In an era where digital innovation is reshaping health systems and services, the Movement Health Foundation (MHF) is taking a step into exploring the intersection between digital health and the global burden of cardiovascular diseases (CVD). Our newly launched Global Cardiovascular and Digital Health Dashboard will offer a collection of indicators that expose these two critical health domains, setting the stage for future discussions that promote digital solutions to improve cardiovascular care.

The Vision Behind the Dashboard
Established in 2019 and officially recognized as a foundation in 2023, the Movement Health Foundation aims to promote equal access to high-quality healthcare worldwide. With a specific focus on reducing mortality from cardiovascular diseases and cancer in low and middle-income countries, MHF recognizes the transformative potential of digital health solutions.

Our goal with this dashboard is to bridge the information between digital health maturity and cardiovascular diseases burden. While we don't yet have direct correlations, bringing these datasets together is a crucial first step in discussing how countries should enhance their digital maturity to promote innovations that tackle cardiovascular diseases globally.

Integrating Global Health Resources
The dashboard, developed in partnership with global health strategy and communication consulting firm Decilion, compiles data in its first stage from authoritative sources, including the recently published Global Burden Disease Study 2021 from the Institute of Health Metrics and Evaluation, the World Bank Data, and the Global Digital Health Monitor (GDHM). It presents this information through interactive maps and charts, allowing users to explore:

• CVD Burden: Prevalence and incidence rates of cardiovascular diseases worldwide
• CVD Risk Factors: Key risk indicators, including alcohol consumption, tobacco use, and obesity prevalence
• Digital Health Maturity Index: An assessment of digital health readiness across 67 countries participating in the GDHM.

By presenting these typically disparate datasets side by side, we're inviting researchers, policymakers, and innovators to draw new connections and insights. This could be the catalyst for novel approaches to cardiovascular care in the digital age.

Global CVD Challenges
The dashboard reveals the sharp contrasts across income levels and geographical regions in the three areas of focus: CVD burden, CVD risk factors, and digital health maturity.

Prevalence and Incidence
CVD prevalence is notably higher in high-income countries compared to low-income countries. France tops the global chart with a CVD prevalence rate of 519 per 1 million inhabitants. Their CVD prevalence is 1.71 times higher than Syria's (302 per 1 million), which has the highest prevalence among low-income countries. Saudi Arabia has the lowest prevalence (170 per 1 million) among high-income countries, almost double the global minimum. Somalia, a low-income country, has the lowest global prevalence at 95 per 1 million inhabitants.

In terms of incidence, Russia led the world in 2021 with 56 new cases per 1 million inhabitants. Syria again stood out among low-income countries, recording an incidence rate of 39 new cases per 1 million inhabitants. The gap between high- and low-income countries was less pronounced for incidence than prevalence. Chile emerged as the high-income country with the lowest incidence (17 new cases per 1 million inhabitants), while Somalia again recorded the lowest figure among low-income nations (10 new cases per 1 million inhabitants).

Risk Factors
The contrast between income groups is less evident for risk factors, except for alcohol consumption. High-income countries generally consume more alcohol, with Finland leading at 29.3 liters per capita (aged 15+) in 2019. Uganda, the highest consumer among low-income countries, averages less than half of Finland's intake (12.21 L per capita).

Excess weight and obesity show significant regional variations. Sub-Saharan Africa, East Asia, and the Pacific (representing low-to-middle and upper-middle income regions, respectively) have lower prevalence rates. In contrast, many countries worldwide report excess weight and obesity in over 50% of their population.

Tobacco consumption is highest in East Asia and the Pacific, with India leading globally (45.1% of the population aged 15+ consuming tobacco). Europe and Central Asia also exhibit high tobacco consumption rates.

The Path Towards Digital Health Maturity
Another key component of our dashboard is the data from the Global Digital Health Monitor (GDHM), a multi-stakeholder, web-based initiative that provides insights into countries' digital health maturity. The GDHM assesses critical components of the digital health-enabling environment and provides an overall score for each country, which can be found in the third section of our tool.

The 2023 GDHM data reveals interesting trends in global digital health maturity. Of the 67 participating countries, 40% are at Phase 3 of digital health maturity (out of five phases, being Phase 5 the highest level of maturity). A third of the analyzed countries remain in Phase 2, while only 22% have achieved Phase 4 of digital health maturity. Notably, no country remains at Phase 1, indicating significant advancements. Leadership and Governance are the most mature components, according to the GDHM, while Workforce development presents the most significant opportunity for improvement.

Digital health maturity data shows a clear divide between high-income and low-income countries. High-income countries are all positioned in either phase four or five. In contrast, low-income countries are predominantly in phases two and three. Notably, Tanzania, Ethiopia, Malawi, Mauritius, and Guinea stand out positively among low-income nations, all achieving phase four status. The situation is very similar for lower-middle-income countries, with most falling into phases two and three. Starting with upper-middle-income countries, we see more nations reaching phase four, indicating improved digital health readiness.

The information presented on the dashboard on CVD prevalence, incidence, risk factors, and digital health maturity is highly relevant when considering what types of interventions are feasible according to the technology available in each country. It also helps identify which countries might need specific interventions the most, and which risk factors could be more effectively tackled given the local digital health infrastructure.

Advancing in Digital Health to Better Respond to CVD Challenges
General strategies for advancing digital health in countries with low to middle digital health maturity have already been proposed. Alain B. Labrique and colleagues emphasize the need to develop a comprehensive national digital health strategy that is integrated with the broader national health strategy and involves all relevant stakeholders, such as government, health providers, private sector partners, and end users. The strategy should prioritize interoperability, data sharing, and the use of open standards to enable the integration of different digital health solutions.

Another critical strategy highlighted by McKinsey is to focus on building foundational digital infrastructure and human capacity. This includes investing in reliable internet connectivity, devices, and data systems and training health workers and managers on digital skills. Partnering with the private sector can accelerate infrastructure development. On the human capacity side, incorporating digital health competencies into medical and health professional education is key. Finally, monitoring, evaluation, and learning systems should be implemented to assess impact and guide refinements. Sustainable financing models involving public-private partnerships must be developed to support long-term scale-up.

The World Health Organization's (WHO) global strategy on digital health provides additional recommendations. WHO emphasizes the need to promote global collaboration and advance the transfer of knowledge on digital health. This includes encouraging countries to engage in global partnerships and knowledge-sharing initiatives and participate in international digital health networks and forums to learn from