A socio-legal critique of the commercialization of digital health in Sub-Saharan Africa

Abstract

The rise of digital health in Sub-Saharan Africa has fuelled enthusiasm about the potential benefits of digitalization. However, current literature has not paid sufficient attention to the ways in which digitization of health may be entrenching structural problems within health systems. In this paper, we illustrate the ways in which digital health has led to increased commercialization of health in Sub-Saharan Africa through the financing of digital health, innovative delivery of diagnostics and pharmaceuticals products, and the management of government information systems and services in the health sector. Using Kenya, Uganda and South Africa as illustrative cases, we undertook a comparative analysis of legal and policy landscapes to critically explore these dynamics. We found that the unregulated involvement of commercial actors in the digital health agenda is distorting already fragile health systems and is increasingly occurring in a governance vacuum. Additionally, existing regulation is not sufficiently targeted towards commercial actors which decentres the role of the state and reduces regulatory oversight due to arm’s length regulation by data commissioners.