What is this article about?

This article explores how artificial intelligence (AI) can strengthen public health emergency management in resource-constrained settings, with a particular focus on South Africa, examining how AI can support disease surveillance, outbreak detection, resource allocation, health communication, telemedicine, and predictive analytics to improve public health responses and healthcare delivery.

The article also seeks to critically discuss the challenges associated with implementing AI in low- and middle-income countries, including limitations in digital infrastructure, workforce capacity, governance, ethics, financing, and sustainability. The paper ultimately provides practical, policy-oriented recommendations for how South Africa and similar settings can integrate AI into public health systems in a manner that is both equitable and sustainable.

Why does this article matter?

This article matters because many resource-constrained settings continue to face significant public health challenges, including infectious disease outbreaks, rising non-communicable diseases, workforce shortages, and limited healthcare infrastructure. Advances in AI are rapidly transforming healthcare globally, yet much of the existing evidence and implementation experience comes from high-income countries. The article seeks to contribute to an important and growing conversation around how AI can be responsibly and realistically applied in settings such as South Africa. Rather than focusing only on technological innovation, the article emphasises sustainability, governance, ethics, equity, and practical implementation within existing health systems, discussions that are especially relevant as countries increasingly explore digital health solutions to strengthen preparedness and resilience.

How did this article come about?

The article emerged from a shared interest in strengthening public health systems and improving preparedness for future public health emergencies, particularly in resource-constrained settings, along with my colleague and fellow registrar, Dr Lamisa Naushin and our supervising author, Mr Nevashan Govender. Experiences from the COVID-19 pandemic highlighted both the vulnerabilities within health systems and the growing role of digital technologies and AI in supporting surveillance, communication, and healthcare delivery. As public health practitioners and researchers, we recognised a need for more context-specific discussions on how AI could be integrated into public health systems in South Africa and similar settings. We also identified an important gap in the literature regarding the implementation feasibility, governance, financing, and sustainability in low and middle-income countries, which motivated us to develop a narrative review that could provide practical and policy-relevant insights.

What was your role in the development of this article?   

This work was truly a collaborative effort. I contributed to the conceptualisation and development of the article, including the identification of the research focus and themes explored in the review, reviewing and synthesising the literature, interpreting the findings within the South African public health context, and contributing to the writing and refinement of the manuscript. Dr Naushin, likewise, contributed to the development and refinement of the manuscript, while Mr Govender, as the supervising author, conceptualised the theme of the article and provided guidance, oversight, and valuable expertise in public health surveillance and response throughout its development.

Why should people read this article?

People should read this article because it provides a practical perspective on the opportunities and challenges associated with AI in public health. While there is growing excitement around AI globally, there is often limited discussion about how these technologies can realistically be implemented in settings with constrained resources and existing health system pressures.

What impact do you hope this article will have on public health policy and healthcare access?

I hope the article contributes to ongoing discussions on digital health transformation and encourages policymakers, researchers, and healthcare leaders to adopt a more strategic and context-sensitive approach to AI integration in public health. Importantly, I hope it shows that AI should not be viewed as a replacement for existing health systems, but rather as a tool that can support more efficient, equitable, and responsive healthcare delivery when implemented responsibly. In terms of healthcare access, I hope the article encourages investment in technologies and systems that can expand access to healthcare services in underserved and rural communities, strengthen disease surveillance and preparedness, and improve decision-making within the health sector. Ultimately, the goal is to support stronger, more resilient public health systems that are better equipped to respond to both current and future health challenges.

Dr Monique Muhali, Public Health Medicine Registrar at the HIV TB in the workplace unit at the National Institute for Occupational Health and Sefako Makgatho Health Sciences University – Community Health Department. 

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