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What is the biggest challenge to health this century? And will digital health make it better or worse?

The answer to the first question is that the greatest threat to health in the 21^st century is climate change – or more accurately, the climate and ecological crisis – according to the WHO. There is scientific consensus that unprecedented climate change is happening, that it is caused by human actions, and that it will have a major impact on human health – the environmental determinants of health.

The answer to the second question is unclear. Will digital health make the climate crisis worse, as most digital technologies do? Well, this depends on whether our sector acknowledges the problem and acts responsibly. All digital technology is environmentally damaging, from mining minerals, manufacture, transport, power during usage and ends up as e-Waste. The digital health community must address this issue – if we don’t, digital health would be part of the problem.

Digital Health as Climate Crisis Solution

There are three areas to consider:

1. Minimize the environmental harm of digital health.

Digital health projects should reduce their carbon footprint as much as possible and there are many approaches to doing this: renewable (e.g. solar) power, recycling and e-cycling, digital temperance, Green Computing, repairable devices, resource pooling, responsible disposal – and simply turning devices off when not in use.

2. Services to mitigate the crisis.

Digital health can increase health system resilience to the climate & ecological crisis, as well as provide services to mitigate problems. This would include:

• Big data combining demographic, meteorological and medical information for planning and management of the health system during the climate crisis;
• Building health system resilience and supporting ongoing health services during climate emergencies such as the current floods covering one third of Pakistan;
• Training and supporting health workers for the rapidly changing demands as the climate crisis escalates;
• User services such as temperature and air pollution Apps, as well as information to inform and empower people to respond to climate-related health issues and weather shocks.

3. Reduce health sector environmental harm.

Digital health could reduce the environmental damage of the whole healthcare industry. If the global health industry was a country, it would be the fifth largest emitter of carbon. Digital health could have a huge role as a tool to reduce the environmental damage of healthcare as a whole.

Examples would be telemedicine not requiring travel, digital self-care requiring fewer health facilities, medical call centres offering service without transport or local infrastructure. This could become a major motivator for expanding digital health.

New Principles of Digital Health

The new principles of digital health that supports climate crisis response could be:

• Do no environmental harm
• Be part of the solution to the climate crisis

Tech projects, such as digital health, always do environmental damage, which may be justified in certain circumstances where there is an evidence-base that suggests there will be a net-benefit to human health.

Some of us have started considering these issues and how digital health should best respond to the climate crisis. We would love to hear about others already working on this, learn from you and see how we can build a bigger movement together.

Climate Crisis Action Plan

To raise awareness of the importance of the climate & ecological crisis in digital health, and develop research, tools and guides so that digital health initiatives become more environmentally responsible.

Possible activities:

• Awareness: Raise awareness on the issue throughout our sector (think pieces, workshops, articles),
• Assessing harm: Develop a methodology for assessing the environmental impact of digital health projects, including data to collect,
• Research: The environmental impact of digital health implementations and effective means of reducing this,
• Guidelines: Produce guidelines and recommendations on environmentally responsible digital health implementation, including minimum standards for environmental waste considerations in designing, deploying and decommissioning digital health systems,
• Advocacy:Advocate that many actors in the digital health value chain incorporate these guiding principles in their projects (implementers, tech suppliers, governments, donors, researchers)
• Mitigation services: Explore digital health services that can mitigate the coming climate crisis, at the individual, community, national and global levels,
• Reducing healthcare damage:Research the role digital health can play in reducing the environmental harm of the healthcare industry which can increase the motivation for implementing digital health in coming decades,
• Framework:Develop a framework that governments can adapt and adopt into national digital health strategies, and that donors could include in their programs.

Please join us by adding your thoughts in the comments section below.

By Dr. Peter Benjamin, an ICT expert with over 20 years of experience leading research and policy projects and organizations.