Cyberspace, Digital Technologies, and Reform of Global Health Governance

As posts on Net Politics have analyzed, the COVID-19 pandemic has reinforced the capabilities that cyberspace and digital technologies provide and fueled cybercrime, cyber espionage, cyber threats to critical infrastructure, online disinformation, and privacy concerns. Efforts to reform global health governance provoked by the pandemic recognize the need to maximize these capabilities and mitigate those problems. Prepared for the upcoming meeting of the World Health Assembly, the much-anticipated report [PDF] from the Independent Panel for Pandemic Preparedness and Response provides a window into high-level policy thinking about cyberspace, digital technologies, and the future of global health.

Among the defining features of the pandemic, the independent panel identified [PDF] the challenges created by a digital environment helpful for disease surveillance and information sharing but “marked by vast social networks, a relentless appetite for instant information, a digital divide, and, in many places, a deep distrust of government and institutions.” In this context, social media spread a global “infodemic” of misinformation and disinformation, even affecting countries where internet access is limited. The panel captured the promise and peril by noting that digital technologies “are a double-edged sword—they are an effective and vital way to convey evidence-based information quickly, but are also a space where rumours, anxieties and fears can be amplified instantly.” In addition, the pressure on governments to contain the pandemic produced digital tools, such as contact tracing apps, often deployed without sufficient protections for privacy and other human rights.

In its recommendations, the panel focused on improving the contributions that digital technologies can make in disease surveillance. It argued that the World Health Organization (WHO) should “establish a new global system for surveillance, based on full transparency by all parties, using state-of-the-art digital tools to connect information centres around the world and including animal and environmental health surveillance, with appropriate protections of people’s rights.”

To unleash this potential, the panel recommended that WHO member states remove barriers to real-time digital surveillance, especially concerning respiratory pathogens, created by the International Health Regulations (2005) (IHR)—the main international legal instrument on infectious diseases. By exploiting the capabilities of digital technologies and changing legal rules that prevent a precautionary approach, the panel seeks to empower the WHO to “publish information about outbreaks with pandemic potential on an immediate basis, without requiring the prior approval of national governments.”

This proposal raises several issues. First, the panel makes no recommendations on how to address the infodemic crisis it identified as a defining feature of the pandemic. As COVID-19 demonstrated,disinformation is a potent way to create serious problems for governments, international organizations, and individuals concerning infectious diseases. The proliferation of disinformation heightens the need for vetting disease information carefully, a process that must involve the governments of countries purportedly experiencing outbreaks. Thus, unless mitigated, the infodemic problem poses a threat to real-time digital surveillance operating under the precautionary principle.

Second, the panel’s assertion that the IHR restricts digital surveillance and inhibits precautionary actions by requiring WHO to obtain “prior approval of national governments” before sharing information is wrong. The IHR operationalizes a precautionary approach and does not give governments a veto over information sharing. The WHO can receive information from non-governmental sources and seek verification without any government’s permission. A country can share evidence with WHO about public health risks outside its territory that could spread internationally without approval from the government of the state where those risks arise. The WHO can share information if a government does not respond to a WHO offer of collaboration concerning a disease event. The WHO can share information it receives from a government without that government’s permission if WHO has evidence of international disease spread. Based on information WHO has received, the WHO director-general can convene the IHR’s emergency committee and declare a public health emergency of international concern without approval of the government affected.

Third, a proposal for a real-time digital surveillance system covering human, animal, and environmental health with “full transparency by all parties” runs headlong into the global rise of cyber sovereignty and digital authoritarianism and the decade-long decline in internet freedom. These trends demonstrate that many governments do not practice “full transparency” of any kind of information, let alone outbreak information that could prove politically or economically damaging. Rather than turning this tide, the pandemic produced more authoritarian actions, including digital censorship, repression of online expression, pervasive electronic surveillance, and government-led disinformation campaigns.

The panel’s failure to tackle the infodemic crisis and digital authoritarianism evokes sympathy because no policy area has developed effective responses to the pervasiveness of online disinformation or the perniciousness of digital repression. However, these cyber problems pose greater threats to maximizing digital technologies for global disease surveillance than the IHR’s provisions on information sharing. Eventually, efforts to reform global health governance in the wake of the pandemic will have to confront them.