WHAT IS DIGITAL DIVIDE?
A digital divide is any uneven distribution within the access to, use of, or impact of data and communications technologies between any number of distinct groups, which may be defined based on social, geographical, or geopolitical criteria.
Digital health technologies are heralded as a critical solution to challenges and gaps within the delivery of quality health care and essential to achieving the Sustainable Development Goals. Yet they also present threats to privacy and confidentiality, which might result in discrimination and violence, leading to violations of the rights to health, housing, employment, freedom of assembly, articulation, protection from arbitrary detention, bodily autonomy, and safety. More broadly, without proper management and protection, digital health technologies can contribute to expanding health inequity, widening the “digital divide” that separates those that can and cannot access such interventions.
This outline key harms associated with digital technologies for health, also as ethical and human rights standards relevant to their use. It also gives several strategies for mitigating risks from digital health technologies and reviews mechanisms of accountability, including recent judicial rulings.
INTRODUCTION
In early 2020, facing the challenge of limiting transmission from a poorly understood and fast-moving virus, governments took steps to implement measures to cut back mobility—including lockdowns, travel bans, and restrictions on large gatherings. Without a vaccine or cure, countries sought to extend social distancing; identify and isolate individuals infected by the SARS-CoV-2 virus that causes COVID-19 disease; and quarantine close contacts of these infected and individuals coming from areas with high levels of transmission.
Many countries also turned to the event and use of digital technologies to support their COVID-19 response. Basic eHealth approaches, including online COVID-19 data dashboards and mobile phone apps for symptom screening and case management, have complemented new digital technologies like infrared thermal screening cameras and wearables (for example, smartwatches) that monitor temperature, pulse, and sleep to screen for the disease. The use of artificial intelligence (AI) and machine learning has allowed for the analysis of huge data sets (“big data”) for prediction, forecasting, contact tracing, and drug and vaccine development.
There are various potential human rights-related concerns which will arise out of the utilization of digital technologies for health, including lack of access (the “digital divide”) and also the privatization of health information and services. Three potential harms associated with digital health technologies which will relate to privatization, moreover as public health systems, include data breach, bias, and function creep. Understanding each is critical to minimizing the harms of digital health technologies.
Establishing ethical frameworks on digital health technologies will be important for advancing rights and mitigating harms, and these frameworks are often accustomed regulate private actors, whether individuals or organizations. However, ethical principles can lack specificity, and enforcement mechanisms is weak. Thus, adopting and executing human rights norms and standards that enshrine basic ethical principles into law can provide important opportunities for enforceability and accountability.
While there's no specific global human rights agreement for digital technologies, many existing human rights obligations are applicable. Within the context of health, the HIV movement has been a leader in integrating human rights to facilitate more just, effective responses. This has also included discussion on the rights-related standards on the utilization of digital technologies for populations at increased risk of HIV. supported this work, moreover because the discussion raised by COVID-19, the foremost relevant standards within the adoption of digital health technologies are the rights to health, nondiscrimination, like scientific progress, and privacy.
The adoption of digital technologies for health must align with the right to health. Enshrined in several human rights treaties, the right to health outlines four key elements: availability, accessibility, acceptability, and quality. The use of digital technologies for health must, at minimum, satisfy these four key elements. These obligations mean that governments should make sure the availability and accessibility of digital infrastructure throughout the country, both in terms of hardware (for example, computers, mobile phones, movable towers, net, and broadband accessibility) and in terms of software (for example, applications). This also includes providing digital literacy trainings for all users, including those in leadership, health care, and communities. Addressing the provision and accessibility of digital health technologies supports efforts to bridge the digital divide. Digital health technologies should be a step toward supporting countries in realizing the right to health, which suggests that they need to be acceptable to any or all communities and must be of fine quality (meaning that they need to be able to deliver on their clinical or public health purpose).
Universal and equal access to the net could be a key principle of the Coalition of Cities for Digital Rights and an integral digital right that influences other human rights principles as well as helps bridge the digital divide.
CONCLUSION
Taken together the challenges that digital inequalities pose for population health and well-being should be addressed in priority. This crisis is a turning point within the way we manage public and global health for various reasons, one among them being that from now on, public health policies can't anymore oversee the impact of digital inequalities. Although the mitigation strategies proposed during this article specifically geared toward reducing the reciprocal effects of digital inequalities and the COVID- 19 crisis, they're going to also contribute to win the war against this invisible enemy.