Session 3: Advancing Public Health Digital Technologies and Artificial Intelligence
On February 7, 2024, IANPHI held a session of the Annual Meeting dedicated to digital technologies and artificial intelligence for advancing public health. This session focused on new digital technologies available for National Public Health Institutes (NPHls) with a particular focus on artificial intelligence (Al) by raising the following questions:
- What are the potential and perils of Al for public health?
- How are concrete Al-powered technologies utilized today and what are the experiences so far?
- What should be the next steps for NPHls to get ready, and should we move quickly or slowly?
The session was moderated by Dr. Trygve Ottersen, Executive Director, Norwegian Institute of PublicHealth (FHl). Norway, and Chair of the IANPHI Europe Regional Network. The speakers were Dr. Eric Remera, Division Manager, Research, Innovation and Data Science and Senior Researcher, Rwanda Biomedical Center (RBC), Rwanda, Dr. Rose Nakasi, Researcher, Al Lab, MakerereUniversity, Uganda and Prof. Dr. Lothar Wieler, Chair, Professor for Digital Global Public Health, Hasso-Plattner-lnstitut, Germany. Dr. Trygve Ottersen, opened the session by emphasizing the pressing need to address the implications of artificial intelligence (Al) for public health institutes. He highlighted the necessity of practical discussions on the short-term impact of Al on operational work, alongside considering long-term prospects. Dr. Ottersen underscored the importance of learning from each other's experiences and varying perspectives within and across institutes, aiming to delineate concrete actions for the future. A distinguished panel of speakers with expertise in Al technologies joined the discussion to present different case studies and perspectives on the matter.
Panelists introductory statements and Case Studies
By Dr. Eric Remera, Division Manager, Research, Innovation and Data Science and Senior Researcher, Rwanda Biomedical Center (RBC), Rwanda
Dr. Eric Remera, delved into the practical applications of artificial intelligence in the realm of public health. Drawing parallels between Al and innate human cognitive functions like pattern recognition, Dr. Remera sought to demystify Al, positioning it as a tool for augmenting human capabilities rather than an autonomous entity. He identified four primary challenges in public health-namely, pandemics/epidemics, healthcare system strains, fragmented working silos, and resource limitations-and proposed Al as a solution to address these hurdles. Dr. Remera articulated how Al could enhance healthcare services by facilitating quicker diagnosis, bolstering surveillance efforts and optimizing clinical management. He stressed the significance of adopting integrated approaches such as one health and leveraging big data to develop comprehensive models for informed decision-making in public health interventions. Providing concrete examples from Rwanda, including the use of robotics in surgery, data-driven on communicable disease diagnosis enhancements, and genomic surveillance initiatives using wastewater to detect outbreaks, Dr. Remera showcased Al's potential to revolutionize healthcare delivery. Despite extolling Al's virtues, Dr. Remera underscored the importance of maintaining human oversight and involvement to ensure the ethical and effective utilization of Al technologies in healthcare settings.
By Dr. Rose Nakasi, Researcher, Al Lab, Makerere University, Uganda
In her presentation, Dr. Rose Nakasi, highlighted the multifaceted role of artificial intelligence (Al) in revolutionizing healthcare. She underscored Al's potential to improve disease diagnosis, treatment, and health management, particularly in resource-limited settings like Uganda. Dr. Nakasi outlined various Al applications in healthcare, including disease surveillance, patient scheduling, and fraud detection in healthcare claims. She highlighted ongoing research at Makerere University, focusing on developing Al solutions for mobile microscopy of malaria to address the shortage of skilled technicians. By using Al algorithms on mobile phones, Makerere University aims to streamline malaria diagnosis, enhance disease surveillance, and integrate real-time data into government health management systems. Dr. Nakasi also addressed challenges such as data scarcity, inadequate infrastructure, and the rapid pace of technological change, stressing the importance of adaptable and resilient Al solutions. She underscored the need for ethical considerations and interdisciplinary collaboration between Al experts and healthcare practitioners to ensure responsible and effective implementation of Al technologies in healthcare systems. Dr. Nakasi's comprehensive overview highlighted both the potential and the complexities associated with integrating Al into public health initiatives, offering valuable insights for policymakers, researchers, and healthcare professionals alike.
