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Digital health has attracted investment in Africa over the past decade, yet health outcomes have not improved at the same pace. In this op-ed, Mike Adeyemi-Lawal, an infectious diseases specialist, examines why digital transformation in health systems is stalling despite the rapid expansion of tools such as electronic medical records and AI diagnostics.
“Digital health is not fundamentally a technology problem. Technology alone does not transform health systems. People, institutions and policies do,” says Lawal.
He argues that many digital health initiatives remain trapped in fragmented, donor-driven pilots that fail to scale sustainably. According to him, digital health solutions must align with national priorities.
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Mike Adeyemi-Lawal is a Malaria and Infectious Diseases Specialist Advisor at Doctors Without Borders.
At the recent stakeholder consultation convened by the World Health Organization on the Global Strategy for Digital Health (2028–2033), one message came through with striking clarity. Digital health is not fundamentally a technology problem. It is a governance, ethics, and human resource challenge that demands a sociotechnological approach.
For over a decade, African countries have invested heavily in digital tools such as mobile apps, electronic medical records, AI diagnostics, and data dashboards. Despite this growth, health outcomes have not improved at the same pace. The reason is simple. Technology alone does not transform health systems. People, institutions, and policies do.
One of the central themes from the consultation was the urgent need to move from fragmented pilot projects to integrated national approaches. Too often, digital health initiatives remain trapped in small-scale pilots, driven by donor priorities or isolated innovation hubs. While these pilots generate valuable insights, they rarely scale sustainably. Countries must now transition toward nationally owned, interoperable systems embedded within broader health system strategies. This requires long-term planning, financing, and alignment with national priorities.
Closely linked to this is the need to reinforce public leadership and institutional governance. Ministries of Health must take a stronger stewardship role, setting clear standards, coordinating partners, and ensuring accountability. Without strong governance, digital ecosystems become chaotic, duplicative, and inefficient. Effective governance is what turns digital health from a collection of tools into a coherent system that delivers value.
Interoperability also emerged as a critical global priority but with a shift in perspective. The conversation is no longer about whether interoperability is important, but how to make it practical. Countries face real-world constraints such as legacy systems, limited infrastructure, and competing vendor interests. Moving forward requires pragmatic solutions, shared standards, open architectures, and incentives that encourage data exchange rather than data silos. Interoperability must be treated not as a technical aspiration, but as a policy and implementation priority.
Another key insight is that digital transformation is ultimately a workforce issue. Health systems cannot digitise without people who have the skills to design, implement, manage, and use these tools effectively. This includes not only IT specialists, but also clinicians, managers, and community health workers. Capacity building must go beyond one-off trainings to include continuous professional development, new roles, and career pathways in digital health. Without a capable workforce, even the most advanced technologies will fail.
The consultation emphasised the importance of keeping equity, trust, and responsible AI at the centre of digital health efforts. As technologies become more powerful, the risks also increase, including data misuse, algorithmic bias, and widening inequalities. Building trust requires transparency, ethical safeguards, and meaningful community engagement. Digital health must work for everyone, especially the most vulnerable.
The future of digital health lies not in better gadgets, but in better systems. A sociotechnological approach that integrates technology with governance, people, and ethics is no longer optional. It is the only path to achieving sustainable, equitable, and impactful digital health transformation.