Health Systems Action

Author name: Gareth Kantor

Nipah virus and SA’s new air quality regulations

Most South Africans have never heard of Nipah virus, which appears on the World Health Organization’s (WHO) list of emerging infectious threats. Nipah outbreaks, including the current one in India, are rare, but the disease has severe consequences, with reported fatality rates of 40-75%. There’s no proven antiviral treatment and no widely available vaccine. WHO …

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Digital twins in maternal and child health

Maternal and child health (MCH) outcomes are good indicators of whether a health system works, and for whom. In rich countries, preventable maternal deaths are concentrated in poor neighbourhoods and marginalised populations. In low- and middle-income countries (LMICs) they reflect deeper and broader system failures that overwhelm clinical services. In both contexts, digital twins offer …

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The limits of “human in the loop”

Large language models (LLMs) are now routinely used to write clinical notes, discharge summaries, referral letters, patient instructions and insurance correspondence. Their appeal is obvious: they are fast, fluent and usually accurate. As the documentation burden increases and clinical time shrinks, AI-generated text is becoming embedded in everyday clinical workflows. The dominant safety response has …

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Conspiracy, misinformation and the three Cs

Editorials urge clinicians and researchers to speak out against misinformation. Public health leaders warn that trust in evidence-based guidance is declining. Scientists describe being “under attack for someone else’s political gain.” These pleas, warnings, repetitions of scientific facts, and proclamations of authority in response to misinformation and conspiracy beliefs are welcome but ineffective. It’s more …

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World models and word models: layers of the AI cake

Development of artificial intelligence (AI) is moving along two distinct paths. The last decade has been centred on large language models (LLM) that generate fluent text by predicting the next word in a sequence. A newer approach focuses on building world models – systems that learn how the physical world behaves and changes over time. …

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Constitutions don’t pump water: why healthcare needs a water strategy

Lessons from the global leader in water management South Africa’s Constitution guarantees the right to sufficient water. Water is recognised as a condition of dignity, health, and citizenship, and the state is obliged to take reasonable measures to realise that right. Constitutions do not pump water. When water systems fail, consequences for healthcare are immediate. Maternity …

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Plausibility is not proof: what two studies reveal about trust in clinical research

Intraoperative EEG-guided depth of anaesthesia monitoring may reduce postoperative complications such as delirium, but the evidence is mixed. This uncertainty is a useful lens for seeing how clinical evidence is produced, evaluated and trusted. A brief report We examined the association between intraoperative EEG-based depth of anaesthesia (DoA) guidance and postoperative delirium in a retrospective …

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AI, improvement, and what it means to know

Artificial intelligence (AI) is a set of technologies that will profoundly impact healthcare in all dimensions of quality. At times, however, the AI industry and the community of healthcare quality specialists talk past each other. This is because they operate with different epistemologies – the term for descriptions about what we treat as knowledge, how …

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The paradox of precision: does disease disappear?

Diagnosis is an act of naming: the point at which we are told what kind of health problem we’re dealing with. With a successful diagnosis, uncertainty ends, explanation is offered and treatment can start. From a biological point of view, however, diagnosis usually arrives late. By the time a condition like type 2 diabetes is …

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Alchemy, chemistry, and the mystery of “Albert”

Albert Invent is a new software platform for chemists and materials scientists  – the people who combine substances in the lab to make products for the modern world. The company doesn’t disclose who or what it is named after. Albert Einstein seems the reasonable guess. But an even better fit is someone further back in …

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