-Rapid change in cities but this is also a challenge 
– legislation, authority may not be with the city ( jurisdiction issue), legal mandate 

-Cities are a perfect laboratory  

-We need to practical

-Support public health services 

-Urban preparedness 

-Urban lens can be added to programmes, contextualization

-Cross programmatic approach should be tackle with managerial tools (it is not a scientific issue)

-Problem solving orientation

-Capacity to reach cities, we work with national networks, association of mayors

•Regional WRs-head of programmes consultation addressing practical actions

•Mapping out governance and commitments in countries 

·         The digital fever

o   Establish action plans and strategies – by engaging other sectors beyond health because digital health has other partners outside of health

·         Lack of human resources and country capacity

o   No NPOs working on digital health; difficult to work on digital health if there are no people in the field

o   Data and digital health is now one unit making it easier to collaborate and mobilize resources

·         Lack of coordination within and outside WHO

o   Digital health is not a programme itself, need to work close collaboration with various technical units as an enabling function

·         Main barriers are UN partners because it is difficult to work with existing projects to include digital health

 

·         Alex: barriers: rigidity of the health systems and the legal norms/regulation that governance it. System is set up that makes it difficult to change and doesn’t happen overnight

 

·         Michel: WHO definition is fraud/prone with inequity. Digital health is to be sure that health sector is getting fair share in a digitalized world. Making sure health is not operating in silos in a digitalized world. 

 

·         Hanni: Does WHO has a strategy to engage with the private sector? There are a lot of competition especially within EURO

 

·         Silviu -Pilot Project: 

o   The barriers is the governance and political instability; lack of human resources; relay on WHO CC but can not get the support from WHO CC; 

Alexandre: KOS

·         Good example: it is possible to collaborate 

·         Bad example: KOS having digital vaccination doesn’t work outside of KOS

·         What is KOS comparative advantage. Service beyond patience record into mainstream; manage expectation and learning from countries. WHO integrated the e-governance system; e-health in UKR

 

Silviu -Pilot Project: 

o   good example: how we position in tele-medicine in GEO in partnership with UNICEF and UNFPA. WHO is building legal and regulation as part of the PHC reform allowing WHO to take the lead in digital health. 

o   The challenge now is to continue to play the leading role. 

 

Marija: ISR is good in IT has a lot of experience especially during pandemic. Good to highlight the experience. 

 

Sergey: learning from Mongolia which started digitalization long time ago. PM announced that Mongolia to become a digitalized nation. All the investment done before was not well coordinated are now being erased. Need guidance on normative issues related to digital health. Need to explore who is implementing. It is private companies and there is huge competition making it difficult for WHO to navigate the relationships with private companies. Mongolia is good in using digital devices (good example/innovation of new technology) but health information system component is very difficult

Michel: Need to have a survey on the landscape on what is and what is not digital health, that facilitate health

 

Hanni: don’t need to start from scratch. Need to consider partnering with IT analysts and IT strategist. A lot of analysis has been done on the barriers, ethical and legal challenges. WHO need to set the right framework for governance and standards. Working with HQ to team up with the IT analysts and specialists

 

Yuka: need to set up early warning systems. Is there a space for ad hoc application like the system set up in war in Bosnia/Balkans in the 1990s 

 

Jihane: WHO’s advantage is evidence, on UHC and getting services out there. To have one information system. 

 

Bettina: process vs outcome – the unit is to work with technical unit to advance digital health. Small country initiatives (11/12 countries) – four possible advantages for rapid success stories

·         Health information system: MNE systems are not combined (PHC, health system, etc – requiring help from WHO)

·         Countries don’t have a proper denominator to calculate the mortality

·         ICE is the world leader in terms of innovation on digital health

·         Social media channels in the small countries – they are getting from everywhere else but there can be the producers of information

·         May 2030 – big topic areas

 

Silviu -Pilot Project: 

o   1-3 things to do: legal review; assessment 

o   Digitalize facilities doesn’t just mean getting equipment. WB is selling loans and investment plans which is unsustainable

Donna: Partnerships and collaboration: huge opportunity with WHO CC e.g. to advocate for us in countries, to address mis-information, a network of WHO CC in digital health can strengthen country impact

Jihane: before the digital, is to make a proper health information system. Need to be MoH to reinforce digital health. UN – ITU is running this at the country level (in MKD). WHO need to be strategic to catch up

Jihane: inter-divisional collaboration is extremely important. E.g. vaccination and digitalization

o   1-2 things:

§  Guidelines on how to assess digital system is useful; maybe can develop a rapid assessment

§  To define the boundaries what is our role and what is others’ role before the RC. To refine with ppl in the country

 

Erwin: 1-2 things– there should be some guidance for a common system for bottom up process

 

Michel: 1-2 things- need to map country at risk, need to have better mapping of country on health sector in digitalizing as countries are not comparable. ISR is digitalization of the entire PHC – it is a major success of the pandemic. Need to focus on law of privacy which is very relax but in EU people are very concerns with privacy which is a major barrier