The role of artificial intelligence (AI) in the healthcare sector is expanding rapidly globally – with the US, especially, speeding up efforts to embed the technology as an integral part of medical care – but locally, experts say while it could fundamentally change how South Africans understand, manage and improve their health, AI must strengthen human capability, not replace it.
Their caution contrasts with US health officials, who are accelerating AI at a pace that has caused alarm and a warning that that AI in healthcare should be driven by clinicians, not Big Tech.
Business Day reports that at an inaugural Wellness AI Summit in Johannesburg last week, hosted by Medihelp Medical Scheme in collaboration with Omnihelp and Old Mutual, Shabana Patel, head of Data Strategy and AI at Medihelp, said healthcare has both a geographical and a timing challenge, and that AI could help close these gaps by making support more immediate and data insights more precise. But she cautioned that data alone were not enough.
“AI can identify patterns, but people give those insights meaning.” She also questioned the long-term effect of cognitive offloading to AI.
Yet, said Dr Shay Ganesh, head of Innovation at Medihelp: “We cannot ignore the powerful play of AI in health and wealth. South Africans are getting sicker, fatter and sadder – and AI can help.”
While the country is steadily transitioning to a more predictive, data-driven model of care, underpinned by AI-assisted diagnostics, interoperable digital patient records and connected medical devices, the shift from reactive treatment to earlier intervention cannot be determined by technology alone.
It will depend on digital tools that can demonstrate clinical value, integrate safely into care pathways, and meet the regulatory requirements governing their use, and these and other issues will come under the spotlight next month at World Health Expo (WHX) 2026 in Johannesburg (6-8 October).
The programme will cover global health priorities, ethical governance in decision-making and how digital transformation, including the responsible adoption of data-driven technologies, can support the development of smarter hospitals.
Speaking ahead of WHX, Professor Edward Kunonga, Healthcare Excellence Indaba chair and global health strategic adviser from the UK, said AI and related innovations offer significant opportunities to improve health in Africa and globally.
“But the adoption of AI must maximise benefits while preventing avoidable harm. A successful pilot does not guarantee that an AI diagnostic tool will work safely and equitably in routine practice,” he cautioned.
“Local validation on South African and African patient populations is essential, as is testing the technology within real healthcare systems, with clear accountability and meaningful human oversight.”
Introduced responsibly, AI can strengthen clinical practice, build trust and improve diagnosis “without leaving less-connected communities behind”.
Healthcare organisations must assess system performance in real-world settings, across representative patient populations, alongside existing equipment and within the workflows of clinicians responsible for patient care, the experts said.
This is especially important for diagnostic applications. While an algorithm’s reported accuracy may be important, it does not address every clinical consideration.
Accuracy must translate into clinical value
Health systems must also evaluate false-positive and false-negative rates, consistency of results across patient groups and facilities, clinicians’ ability to identify or contest erroneous outputs, and the implications of algorithm updates or exposure to unfamiliar data.
The commercial opportunity is now becoming more tangible. South Africa’s connected healthcare ecosystem, valued at an estimated $47m in 2025, is expected to grow to $77.4m by 2033, according to Grand View Research’s Horizon Databook.
This trajectory indicates that connected care is evolving from early-stage innovation into an established commercial market.
Regulation shapes the path to adoption
AI and machine learning-enabled medical devices, including standalone software and software integrated into hardware, are subject to the country’s medical-device regulatory framework, with the South African Health Products Regulatory Authority stipulating that suppliers must identify the correct regulatory pathway before placing qualifying devices on the market or making them available for use.
The Medihelp summit speakers consistently cautioned against treating technology as a substitute for human judgment, relationships, or professional care, saying the future of wellness would not be shaped by AI alone, that it would depend on how intelligently and responsibly organisations used it to strengthen prevention, build human capability, and help people live healthier lives.
Local restraint
Digital health suppliers have enormous opportunity to address a number of significant healthcare needs, but will also increasingly be expected to demonstrate not only how their technologies perform, but also how they can be deployed responsibly, lawfully and at scale.
For South African providers, the challenge lies in connecting innovation decisions to clinical governance, interoperability, workforce readiness and measurable patient benefit – and assessing whether technologies suit the local context, integrate with existing clinical and information systems, and have a clear route to sustained use beyond an initial pilot or demonstration.
