Optimism during a Pandemic – The Creative Disruption of Global Health

While mental health is a central pillar of a well-rounded approach on global health policy formulation, it appears to be something that is not easy to maintain for the majority of people affected by the COVID-19 crisis. People have spent years of their lifetime working passionately on their goals that now may seem impossible to reach. Within the wider global health community, these ‘lifetime goals’ are quite accurately represented by the Sustainable Development Goals.

Has the success of reducing the worldwide mortality of diseases such as HIV/AIDS, tuberculosis (TB), malaria or neglected tropical diseases been all in vain? The Stop TB Partnership, for example, predicted 126,100 excess TB deaths for every month of lockdown because of the implied service disruptions. It is hard to stay optimistic, to say the least. However, optimists adjust better than pessimists to stressful situations and moreover, optimism is a potentially modifiable condition. Or, as Winston Churchill expressed it in a less medicalized and more pragmatic way: "For myself, I am an optimist—it does not seem to be much use being anything else."

The worst crises demand the most innovative solutions from society. Not least because of the fundamental economic ripple effects of the COVID-19 crisis, the Global Health community is facing a situation of creative destruction, to borrow from economist Joseph Schumpeter and to depict the dismantling of longstanding structures to make way for innovation.

The concept of knowledge-sharing has been flipped upside-down. In the last months, people of diverse backgrounds have been gathering virtually to find bottom-up solutions for this global health challenge – clearly illustrated by thousands of participants in Hackathons across the globe, in countries like Estonia, Spain, Namibia or the Republic of Congo.

The concept of knowledge-sharing has been flipped upside-down. In the last months, people of diverse backgrounds have been gathering virtually to find bottom-up solutions for this global health challenge

‘New Work’, a fancy term for the current necessity to work remotely, has also taken a foothold in the public health sector. Physicians participate in Online-Sessions of Health-Tech-Hubs to share hands-on insights and thus, provide key stimuli for the tech-innovation community. Platforms such as “ El día después será…” bring together experts and organizations of different backgrounds to discuss on how to shape our future. Viewers are invited to participate as well.

The way life sciences are traditionally taught in secondary school and universities has, over centuries, created a somewhat awkward dichotomy of creativity and science: “I’m the rather artsy/crazy guy/girl; thus research is not for me”. In contrast, it is great to see that the science of creativity has gained more popularity and will probably gain increasing interest and attention whilst Artificial Intelligence (AI) is on the rise. Those two seem to naturally complement each other.

Finland, known for one of the best education systems in the world, has started teaching 1% of its population in the basics of AI; touted to be the scientific discipline that will change all our lives to a ground-breaking extent. What an original strategy to create innovation in all sectors of society. Certainly, some of the people that completed the AI-course offered by the University of Helsinki turned into enthusiastic participants of the hackathons.

Before COVID-19, we had never seen this amount of interdisciplinary work between medical doctors, nurses, data scientists, creative freelancers, anthropologists, educators, activists and others to identify solutions for a public health problem. In fact, even Tik Tok influencers, spurred by this new age of connectivity, contributed to global health education.

Before COVID-19, we had never seen this amount of interdisciplinary work between medical doctors, nurses, data scientists, creative freelancers, anthropologists, educators, activists and others to identify solutions for a public health problem

So why can and should one be optimistic?

1. The already established networks, collaborations and platforms will most probably last to a great extent and create a new era of collaborative research between public health experts and digital innovators.
2. New, successful tools developed during the COVID-19 crisis can be adapted for other global health challenges and significantly contribute to tackling them.
3. Potentially groundbreaking advances in AI will allow researchers and tech innovators to focus on the creative part of their work and thus, more efficiently find solutions for global health problems.

A captivating example is the research study supported by Hospital Clínic de Barcelona. The multidisciplinary team gathered by Catalan researcher Brian Subirana from the Mechanical Engineering department of the M.I.T. is using cough recordings to develop an algorithm that works on AI in order to help detecting COVID-19 cases. When taking a guess, one could expect the concept to potentially be applied to help differentiate the causes for hoarseness of unclear origin in adults that accounts for 1% of visits in primary care. Or to improve COPD surveillance. Or to help detect tuberculosis and Pneumocystis carinii pneumonia in resource-limited settings.

The sharing of knowledge on AI with the medical community is one example of why it is never wrong to rule out optimism. AI-based studies on e.g. malaria, Chagas or Soil Transmitted Helminths have already been underway before COVID-19 and potential breakthroughs might now come to fruition whilst talents of all backgrounds work in Global Health.

The sharing of knowledge on AI with the medical community is one example of why it is never wrong to rule out optimism

Creativity, a high degree of out-of-the-box thinking as well as AI are surely a great toolbox to tackle major global health problems, but only when concerns about data privacy and ethics are taken seriously – something that could easily be deprioritized in the current haste and hunt for innovation and discoveries, and in times when realities change daily.

It is also important that community leaders and social scientists, for example digital anthropologists, participate in the discussion on how to structure the new scientific community that not only faces a large diversity of global bioethics beliefs and practices, but that might also tend to make big-data-driven decisions without prior contextualization. This, however, is critical in assuring that the advances being made lead to equity in health and especially benefit the populations that had already been marginalized before and are now hardest hit by the crisis.

Finally, the vast influx of creative talent from all areas into global health has created completely new coalitions that are ready to take on the SDGs, through a completely new interpretation of collaborative science.

Let’s hope for and work towards the best. Step by step. We’re only human.