Global Perspectives on Digital Health

How do global organizations built to respond and aid in conflict respond to digital transformation? The International Committee of the Red Cross (ICRC) : you’re probably familiar with the work that happens here : emergencies, conflict zones, disasters, working at the last mile in difficult circumstances. How does an organization like even begin to approach “tech innovation” There’s clearly lots of need.

What do you prioritize when everyone needs improvements now? 

PLUS How do you adapt off the shelf LLM models for remote humanitarian contexts?

Javier Elkin spent 3 years as Director of Digital Innovation at the ICRC. He set the unit up from scratch. Coming in at a time, post COVID, the opportunities for tech addressing unmet need proliferated. And in parallel trying to create stability with multiple financial crises and organizational challenges.  

If you’re in digital health and wrestling with the global scale and local trust and value tradeoffs, have a listen to how an actual global organization dealt with it. 

Some standouts for me from our convo:

We spoke about context : correctness vs being useful

If you ask a LLM : What do I do for this gunshot or limb trauma, it might be reasonable to say that a response like : call emergency services is universally correct. 
But in a conflict zone or very rural setting, that has zero value compared to “take two pieces of wood to act as a splint”, or try X to stem blood loss.
How did the ICRC digital team work (with partners at EPFL) on their validation and evaluation to get better at these aspects?

Your LLM might be technically, and even medically correct, but completely useless on the ground for someone. 

2. Prioritization based on outcomes, constraints, feasibility

3. We get some proper concrete examples that cover:

How they used tech to aid a handover to a local healthcare system in Western Nigeria after years of being there. 
How they used an open source tool already being used in the field to help spin up digital workflow solutions FAST
How they partnered with EPFL to develop testing, validation and evaluation pipelines for LLM decision support specific and relevant for conflict settings (some absolute gold in here)

We also get Javier’s honest reflections about the humanitarian sector in general : how the financial crises (esp the last year with huge funding challenges) have manifested, what next for the humanitarian sector and what could be done differently. 

Packed with lessons this one, do not miss it.

Chapters:
00:00 Introduction to Digital Health and Javier's Journey
07:55 Approach to creating a digital health unit from scratch
13:53 Prioritization Framework at the digital health
22:32 Innovative Solutions in Humanitarian Health
29:21 Strategic Handover and Local Ownership
35:20 Integrating Digital Health in Conflict Zones
41:21 Evaluating AI in Humanitarian Settings
53:26 Reflections on Trust and the Humanitarian Sector

At the end of last year I got the chance to record the first episode of the show in an actual studio. Still a lot to learn about this versus virtually, but Patty Mecheal was a gracious and very awesome guest. 

Patty, CEO of healthenabled brings nearly three decades of mHealth and digital health experience into this discussion we recorded during the Global Digital Health Forum in Nairobi in December 2025.  
After a tumultuous year of policy shifts with USAID funding, WHO shifts and the cascading challenges globally, our conversation examines how we got here and where we need to go when ethics and inclusivity are politically sidelined.

What we cover:
The state of 2025 - USAID cuts and their ripple effects on healthcare and digital health in underserved communities
Lessons from the 1990s to now - what patterns keep repeating, and what fundamental mistakes we're still making
Women as decision-makers AND consumers - why this isn't just the "right thing to do" (though it is), but represents massive unmet market opportunity
Value and context in evaluation - how to actually assess digital health and AI tools in ways that matter
Leadership with values - Patty's honest reflections on what she's learned and gotten wrong
Building responsibly when the incentives don't reward it - what does ethical implementation look like now?

This episode is for you if you:
Build digital health or AI solutions
Make policy or funding decisions
Research or evaluate health interventions
Are working on impact in women’s health

Unfiltered, real insights from someone who's seen it all. 

Chapters and Timestamps

00:00 Introduction to Global Perspectives on Digital Health
01:24 Reflections on the Global Digital Forum
04:03 Patti's Journey and Background
08:20 Aha Moments in Public Health
11:46 The Importance of Data in Health Interventions
16:01 Learning from low resource settings
21:55 Building Trust in Digital Health Solutions
24:50 Balancing Scalability and Trust
30:22 The Role of Compassion in Healthcare
40:53 The Theory of Change in Digital Health
46:13 Bootstrapping Innovations in Digital Health
52:49 Compassionate Leadership and Ethical Practices
57:08 The Role of Women in Health and Technology
About Patty:
Dr. Patricia (Patty) Mechael is a global digital health leader, speaker, and award-winning author with nearly 30 years of experience shaping equity-centered health and technology initiatives across more than 45 countries. She is Co-Founder and CEO of health.enabled, where she leads the Global Digital Health Monitor and Digital Health and AI Strategy efforts with Gavi, the Vaccine Alliance, WHO, UNICEF, and others. She is also a Senior Associate Professor at the Johns Hopkins Bloomberg School of Public Health where she serves as the Co-Principal Investigator for the Gates Foundation’s Digital Health Exemplars and where she also teaches a course on Gender-intentional Digital Health. Known for translating complex ideas into human, actionable insights, Patty writes and speaks widely on responsible AI, gender equity, and the future of work and health—bringing a grounded, compassion-driven leadership lens shaped by both evidence and lived experience.

