Global experts call for coordinated action on digital health risks

Evidence of digital harms justifies immediate public health action

Business models, design choices, and weak governance

The Series argues that digital media use today is predominantly shaped by large, international technology companies that governments have allowed to self-regulate for decades, producing a digital environment where commercial growth is favoured over health.

"Most digital platforms are designed by companies to capture attention and collect data, not to protect health: features such as infinite scroll, autoplay and personalised recommendation feeds are deliberate design choices, not simply a matter of individual self-control," says author Dr Jay Shaw, University of Toronto (Canada). "We need much more research into how these specific design choices in digital media influence the way people use the technology, instead of only investigating the impact of how long people spend online."

The authors argue that technology companies are drawing on a 'corporate defence playbook' to delay, weaken, or shape regulation in response to evidence that their products may harm health.

"Technology companies are borrowing a playbook well known from tobacco and fossil fuels: manufacture doubt, discredit critics, frame regulation as a threat to freedom. A public health approach counters this by looking at what the evidence suggests about harm across the whole population, not just what any single case can tell us," says author Professor Barbara Prainsack, University of Vienna (Austria). "Seen that way, good regulation isn't the enemy of innovation - it's a driver of good innovation, channelling it toward safety and trust. And when regulation is missing, it doesn't mean that a technology is ungoverned; it just means that companies set the rules instead of public policy."

No single measure is enough

The Series says that single measures, such as age limits, are not enough on their own to tackle the risk of digital harms to health. Instead, the authors call for wide-ranging, coordinated policy action at the company, national and global levels, including:

• Technology companies to be required to assess new products or features for harm before releasing them, and to share data on how their features affect users' health with vetted public-interest researchers.
• A global governance treaty through WHO to set baseline standards to prevent weak regulation in one country from undermining progress elsewhere. 
• A dedicated international body to monitor AI harms to children and young people.

The Series also highlights how litigation is emerging as a route to hold technology companies to account for harms to health.

Professor Ilona Kickbusch says, "Legal action can do something regulation often cannot: compel companies to disclose internal documents and shift the public conversation about who is responsible for harm. However, litigation is not a substitute for regulation and should be considered as one route to accountability among several, not the answer on its own."

The Series had input from a Youth Advisory Group of six young adults aged 23-30 years who discussed with the authors what the research couldn't identify about lived experience.

Youth Advisory Group member Dr Salman Fitrat Khan (India) says, "The health risks and harms associated with digital systems are preventable. With better governance and by empowering citizens – especially young people – to co-shape digital systems around them, the online world can give us connection, information and opportunities without putting our health at risk. Governments shouldn't wait for 'perfect' evidence before acting for our generation and the ones coming after us."

Source:

The Lancet

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