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I had a rare opportunity to speak with innovative people questioning whether global immune technologies seeking to find systemic solutions to global pandemics can help build a shock-resistant planet. Such technologies include those that "can detect a novel pathogen in the air, water, or soil of the Earth and rapidly sequence its DNA or RNA"[1] to neutralize the pathogen before its damaging effects begins, and in a sense entirely bypass the limitations we have seen with governments in managing diseases like COVID – 19. This conversation can be retrieved from https://bit.ly/2ZNiSqU.
I live in a continent that shoulders one-quarter of the global disease burden, has less than 2% of the world doctors, invests less than 1% of global health expenditure, and is among the continents with the lowest access to healthcare services in the world. While these impressive innovations towards "precision medicine" seek to prioritize preparedness, prevention, and confinement of disease outbreaks, I often wonder the extent to which such innovations can genuinely be global in a world of such significant difference.
The global health sector is predicated on an exploitative model that prioritizes profits over people. As such, it has built a curative system that is mostly available to those who can pay, and which has proved to be unsustainable with occurrences of global pandemics like SARs and COVID-19, especially among the poor. For any such system to work optimally, it must avail health as a public good and a right while collectively working towards the achievement and maintenance of good health through preventive healthcare that is inherently less costly. This value-based health system would have to centralize the needs of people to produce consistently superior outcomes at the lowest cost. This means universal access to high-quality medical care, patient safety, convenience, cost containment, and ultimate satisfaction in services rendered for the collective wellbeing of all to remove the threat of global infections effectively.
Problem-solving technological innovations have been vital in making enormous strides in the health sector. However, technology has not been without its challenges. A first critical concern is the relationship between humans and machines. Weak collaborations between people and machines resulting from technological misuse - which occurs when people overly rely on automation inappropriately, or technological disuse - which occurs when people do not fully appreciate the benefits of automation, have become increasingly costly and catastrophic in as far as they compromise people's safety. WHO acknowledges that the diffusion of innovations is a major challenge because of: user perceptions - on the benefits of change, on uncertainty levels, on compatibility between values and current needs, as well as on simplicity of use. This means that the process of acceptance and diffusion has its own pace, rules of the game, and complexity level. For the successful and accelerated interface between humans and technology, trust becomes a critical factor. Just as trust aids relationships between people, it also guides and influences reliance and use of the said technology, its mastery, and the extent one feels a sense of security when using the technology, especially in complex and uncertain situations. This means that the way certain technologies are introduced is critical in building or undermining trust.
A predominant characteristic of the health model that has been pursued over time is the top-down prescriptive approach of creating solutions by the 'power holders' because they have the resources and the capacity to do so. The only problem with this approach is that it now has to create solutions for cross-border challenges that manifest differently in different cultures and communities. As such, automated systems have to genuinely understand the users' unique situations in different parts of the globe to design truly inclusive and adaptive systems. This can only be achieved through new processes that are mutually collaborative and participatory – to co-design and co-produce unique gap-filling solutions that value diversity and incorporate indigenous knowledge to build true resilience. Therefore, the system's effectiveness will only be achieved with the dismantling of hierarchical, bureaucratic, and egocentric institutions and constructing transformative ones that are responsive and agile enough to bring about the needed change. The only question here is, are the beneficiaries of the current global order able to shift to the required paradigm?
References
Berwick, D. M. (2003). Disseminating innovations in health care. Jama, 289 (15), pp. 1969-1975.
Hoc, J. M. (2000). From human–machine interaction to human–machine cooperation. Ergonomics, 43 (7), 833-843.
Lee, J. D., & See, K. A. (2004). Trust in automation: Designing for appropriate reliance. Human factors, 46 (1), 50-80.
Porter, M. E. (2009). A strategy for health care reform—toward a value-based system. New England Journal of Medicine, 361(2), 109-112.
Porter, M. E. (2010). What is value in health care?. New England Journal of Medicine, 363(26), 2477-2481.
World Health Organization. (2006). The world health report 2006: working together for health. World Health Organization.
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