The Council for Health Service Accreditation of Southern Africa (COHSASA), which will be at the World Health Expo next month, said the rising interest in AI-assisted diagnostics and digital health underscores the need for robust clinical governance, quality management, and patient safety measures to accompany innovation.
COHSASA CEO Jackie Stewart said that in South Africa, especially, where there are challenges of overcrowded facilities, long queues, and shortages of staff, including shortages of medical specialists, technology could definitely be used to fast-track some activities.
Rushing ahead
Meanwhile in the US, the Trump administration is rolling out AI agents countrywide that offer therapy and prescribe medicine, raising concerns about safety and the influence of venture capital investors, reports The New York Times.
Some officials believe the Department of Health and Human Services is moving too quickly, with inadequate evidence of the technology’s safety and effectiveness, and they also worry about outsized influence of Silicon Valley investors who have previously played little role in federal health policy.
Vinod Khosla, a billionaire Silicon Valley venture capitalist whose son has a healthcare AI company, has been particularly influential in conversations with top health department officials, including Dr Mehmet Oz, head of Medicare and Medicaid.
Khosla has predicted for more than a decade that AI would largely replace doctors. “It’s over for doctors, human doctors,” he said at a July AI start-up event. “AI is just going to be better.”
Concerns about the dangers of AI and calls to regulate it have erupted in recent days as some top executives of AI labs have called for slowing the pace of development.
Doctors are increasingly relying on AI for help with administrative tasks, but the prospect of AI taking over physician roles in assessing and treating patients is unnerving to some.
Models meant to render care independently to patients “are not ready for prime time”, said Dr John Whyte, chief executive of the American Medical Association.
He said the evidence that Khosla and others have cited as showing AI’s superiority to doctors was not convincing and were largely based on simulations.
“AI in health should not be driven by the tech industry,” Whyte said. “It should be driven by the clinical community. And right now, what we have going on is that tech is the tail wagging the dog.”
The FDA has approved more than 1 500 medical devices that include AI to perform discrete tasks, such as spotting a tumour or a blood clot. But the agency does not have rules built to address newer models, like chatbots or so-called agentic AI that perform tasks that a doctor would do, such as prescribing a drug.
The agency is still discussing how it should regulate complex AI models that change over time and perform actions like prescribing.
The task is daunting: the agency would have to manage the risks of large-language models; one was already accused of giving “dangerous” medical advice to a man who delayed care for a life-threatening blood clot.
It would also have to contemplate whether AI doctors could go rogue in a manner akin to the OpenAI agents that co-ordinated a hacking campaign on a company called Hugging Face.
Robert F. Kennedy Jr, health secretary, has publicly acknowledged the risks, but said during a congressional hearing in April that AI was “going to revolutionise medicine”.
One of his sons, Finn, started a venture capital fund this year that says it “builds and invests in generational health companies” and was reported to have solicited funds to invest in healthcare AI.
Within the administration, conversations about AI have included whether to pay AI doctors operated by tech companies and start-ups as much as 60% to 80% of what human doctors earn for the same service.
Other projects offer payment based on whether they demonstrate benefits to patients and cost savings to Medicare. One of them is from the company Limbic, offering cognitive behavioural therapy to Medicare beneficiaries who were diagnosed with depression or anxiety.
The company, backed by Khosla Sr, was selected by the FDA to participate in a Medicare AI pilot. In it, an AI counsellor, which has a female voice and uses the name “Hope”, offers an hour-long session each week with check-ins as needed.
A study by company scientists and engineers that was published in the journal Nature Medicine found that clinicians who were unaware if they were reviewing a therapy transcript led by a human or a chatbot concluded that the Limbic AI outperformed humans and a general chatbot.
Ross Harper, Limbic’s chief executive, said that one clinician would supervise thousands of AI therapists. “We have to remind ourselves: what are we comparing this against? We’re comparing it against no treatment, a long waiting list.”
See more from MedicalBrief archives:
OECD: How artificial intelligence could change the future of health
Case study insights into ethics of AI and data science in medicine
ChatGPT sued over health advice that discouraged medical care