Social Participation and AI in Healthcare
At the Seventy-seventh World Health Assembly, a resolution was endorsed to embed regular and meaningful social participation in decision-making processes for health. The World Health Organization (WHO) defines social participation as empowering people, communities, and civil society through inclusive participation across the policy cycle and at all system levels. This shift towards social participation is critical for building equitable, responsive, and resilient health systems, especially in the context of artificial intelligence (AI) development for healthcare.
True social participation transcends mere handoffs and surveys. It involves genuine capacity building and collective learning. This process must foster a unified vision, leading to unified thoughts and actions. Trustworthiness is built, and unintended consequences are mitigated when actions are guided by purity of intent. This approach is particularly vital in the development and deployment of AI in healthcare, where the stakes are high, and the potential for both benefit and harm is significant.
To achieve this, we must start at the individual level. Individuals need to develop a mindset of service and a desire for truth. This step is crucial for cultivating a culture of social participation. People must be willing to engage sincerely and transparently, prioritizing collective well-being over individual gains. In healthcare, this means that both the institutions (hospitals and companies building software) as well as the individual participants (developers and users of AI technologies) must be committed to learning and exploring how to integrate ethical principles. This effort must be motivated by a genuine desire to improve health outcomes for all without ethical compromise. Equally important is the adoption of a learning posture in which a process of reflection and action is practiced both individually and collectively. With a unified vision of using technology to elevate wellness, and a process in which incremental learning and progress is being made, cynicism and pessimism will subside, replaced by enthusiasm and hope.
At the community level, behaviors consistent with agreed-upon values must be promoted. This involves creating an environment where diverse voices are heard and respected. Communities should also make space and time to actively participate in the development and implementation of AI technologies, ensuring that these tools address their specific needs and contexts. For instance, AI-driven healthcare solutions must be designed with input from the communities they intend to serve, ensuring cultural relevance and appropriateness.
Institutionally, policies and procedures must evolve to enable behaviors and values that align with the overarching goal of equitable and effective healthcare. Institutions will begin to reorganize and develop frameworks that support continuous engagement and feedback from all stakeholders. This includes creating participatory mechanisms that are inclusive, diverse, and equitable, with a particular focus on marginalized and vulnerable populations. Examples are already emerging from Community-Based Participatory Research (CBPR) which is an approach that involves community members in research to programs such as HeallthLINK in London, in which older house-bound people are involved in planning and monitoring health and social are using community development techniques.
The WHO resolution emphasizes the need for sustained participatory mechanisms, strengthening public sector and civil society capacities, and enabling equitable participation. The key term here is sustained. For this to occur, there need to be capacity building and learning bidirectional especially in areas in which are broad and complicated such as AI. Doctors and nurses need to lean in and begin to learn and work with companies who are building AI tools, to build a common language and help bridge misconceptions and fears that currently exist, and begin to focus on the topics that currently matter for ensuring that AI technologies are developed and deployed in ways that are ethical, inclusive, and effective.
Moreover, the resolution highlights the importance of policy uptake of recommendations from participatory processes, allocation of adequate resources, supportive public policy and legislative frameworks, and advancing research, monitoring, and evaluation of social participation impacts. These actions are essential for creating a robust environment where AI can thrive in ways that truly benefit humanity.
Social participation ensures that technologies are not just imposed but are co-created with the communities they aim to serve. This collaborative approach builds trust and fosters mutual respect, and requires health systems to be more responsive and innovative.
The WHO’s commitment to advocating for regular and sustained social participation to reorient health systems towards primary healthcare is commendable. As AI continues to evolve, it is imperative that we adopt a holistic approach to social participation, one that acknowledges the progress nature of change — from individual mindsets, community behaviors, to institutional frameworks. Developing a unified vision first, will enable for thoughts and actions to then be aligned. This will ensure that AI in healthcare is developed and implemented in ways that truly serve humanity, mitigating risks and maximizing benefits. Most critical is to recognize that social participation is not a box to be ticked but a continuous, dynamic process of building capacity, fostering collective learning, and creating unified actions based on trust and ethical intent.
Salim Afshar
Chief Medical and Innovation Officer
