Large language models in global health

Abstract

Large language models (LLMs) are emerging as powerful tools in healthcare, with a growing role in global health, particularly in low- and middle-income countries (LMICs). This Perspective examines the current progress, challenges and prospects of LLMs in addressing health system disparities and supporting the achievement of the Sustainable Development Goals (SDGs). While high-income countries dominate the development and deployment of LLMs, LMICs face substantial barriers. These include limited digital infrastructure, a scarcity of locally relevant data, regulatory gaps, under-representation of local languages and dialects, and challenges related to privacy and data security. The limited availability of local expertise, capacity building programmes and sustained technical support remains a key barrier to scaling LLMs in LMICs. Nonetheless, case studies highlight how mobile-based LLM applications, hybrid artificial intelligence systems and open-weight models like DeepSeek are enhancing access to care, improving diagnostics and supporting clinical decision-making in resource-limited settings. Key risks include model hallucinations, equity concerns and environmental impacts. These underscore the need for rigorous validation, localized fine-tuning and global governance frameworks. The implementation of LLMs with contextual sensitivity, responsible oversight and codevelopment partnerships is important to avoid perpetuating health inequities. With the right safeguards and strategic investments in capacity building, LLMs have the potential to transform global health by bridging divides in access, augmenting overburdened health workforces, and enabling scalable and cost-effective innovations for the most underserved communities. Large language models (LLMs) are emerging as powerful tools in healthcare, with a growing role in global health, particularly in low- and middle-income countries. This Perspective examines the current progress, challenges and prospects of LLMs in addressing health system disparities and supporting achievement of the Sustainable Development Goals.

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