Chris Zielinski

Visiting Fellow, University of Winchester and Programme Lead, Partnerships in Health Information (Phi), UK

Access to health information is a human right, as underscored in the Covenants to the Universal Declaration of Human Rights (UN/ECOSOC, 2000), and the UNESCO declaration on “Multilingualism and Cyberspace” (UNESCO, 2003). However, when we consider how knowledge is used in health development, it becomes clear that there are “knowledge gaps” – the various failures of communication (some due to a lack of access, some to social, economic or cultural factors) that impede the access to and application of knowledge in the health sector. The “know-do gap” – where, although the knowledge exists to resolve a health problem, it is not applied for various reasons – is the most pernicious problem.

The many years of colonial rule which many countries in sub-Saharan Africa experienced contributed to the creation and continued persistence of knowledge gaps in their health systems. The departure of the colonial powers (which has typically been partial or incomplete) has not been accompanied by complete decolonisation of the health systems and their associated knowledge systems. This is evident in the important and continuing role of traditional medicine and traditional healers, and the local/indigenous knowledge associated with the practice of traditional medicine. So far, this knowledge fits uncomfortably into the modern health system. Traditional systems of knowledge have long been disparaged in the development process. On one hand, indigenous knowledge has been denigrated, and on the other, it has been appropriated or simply stolen.

The decolonisation discourse also applies to the Open Access movement: while better access to health information is to be welcomed, there is concern that the information pouring through the open floodgates will sweep away access to and respect for local knowledge altogether, and that a new kind of knowledge colonisation will take place.

Specific possible solutions include the establishment of national health observatories – online platforms collecting and disseminating aspects of available national health knowledge. Allied to such platforms, some countries have begun to follow WHO’s recommendation to draw up full-scale national knowledge management plans.

The new field of infodemiology and the principal issues arising in an infodemic, as experienced during Covid-19, focuses on “information disorders” such as misinformation, disinformation and misinformation (Zielinski, 2021). Care must be taken in applying generative artificial intelligence and other emergent technologies, which are a double-edged sword: capable of helping to provide unparalleled access to health information, but also capable of greatly increasing the confusion produced by information disorders (Zielinski et al, 2023).

Keywords: global health, knowledge, capacity building, knowledge management, policy, practice