The incompleteness of patient health data is a threat to the management of COVID-19 in Africa and globally. This has become particularly clear with the recent emergence of new variants of concern. The Virus Outbreak Data Network (VODAN)-Africa has studied the curation of patient health data in selected African countries and identified that health information flows often do not involve the use of health data at the point of care, which renders data production largely meaningless to those producing it. This modus operandi leads to disfranchisement over the control of health data, which is extracted to be processed elsewhere. In response to this problem, VODAN-Africa studied whether or not a design that makes local ownership and repositing of data central to the data curation process, would have a greater chance of being adopted. The design team based their work on the legal requirements of the European Union's General Data Protection Regulation (GDPR); the FAIR Guidelines on curating data as Findable, Accessible (under well-defined conditions), Interoperable and Reusable (FAIR); and national regulations applying in the context where the data is produced. The study concluded that the visiting of data curated as machine actionable and reposited in the locale where the data is produced and renders services has great potential for access to a wider variety of data. A condition of such innovation is that the innovation team is intradisciplinary, involving stakeholders and experts from all of the places where the innovation is designed, and employs a methodology of co-creation and capacity-building.

This article investigates expansion of the Internet of FAIR Data and Services (IFDS) to Africa, through the three GO FAIR pillars: GO CHANGE, GO BUILD and GO TRAIN. Introduction of the IFDS in Africa has a focus on digital health. Two examples of introducing FAIR are compared: a regional initiative for digital health by governments in the East Africa Community (EAC) and an initiative by a local health provider (Solidarmed) in collaboration with Great Zimbabwe University in Zimbabwe. The obstacles to introducing FAIR are identified as underrepresentation of data from Africa in IFDS at this moment, the lack of explicit recognition of situational context of research in FAIR at present and the lack of acceptability of FAIR as a foreign and European invention which affects acceptance. It is envisaged that FAIR has an important contribution to solve fragmentation in digital health in Africa, and that any obstacles concerning African participation, context relevance and acceptance of IFDS need to be removed. This will require involvement of African researchers and ICT-developers so that it is driven by local ownership. Assessment of ecological validity in FAIR principles would ensure that the context specificity of research is reflected in the FAIR principles. This will help enhance the acceptance of the FAIR Guidelines in Africa and will help strengthen digital health research and services.