Can AI cure health care?

Here’s what we’re following in the world of health security this week, from the latest on efforts to fight mpox to some fresh thinking on the role of digital health records and AI. Subscribe to get PPF: Health Security in your inbox every Tuesday morning. 

Mpox not the new COVID 

The World Health Organization’s (WHO) Regional Director for Europe, Dr. Hans Henri P. Kluge has said that “mpox is not the new COVID,” regardless of which type or ‘clade’ it is.  

“We know how to control mpox and … the steps needed to eliminate its transmission altogether,” Kluge said. While mpox clade 1 is responsible for the current outbreak in Africa, its milder cousin, clade 2 – the spread of which prompted a WHO emergency declaration two years ago – still causes about 100 new cases in Europe every month, Kluge said. “Through a lack of commitment and a lack of resources, we failed to go the last mile” in eradicating clade 2 in Europe, Kluge added. “However, the current state of alert due to clade 1 gives Europe the opportunity to refocus.”  

Meanwhile, the WHO is recommending widespread distribution of smallpox vaccines to help fight the mpox outbreak in Africa. There are second- and third-generation smallpox vaccines that the WHO also recommended for use against mpox in 2022, during its last emergency declaration. A WHO spokesperson last week said that the producer of one of the vaccines, Bavarian Nordic, “has capacity to manufacture 10 million doses by the end of 2025 and can already supply up to two million doses this year.” Another vaccine is produced on behalf of the Government of Japan, which has a considerable stockpile and is currently negotiating with the DRC government about how to share it. 

Also last week, Canadian Minister of Foreign Affairs Mélanie Jolie said that Canada is currently supporting the WHO’s response to the outbreak via a $2 million contribution to its Contingency Fund for Emergencies , and announced a further $1 million to the WHO specifically for urgent mpox response on the African continent.  

DHRs in the NHS? 

In the latest of its Future of Britain reports, the Tony Blair Institute (TBI) makes an extended argument for digital health records (DHRs) as a cornerstone of a reformed National Health Service (NHS).  

The report argues that an individual’s DHR “would be the ‘single source of truth’ for their health and care data” that currently sits strewn across various hospitals, doctor’s offices, pharmacies and personal mobile phones. The TBI says DHRs “would be the fundamental building block of all modern health systems and open up a new way of generating health and delivering health care in the future,” including, the report states, helping the NHS prepare for the AI era.  

The Institute says DHRs would have the biggest impact outside hospitals, helping to ensure people with acute care needs are assessed by the right person (with their complete health record accessible), empowering patients with long-term conditions to take greater control of their health, and helping in preventative care.  

The TBI report also makes two recommendations that worry some health-care advocates in the U.K. First, it suggests that the NHS adopt what it calls an “AI doctor” – a self-learning, large language model trained on anonymized data from DHRs, peer-reviewed journals and practitioner insights, regularly updated on real-world evidence with protections against bias and cybersecurity issues (no small order). Patients could consult with the AI doctor to help maintain their health. Second, the Institute suggests that the NHS allow for primary care networks to expand beyond serving populations of between 30,000 and 50,000 and scale to 250,000.  

 “Blair wants Labour to close your GP and have you talk to a chatbot instead,” Sam Smith from Medconfidential, an organization that campaigns on issues related to health data, told POLITICO. As for expanding primary care, this will “translate into fewer GPs,” Diarmaid McDonald, director of Just Treatment – which campaigns against NHS privatization – also told POLITICO. 

 MORE FROM PPF: Unlocking Health Care: How to free the flow of life-saving health data in Canada 

 In AI we trust? 

Meanwhile in the United States, a new poll from Ohio State University’s Wexner Medical Center found that Americans are, by and large, comfortable with AI being part of their health-care experience, with a few key reservations. Three-quarters of respondents said they think using AI to minimize human errors is important, while nearly the same proportions – 71 percent and 70 percent respectively – said they’d like AI to reduce wait times and are comfortable with AI taking notes during a health appointment.  

Fewer — 66 percent — said they think AI could improve work-life balance for health-care providers. However, more than half of respondents – 56 percent – said they still find AI “a little scary” and 70 percent also said they have concerns about data privacy.  Accuracy is another consideration. Earlier this summer, a research team from Western University released findings from a study it conducted on ChatGPT’s accuracy when faced with 150 complex medical cases. The program only managed to answer 49 per cent correctly, leading researchers to conclude that ChatGPT “in its current form is not accurate as a diagnostic tool,” and doesn’t “necessarily give factual correctness, despite the vast amount of information it was trained on.”  

Further, ChatGPT “struggles with the interpretation of laboratory values, imaging results and may overlook key information relevant to the diagnosis.” But it still holds some promise as an educational tool, particularly its ability to simplify complex medical concepts.  

COVID vaccine updates 

The U.S. FDA has approved updated COVID vaccines from Pfizer and Moderna, targeting the KP.2 strain of the virus, a descendent of the JN.1 Omicron subvariant that made so many people sick earlier in the year. Health Canada, meanwhile, says it’s reviewing the new vaccines.  

 Wastewater data from across the U.S. supports anecdotal evidence of a surge in COVID across the country. Wastewater viral activity levels are “very high” throughout most of the western states, and “high” nearly everywhere else other than Michigan, Illinois and Virginia. The CDC has also reported that hospitalization rates for COVID are up this summer – about four people for every 100,000 are being hospitalized for COVID versus about one for every 100,000 people in May.  

Although these updated COVID vaccines are receiving U.S. approval a few weeks earlier than last year’s (which the FDA didn’t approve until mid-September), some wonder whether they are still too late – and, given COVID’s tendency to surge throughout the year, whether there should be two boosters per year, rather than just one.  

But trying to nail down the perfect time to administer COVID vaccines “becomes a little bit of a game,” CDC epidemiologist Ruth Link-Gelles told an FDA advisory committee meeting in June. Unlike flu and RSV, which follow regular annual patterns, “that’s not true at all” for COVID. 

Conflict impact on health care 

The WHO has said that there have been 1,940 attacks on health-care facilities, vehicles and workers in Ukraine since the beginning of Russia’s invasion in February 2022. The tally, released on World Humanitarian Day, is the highest the WHO has ever recorded in any humanitarian emergency globally to date.  

The WHO also noted that the attacks from Russia on health care in Ukraine have been rising since December 2023, “occurring on a near-daily basis.” A representative for the WHO in Ukraine said that this year the organization is “observing a lot of double-tap attacks” in which Russian forces will hit a target, wait for aid workers to arrive on the scene, then hit the same area again.  

“We are losing colleagues – health-care workers, nurses, doctors, paramedics,” the WHO’s representative, Dr. Jarno Habicht, said in a statement. “This year, many more health care workers have also been injured than before.”  

Elsewhere, aid organizations are urging a pause in the conflict between Israel and Hamas in Gaza to allow for a vaccination campaign for more than 600,000 children against polio. The disease threatens to become an outbreak in the region. There has been one confirmed case of polio and others are likely after it was detected in wastewater in six different locations in July. Since the conflict began last October, the region has become a breeding ground for polio, with thousands of Palestinians living together in cramped conditions without clean water or sanitation.  

This newsletter is produced by journalists at PPF Media. It maintains complete editorial independence.