomics, the report notes that many member states remain paralysed by “fragmented systems with limited interoperability.” And it warns that without reliable, representative data, AI risks amplifying biases and inefficiencies.

“Innovation alone is not enough,” stated Hans Kluge, WHO Regional Director for Europe. “Without skills, governance and trust, digital tools widen gaps instead of closing them.”

Kluge also warned that “the risk of a new digital divide is real”.

Based on the deliberations, the Secretariat will continue its technical work on the strategy. To this end, the WHO has established a tripartite collaboration with the International Telecommunication Union and the World Intellectual Property Organization.

The board also decided to move forward on consultations to strengthen the global health workforce code, while the fight against substandard medicines moves to a new operational phase under an approved work plan. 

Closing the rift in AI regulation

Regarding AI and digital health, a regulatory rift is opening as high-income regions press forward. While the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) have established guiding principles on AI, a formal global standard remains elusive.

The European Union, represented by Bulgaria, argued that health data and information systems are the “essential foundation”, calling for the WHO to lead harmonisation efforts. These ought to focus on autonomy, safety, well-being of patients and health care professionals. Israel supported this, proposing “regulatory sandboxes” to test technologies safely while integrating economic considerations.

However, the African Region and other LMICs shifted the focus from technical standards to ownership. Cameroon, speaking for the region, called for rigorous ethical governance. The prevailing fear is that international companies will harvest data from the Global South to train AI models or develop products that are then sold back for profit.

Barbados reinforced this, rejecting the model of “donor-funded surveys”. The delegate argued that health data must be treated as a “national asset” under local control.

Positioning the country as a “living laboratory” for digital innovation, Barbados demanded sustainable financing models to advance universal health coverage rather than short-term extraction.

Rich nations urged to ‘pay up’ for imported health talent

The board also confronted the escalating crisis of health worker migration, reviewing new data confirming that active recruitment from nations with fragile health systems is intensifying ‘brain drain’ to plug staffing gaps in the Global North.

Zimbabwe, speaking for the African Region, issued a sharp rebuke of current practices. “Targeted recruitment continues to strain our fragile health systems,” the delegate warned. The region demanded that development banks and donor agencies move beyond rhetoric to “co-invest” in the education and retention of the workforce in source countries.

Pakistan amplified this, arguing that while the principle of co-investment is recognised, there is currently a lack of “binding commitment to deliver it”.

The United Kingdom, a major destination country, maintained that the Global Code of Practice remains “central to ethical international recruitment.” However, the UK acknowledged the need for clearer guidance on safeguards and supported a process to refine the Code’s application.

To bridge this divide, the Secretariat, and member states agreed to launch informal consultations to draft a decision for the World Health Assembly in May. The talks will focus on specific additions to the Code, such as co-investment mechanisms and protections for care workers.

Debate on ‘scourge’ of substandard medicines ongoing

On a last item, the board confronted the lethal proliferation of substandard and falsified medical products, a crisis described by delegates as a critical threat to both public health and economic security. The WHO’s surveillance system has recorded over 10,000 suspect products since 2013, with the Secretariat highlighting a recent, deadly spike in contaminated medical products containing diethylene glycol, like cough syrups.

Togo, speaking for the African Region, characterised the issue as a “scourge,” exacerbated by open borders and informal markets. The region called for “innovative financing” to support regulatory authorities in resource-poor settings, where the risk of infiltration into public supply chains remains high.

Ukraine shifted the focus to modern distribution channels, warning of the specific threat posed by “unregulated online sales.” The delegate urged the WHO to help secure supply chains for high-risk excipients – inactive ingredients often implicated in contamination cases.

The International Pharmaceutical Federation backed these concerns, emphasising that the workforce must be trained to detect fakes before they reach patients. “Protecting patients requires safeguarding the quality of medicines,” the Federation argued.

To close the detection gap, the Board noted the urgent need to roll out market surveillance technologies, specifically the Epione reporting tool, to track suspect products in real-time.

The Secretariat will now develop the draft global strategy for 2028 to 2033, which is scheduled for submission to the board at its 160th session in January 2027 before final consideration by the 80th World Health Assembly.

Image Credits: Felix Sassmannshausen, WHO/Christopher Black , Pexels/Towfiqu barbhuiya.