By Derick Ngaira
As emerging technologies become more integrated into healthcare systems in Africa, they bring with them a host of ethical challenges that must be carefully navigated. This final part of the blog series on insights from the Regional Dialogue on Emerging Health Technologies to Improve Healthcare Delivery Systems in Africa, hosted by the African Institute for Development Policy (AFIDEP) and the African Union Development Agency (AUDA-NEPAD), on September 4–5, 2024, explores key ethical considerations that must be addressed to ensure that the benefits of these innovations are realised without compromising patient rights, equity, and trust.
Informed consent
Delegates noted that the use of data is critical in realising the full potential of the emerging health technologies such as artificial intelligence, blockchain, biobanks and telemedicine. The technologies involve collection, analysis, and sharing of personal health data, making it crucial for patients to fully understand how their information will be used.
For example, AI-powered diagnostic tools may analyse patient data to provide treatment recommendations. If patients are not adequately informed about how these algorithms work, the limitations of the technology, or the potential risks involved, their ability to make independent decisions may be compromised. Informed consent requires clear communication, transparency about the technology's capabilities, and continuous conversations between patients and healthcare providers.
Data privacy and security
The increasing reliance on digital health technologies raises significant concerns about data privacy and security. Delegates noted that, with the widespread use of electronic health records and mobile health apps, vast amounts of sensitive personal health data are being generated and stored. This data is highly valuable not only for improving individual patient care but also for research and public health initiatives.
However, the potential for data breaches, unauthorised access, and misuse of information poses serious ethical risks. Patients must be confident that their data is being handled with the highest standards of security and that their privacy is being protected. This requires robust encryption measures, strict access controls, and clear policies on data sharing. Additionally, developers and healthcare providers must be transparent about who has access to patient data and for what purposes.
Digital divide
The digital divide remains a significant ethical challenge in the adoption of emerging health technologies. While these technologies have the potential to improve healthcare access, they may also exacerbate existing inequalities if not implemented with equity in mind. For example, telemedicine and mobile health applications offer convenient access to healthcare services, but they are less accessible to populations without reliable internet connections, smartphones, or digital literacy.
This is particularly concerning in low-resource settings, where the people who could benefit most from these technologies may be the least able to access them. For instance, in Kenya, women are 39% less likely than men to have access to mobile internet as reported in the 2019 release of the Global System for Mobile Communications Association (GSMA)’s Mobile Gender Gap Report. They are also 23% less likely to own a smartphone. Such factors may end up limiting some members of the populating from accessing health technologies.
To promote equitable access, policymakers and healthcare providers must work to bridge the digital divide by investing in infrastructure, providing affordable technology options, and offering digital literacy programmes. Additionally, designing technologies with inclusivity in mind—such as creating interfaces that are accessible to users with disabilities or those with limited technical skills—is essential for ensuring that no one is left behind.
Ethical use of emerging technologies in research
Emerging health technologies are not only being used in clinical settings but also in research, where they have the potential to accelerate scientific discovery and improve public health. However, the use of these technologies in research raises additional ethical considerations.
For instance, wearable devices that collect real-time health data can provide valuable insights into population health trends. However, researchers must navigate the ethical implications of collecting and analysing such data, particularly when it involves vulnerable populations. Ensuring that research participants are fully informed about how their data will be used, that their privacy is protected, and that they are fairly compensated for their participation are all critical ethical concerns.
Moreover, the use of AI in research to identify patterns or make predictions must be carefully managed to avoid reinforcing biases or making decisions that could harm certain groups. Ethical oversight, including the involvement of ethics review boards and the establishment of clear guidelines for the use of emerging technologies in research, is essential for safeguarding the rights and wellbeing of research participants.
Conclusion
The integration of emerging health technologies into healthcare systems offers tremendous potential to improve patient care, increase access to services, and advance medical research. However, these benefits can only be fully realised if the ethical challenges associated with these technologies are carefully addressed. By prioritising informed consent, data privacy, and ethical use of emerging technologies in research, healthcare providers, developers, and policymakers can ensure that emerging health technologies contribute to a more just and effective healthcare system for all.