Digital health is often sold as a shortcut to universal access: more telehealth, more apps, more portals. WHO’s Global strategy on digital health frames digital tools as a way to strengthen health systems and support equitable, people-centred care. That promise is real — and conditional. Without literacy, broadband, inclusive design, and governance, the same tools can widen the gap between those who can navigate digital services and those who cannot.

Key takeaways

  • WHO Europe reports that only about 1 in 2 countries in the Region have policies to improve digital health literacy.
  • National digital strategies are common; literacy and inclusion plans still lag.
  • OECD and CDC evidence both treat connectivity, skills, and trust as equity determinants — not optional add-ons.

The access promise

WHO’s Global strategy on digital health 2020–2027 calls for accessible, affordable, secure, and sustainable digital solutions that support universal health coverage. Telehealth, remote monitoring, and digital records can reduce distance barriers and free clinical capacity — when infrastructure and workforce readiness exist.

The digital health divide

In September 2023, WHO Europe warned of a digital health divide: while most countries in the Region have a national digital health strategy, only about half have developed policies for digital health literacy and implemented a digital inclusion plan. Older adults, migrants, people with disabilities, and rural residents are among those most likely to be left behind — even though they may benefit most from well-designed remote care.

WHO European Region: digital health literacy policies

Source: WHO Europe digital health divide news (2023) — “only 1 in 2 countries”.

Equity is not automatic

OECD analyses of digital health and telemedicine repeatedly show that uptake follows existing advantages: stable internet, digital skills, language access, and the ability to take time for virtual visits. CDC evaluations of telehealth for hypertension likewise flag unreliable broadband, device limits, and language barriers as access obstacles — especially for older and rural patients. Digital expansion without an equity plan is redistribution upward.

What inclusion requires

Inclusion means literacy policies, assisted digital pathways, offline alternatives, accessibility standards, and evaluation that asks who is missing. WHO Europe’s digital health reporting also shows gaps in evaluating digital interventions and overseeing mobile health apps — weak quality governance is itself an equity risk.

Closing

App counts and portal launches are poor equity metrics. What matters is whether digital pathways reduce barriers for the groups WHO Europe flags as most likely to be left behind — older adults, migrants, people with disabilities, and rural residents — without shutting the offline routes that still keep people in care.

Digitization is not the same as access. A portal that works for the digitally confident can become a wall for everyone else. I do not oppose digital health — I oppose treating app launches as equity victories. Serious public health practice means measuring exclusion as carefully as downloads, and keeping non-digital routes open until inclusion is demonstrated rather than assumed. The question worth repeating is simple: who still cannot use this, and what did we build for them?

Sources & further reading

  1. WHO — Global strategy on digital health 2020–2027
  2. WHO Europe — Digital health divide (1 in 2 countries with literacy policies)
  3. OECD — Digital health
  4. CDC — Telehealth strategies and access barriers (broadband, skills, language)

Disclaimer: Content on this site provides general public health information for educational purposes only. It is not medical advice and does not replace consultation with a qualified healthcare professional.