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<p>Artificial intelligence (AI) is increasingly deployed in healthcare across sub-Saharan Africa, often framed as a tool to reduce disparities in access and health outcomes. This paper argues that, without critical intervention, such technologies risk reproducing and entrenching existing structures of inequality. Decolonizing health algorithms requires a three-pronged approach grounded in social determinants of health: (1) integrating social determinants into algorithmic design at the research and development level, (2) implementing participatory reform centering African sovereignty at the policy level, and (3) ensuring ongoing community engagement that treats African knowledge as valuable. Technical solutions alone—better data, improved algorithms, refined methodologies—cannot address problems rooted in the coloniality of power. Without fundamental shifts in power, AI applications in African healthcare are likely to propagate existing inequities.</p>

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Algorithmic colonialism: rethinking AI’s role in Sub-Saharan African health systems

  • 期刊论文

  • 发表日期：

    2026年5月12日

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  • Anish Alur

摘要

Artificial intelligence (AI) is increasingly deployed in healthcare across sub-Saharan Africa, often framed as a tool to reduce disparities in access and health outcomes. This paper argues that, without critical intervention, such technologies risk reproducing and entrenching existing structures of inequality. Decolonizing health algorithms requires a three-pronged approach grounded in social determinants of health: (1) integrating social determinants into algorithmic design at the research and development level, (2) implementing participatory reform centering African sovereignty at the policy level, and (3) ensuring ongoing community engagement that treats African knowledge as valuable. Technical solutions alone—better data, improved algorithms, refined methodologies—cannot address problems rooted in the coloniality of power. Without fundamental shifts in power, AI applications in African healthcare are likely to propagate existing inequities.