Leveraging digital public infrastructure for sustainable health system transformation

Executive Summary

Over three days in February 2026, senior government officials, multilateral institutions, development banks, civil society, academia, and the private sector gathered at Wilton Park. Their focus was a question that sits at the intersection of technology, governance, and public finance: how can countries sustainably leverage digital public infrastructure (DPI) to transform their health systems?

Representatives from across Asia, Africa, Latin America, the Caribbean, Europe, and North America gathered to take stock of where progress has been made, where systemic bottlenecks persist, and what concrete action is required to move the agenda forward. Discussions were frank, forward-looking, and grounded in country experience. Shaped by a shared recognition that the scale of current and planned investments in DPI creates both unprecedented opportunity and heightened responsibility: to avoid reinforcing silos, sectoral fragmentation, or investing in technical systems that outpace the governance and human capacity required to use them effectively.

The overarching message from the dialogue was clear – DPI is no longer primarily a technical challenge. It is a state capability challenge that requires political leadership, institutional reform, sound financing, and sustained investments in systems and people. While many countries now have foundational DPI components in place, health systems continue to underperform. Fragmentation is a defining feature in the current ecosystem: DPI for health is too often absent from investment decisions within Ministries of Finance and development organisations, governance structures are weak, and incentives are often misaligned. Yet the potential to leverage DPI for sustainable health system transformation is vast and the foundations on which to build are, in many countries, increasingly in place.

Highlights and emerging themes

1. DPI must be reframed not as infrastructure but as a way to enable services that deliver tangible value for patients, health workers, administrators, and political leaders.
2. The value proposition must be better articulated to show the tangible benefit for different stakeholders – from political leaders to health workers and service users.
3. Cross-sector collaboration is considered essential, but the realities of working across ministries and institutions remains complex – changing this will require realigning incentives and responsibilities, informed by practical guidance.
4. There is a need to identify and document pre-cursors and minimum dependencies related to financial, technical, and governance foundations so that countries can appropriately plan and effectively execute their (investments) in health sector transition to a DPI based approach.  
5. Governance, not technology, is a primary constraint, and cross-cutting DPIs require institutional authority – and responsibility – above individual Ministries.
6. Financing models remain misaligned to the realities of scaling shared infrastructure, requiring a shift from project-based capital expenditure to longer-term, opex, service-oriented models.
7. Interoperability failures are more often institutional and political than technical and remain a critical dependency for successful digital transformation of the health sector.
8. State capacity – particularly in the absence of roles such as digital and enterprise architects within government and even within countries – represents a hidden but critical bottleneck.
9. The evidence base for DPIs for health needs expanding, including through case studies and exemplars which provide practical insights relevant to policy makers and practitioners alike.

The dialogue closed with concrete commitments to advance a shared agenda over the next three to six months, structured around five issue areas identified during the Day 3 action planning discussions. These include strengthening a community of practice, developing a value narrative for DPI in health, conducting a capacity gap assessment (which would inform training and coaching programmes), and further developing country case studies to anchor the evidence base.