There has been much hype recently around the potential of digital technologies to curb the Covid-19 pandemic, save lives and help societies return to normality. At the same time, critics voice concerns about how the digital response to the pandemic may extend state surveillance and exacerbate inequalities through the exclusion of vulnerable groups or algorithmic biases. What the rise of new digital pandemic tech may reveal about an ongoing shift in the relationship between state and corporate power (to the latter’s advantage), remains largely overlooked, however.
Our article just published in Global Public Health explores some of the new forms of cooperation between Big Tech, the telecommunications industry and public health authorities that have arisen during the first year of the pandemic. These new partnerships provide a unique opportunity to showcase the value of digital solutions to solve the world’s problems, but also allow private companies to enter into the heart of health policy and consolidate their positions in the health sector, a highly lucrative market.
In our article, we survey three domains of public health action in which major tech companies have cooperated with public health agencies and asserted themselves over the past year.
The first domain in which technology companies and public health authorities have converged is in the use of smartphones for digital contract tracing. Governments all over the world have turned to Google and Apple to automate and support contact tracing through their “Exposure Notification System”. In exchange for using the technology, public authorities must comply with the companies’ terms and conditions and relinquish access to key data that would be useful for the public health response, all in the name of privacy.
A second example is epidemic modelling, where public authorities have partnered with major social media companies like Facebook and telecoms providers like Telenor to access localisation data from smartphones. This data is used to model and predict the spread of epidemics and assess the effectiveness of government regulations such as travel bans and quarantine. The modelling developed during the pandemic builds on tech and telecom companies’ experimentation with the use of localisation data from mobile phones in the global South and in humanitarian settings. Telenor ‘s involvement in Covid-19 in Norway, for example, builds on the company’s experience in countries including Myanmar, Bangladesh and Pakistan.
Thirdly, new partnerships have arisen between Big Tech companies and public health authorities in managing the “infodemic” of misinformation and conspiracy theories that has undermined trust in public authorities and vaccines. At the start of the pandemic, the World Health Organization travelled to Silicon Valley to develop joint strategies, one of which included a partnership with WhatsApp to develop a chatbot for channelling authoritative information about the novel coronavirus, and partnerships with Google and others to ensure that public health agencies’ information features prominently in search engines.
Big Tech’s growing influence over public health practice propagates a techno-optimism that is easy for politicians to sell, despite the questionable effectiveness of many of these technologies. There is no scientific evidence for the effectiveness of digital contact tracing, governments have been blamed for relying too much on mathematical modelling based on smartphone location data to inform policy, and the spread of misinformation via social media platforms has, despite efforts, increased substantially since the pandemic started.
Google and Apple claim they jointly created their Exposure Notification System “out of a shared sense of responsibility to help governments and our global community fight this pandemic”, while Facebook and major telecoms companies share geolocation data as part of Big Data for Social Good initiatives. Yet it would be wrong to take tech companies’ claims that these partnerships are acts of “corporate social responsibility” at face value.
Not only do new partnerships with public health authorities lend tech companies a positive image at a time of heightened scrutiny about their monopolistic business models, they also enable them to set foot in new markets. WhatsApp, for example, is conveniently positioning itself in the emerging market of AI-enabled chatbot technology. Social media and telecoms companies may hand over localisation and other metadata for free during the pandemic, but this does not preclude their future commercialisation, once public authorities are made dependent on these tools for decision-making. Tech companies are also contributing to the routinisation of digital contact tracing, whether through apps or registration systems (QR codes), that already have commercial value.
But the most important consequence of the new partnerships between Big Tech and public health authorities may be the threat that these pose to “digital sovereignty”, and the fear that citizens, businesses and European states are losing control over their data to American tech companies, and with it, their ability to shape legislation in the digital environment. Only a few European countries like France and Latvia, have pushed back against tech corporations’ involvement in the public health response. A Latvian official described how the country ran into a “Silicon Valley-built brick wall” when they tried to develop their own digital contact tracing solution.
How the entry of tech giants into public health practice will play out in low- and middle-income countries, which technology companies see as lucrative and largely unregulated markets for expansion, remains to be seen. Their activities should be assessed by the Lancet & Financial Times ommission which is examining the convergence of digital health, artificial intelligence and other frontier technologies with UHC to support attainment of the Sustainable Development Goal on health and well-being (SDG 3). What is clear, however, is the need for a broader public and political debate about how technologies ushered in hastily and without much scrutiny during the Covid-19 crisis may be reconfiguring the power balance between the public and private interests in ways that will far outlive the pandemic.
This article is adapted from a Norwegian-language version first published in Morgenbladet. The full research article it describes was supported by the Research Council of Norway and is available open access from Global Public Health.