digital

Jimmy John had been battling a severe toothache for days. The pain made eating and sleeping almost impossible. Early in the morning on Monday, July 7, 2025, he walked into New Boshang Hospital in Jimeta-Yola, northeastern Nigeria, hoping for relief. He queued, was registered, and eventually called in to see a clinician.

After an examination and scans, he was told that he needed a root canal, a dental procedure that removes infected or inflamed pulp from inside a tooth. Jimmy didn’t bother about the cost; the procedure is covered by his insurance under Adamawa State’s health insurance scheme. 

However, he was asked to wait. 

The hospital needed to confirm his insurance details. A desk officer explained that an authorisation code would be sent from his Health Maintenance Organisation (HMO). It would not take long, he was told. Two days at most.

Jimmy left the facility with painkillers and a promise, but the aches kept getting worse. 

“It was a terrible toothache,” he said. 

Two days passed. Then a week. “It took about three weeks,” Jimmy told HumAngle. “I had to be constantly calling and asking if it had been sent.” Each time, the answer was the same: they were still waiting for the code.

By the third week of waiting, Jimmy made a decision he had hoped to avoid. “I ended up paying ₦35,000 for something my insurance should have covered,” he said. “The money I planned to use for food was what I used for treatment.”

Growing coverage, inconsistent access 

Launched in 2020, Adamawa State’s contributory health insurance scheme has expanded in recent years. The Adamawa State Contributory Health Management Agency (ASCHMA) now covers the formal sector, informal sector, equity, retirees’, and tertiary students’ health plans. Official figures show that more than 170,000 people are enrolled across the state, a significant increase from its early years. 

Yet, Jimmy’s experience showed that being insured does not always mean being able to access care when it is needed.

Under ASCHMA’s design, access to healthcare operates at two levels. At the primary care level, enrollees are entitled to services such as malaria treatment, antenatal care, immunisation, and basic diagnostics by simply presenting their insurance ID card at their chosen facility.

According to ASCHMA’s Executive Secretary, Ujulu Amos, this process does not require involvement from HMOs. “Verification at that point only requires an ID card,” he explained. “Once the hospital cross-checks the enrollee’s number with the list sent to them, the person is entitled to access all primary care. The HMO is not involved.”

The process changes once a patient needs secondary or specialised care, such as surgery or a root canal procedure. At that stage, hospitals must request an authorisation code from the patient’s HMO before treatment can proceed. The code allows the hospital to later claim payment for the service.

Ujulu emphasised that this authorisation step is meant to be fast and tightly regulated.

“In our operational guideline, requesting a code should not take more than one hour,” he said. “Three hours is the maximum. If it takes three days, that is a problem.”

In Jimmy’s case, that process stretched into three weeks.

Where the system breaks down

At the heart of these delays is a lack of interoperable digital health infrastructure. While hospitals can confirm that a patient is enrolled, they cannot proceed with secondary care without explicit approval from the HMO, even when coverage is obvious. 

This multi-step process, often reliant on emails, phone calls, and individual responsiveness, leaves patients stuck in the middle.

Ujulu said patients are not powerless in such situations. According to him, ASCHMA operates a 24-hour toll-free call centre that enrollees can contact if authorisation delays exceed the allowed timeframe. In such cases, the agency can intervene, issue the authorisation, and later deduct the cost from the HMO. HumAngle attempted to reach the agency through the toll-free line, and the line was active at the time of reporting.

Beyond awareness gaps, however, fundamental system weaknesses are a factor. Many health facilities still rely on manual processes, and digital literacy among healthcare workers remains low, slowing down requests.

“We discovered low digital literacy among healthcare workers as one of the bottlenecks,” Ujulu admitted. “A good number of them either are not willing or don’t know how to log into the platform to request the code.”

In practice, this means insurance verification is hardly real-time or reliable. 

At New Boshang Hospital, staff say such delays are common once care goes beyond the primary level. Godiya James, a technician at the dental unit, explained that authorisation requests often stall.

“We send the diagnosis and treatment plan for authorisation,” she said. Sometimes it takes a day or two for us to get a response. Sometimes it takes longer. Sometimes there won’t be a response until we resend it.” 

Some patients, she added, can’t wait longer. 

For patients like Jimmy, long wait periods mean prolonged pain. 

