The Seventh Global Symposium of Health Systems Research (HSR) was organized from October 31 to November 4, 2022. Participants gathered on site in Bogota, Colombia, or online to discuss the theme "Health Systems Performance in the Political Agenda: Sharing Lessons for Current and Future Global Challenges". As the Smartphone Pandemic project is coming to an end this year, team members took the opportunity to organize a panel session to present their research findings and reflect on the role of digital technology in the COVID-19 response in Sierra Leone, Myanmar, Japan and the UK. The online session addressed several of the conference sub-themes, including “the changing dynamics of health provision models to promote equity” and “the politics and policies of health systems”.
Project lead Katerini Storeng from Centre for Development and the Environment kicked off the session highlighting global trends in the use of smartphone technologies in the COVID-19 response. She described and problematized how new partnerships between technology companies and national and international health authorities were formed during the pandemic. These new partnerships challenged established public health norms and principles of digital sovereignty and highlighted the growing power of tech corporations to influence public health agendas.
Fredline M’Cormack-Hale from the Institute for Governance reform in Sierra Leone was the first to share insights from the different case studies involved in the project. She emphasized how many of the technologies that were pressed into service in Western countries were not considered necessary for managing the pandemic in Sierra Leone, which relied on quick lock downs, low-tech apps, and the use of locally based mechanisms such as people-based contact tracing. The findings suggest that the focus on apps is misplaced in the context of Sierra Leone and should rather be on getting the conditions right first i.e., strengthening health care systems.
High-tech digital contact-tracing also played little role in Myanmar’s initial successful management of the pandemic. Tom Traill, Director of Policy and Research at Community Partners International, explained how low-tech approaches and local government structures were key in managing the first wave of infections. However, existing positive attitudes to the government’s use of digital technology to offer health information completely shifted with the military coup in 2021. Feelings of fear, oppression and mistrust now run through society as the military increasingly uses technologies to manage dissent.
Finally, Sakiko Fukuda-Parr from the New School shared perspectives from comparing contact-tracing responses for COVID-19 in Japan and the UK. Despite high investments in the UK, contact tracing apps had poor results and a displacement effect on manual contact tracing, while in Japan, technological tools were not central in the national strategy at all, and manual contact tracing implemented by a network of local public health centers played a more important role. Fukuda-Parr explained how this highlights that contextual factors such as social and political determinants of health and relationships to techno-optimism matters in technological innovation.
The session ended with an engaging discussion with the audience led by Sridhar Venkatapuram from King’s College London. The panel reflected on several lessons learned from the research project, including the need to 1) include ethical considerations in pandemic preparedness and response, 2) scrutinize companies’ involvement in public health policy during and after crises and 3) challenge uncritical techno-optimism.
The research findings from the different national case studies will feature in forthcoming publications.