I sat down to talk to Nadia Kadhim, co-founder of Naq about digital identity and healthcare for displaced people. 

Nadia’s father was a refugee, and we hear about her journey into human rights law and eventually into data security and compliance. 

We cover:
That digital identity for displaced people is messed up. 
How this creates very real barriers to care (with examples)
How healthcare systems aren’t set up for real access or meaningful care for refugees
Can we even do anything about this when political agenda in many places cares less and less about this?
Why, even so, we should wake up - the likelihood of us being displaced due to conflict or climate change is going up. How would we want to be cared for?
This is an everybody problem, which is part of why it’s so hard to solve. 

If you’re into policy, data security, health and digital for displaced people, or building tools that could be being used by refugees, you’ll gain a lot from spending less than an hour on this topic. 

If you care about this topic you should also listen to the episode with Aral Surmeli. Inspiring in equal measure.
Chapters
00:00 Introduction to Digital Health and Human Rights
07:19 Data, Identity, and Access to Healthcare
10:39 Challenges Faced by Refugees in Healthcare
15:21 Real-Life Stories of Refugees and Healthcare Access
20:32 Why no solution yet?
23:01 The Future of Healthcare for Displaced People
30:29 The Role of Funding and Multi-Stakeholder Approaches
31:59 Data and Human Lives: The Health Data Poverty Problem
34:22 Ethics and Regulatory Compliance in Digital Health
38:22 Ownership and Security of Health Data
43:13 Nadia's Recommendations for Policy Makers and Digital Health Founders

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Global Perspectives on digital health shares the insights of innovators, donors, policy makers and researchers on what it takes to create impact at the last mile with digital health and AI in underserved communities around the world through audio and video. 

We’re telling the underreported stories of impact that the digital health industry needs to pay more attention to. 

There’s a growing back catalogue of over 20 engaging, inspiring and real conversations about the places in the world where the biggest challenges lie, but where the deepest impact in healthcare is happening. Tune in on gpodh.org
Subscribing and sharing really helps get this to the noggins of people who care about this topic. If you found this useful, please leave us a comment and some review stars.

🎯 Evaluation! A make or break thing in the digital health. 
I sat down with Dr Shay Soremekun from the London School of Hygiene & Tropical Medicine to talk about the very hot topic of evidence generation and evaluation. 
Everyone's talking about LLM evals, technical performance, benchmarking. 
But ultimately people care about impact. Yet impact is rarely a neat, linear path to a yes/no answer. Anyone who's actually implemented something in the field knows about all the other contributing factors, the daily challenges and how hard it is to move the needle on big clinical outcomes with robust clinical evaluation.
To understand why it improved care, if it did, was as important, if not more important, than understanding that it did. Because that will help us to understand how we need to potentially modify or adapt the intervention either in the same place or in future places to be able to achieve the same success. 

🌟 Who will benefit from listening to this episode?
Digital health companies : Founders, data scientists, AI/ML scientists, PMs, designers, clinical evaluation/study teams, clinicians
Funders : donors, investors
Global and public health professionals
Implementers
Researchers
Regulators

Shay explains the use of Program Theory and Logic models to visually connect your intervention, all the intermediate steps (not just technology, but people and change) to outputs, outcomes and long term impact.  Making space to observe other levers in the system you didn't initially anticipate. 

The work that Shay and her team have done with The Malaria Consortium and LSTM's Centre for Evaluation looking at a digital health tool for community health workers in villages and facilities showed this perfectly. Because they were intentional about observing the whole system, they discovered other factors contributing to impact and could redirect efforts accordingly.
In this age of tightening budgets, and pressure to show clean shiny KPIs, how do you make room to observe these things? 
We also discussed decolonizing evaluation: capturing what's locally valuable, not just paradigms of success developed in comfortable offices and ivory towers.
So many learnings here for understanding good co-design, implementation, and how to measure what matters.
Chapters
00:00 Intro
04:15 Mozambique digital health tool for CHWs : context
14:19 Tsking a system lens approach
16:25 Measuring What Matters in Health Interventions
23:02 Resourcefulness in Low-Resource Settings
27:25 Challenges and Successes in Digital Interventions
29:34 Proactive Measurement and Adaptation
31:20 Scaling Up Successful Interventions
32:59 Revolutionizing Evaluation Practices
39:38 Incorporating Indigenous Knowledge in Evaluations
44:57 Key Recommendations for Measuring What Matters
 
💡 Keep learning!
If you found this episode helpful listen to:
Episode 15 : Implementation 101 and how to Fail well with Caroline Perrin
Episode 12 : Health First, Innovation second, with Smisha Aggarwal
Episode 5 : What is the right approach for regulation and evaluation of digital health technologies?
I have also written a Substack article summarising what I learned from this episode. Check it out for easy reference to the concepts outlined.

