G20 summit in India: unveiling the digital health initiative with ‘Vasudhaiva Kutumbakam’

Dear Editor,

The global scientific community has made significant efforts to encounter various infectious disease outbreaks in the last three decades, such as SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), and mpox (monkeypox)^1,2. The 18th Heads of State and Government Summit of the Group of 20 (G20) will take place on 9th and 10th September 2023 in New Delhi, India³. Under the Indian Presidency, the G20 in 2023 will focus on the theme, ‘One Earth, One Family, One Future’ or ‘Vasudhaiva Kutumbakam,’ the Sanskrit text from Maha Upanishad (Fig. 1). The theme affirms the value of humans, animals, plants, and microorganisms and their interconnectedness on Earth and in the broader universe. This correspondence highlights the relevance of the G20 summit 2023 to be organized in New Delhi, India, on 9th and 10th September 2023 in the implementation of the ‘One Health’ concept. The G20 is made up of 19 countries and the European Union. The 19 countries are Argentina, Australia, Brazil, Canada, China, Germany, France, India, Indonesia, Italy, Japan, the Republic of Korea, Mexico, the Russian Federation, Saudi Arabia, South Africa, Turkey, the UK, and the US. India holds the Presidency of the G20 from 1st December 2022 to 30th November 2023.

Figure 1.

(A) The thematic logo of the G20 summit is to be held in India in September 2023 on the theme, ‘One Earth, One Family, One Future’ or ‘Vasudhaiva Kutumbakam,’ the Sanskrit text from Maha Upanishad. (B) Geographical location of various countries of the G20.

The first World Health Organization (WHO) Traditional Medicine Global Summit was held between the 17th and 18th of August 2023 in Gandhinagar, Gujarat, alongside the Group 20 (G20) health ministerial meeting, which concluded on 19th of August 2023. The Health Minister’s Meeting of the G20 Summit announced a new Global Initiative on Digital Health (GIDH), a joint effort between the WHO and the G20 India presidency⁴.

The GIDH has been launched to aid in the rollout of the World Health Organization’s Global Strategy on Digital Health for 2020–2025. The WHO acts as the strategy’s Secretariat, coordinating the efforts of stakeholders to align on global standards, best practices, and resources in order to accelerate the transition to a digital health system. The initiative will provide a forum where the modules of our diverse international ecosystem may join forces to increase national preparedness and foster more international collaborations in the field of digital health.

With an aim to accelerate the achievement of the strategic objectives outlined in the Global Strategy on Digital Health 2020–2025, GIDH will focus on the following core areas of work: assessment and prioritization of the needs of Member States; evaluation of the availability and report on the country-level digital health resources and identification of under-funded priorities; capacity building and convergence of the efforts to encourage the development, adaptation, and maintenance of the digital health systems. The initiative will amplify the best practices, open standards, and quality-assured building blocks to address the inconsistencies in the quality of digital solutions and new technologies regarding standards, data protection, security, interoperability, etc⁵.

Universal Health Coverage (UHC) and other health-related Sustainable Development Goals may be accelerated with the use of digital health technologies. For over two decades, WHO’s Member States have collaborated to speed up national and global health goals by using digital technology. Over 120 WHO Member States have created a national digital health policy or plan since the first Member State-driven resolution on eHealth in 2005, which culminated in the comprehensive Member States’ Global plan on Digital Health 2020–2025. However, successful national digital health transformation is slowed by fragmentation in budget allocation and alignment of solutions to Member States’ priorities, as well as by varying definitions and degrees of quality of digital solutions. Trusted and quality-assured technical support to address national digital health priorities is a recognized need, and member states are looking for help in making the transition from product-focused digital health initiatives to establishing national digital health systems and applications with the appropriate national competency to maintain and adapt these.

The GIDH is looking for political, financial, and technical assistance from G20 member countries, and it plans to keep pushing for that support even when other nations take the helm of the G20. Beyond taking part in established WHO procedures via the World Health Assembly, these member countries get no special scrutiny. The Country Resource Portal will be promoted as a means for member nations to record their contributions (both monetary and otherwise) to the advancement of digital health.

