Work

Flipping the script: co-creation and local innovation in AI for global health paradigms

Year: 2026

Type: article

Abstract: Artificial intelligence (AI) in global health is often framed through a narrative of technological salvation, in which models and systems developed in high-income countries (HICs) are exported to low and middle-income countries (LMICs) as turnkey solutions. This top-down paradigm overlooks local expertise and frequently produces context-mismatched, unsustainable tools. We argue for a shift towards cocreation and reverse knowledge flow, in which LMIC innovators lead AI initiatives across the entire pipeline, from problem definition and data stewardship to model development, validation, deployment and governance. Rather than ‘contextualising’ HIC-built systems, cocreated AI is rooted in local health system realities, leveraging local providers and community health workers, cost-conscious innovation and decentralised care models.Early examples from LMICs suggest that locally led AI decision-support platforms can improve access, quality and continuity of care. Building on emerging South–South collaborations, we describe how networks of LMIC-based AI researchers can generate solutions validated across diverse populations and inform new global standards.To enable this, international funding, evaluation and governance architectures must be restructured to require LMIC coleadership, data sovereignty, equitable intellectual property arrangements and long-term capacity building. Grounding global AI norms in ethical frameworks originating in LMICs, such as African discourses on data sovereignty and Ubuntu ethics, can prevent the universalisation of HIC-centric values. Repositioning LMICs as engines of innovation is a practical necessity to realise equitable, effective AI for global health.

Source: BMJ Health & Care Informatics

DOI: 10.1136/bmjhci-2026-102172