What’s the issue?

Health insurance schemes like ASCHMA are designed to reduce out-of-pocket spending, which dominates healthcare expenditure in Nigeria, yet the systems that support them are not well-connected. Many facilities and HMOs rely on emails, phone calls, paper records or ad-hoc networks to verify coverage. 

Without digital interoperability, the ability for different software and data systems to talk to one another, each verification becomes a manual transaction, dependent on network stability, personal responsiveness, or manual cross-checking.

Farida Abalis Paul, Chief Operating Officer of A&M Healthcare, one of the HMOs working with ASCHMA, said verification depends largely on monthly enrolment lists. 

“Once a facility requests verification, we check the list. If the person’s name is there, they can go ahead with treatment,” she explained. However, the process is delayed when a patient’s name is missing from the list, even if they hold a valid insurance card. 

This can result from delayed updates, data entry errors, or changes in facility selection.

“You may have an ID card, but when we check the list, your name is not there,” she said. “Today you’re on the list, tomorrow you’re not. Along the line, something happened.”

When this happens, HMOs cannot approve care until ASCHMA corrects the records. 

For patients, the consequences are immediate. 

Aishatu Haliru, a lecturer at Adamawa State Polytechnic, Yola, was turned away from the Specialist Hospital despite presenting her insurance card.

“They told me my name was not on the list,” she said. “I couldn’t understand how that happens when nothing has changed.”

She was referred to ASCHMA, where an official confirmed that her record had been omitted during a routine database update. Although the issue was corrected the same day, Aishatu missed the clinic schedule and had to wait several more days for care.

“But the question is, why did it disappear in the first place?” she asked.

Ujulu, ASCHMA’s Executive Secretary, argued that such disappearances could result from platform migration, noting that data loss also slows down authorisation processes for patients like Jimmy.

These gaps highlight a broader challenge within Nigeria’s evolving digital health system. 

Nigeria’s push toward efficient digital healthcare systems

At the national level, Nigeria has begun laying policy foundations for digital transformation in healthcare, although implementation remains uneven. 

One of the key efforts is the Nigeria Digital in Health Initiative (NDHI), which aims to build a national digital health architecture that supports interoperable electronic medical records and efficient data exchange between healthcare facilities, insurers, and government systems. In practical terms, such a system would allow clinics to instantly confirm a patient’s insurance coverage, treatment entitlements, and provider claims eligibility, eliminating the kind of long delays Jimmy experienced.

Alongside this, the National Digital Public Infrastructure (DPI) Framework and the emerging Nigerian Data Exchange standards, coordinated by the National Information Technology Development Agency (NITDA), seek to promote shared digital rails for public services. These include interoperability, data security, and service integration. 

Applied to healthcare, these principles mean that insurance verification, patient identity, and claims processing should function as shared public infrastructure: secure, privacy-preserving, and accessible across institutions. In practice, a hospital should be able to instantly confirm a patient’s coverage without manual escalation.

NITDA’s ongoing strategic roadmap also emphasises inclusive access to digital infrastructure across the country and equitable digital literacy, both of which are foundational to reliable nationwide digital service delivery. 

The goal of such policies is straightforward: when systems can talk to each other securely and immediately, services like insurance verification become almost instant, reducing delays and unnecessary costs.

“Interoperability sounds like a technical word, but in reality, it’s about time, trust, and dignity,” said Muhammed Bello Buhari, a Nigerian-based digital rights activist. 

In a state like Adamawa, where insecurity and economic pressure already shape access to care, the ability of systems to speak to one another determines whether insurance works in practice or remains theoretical, leaving people insured on paper but uninsured in practice. 

Muhammed argues that without shared, real-time systems, patients are pushed into delays and out-of-pocket payments not because they lack coverage, but because institutions cannot confirm what they already know. 

“Interoperability is less about cutting-edge innovation and more about treating health information as essential public infrastructure that respects patients’ vulnerability and ensures care moves quickly, reliably, and with dignity,” he added. “When a patient arrives sick or in pain, insurance must work immediately, or it loses its value.”

This report is produced under the DPI Africa Journalism Fellowship Programme of the Media Foundation for West Africa and Co-Develop.

