Opinion: Robust health data today avoids fragile health systems tomorrow

As international health care funding faces unprecedented uncertainty, a crucial question dominated my recent discussions with ministry of health officials across East Africa: How can countries maintain critical health services when traditional aid frameworks are changing very rapidly? The answer lies not in being constrained by dwindling support, but in revolutionizing how countries build, control, and leverage their health data systems. After a decade working at the intersection of data and public health, I've witnessed firsthand how countries with robust, locally controlled health care data infrastructure navigate funding transitions successfully, while those without it struggle to maintain even basic services. The evidence is compelling and the path forward clear: We need immediate action to strengthen health data systems before the next funding shift arrives. Here’s how to achieve quality health care data 1. Prioritize data sovereignty as a cornerstone of health care independence. When USAID recently withdrew from certain regions, I watched as ministries of health confronted a startling reality — they couldn't access their own historical health data. Without this fundamental resource, they struggled to track progress, allocate resources effectively, or maintain service continuity for vulnerable populations. This vulnerability underscores a fundamental principle: Countries must control their own health care data. True health care independence requires local ownership of the entire data ecosystem, from vaccine distribution systems to equipment tracking platforms to patient records. Countries that have invested in building deeply integrated, locally controlled data systems retain the power to make strategic decisions regardless of external funding fluctuations. This isn't just about technology; it's about sovereignty in health care decision-making. 2. Break the cycle of failed innovations through integrated data systems. The statistics are staggering: Across low- and middle-income countries, up to 40% of medical equipment sits nonfunctional, largely due to fragmented pilot programs that introduce various technologies without comprehensive support systems. The same problem plagues data collection efforts. During my work in community health programs, I've seen countless short-term data gathering initiatives that satisfy grant requirements but fail to strengthen health care systems in meaningful, sustainable ways. These isolated efforts create “data islands” that fragment, rather than unify, health information. In Tanzania, I visited a district hospital where medical equipment sat nonfunctional, much of it left behind by completed pilot programs without ongoing support. This extends to data systems as well, where short-term data collection rarely strengthens lasting health system capacity. Funders and implementers must shift away from technology pilots toward sustained implementation with clear handover protocols. The Digital Health Investment Review Tool, for example, offers a practical framework for assessing whether new technologies will genuinely strengthen systems or merely create more disconnected data islands. The solution requires moving beyond pilot projects and toward sustained implementation of integrated data systems. When countries build interoperable platforms that connect previously siloed information, they create resilient infrastructure that survives funding transitions and drives continuous improvement in health care delivery. 3. Transform data from evidence of past impact to the driver of future action. The transformative potential of health data remains largely untapped when data is collected to serve reporting purposes rather than to inform local decision-making. In Kenya's health facilities, I've observed how data that flows only upward toward funders, rather than back to frontline providers, leads to missed opportunities for responsive care. Reimagining data as an active, functional component of health care systems, not merely evidence of past impact, requires a fundamental shift in perspective. When used proactively, data becomes a powerful tool allowing governments to anticipate challenges, reduce dependence on external support, and allocate resources strategically, regardless of the funding source. The most resilient health systems treat data as their central nervous system: They constantly gather signals about performance, needs, and outcomes, then respond with agility to emerging challenges. This approach transforms health systems from reactive to proactive, enabling them to maximize impact even as resources fluctuate. 4. Invest in local technical capacity as the ultimate sustainability strategy. Despite competing priorities in resource-constrained health systems, underinvesting in data infrastructure and local technical capacity ultimately compromises a country's ability to respond nimbly to emerging health care needs. I've observed this pattern repeatedly. When funding transitions occur, countries with locally trained data scientists and system administrators maintain continuity, while those dependent on external technical expertise experience critical service disruptions. Building this capacity isn't a luxury; it's essential infrastructure for health care independence. As global funding patterns continue to fluctuate unpredictably, ensuring local control of robust health data systems becomes not just important but essential. Countries and their funding partners must prioritize investments in data infrastructure and human capacity as the cornerstone of health care resilience. The path forward: From data collection to data empowerment The disciplines of data science and public health have always been natural allies. Achieving universal health care access demands an interconnected data ecosystem extending to every community, ensuring resources flow precisely where they’re most needed, today and in the uncertain funding landscape of tomorrow. The greatest risk countries face isn’t insufficient external funding, it’s entering the next era of global health without the data systems and capabilities needed for self-determined health care delivery. By implementing these four strategies, countries can transform data from a reporting requirement into a powerful engine for health care sovereignty. The urgency couldn’t be clearer: Build robust, locally controlled health data systems today, or face increasingly fragile health care delivery tomorrow. The choice, and the opportunity, is ours.