In order to analyze and assist in steering investments and technical support in digital health, GIDH will only gather data that has been willingly submitted, using recognized WHO standards. Open health data standards, best practices, and lessons learnt from nations worldwide will be promoted via GIDH’s international and regional stakeholder gatherings. No private information will be collected by GIDH under any circumstances. It will not conflict with the General Data Protection Regulation (GDPR) enacted by the European Union, the Health Insurance Portability and Accountability Act (HIPAA) of the United States, the Personal Information Protection and Electronic Documents Act (PIPEDA) of Canada, or any other similar law, regulation, or initiative enacted by a single country to protect health data, ensuring the privacy and security of individuals’ personal health information.

Moving away from a product-focused digital health revolution, the GIDH will promote equal access to quality guaranteed digital solutions by using WHO norms, guidelines, and advice to increase global alignment in the vision and execution of digital services and applications. In order to facilitate quality-assured digital health transformation that meets national needs, the GIDH Transformation Toolkit will promote and make use of the existing WHO Digital Health Clearinghouse as a repository of curated digital solutions. Individual digital health tools and technologies will not be promoted by the GIDH.

Following an existing structure and process with a lean management system recognized by WHO Member States, the GIDH will be established as a WHO Managed Network of Networks. Instead of having its own legal identity, GIDH will take its legitimacy from WHO. Because of this, it will be housed and managed by WHO. WHO’s Constitution and General Programme of Work, Financial Regulations and Staff Regulations, manual provisions, and relevant WHO regulations, policies, procedures, and practices will be strictly adhered to in the administration of GIDH’s activities.

In the past, digital solutions to boost productivity were created in isolation, one for each distinct domain. Employing digital technology to improve the efficiency and efficacy of these health financing tasks is what we mean when we talk about ‘digital’ in health finance and how it can help bring about universal health care. Providing useful and reliable information for common provider payment mechanisms including line-item budget repositories, patient lists, empanelment for capitation-based techniques, diagnosis-related group case reporting, etc. is a big challenge today. Lower-middle-income countries are investing in budget management systems and social insurance premium collection systems, aiming to better pooling and resource mobilization. These countries are also ensuring that their insurance registries are complete and accurate and that the ease of electronic payment creates opportunities for increased revenue collection. Existing systems that supply data for various provider payment mechanisms are typically separated from clinical information systems, necessitating separate lines of reporting. This reduces data quality in connecting administrative data to clinical data and increases the administrative burden on providers. Data (mis)management is a potential deciding element in the success or failure of health funding initiatives. For instance, Kosovo’s primary care health finance reform was put on hold for almost 2 years because it was assumed that the country’s information systems couldn’t provide enough data for results-based metrics. Analysis of health payment data can help pinpoint wasteful outlays by revealing patterns indicative of things like unnecessary care (referrals, visits, lab tests, etc.), noncompliance with best practices, duplication of services, suboptimal drug prescriptions (for example, less use of generics than expected), suboptimal use of infrastructure and medical equipment, low workforce productivity, detectable high-cost centers (for instance, populations with disproportionately high healthcare costs), and so on. Care provider performance and quality may be assessed with the use of health finance data when combined with clinical data, paving the way for value-based payment models. Payers of the future will embrace digital solutions to maximize efficiency, cut down on waste, and minimize the usage of resources. Payers will be able to save money on overhead thanks to digital technologies that streamline traditionally inefficient administrative operations. Thirty-five to forty percent of the effect of the digital transformation of payers in the United States may be attributed to administrative cost savings generated by innovations like self-service tools, paperless communication, and automated sales support procedures. In addition, by analyzing health data, payers may find ways to save money via enhanced analytical, financial, and risk management capabilities. From the perspective of the population, novel DPI (Digital Payment Infrastructure) approaches like India’s unified payment system or Kenya’s M-Pesa system could allow the population to pay for health services in new ways, effectively allowing them to ‘vote with their feet’ by choosing and supporting higher-quality facilities⁶.

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Sources of funding

No funding was received.

Author contribution

H.C.: study concept and writing of the paper; P.: data collection and data analysis; O.P.C.: review and editing; T.B.E.: review and editing.

Conflicts of interest disclosure

The authors declare no conflicts of interest.

Research registration unique identifying number (UIN)

Not applicable.

Guarantor

Talha B. Emran

Data availability statement

No data sets were generated during the study.

Provenance and peer review

Not commissioned, externally peer-reviewed.