Jan. 2 (UPI) — An anti-terrorism court in Islamabad, Pakistan, on Friday sentenced five journalists, a YouTube influencer and a military officer to two life sentences each for “digital terrorism” crimes.

Anti-Terrorism Court Judge Tahir Sipra announced the verdicts for the defendants, who were tried in absentia.

Pakistani law allows for trials in absentia, but their verdicts must be confirmed by the Islamabad High Court.

Those who were sentenced were Akbar Hussain, Wajahat Saeed Khan, Haider Raza Mehdi, Moeed Pirzada, Shaheen Sehbai, Sabir Shakir and Adil Raja.

Raja is a YouTube influencer, while Khan, Shakir, Sehbai, Mehdi and Pirzada are journalists. Hussain is a former Pakistan army officer.

The court found that the seven defendants encouraged riots on May 9, 2023, after former Pakistani Prime Minister Imran Khan was arrested briefly in Islamabad for alleged corruption.

Imran Khan’s supporters attacked governmental buildings and military facilities in several locations.

Prosecutors brought 24 witnesses against the defendants and said they used their respective digital media channels to incite riots, enable attacks and amplify the violence against governmental institutions.

If their sentences are upheld, each faces up to life in prison plus a $5,500 fine for criminal conspiracy.

Each also could be sentenced to another 10 years in prison and fined more than $2,200 for waging or attempting to wage or abetting in waging war against Pakistan.

Additionally, each defendant has been sentenced to 15 years in prison for three counts of violating the Anti-Terrorism Act of 1997 and fined nearly $7,000.

All sentences are to run concurrently if upheld by the higher court.

Gamal Mansour of the University of Toronto says Syria’s authorities are still in a fragile state-building phase, and the clashes in coastal Syria have exposed gaps in control.

Barin Kayaoglu, of the Social Sciences University of Ankara, says that a Libyan general’s plane crash in Turkiye is unlikely to impact the broader framework of Turkiye’s role in Libya.

In a territory where 81 percent of buildings lie damaged or destroyed, a small community of young Palestinians is fighting to preserve what remains of Gaza’s digital world.

Coders, repair technicians and freelance workers are labouring under impossible conditions to keep the besieged enclave connected to the outside world.

Against all odds, Gaza’s youths continue to adapt. They work offline, code in notebooks, store solar power whenever the sun is out, and wait for rare moments of connectivity to send their work to clients around the world.

In a war that has taken nearly everything, digital skills have become a form of survival – and resilience.

Many now also rely on online work to make a living. But even that fragile lifeline is now hanging by a thread after more than two years of Israel’s genocidal war.

According to the Palestinian Central Bureau of Statistics, Israeli forces have “deliberately and systematically destroyed” the telecommunications infrastructure.

“We just always look for another way to get connected, always find another way,” said Shaima Abu Al Atta, a coder working from a displacement camp. “This is what actually gave us purpose because if we didn’t do this, we would just die surviving and not doing anything. We would die internally.”

Before the war erupted in October 2023, Gaza had a modest but vibrant tech scene. Innovation hubs hosted coding bootcamps, and hundreds of freelancers worked remotely for international clients. Much of that ecosystem now lies in ruins.

Shareef Naim, an engineer who led a technology hub, described what was lost. His building housed more than 12 programmers with contracts for companies outside Gaza, he said. “The team was very active,” Naim told Al Jazeera.

Today, the structure is destroyed, though some team members are still trying to work from tents and emergency shelters.

Computer technician A’aed Shamaly says, “The main challenge is electricity. Today, electricity is not available all the time, and if it is available, it is unstable,  and there will be a lot of cuts. Prices are also high.”

Electricity, when available at all, is unstable and prohibitively expensive, $12 per kilowatt compared with $1.50 for 10 kilowatts before the war, he said. “There are no spare parts,” he added, so technicians must scavenge components from broken equipment pulled from bombed buildings.

The scale of destruction is staggering. According to the United Nations Satellite Centre (UNOSAT), approximately 198,273 structures across Gaza have been damaged, with 123,464 completely destroyed. The telecommunications sector has been particularly hard hit.

Data from the Palestinian Central Bureau of Statistics reveals that 64 percent of mobile phone towers were out of service as of early April 2025. In Rafah, coverage has collapsed to just 27 percent, down from near-universal access before the war.