Found it useful? Know someone who is struggling with this very thing? Share and keep raising the profile of people impacting underserved community globally.
References and links to things we spoke about

inSCALE papers:
https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0000235
https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0000217
 
Link for upSCALE  (roll-out of project):
https://www.malariaconsortium.org/projects/upscale
https://www.malariaconsortium.org/resources/integrating-upscale-into-the-ministry-of-health
 
Study protocol for Uganda and Mozambique:
https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-015-0657-6
 
Links to Chilisa Bagele – one of the most foremost voices on decolonial evaluation methodology so a good start for anyone interested (talk at LSHTM):
https://www.lshtm.ac.uk/newsevents/events/decoloniality-and-indigenous-methods-global-health-evaluation-professor-bagele

Centre for Evaluation Website 
https://www.lshtm.ac.uk/research/centres/centre-evaluation
 
About Dr Shay Soremekun
Dr Shay Soremekun is an epidemiologist and co-deputy Director of the Centre for Evaluation at the London School of Hygiene and Tropical Medicine.
Her research in child and adolescent health and development covers trials of low-cost disease prevention programmes, and identification of risk factors and mitigation strategies for poor developmental and economic outcomes in this group. She is a member of the UK Government Evaluation and Trial Advice Panel (ETAP), and sits on the steering committee for the John Snow Society. She lectures at postgraduate level on topics of evaluation, epidemiology and public health, and has developed and organises an MSc module in Study Design.
 
LSHTM page: https://www.lshtm.ac.uk/aboutus/people/soremekun.shay

🚨 Nick Martin, social impact titan, one of the biggest voices out there in this space with a huge following and community, helping connect people to jobs, funding and much more.  Founder and CEO of TechChange, working with funders, government and tech, and giving people the skills they need to create real impact. 

We’ve talked a lot about the impacts of the USAID funding cuts on this podcast. Nick, who has worked shares his view on the impact on grantees, humans and more. We cover:

How do we deal with this new world order, and this new scarcity?
What have we learned about the things that went well with USAID, and what could be better in the future?
How do people affected think about their careers?
How do organizations  adapt their vision, strategy and tactics in a world of scarcity, and be sustainable through this perma-uncertainty. 

We also talked about the upcoming Global Digital Health Forum, a gathering that has been going strong for years, and why this year feels particularly important to bring people in global and digital health together. The next one at the time of recording is 3-5 December 2025, online and in Nairobi in person. If you're into Global Digital Helath and underserved communities, this is a great gathering to attend.

If you are working in this space, dealing with the uncertainty, either as an organization or an individual, then this podcast is for you. 
Nick shares some of the wisdom and insights he has gained over the years, and why community across borders is such an integral part of how we shape what global digital health looks like in the next 10 years. 

Check it out - share with others working in the space. Leave us a comment or review - it really helps us reach more people. 

00:00 Intro : Nick's story
03:58 USAID cuts. Before, during, after : reflections from the development sector
21:13 Career transition advice
24:14 Funders need to step up more, but it's not that simple
26:34 TechChange origins
28:22 The Global Digital Health Forum : bringing people together
34:30 Fail festivals and creating the space to talk about failure
38:56 Wisdom corner : Nick's top tips
Liked this episode? What to listen to next:
- Episode 15: Implementation 101 and how to fail well
- Episode 16 : How the WHO is evolving
What to read next:
Check out my Substack : Can Global Health and Venture Capital Get Along?
About Nick
Nick Martin is the Founder and CEO of TechChange, a social enterprise that has become a leading provider of digital health training and convening solutions worldwide. Under his leadership, TechChange has trained thousands of Ministry of Health officials in more than 90 countries through flagship programs such as Digital Health: Planning National Systems, developed in partnership with USAID, WHO, and Digital Square.
He also leads the Global Digital Health Forum, the premier annual gathering for policymakers, donors, researchers, and implementers working at the intersection of technology and health. With two decades of experience in global development and public health, Nick has built partnerships with organizations including USAID, UNICEF, WHO, and the Gates Foundation. His work has been featured in outlets such as The Economist, Forbes, The New York Times, and Fast Company, highlighting his role in advancing digital health and social impact through technology.