The many faces of the big data revolution in health for sub-Saharan Africa

This special issue of the South African Journal of Science on 'Big data and AI in health sciences research in subSaharan Africa' comes from within a large-scale initiative, sponsored by the US National Institutes of Health, to promote research use of 'big data' for health promotion in Africa. As stated on its website (https://dsi-africa.org), the Data Science for Health Discovery and Innovation in Africa (DS-I Africa) Initiative aims to leverage data science technologies to transform biomedical and behavioural research and develop solutions that would lead to improved health for individuals and populations. Started in 2021, DS-I Africa has the ambitious goals of creating pan-African scientific networks; developing data science centres of excellence; creating new data collection and analytic systems, applications and tools; facilitating data resource access to the global scientific community; and advancing policies in Africa related to ethical issues raised by data science. A notable structural feature of DS-I Africa is the intentional pairing of specific scientific projects (or 'data hubs') with projects focusing on the ethical, legal and social implications (or ELSI) of data science. While this embedding of ELSI projects within large scientific initiatives in Africa is by no means new - it was also a feature of the H3Africa initiative (https://h3africa.org) - it does raise some complex questions about the relationships between social science, ethics, law and the scientific pursuit of knowledge through digital technologies in the context of global, regional and domestic inequities. Africa is, albeit unevenly in some regions, undergoing an accelerated process of data digitisation. Increased access to and use of the Internet, personal computers and mobile devices in Africa, as well as advances in data storage and transfer capacity, means that individuals, communities and environments are becoming more 'visible' to researchers, and with this new visibility comes the potential for improved understanding and more effective health interventions. In principle, this digital (r)evolution should be warmly welcomed by adherents to evidence-based medicine and public health. For decades, there have been complaints about a 'data vacuum' in Africa, which has hampered efforts to provide effective clinical care, conduct rigorous scientific research, strengthen fragile health systems and tackle emerging public health threats. The pendulum, it seems, is starting to move in t