GenNursing

A successful first Global Dialogue on AI Governance should translate high-level principles into practical, inclusive, and measurable outcomes that reflect the realities of care, extendier beyond patients and health professionals to families and informal caregivers, who are essential partners in health systems. First, it should define clear roles, responsibilities, and accountability frameworks across the AI lifecycle, explicitly recognizing health professionals (including nurses) and family caregivers as key stakeholders in design, implementation, and evaluation. AI solutions must reflect the lived realities of care at home, not only in clinical settings. Second, success would include a global competency framework for AI in health, expanded to incorporate not only professionals but also health literacy and digital readiness for families and caregivers. This ensures safe, informed use of AI-supported tools in home care, chronic disease management, and aging populations. Third, the Dialogue should produce practice and use guidelines that address clinical integration as well as home and community use, including informed consent, data privacy, transparency, and the management of algorithmic bias. Families must understand when AI is used, how decisions are made, and how to escalate concerns. Fourth, it should prioritize AI solutions that strengthen the care continuum, supporting coordination between professionals and families this reducing fragmentation, improving communication, and enabling shared decision-making. Fifth, success would include mechanisms for feedback and reporting not only from professionals but also from patients and families, capturing real-world risks, usability challenges, and unintended consequences. Finally, the Dialogue should ensure representation of families and caregivers in governance structures, alongside professionals and policymakers, to ground AI governance in real-world care dynamics. In essence, success means advancing from "AI for health systems" to "AI for people and those who care for them". ensuring technology strengthens trust, safety, and collaboration across the full circle of care.

• Safe, secure and trustworthy AI
• Social, economic, ethical, cultural, linguistic and technical implications of AI
• Protection and promotion of human rights
• Transparency, accountability, and human oversight

From our perspective, all four thematic areas are critical and interdependent, particularly in the context of health systems. However, urgent action and active engagement are required where their intersection most directly impacts care delivery, workforce sustainability, and public trust. Safe, secure and trustworthy AI is a top priority. In health, AI must meet the highest standards of safety, reliability, and clinical validity. This requires robust validation in real-world settings, continuous monitoring, and clear risk classification. Trustworthy AI is essential not only for patient outcomes, but also for adoption by health professionals and families who rely on these systems in high-stakes environments. Transparency, accountability, and human oversight are equally urgent. Health professionals must be able to understand, question, and override AI-supported decisions. Clear accountability frameworks are needed to define responsibility across developers, institutions, and users. Human oversight must remain central to ensure that clinical judgment, ethical standards, and contextual decision-making are preserved. Protection and promotion of human rights is fundamental, particularly regarding equity, privacy, and non-discrimination. AI systems must not reinforce existing disparities in access to care or outcomes. Special attention is needed to protect vulnerable populations and ensure that data governance frameworks uphold dignity, consent, and confidentiality across both clinical and home settings. Finally, the social, economic, ethical, cultural, linguistic, and technical implications of AI must be addressed to ensure relevance and inclusivity. AI solutions must be adaptable to diverse health systems, languages, and cultural contexts, while also considering impacts on the workforce, including workload, roles, and required competencies. Together, these priorities ensure that AI strengthens health systems in a way that is safe, equitable, and centered on people, patients, health professionals, and families.

Yes, while the listed themes are comprehensive, several cross-cutting and emerging issues require more explicit attention to ensure effective and equitable AI governance in health. First, workforce transformation and protection is insufficiently emphasized. AI is rapidly reshaping roles, workflows, and decision-making in healthcare. There is an urgent need to define how AI augments-not replaces-health professionals, including nurses, while addressing workload, burnout, and new competency requirements. This also includes preparing future professionals through education and continuous learning systems. Second, integration into real-world care ecosystems remains underexplored. Governance must move beyond standalone systems to address how AI interacts across the full continuum of care, hospitals, primary care, and home settings, where families and informal caregivers play a critical role. Interoperability, continuity of care, and shared decision-making across these environments are essential. Third, data stewardship and global equity require stronger focus. Many countries lack the infrastructure, regulatory capacity, and representative datasets needed to develop and deploy AI safely. Without intentional strategies, this risks deepening global inequities. Mechanisms for equitable data access, capacity building, and inclusive innovation are critical. Fourth, implementation science and evaluation is an emerging gap. There is limited understanding of how AI performs in complex, real-world settings over time. Governance frameworks should include continuous evaluation, post-deployment surveillance, and mechanisms to capture feedback from health professionals, patients, and families. Finally, trust as a measurable and operational objective should be elevated. Trust is not only an outcome but a prerequisite for adoption. It must be actively built through transparency, engagement, cultural adaptation, and demonstrated value in practice. Addressing these cross-cutting issues will ensure that AI governance is not only principled, but also actionable, inclusive, and grounded in the realities of care delivery.

