Building health systems capable of leveraging AI: applying Paul Farmer’s 5S framework for equitable global health

Abstract The development of artificial intelligence (AI) applications in healthcare is often positioned as a solution to the greatest challenges facing global health. Advocates propose that AI can bridge gaps in care delivery and access, improving healthcare quality and reducing inequity, including...

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Main Authors: Liam G. McCoy, Azra Bihorac, Leo Anthony Celi, Matthew Elmore, Divya Kewalramani, Teddy Kwaga, Nicole Martinez-Martin, Renata Prôa, Joel Schamroth, Jonathan D. Shaffer, Alaa Youssef, Amelia Fiske
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Global and Public Health
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Online Access:https://doi.org/10.1186/s44263-025-00158-6
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author Liam G. McCoy
Azra Bihorac
Leo Anthony Celi
Matthew Elmore
Divya Kewalramani
Teddy Kwaga
Nicole Martinez-Martin
Renata Prôa
Joel Schamroth
Jonathan D. Shaffer
Alaa Youssef
Amelia Fiske
author_facet Liam G. McCoy
Azra Bihorac
Leo Anthony Celi
Matthew Elmore
Divya Kewalramani
Teddy Kwaga
Nicole Martinez-Martin
Renata Prôa
Joel Schamroth
Jonathan D. Shaffer
Alaa Youssef
Amelia Fiske
author_sort Liam G. McCoy
collection DOAJ
description Abstract The development of artificial intelligence (AI) applications in healthcare is often positioned as a solution to the greatest challenges facing global health. Advocates propose that AI can bridge gaps in care delivery and access, improving healthcare quality and reducing inequity, including in resource-constrained settings. A broad base of critical scholarship has highlighted important issues with healthcare AI, including algorithmic bias and inequitable and inaccurate model outputs. While such criticisms are valid, there exists a much more fundamental challenge that is often overlooked in global health policy debates: the dangerous mismatch between AI’s imagined benefits and the material realities of healthcare systems globally. AI cannot be deployed effectively or ethically in contexts lacking sufficient social and material infrastructure and resources to provide effective healthcare services. Continued investments in AI within unprepared, under-resourced contexts risk misallocating resources and potentially causing more harm than good. The article concludes by providing concrete questions to assess AI systemic capacity and socio-technical readiness in global health.
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issn 2731-913X
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publishDate 2025-05-01
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spelling doaj-art-bc08bd59d98f487cb351b307f9651ad12025-08-20T02:55:32ZengBMCBMC Global and Public Health2731-913X2025-05-013111110.1186/s44263-025-00158-6Building health systems capable of leveraging AI: applying Paul Farmer’s 5S framework for equitable global healthLiam G. McCoy0Azra Bihorac1Leo Anthony Celi2Matthew Elmore3Divya Kewalramani4Teddy Kwaga5Nicole Martinez-Martin6Renata Prôa7Joel Schamroth8Jonathan D. Shaffer9Alaa Youssef10Amelia Fiske11Institute for Medical Engineering & Science, Massachusetts Institute of TechnologyDepartment of Surgery and Anesthesiology, University Of Florida College of MedicineInstitute for Medical Engineering & Science, Massachusetts Institute of TechnologyDuke Health AI Evaluation & Governance, Duke University School of MedicineDepartment of Surgery, Rutgers Robert Wood Johnson Medical SchoolDepartment of Ophthalmology, Mbarara University of Science and TechnologyCenter for Biomedical Ethics, Stanford School of MedicineDepartment of Global Health and Population, Harvard School of Public HealthFaculty of Population Health Sciences, University College LondonDepartment of Sociology, University of VermontDepartment of Radiology, Stanford School of MedicineInstitute of History and Ethics in Medicine, Department of Preclinical Medicine, TUM School of Medicine and Health, Technical University of MunichAbstract The development of artificial intelligence (AI) applications in healthcare is often positioned as a solution to the greatest challenges facing global health. Advocates propose that AI can bridge gaps in care delivery and access, improving healthcare quality and reducing inequity, including in resource-constrained settings. A broad base of critical scholarship has highlighted important issues with healthcare AI, including algorithmic bias and inequitable and inaccurate model outputs. While such criticisms are valid, there exists a much more fundamental challenge that is often overlooked in global health policy debates: the dangerous mismatch between AI’s imagined benefits and the material realities of healthcare systems globally. AI cannot be deployed effectively or ethically in contexts lacking sufficient social and material infrastructure and resources to provide effective healthcare services. Continued investments in AI within unprepared, under-resourced contexts risk misallocating resources and potentially causing more harm than good. The article concludes by providing concrete questions to assess AI systemic capacity and socio-technical readiness in global health.https://doi.org/10.1186/s44263-025-00158-6Artificial intelligenceHealthEquityHealth systemsGlobal healthPaul Farmer
spellingShingle Liam G. McCoy
Azra Bihorac
Leo Anthony Celi
Matthew Elmore
Divya Kewalramani
Teddy Kwaga
Nicole Martinez-Martin
Renata Prôa
Joel Schamroth
Jonathan D. Shaffer
Alaa Youssef
Amelia Fiske
Building health systems capable of leveraging AI: applying Paul Farmer’s 5S framework for equitable global health
BMC Global and Public Health
Artificial intelligence
Health
Equity
Health systems
Global health
Paul Farmer
title Building health systems capable of leveraging AI: applying Paul Farmer’s 5S framework for equitable global health
title_full Building health systems capable of leveraging AI: applying Paul Farmer’s 5S framework for equitable global health
title_fullStr Building health systems capable of leveraging AI: applying Paul Farmer’s 5S framework for equitable global health
title_full_unstemmed Building health systems capable of leveraging AI: applying Paul Farmer’s 5S framework for equitable global health
title_short Building health systems capable of leveraging AI: applying Paul Farmer’s 5S framework for equitable global health
title_sort building health systems capable of leveraging ai applying paul farmer s 5s framework for equitable global health
topic Artificial intelligence
Health
Equity
Health systems
Global health
Paul Farmer
url https://doi.org/10.1186/s44263-025-00158-6
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