The World Health Organization (WHO) has joined the newly established Open Health Stack Software Foundation (OHS-SF), an initiative designed to help countries build interoperable, standards-based digital health systems. Hosted by the Linux Foundation and supported by WHO, Google and an international coalition of health and technology organizations, the foundation aims to reduce fragmentation in digital healthcare by providing open-source software, shared standards and reusable infrastructure.
According to WHO, the initiative addresses a long-standing challenge: many national digital health systems have evolved as isolated solutions for individual care programs, such as immunization, HIV or maternal health. These disconnected platforms often cannot exchange information efficiently, forcing healthcare professionals to enter the same data multiple times while limiting policymakers' ability to gain a comprehensive overview of healthcare delivery.
Shared infrastructure
The Open Health Stack Software Foundation builds on a collaboration that began in 2020, when WHO sought practical ways to embed its clinical guidance directly into digital health systems. Rather than publishing recommendations solely as documents, the organization aimed to make them available in machine-readable formats that software developers could integrate into healthcare applications.
To achieve this, WHO partnered with Google to develop open-source software based on international interoperability standards, including HL7 FHIR. The collaboration resulted in the launch of Open Health Stack in 2023, creating a growing ecosystem of developers, ministries of health, implementation partners and healthcare organizations.
Since then, Open Health Stack technologies have been incorporated into national digital health record systems and community health worker platforms serving millions of people across countries in Sub-Saharan Africa, South Asia and Southeast Asia. To ensure the platform remains independent and community-governed, Google has transferred the Open Health Stack codebase and related assets to the Linux Foundation-hosted Open Health Stack Software Foundation.
International standards
The foundation's software is designed around internationally recognized standards already recommended by WHO, including HL7 FHIR for health data exchange and global clinical terminologies such as the International Classification of Diseases (ICD). These standards help ensure that health information recorded in one system can be interpreted consistently by another.
Another important component is the integration of WHO SMART Guidelines, machine-readable versions of WHO's clinical and public health recommendations. By embedding these guidelines directly into software, countries can implement evidence-based healthcare recommendations without having to translate policy documents into digital workflows themselves.
The foundation will maintain open-source software libraries, developer tools and reference applications that governments and implementation partners can use without licensing fees or vendor lock-in. According to WHO, this supports the development of resilient national digital health infrastructures that remain technically and financially sustainable over the long term.
Because the software is open source, countries and local technology companies can adapt, extend and maintain the systems themselves instead of relying on proprietary platforms or external vendors. WHO believes this approach supports greater national ownership of digital health infrastructure while helping build local technical expertise and stronger domestic digital health ecosystems. The initiative also aligns with broader international efforts to encourage countries to move away from donor-driven, stand-alone digital health projects toward nationally governed, interoperable platforms that can evolve over time.
Preparing healthcare for AI
Beyond digital infrastructure, the foundation also introduces AI Commons for Global Health, a collaborative environment for developing shared tools needed to deploy artificial intelligence safely within healthcare systems. The initiative, co-developed with WHO, focuses on creating common AI protocols, health-specific capabilities, benchmarking tools and evaluation frameworks. By building AI on the same open standards used throughout Open Health Stack, countries can integrate future AI applications into existing health systems while maintaining interoperability, transparency and alignment with WHO guidance.
WHO emphasizes that open, community-governed infrastructure is essential for ensuring digital health systems remain sustainable beyond individual funding cycles. Membership of the Open Health Stack Software Foundation is free for governments, academic institutions and non-profit organizations, allowing countries not only to use the software but also to contribute to its ongoing development and tailor it to national healthcare needs.
