Political determinants of digital health: beyond the rainbow

In 2021, the World Health Organization issued its first global strategy on digital technologies and health, calling on member states to develop their own national digital health strategies. However, the normative tools that guide the development of these strategies do not prompt member states to consider how broader political factors, such as law and policy, governance, and civic engagement, could shape health outcomes in the digital age. The digital gender divide, algorithmic biases linked to race, transnational private sector actors, and more must be thoroughly addressed in future digital health strategies. Experiences from the global HIV response have demonstrated that it is possible to do this, by mobilizing diverse government and non-governmental actors to systematically assess and act to strengthen the legal and political environment for health. This essay draws on the HIV response to critically engage with recent literature on the digital determinants of health, proposing an approach to analyzing broader political determinants of health, including commercial determinants of health, and other laws, policies, governance, and civic engagement relevant to digital health strategies. By rendering visible the role of politics, governance, and civic engagement in digital health, strategies can be tools to mobilize broad collaborations and advocacy that creates an enabling environment.