In the health sector, governance gaps across safe, trustworthy AI; transparency and accountability; human rights; and socio-ethical implications are shaping both challenges and opportunities. Challenges include workforce readiness, regulatory capacity, and equity. Health professionals, particularly nurses, often lack guidance on AI integration, creating uncertainty and inconsistent adoption. Limited regulatory frameworks make accountability unclear, while privacy and data protection remain pressing concerns. AI tools developed in high-resource settings may not fit local contexts, risking inequities. Families and informal caregivers also lack guidance on using AI safely, affecting trust and care quality. Opportunities emerge where governance is strengthened. AI can enhance decision-making, optimize workforce allocation, and support underserved populations when co-designed with frontline professionals and families. Advances in global frameworks and multi-stakeholder collaborations provide pathways to standardize safety, transparency, and accountability. Expanding digital infrastructure enables interoperable solutions linking hospitals, primary care, and home care, empowering families and improving continuity of care. Embedding AI literacy and ethics into health professional education also helps future-proof the workforce and build trust. The most significant challenge is ensuring governance keeps pace with rapid technological development while remaining inclusive. The corresponding opportunity lies in leveraging global dialogue and evidence-based frameworks to co-create practical, context-sensitive, and equity-focused governance, ensuring AI strengthens health systems, protects human rights, and supports the full circle of care—patients, professionals, and families alike.

The AI Dialogue can serve as a catalyst for coordinated, inclusive, and actionable international cooperation on AI governance, particularly in health. By bringing together governments, International Organisations, health professionals, industry, academia, civil society, and patient and family representatives, the Dialogue creates a forum to align principles with practical implementation across diverse contexts. First, it can establish shared global standards and frameworks that define safe, trustworthy, and accountable AI use in health, reducing fragmentation and ensuring that AI tools meet consistent quality, safety, and ethical standards worldwide. This is critical for cross-border collaboration, clinical research, and deployment of AI in low- and middle-income countries. Second, the Dialogue can foster multi-stakeholder partnerships that include health professionals and families in governance and co-design. Their participation ensures that AI solutions are not only technically sound but also contextually relevant, culturally sensitive, and responsive to real-world care needs. Third, it can promote knowledge exchange and capacity building, sharing lessons learned, best practices, and regulatory innovations across regions. This accelerates adoption of safe AI while avoiding duplication, particularly in countries with limited resources or emerging digital infrastructure. Fourth, the Dialogue can prioritize equity, human rights, and workforce considerations in AI governance, ensuring that solutions strengthen, rather than replace, health professionals, and empower patients and caregivers. Finally, it can create mechanisms for follow-up, monitoring, and continuous learning, ensuring that international cooperation is not a one-time event but an ongoing, adaptive process that responds to emerging risks, technological advances, and evolving health system needs. In essence, the AI Dialogue can transform global commitment into coordinated action—building trust, aligning ethical and regulatory frameworks, and fostering an international ecosystem where AI safely, equitably, and effectively supports health professionals, patients, and families worldwide.

The AI Dialogue should build on initiatives such as the WHO's Global Digital Health Strategy, the UN Secretary-General's Roadmap on AI, OECD AI Principles, and multi-stakeholder networks like Health Data Collaborative. It should connect with professional bodies, including nursing and medical associations, and platforms advancing ethical AI, interoperability, and workforce capacity. The added value of the Dialogue lies in bringing a unified, health-focused perspective, amplifying voices of professionals and families, fostering cross-sector collaboration, and translating global principles into practical, context-sensitive governance frameworks that ensure AI strengthens health systems safely, equitably, and sustainably.