During the war, connectivity watchdog NetBlocks documented repeated disruptions, including what it called a “near-total telecoms blackout” in January 2024 that lasted for days.

Israel has long restricted Gaza to outdated 2G mobile technology while allowing 4G in the occupied West Bank.

The telecommunications sector’s value has cratered from $13m in 2023 to just $1.5m in 2024, an 89 percent collapse. Estimated losses exceed half a billion dollars, while reconstruction is projected to cost at least $90m.

The consequences ripple across Gaza’s economy and society.

Remote work was a crucial income source in a territory where unemployment exceeded 79 percent even before October 2023. Now, erratic internet access has pushed many freelancers into joblessness just as Israeli-induced famine has sent food prices soaring.

The telecommunications collapse has also paralysed the banking system, preventing money transfers and leaving families unable to access cash. Healthcare has been disrupted, with the World Health Organization documenting deaths caused by the inability to contact emergency services in time.

Even during the fragile ceasefire that took effect in October 2025, Israel has blocked essential repair equipment from entering Gaza. The restrictions form part of what analysts describe as a deliberate strategy to maintain control over Palestinian digital infrastructure and suppress the flow of information to the outside world.

The future remains deeply uncertain, as efforts to push a fragile ceasefire forward appear to stall and Israel threatens the possibility of returning to full-scale war.

Kitsch Liao, associate director at the Atlantic Council Global China Hub, says Beijing’s reaction to the largest US arms sale to Taiwan is an information warfare tactic.

The Eurovision likes to sell itself as a glittering exercise in European unity, colorful, loud, proudly diverse, and (officially) above politics. Yet anyone who has watched the contest with both eyes open knows that “apolitical” has always been more of a brand promise than a lived reality. In late 2025, that gap widened into a full-blown crisis, as a number of broadcasters reported across outlets that Spain, Ireland, Slovenia, the Netherlands, and Iceland signaled they would not take part in Eurovision 2026 after the European Broadcasting Union (EBU) decided not to exclude Israel amid the ongoing war in Gaza, Palestine.

This episode is not simply “politics invading culture.” It reflects a shift in how legitimacy is demanded and contested in Europe’s cultural diplomacy, particularly when public broadcasters operate under constant online scrutiny. A constructivist lens helps explain why withdrawal can become socially “appropriate” not only because of interests, but because identities, norms, and public expectations set the boundaries of acceptable action.

Eurovision’s political DNA

Eurovision was launched in 1956 as a post-war cultural bridge. Its origin story is important: a shared stage was meant to build familiarity, and familiarity was meant to soften rivalry. That heritage still shapes the contest’s self-image. But Eurovision has long functioned as a stage where politics appears in coded ways through voting patterns, representation debates, and symbolic messaging.

In 2026, the argument is no longer coded. The EBU’s insistence that Eurovision must remain apolitical is being tested by publics who increasingly expect cultural institutions to reflect basic humanitarian values. This tension has been building for years, but the Palestine crisis and the EBU’s decisions have turned it into a legitimacy problem, not merely a public relations headache.

Why withdrawal became “appropriate”

Constructivism in international relations focuses on how identities and norms shape behavior. States and national institutions do not act only from material interests; they also act from what is socially acceptable, what fits their self-image, and the expectations of their audiences.

Three dynamics stand out.

Identity signalling, domestically and externally

For several withdrawing countries, participation carried an identity cost. Public broadcasters—especially those that see themselves as guardians of civic values—operate within national narratives about solidarity, rights, and moral responsibility. Remaining in the contest while public debate framed Israel’s participation as incompatible with humanitarian concerns risked looking like complicity or indifference. Withdrawal, by contrast, functioned as a signal: this is who we are, and this is the line we will not cross.

Importantly, this signalling was not addressed only to external audiences. It was also addressed inward towards domestic publics, artists, and civil society networks. In many European societies, those constituencies are no longer passive consumers of cultural events; they are active participants in the reputational economy surrounding public institutions.

Norm cascades and moral momentum

Once a few broadcasters moved towards withdrawal, the decision quickly gained social momentum. This is what Finnemore and Sikkink described as a “norm cascade”: when a norm shifts from being optional to being expected, and the reputational cost of non-compliance rises. In practical terms, it can start to feel safer to leave than to stay—because staying invites condemnation, while leaving can be framed as moral coherence.