By Prof. Dr. Lothar Wieler, Head of the Chair, Professor for Digital Global Public Health, Hasso-Plattner-1nstitut, Germany
In his presentation, Prof. Dr. Lothar Wieler, Head of the Chair for Digital Global Public Health at Hasso-Plattner-lnstitut, delved into the imperative role of artificial intelligence (Al) within public health institutions. He contextualized Al's omnipresence in daily life, urging these institutions to proactively leverage its capabilities. Prof. Dr. Wieler elaborated on the transformative potential of Al in streamlining workflows and disseminating knowledge across public health domains. Despite these promising prospects, he acknowledged prevalent challenges, including the digital divide, inherent biases in algorithmic training, and the propagation of misinformation. To address these hurdles, Prof. Dr. Wieler proposed comprehensive strategies, emphasizing the need for systematic identification of Al use cases tailored to diverse public health functions. He underscored the significance of collaborative efforts among national public health institutes to rigorously evaluate and implement Al solutions, advocating for a lead-by-example approach to showcase the efficacy of Al tools compared to traditional methodologies. Additionally, Prof. Dr. Wieler highlighted surveillance and antimicrobial resistance and misinformation as pivotal areas for the global application and comparative analysis of Al solutions, emphasizing the importance of meticulous evaluation methodologies and strategic partnerships to drive advancements in digital public health initiatives.
Open discussion and reflections from the audience
Dr. Ottersen introduced the open discussion by highlighting some areas of debate and some of the areas where it seems to be widely shared optimism. He also emphasized that Al for public health goes far beyond Al for health care. One of the areas where many people seem to expect early benefits from Al is infectious disease surveillance and modelling. Dr. Ottersen further acknowledged the diverse attitudes towards Al in general, ranging from cautious to enthusiastic, noting the value of an approach that combines these two attitudes, i.e. leaning forward while being critical about the benefits and harms of the various technologies and tools. He also underscored that Al is not one thing, and thus we need to assess each specific technology and tool carefully. He encouraged participants in the audience to share their experiences and case studies to further enrich the discussion.
Several participants shared insights into the implementation of artificial intelligence (Al) in public health. Dr. Theresa Tam, Chief Public Health Officer, Public Health Agency of Canada IPHACI, Canada outlined several ways her agency leverages Al, including automated systems for data collection and analysis, genomic analysis for disease surveillance, and innovative applications like social media data analysis for vaccine adverse events. Prof. Henrik Ullum, Director of the StatensSerum lnstitut discussed Denmark's Al strategy, emphasizing the importance of balancing new opportunities with caution to prioritize data privacy and security. Zheng Jie Marc Ho, Group Head, Interim Communicable Diseases Agency, Ministry of Health Singapore, shared experiences and concerns, such as the choice between commercial products and in-house development, the need for transparency in Al decision-making, and the sustainability of Al solutions. Dr. lfedayo Adetifa, Director General of the Nigerian Centre for Disease Control and Prevention, raised concerns about the increasing focus on Al in public health, labeling it as a "sexy" topic attracting attention and funding. He cautioned against overly prioritizing Al over foundational public health informatics, stressing the need for expertise in basic statistics and data analysis. Dr. Ottersen mentioned a user case from the Norwegian Institute of Public Health, involving the use of machine learning in evidence synthesis and systematic reviews. He concluded by highlighting how many initiatives are already underway, how diverse they are, and how much we can learn from each other. He underscored that IANPHI can play a supportive role in this space and that next steps will be discussed against the background of the points raised in this session. He thanked all participants for sharing their views and experiences.