Artificial intelligence needs better health systems to reduce inequalities.

van Kessel, Robin; Carter, Alexander W; Nasir, Khurram; Mossialos, Elias · NPJ Digit Med · 2026

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Abstract

Artificial Intelligence (AI) technologies are increasingly prevalent in healthcare, yet without adaptive governance, even well-designed systems risk exacerbating health inequalities. This perspective examines five interconnected governance domains: legal frameworks, evidence generation, regulation and market access, workforce readiness, and public trust. We argue these form a cyclical governance chain in which weaknesses cascade across domains, and identify critical gaps and system-level reforms to ensure AI reduces rather than amplifies disparities.