ChatGPT: promise and challenges for deployment in low- and middle-income countries

Xiaofei Wang¹, Hayley M Sanders², Yuchen Liu¹, Kennarey Seang³, Bach Xuan Tran^{4

5}, Atanas G Atanasov^{6

7}, Yue Qiu⁸, Shenglan Tang⁹, Josip Car^{10

11}, Ya Xing Wang¹², Tien Yin Wong^{13

14

15}, Yih-Chung Tham^{13

16

17}, Kevin C Chung²

Affiliations

¹ Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
² Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
³ Grant Management Office, University of Health Sciences, Phnom Penh, Cambodia.
⁴ Department of Health Economics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
⁵ Institute of Health Economics and Technology, Hanoi, Vietnam.
⁶ Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
⁷ Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, 05-552, Magdalenka, Poland.
⁸ Institute for Hospital Management, Tsinghua University, Beijing, China.
⁹ Duke Global Health Institute, Duke University, Durham, NC, USA.
¹⁰ Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore.
¹¹ Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
¹² Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
¹³ Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
¹⁴ Tsinghua Medicine, Tsinghua University, Beijing, China.
¹⁵ School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China.
¹⁶ Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁷ Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore.

PMID: 37731897
PMCID: PMC10507635
DOI: 10.1016/j.lanwpc.2023.100905

Review

ChatGPT: promise and challenges for deployment in low- and middle-income countries

Xiaofei Wang et al. Lancet Reg Health West Pac. 2023.

. 2023 Sep 15:41:100905.

doi: 10.1016/j.lanwpc.2023.100905. eCollection 2023 Dec.

Authors

Affiliations

¹ Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
² Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
³ Grant Management Office, University of Health Sciences, Phnom Penh, Cambodia.
⁴ Department of Health Economics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
⁵ Institute of Health Economics and Technology, Hanoi, Vietnam.
⁶ Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
⁷ Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, 05-552, Magdalenka, Poland.
⁸ Institute for Hospital Management, Tsinghua University, Beijing, China.
⁹ Duke Global Health Institute, Duke University, Durham, NC, USA.
¹⁰ Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore.
¹¹ Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
¹² Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
¹³ Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
¹⁴ Tsinghua Medicine, Tsinghua University, Beijing, China.
¹⁵ School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China.
¹⁶ Centre for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
¹⁷ Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore.

PMID: 37731897
PMCID: PMC10507635
DOI: 10.1016/j.lanwpc.2023.100905

Abstract

In low- and middle-income countries (LMICs), the fields of medicine and public health grapple with numerous challenges that continue to hinder patients' access to healthcare services. ChatGPT, a publicly accessible chatbot, has emerged as a potential tool in aiding public health efforts in LMICs. This viewpoint details the potential benefits of employing ChatGPT in LMICs to improve medicine and public health encompassing a broad spectrum of domains ranging from health literacy, screening, triaging, remote healthcare support, mental health support, multilingual capabilities, healthcare communication and documentation, medical training and education, and support for healthcare professionals. Additionally, we also share potential concerns and limitations associated with the use of ChatGPT and provide a balanced discussion on the opportunities and challenges of using ChatGPT in LMICs.

Keywords: ChatGPT; Equity; Global health; Large language model; Low to middle income countries; Public health.

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Conflict of interest statement

YQ received payment from Asia Pacific Medical Technology Association for presentation. TYW received editorial support and medical writing from ApotheCom, study funding and article processing charges from Bayer AG, Leverkusen, Germany; funding of editorial support and medical writing from Bayer Consumer Care AG, Basel, Switzerland; study funding from Regeneron Pharmaceuticals, Inc; consulting fees from Aldropika Therapeutics, Bayer, Boehringer Ingelheim, Genetech, Iveric Bio, Novartis, Oxurion, Plano, Roche, Sanofi and Shanghai Henlius. He is also an inventor, patent-holder and a cofounder of start-up companies EyRiS and Visre. KC received funding from the National Institutes of Health, book royalties from Wolters Kluwer and Elsevier, and a research grant from Sonex to study carpal tunnel outcomes.

Figures

**Fig. 1**
The impact of ChatGPT on medicine and public health in low- and middle-income countries.

**Fig. 2**
ChatGPT provides potential diagnoses when presented with a list of symptoms.

**Fig. 3**
ChatGPT simplifies complex medical terminology.

**Fig. 4**
ChatGPT provides empathetic support when presented with mental health symptoms.

**Fig. 5**
ChatGPT provides learning strategies.

See this image and copyright information in PMC

References

1. World Health Organization . World Health Organization; Budapest, Hungary: 1998. Improving health care in developing countries using quality assurance: report of a World Health Organization pre-ISQUA joint review meeting; pp. 5–6.
1. World Health Organization . 2021. COVID-19 and the social determinants of health and health equity: evidence brief.
1. OpenAI . 2023. GPT-4 technical report.http://arxiv.org/abs/2303.08774
1. Eloundou T., Manning S., Mishkin P., Rock D. 2023. GPTs are GPTs: an early look at the labor market impact potential of large language models.http://arxiv.org/abs/2303.10130 - PubMed
1. Schwalbe N., Wahl B. Artificial intelligence and the future of global health. Lancet. 2020;395:1579–1586. - PMC - PubMed

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ChatGPT: promise and challenges for deployment in low- and middle-income countries

Affiliations

ChatGPT: promise and challenges for deployment in low- and middle-income countries

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources