World Health Organization

Data and artificial intelligence

The response to COVID-19 reinforced the centrality of data and AI for the health sector and WHO’s activities. Data and AI policies are covered by the following instruments:

• Data policy: Guideline on data integrity
• Data standardization: Resolution WHA66.24: eHealth Standardization and Interoperability (May 2013)
• Data sharing during health emergencies: Policy Statement on Data Sharing by WHO in the Context of Public Health Emergencies (as of 13 April 2013) (May 2016) | Best Practices for Sharing Information through Data Platforms: Establishing the Principles (April 2016)
• Data and member states: Text for Inclusion in Data Collection Forms in all Data Collection Tools (Paper-based, Electronic, or Other) used by WHO to Collect data from Member States
• Data sharing: FAQs on WHO Data Sharing Policy in Non-Emergency Contexts | Policy on the Use and Sharing of Data Collected in Member States by WHO Outside the Context of Public Health Emergencies (August 2017) | WHO Statement on Public Disclosure of Clinical Trial Results (April 2015).

Digital standards

• Integration of Health Information Exchange (HIE): WHO collaborates with health information exchange standardisation bodies and organisations, such as HIE and Health Level Seven International (HL7®), to promote sustainable investment in interoperable digital health technologies and systems. Digital health technologies, standards, and protocols enable health systems to integrate the exchange of health data within the health system. Coupled with data governance, ethics, and public health data standards, digital health and innovation enable the generation of new evidence and knowledge through research and innovation and inform health policy through public health analysis. Promoting Better Integration of Health Information Systems: Best Practices and Challenges (2015).
• SMART Guidelines – Digital Adaptation Kits: Implementation Research and Technical Support: Digital adaptation kits (DAKs) are software-neutral, operational, and structured documentation based on WHO clinical, health system, and data use recommendations to systematically inform the design of digital systems. DAKs include the package of business process workflows, core data needs, decision support algorithms, linkages to indicators, and functional requirements for a health domain area, which can then be incorporated more easily in a digital system. In creating these operational tools derived from WHO guidelines, DAKs provide a unique way to reinforce recommendations and ensure adherence to clinical guidelines and standards within digital systems for improved service delivery.
• WHO Guideline: Recommendations on Digital Interventions for Health System Strengthening: Recommendations based on a critical evaluation of the evidence on emerging digital health interventions that are contributing to health system improvements, based on an assessment of the benefits, harms, acceptability, feasibility, resource use, and equity considerations.
• Classification of Digital Health Interventions v2.0 – A Shared Language to Describe the Uses of Digital Technology for Health: The classification of digital health interventions categorises the different ways in which digital and mobile technologies are being used to support health system needs. A shared and standardised vocabulary was recognised as necessary to identify gaps and duplication, evaluate effectiveness, and facilitate alignment across different digital health implementations.
• Electromagnetic Field and Health Protection: As the digital reality moves from ‘cable’ to wireless traffic (Wi-Fi and mobile), a growing number of concerns are emerging on the impact of electromagnetic fields on human health. This technology has become part of the wider public debate and has given rise to conspiracy theories such as those that claim 5G spreads COVID-19. These concerns increase the importance of WHO’s research and policymaking within a broader evidence-based discussion on the impact of Wi-Fi and mobile devices on health. Model Legislation for Electromagnetic Field Protection (2006); Institute of Electrical and Electronics Engineers’ (IEEE) Standard for Safety Levels with Respect to Human Exposure to Radio Frequency Electromagnetic Fields, 3 kHz to 300 GHz.

Online gaming: Since 2018, gaming disorder has been included in WHO’s International Classification of Diseases (ICD). While the negative impacts of online gaming on health are being increasingly addressed by national health policies, it has been recognized by some authorities, such as the US Food and Drug Administration (FDA), that some game-based devices could have a therapeutic effect. Given the fast growth of online gaming and its benefits and disadvantages, the implications on health are expected to become more relevant.

The health top-level domain name: Health-related generic top-level domain (gTLD) names, in all languages, including ‘.health’, ‘.doctor’, and ‘.surgery’, should be operated in a way that protects public health and includes the prevention of further development of illicit markets of medicines, medical devices, and unauthorized health products and services. Resolution WHA66.24: eHealth Standardization and Interoperability (2013).

Net neutrality

The issue of net neutrality (the equal treatment of internet traffic) could affect bandwidth and the stability of digital connections, especially for high-risk activities such as online surgical interventions. Thus, health organizations may be granted exceptional provisions, as the EU has already done, where health and specialized services enjoy exceptions regarding the principle of net neutrality. Resolution WHA66.24: eHealth Standardization and Interoperability (2013).

