Regulating AI is not a spectator sport, according to Kent Buse, Professor of Health Policy at Monash University Malaysia. In a recent Q&A, he stressed the importance of wide engagement with the Government’s development of AI regulation, saying “the consultation on the legislation, and the National Cabinet process, will be dominated by industry and investors unless public health, climate, and community voices insist on a seat.”
The Australian Government has announced plans for national standards for artificial intelligence, to be driven by an Office of AI established in the Department of Prime Minister and Cabinet. However, Buse notes that health appeared in the speech only in passing, as a cancer-screening tool, and climate only as an energy problem to be managed.
Buse would have liked to hear that the new Australian Standards will be subject to independent health, equity, and climate impact assessment, and that the Office of AI will carry an explicit mandate for health and equity. He believes that standards written without a health lens will still determine health outcomes.
AI is fast becoming a determinant of health in its own right, shaping who is diagnosed and who is missed, whose work is dignified and whose is degraded, what information people receive about their bodies, and whose communities carry the environmental costs of the infrastructure.
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Buse highlights three key issues around AI regulation and public health: concentration, invisibility in the data, and commercial determinants. A handful of largely foreign corporations control the models, the data, and the compute, and the issue for public health is who stands to gain, who loses, and what issues are being kept off the agenda entirely.
AI systems are trained on data that under-represent women, Indigenous peoples, and marginalized communities, so they reproduce and automate existing inequities in diagnosis, triage, and access. The same health-harming industries that perfected targeted advertising will use AI to market alcohol, gambling, junk food, and misinformation with unprecedented precision.
Buse emphasizes the need for accountability and transparency in AI regulation, saying that standards without accountability are aspiration. He suggests that the community should make submissions arguing that health and equity be written into the mandatory standards, demand transparency and disaggregated reporting, and build alliances with unions, the creative sector, and the climate movement.
Other recommended reading includes the European Observatory on Health Systems and Policies’ Demystifying artificial intelligence in health, The Lancet and Financial Times Commission’s Governing Health Futures 2030, Kate Crawford’s Atlas of AI, and Shoshana Zuboff’s The Age of Surveillance Capitalism.
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Buse notes that the global dimension of AI regulation is significant, and that Australia has an opportunity to make health-centred AI governance a global public good, working through the WHO and the multilateral system.
Finally, Buse emphasizes the need for explicit commitments to equality in the governance of powerful sectors, saying that when the governance of powerful sectors is designed without explicit commitments to equality, it is led by, and works for, the already powerful. There is no reason to expect AI to be different unless the standards say otherwise.
Health is a key factor.