ATThe possibilities of virtual health go far beyond video consultations with a doctor. They now cover a wide range of applications, from bots that check people for common diseases to artificial intelligence that can read x-ray images just like a human radiographer. Many experts see virtual technology as a promising tool to remove barriers to healthcare and address long-standing global health inequities.

But this promise is far from guaranteed. Many people do not have access to the Internet or do not have the digital literacy required to interact remotely with medical practitioners or benefit from health promotion services. According to report for 2021 International Telecommunication Union (ITU), the United Nations information and communications technology agency, 37% of the world’s population – that’s 2.9 billion people – never used the internet. Of these, 96% live in low- and middle-income countries. Unless policy makers, health care providers and end users work together to better manage the process, the transition to virtual health and care delivery will create new digital barriers that prevent millions of people from accessing the care they need.

Consider how age affects people’s online habits. In the United States, 99% of people aged 18 to 29 are online. The elderly, however, less connected to the Internet – and this is a demographic group for which access to reliable health care is often a matter of life and death. Similarly, minority people and rural residents are much less likely to have access to broadband than white Americans and urban or suburban residents. Black Americans of any age almost twice as often not have access to broadband internet compared to the general US population.


In India, 67% of people living in urban areas have access to the Internet compared to 32% of people living in rural areas. Collected data in 34 African countries show that women are less likely than men to own a smartphone, computer or use the Internet. In Sweden, the country that ranks first in The Economist Inclusive Internet Indexup to every fifth person people with disabilities feel excluded from the digital society.

Fortunately, there are pragmatic ways to ensure that virtual technologies make health more equitable, not less.


ITU/UNESCO Working Party on Broadband for Sustainable Development on Health published on Thursday a comprehensive overview of how age, gender, income, location, race, disability and other factors determine people’s ability to enjoy the benefits of virtual health or risk being left behind. This report highlights several policy areas that are emerging to address these gaps and provides the clearest recommendations to date on how virtual technologies can help make healthcare and care accessible to all.

Governments will benefit from developing national strategies to equitably expand virtual health and care and integrate it into the health system as a complement to in-person care. (Virtual health solutions are those that focus on keeping people healthy; virtual care solutions treat those who are already sick.)

An effective national strategy will provide a coherent vision and policy that promotes the expansion of virtual health and care across the country in line with national priorities to strengthen broadband Internet and mobile communications infrastructure. It will also direct public funding towards virtual applications that will help the country make progress in improving access to virtual health and care.

Virtual app developers can help make access to health care more equitable by consulting across demographics throughout the development process. Applications must then go through rigorous real-world testing to ensure they provide better health outcomes than existing solutions.

In Germany, for example, virtual health app developers must demonstrate patient benefits before being granted a permanent license. In this way, testing helps direct significant investment in the solutions that have the greatest impact, as well as providing developers with information they can use to optimize applications for different populations.

Both health authorities and civil society organizations can do more to help consumers develop the skills and digital literacy that virtual health and care applications require. But even when people know how to use an app, they are unlikely to do so unless they trust the institutions, industries, or companies behind it. Government policies that provide transparency on how applications work and how personal information is used, and promote understanding of digital security standards, are critical to making users feel confident and secure when accessing virtual assistance. The policy should also provide clear opportunities for users to express and receive thoughtful responses to their feedback.

The transition to the virtual provision of health and care services will continue even after the end of the Covid-19 pandemic. With the principles of equity, inclusiveness and transparency guiding this transition, virtual health and care can be a vital complement to in-person care and deliver the highest levels of health. accessible to all.

Tedros Adhanom Ghebreyesus is the Director-General of the World Health Organization. Ann Earths leads the Novartis Foundation. They co-chair the ITU/UNESCO Commission on Broadband for Sustainable Development Working Group on Virtual Health and Care.

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