WHO has dedicated cybersecurity focal points, who work with legal and licensing colleagues to provide frameworks for the organization to not only protect WHO data from various cyber-risks, but also provide technical advice to WHO and member states on the secure collection, storage, and dissemination of data. Health facilities and health data have always been the target of cybercriminals; however, the COVID-19 crisis has brought into sharp focus the cybersecurity aspects of digital health.

Ransomware attacks threaten the proper functioning of hospitals and other healthcare providers. The global Wannacry ransomware attack in May 2017 was the first major attack on hospitals and disrupted a significant part of the UK’s National Health System (NHS). Ransomware attacks on hospitals and health research facilities accelerated during the COVID-19 crisis.

Considering that data is often the main target of cyberattacks, it should come as no surprise that most cybersecurity concerns regarding healthcare are centred on the protection of data. Encryption is thus crucial for the safety of health data: It both protects data from prying eyes and helps assuage the fears patients and consumers may have about sharing or storing sensitive information through the internet.

Data governance

The 2021 Health Data Governance Summit brought together experts to review best practices in data governance, sharing, and use. The result was a call to action to tackle the legal and ethical challenges of sharing data, ensure data is shared during both emergency and non-emergency situations, and encourage data and research stewardship that promotes tangible impact. Key WHO resources include WHO’s Data Sharing Policies, the UN Joint Statement on Data Protection and Privacy in the COVID-19 Response, and GATHER (Guidelines for Accurate and Transparent Health Estimates Reporting).

WHO’s SCORE technical package (Survey, Count, Optimize, Review, and Enable) identifies data gaps and provides countries with tools to precisely address them. SCORE has been developed in partnership with the Bloomberg Data for Health Initiative. As part of SCORE, WHO completed the first ever global assessment of health information systems capacity in 133 countries, covering 87% of the world’s population.

The project Strengthening National Nutrition Information Systems1 is running in five countries in Africa and Asia – Côte d’Ivoire, Ethiopia, Laos, Uganda, and Zambia – for a period of four years (2020–2024). Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS) and national nutrition surveys are the major sources of nutrition data for many countries, but they are complex and expensive undertakings that cannot be implemented with the required frequency. It is, therefore, critical to strengthen or establish integrated nutrition information systems (NIS) of countries to enhance the availability and use of routine nutrition data to better support policy development, programme design and monitoring.

• Data and digital health in the WHO European Region in 2022: a year in review
• How can digital technologies be used to enhance health financing? Claims management in Estonia
• Digital Health in the European Region: the ongoing journey to commitment and transformation

Data-driven delivery approach

A data-driven delivery approach sharpens WHO’s focus to address gaps, close inequalities, and accelerate progress towards national and regional priorities from WHO regions. The WHO Regional Office for the Americas is working to create open data platforms for evidence-based decisions and policymaking. The Core Indicators Portal provides a dataset of around 200 health indicators for 49 countries across the region from 1995 to 2021. The WHO Regional Office for the Eastern Mediterranean is conducting harmonized health facility assessments and tracking 75 indicators through the Regional Health Observatory (RHO). The WHO Regional Office for Africa has prioritized investments in civil registration and vital statistics (CRVS) and digital health. Its integrated African Health Observatory (iAHO) offers high-quality national and regional health data on a single platform and District Health Information Software (DHIS2) is now implemented in all but four African countries. The WHO Regional Office for South-East Asia is focused on promoting health equity through workshops that introduce member states to WHO’s Health Equity Assessment Toolkit (HEAT). High-quality data on health indicators is available on the Health Information Platform (HIP). The WHO Regional Office for Europe is prioritizing support for countries’ national health information systems (HIS) through more robust data governance frameworks. Member states also have access to the European Health Information Gateway, a one-stop shop for health information and data visualization. The WHO Regional Office for the Western Pacific has released a progress report on each member state’s journey to achieving universal health coverage (UHC). Additionally, the Western Pacific Health Data Platform provides a single destination where countries can easily monitor and compare their progress towards national and global health objectives.

Access

WHO is working with Facebook and Praekelt.Org to provide  WHO’s  COVID-19  information to the world’s most vulnerable people through Discover and Free Basics in a mobile-friendly format. Though over 85% of the world’s population lives in areas with existing cellular coverage, many people can’t afford to purchase mobile data consistently and others have not yet adopted the internet. This initiative enables underserved communities to access life-saving COVID-19 health information through participating operators in more than 55 countries.