The question of how digital health is regulated has become increasingly important within debates on technology, inequality and global health. While digital health is frequently celebrated for its capacity to expand access, build resilient systems and advance equity, scholars have raised critical concerns about its role in reproducing asymmetries of power. The potential for reproducing rather than curbing inequality is particularly relevant for the Global South. This Special Issue of the International Journal of Law in Context interrogates the ways in which digital health infrastructures, regulatory frameworks and transnational data flows are constitutive of coloniality and neoliberal capitalism. Bringing together socio-legal, feminist and decolonial perspectives, the contributions examine regulation as a terrain in which vulnerabilities, exclusions and structural inequalities are reinforced. Against the celebratory rhetoric of innovation, this collection situates regulation as a key site for understanding the entanglement of digital health with broader histories of coloniality and capitalism.

Trade in counterfeit medicines raises serious public health concerns. However, efforts geared towards combating trade in counterfeit medicines tend to focus more on the protection of trademarks, which may not necessarily protect the public from the adverse consequences of using counterfeit medicines. This arises from differences in the meaning of “counterfeit” in the intellectual property and public health contexts. This article analyses the extent to which the anti-counterfeiting legislation and institutions in two African countries, Kenya and South Africa, are capable of combating trade in counterfeit medicines in a manner that protects both the public and brand name owners. The article examines the anti-counterfeiting legislation and institutions that ensure compliance with the standards for marketing medicines that are in place in these countries, in order to draw lessons on how they can be used to balance the protection of public health interests and trademarks.

The ongoing efforts to establish biobanks in Africa envisage the availability of biological samples and data in accordance with relevant national legislation and ethical principles. Current literature has established that many African countries “do not have national legislation or guidelines on the use of stored biological samples” or if such guidelines are in place, then “disparities exist in relation to informed consent and export and import requirements.” In this regard, this article considers the extent to which the available legal and ethical regulatory frameworks in South Africa are capable of governing the use of stored biological samples in a manner that facilitates health research while at the same time protecting the interests of sample donors.

Researchers from the Universities of Oxford, Nairobi, and Manitoba are collaborating on a project to develop an HIV vaccine based on the immunological protection mechanisms found in commercial sex workers from the Majengo slum in Nairobi. This group consists of educationally and economically disadvantaged women who resort to commercial sex work for a living. A clinic was established in the slum to study sexually transmitted diseases, which now includes HIV/AIDS. The clinic serves as a research facility for the collaborating researchers who have been using the women's blood, cervical, vaginal, and saliva samples for the ongoing studies. The clinic runs two HIV-integrated activities: HIV research and HIV care and treatment. For HIV negative participants, samples are collected and used for research and care after they give informed consent.