This is also why the dispute escalated so quickly. A single broadcaster withdrawing is a story. Multiple broadcasters withdrawing is a pattern, and patterns trigger moral comparisons. The question changes from “Why did they leave?” to “Why are you still staying?”

The ‘apolitical’ norm is under strain because it looks selective.

The apolitical claim does not collapse simply because people become more emotional. It collapses when it appears inconsistent. Critics repeatedly pointed to Russia’s exclusion in 2022 after the invasion of Ukraine and asked why a different standard was being applied now. The EBU, for its part, has emphasized the contest’s non-political ethos and introduced new rules aimed at insulating Eurovision from government influence.

But in the public sphere, the argument is not purely procedural. It is moral and comparative: if Eurovision can act decisively in one case, why not in another?

Constructivism predicts that institutions struggle when the norms they rely on no longer align with the moral intuitions of their audiences. That is exactly what this crisis reveals.

Digital activism as a legitimacy engine

If this controversy had happened twenty years ago, it would likely have moved more slowly, mediated by newspapers and official statements. Today it unfolds in a real-time digital public sphere where narratives travel quickly across borders and reputational costs escalate fast. Online mobilization—through petitions, artist statements, and hashtag campaigns—helped turn Eurovision into a symbolic battleground, pressuring broadcasters to respond to highly visible moral claims.

Two effects matter most. First, digital dynamics accelerate moral consolidation, which means once “selective neutrality” becomes a dominant frame, hesitation itself is read as a political stance. Second, institutions face continuous visibility. Decisions are no longer a single event but an ongoing justification process, renewed by viral moments and high-profile protest actions linked to Israel’s inclusion.

For cultural diplomacy, this shifts the logic of soft power from image-making towards moral credibility under public scrutiny.

Withdrawal as cultural diplomacy

Withdrawal from Eurovision is, in a strict sense, symbolic. But symbolism is precisely what cultural diplomacy trades in. The act of leaving, particularly when done by public broadcasters, served three strategic functions.

First, moral signalling, which meansbroadcasters and states communicated alignment with humanitarian values and a refusal to normalize perceived injustice.

The second one is reputation management.  In a digital environment, silence can be more costly than action. Withdrawal can reduce domestic backlash and preserve trust in public institutions.

Last, this is ethical positioning as soft power.  The logic of soft power is shifting from colorful branding to ethical coherence. A state may gain credibility not by appearing “fun,” but by appearing consistent with its professed values.

These functions help explain why the controversy is bigger than Eurovision. What is being tested is the idea that cultural platforms can remain insulated from global crises. Many audiences no longer accept that separation.

The EBU’s dilemma: rules, legitimacy, and consistency

The EBU now sits at the center of competing demands. On one side is the institutional need for predictability: rules that keep Eurovision from becoming an arena for state-to-state confrontation. On the other side is the public demand for moral consistency: rules that do not appear selective or politically convenient.

The EBU’s recent approach of avoiding an immediate exclusion decision while adjusting rules—may be defensible from a governance perspective.

Yet governance solutions do not automatically restore legitimacy, because legitimacy is also emotional and relational. It depends on whether audiences believe the institution is acting in good faith and applying standards fairly.

This is where cultural diplomacy meets a hard truth: neutrality is not simply declared; it is earned. And in the digital age, it is re-earned continuously.

What this means for Europe’s cultural diplomacy

Three implications stand out.

First, moral expectation is becoming structural.  European publics increasingly demand moral coherence not only from governments but from cultural institutions as well. Cultural diplomacy is being asked to carry ethical weight.

Second, “European values” are being operationalized. They are no longer abstract slogans. They are used as benchmarks to judge institutions and to accuse them of hypocrisy when they fall short.

Third, public opinion has become a strategic force, not background noise.  Digital mobilization can shape state behavior indirectly by pressuring broadcasters, artists, and institutions that sit at the heart of national identity.

Policy takeaways

If the EBU seeks to protect Eurovision’s legitimacy without turning it into a geopolitical tribunal, three steps would help. First, it should clarify participation principles by defining what “neutrality” means operationally and what thresholds trigger institutional action. Second, it should build a credible consistency mechanism, as audiences will continue comparing cases and demanding transparent reasoning. Third, the EBU should treat the digital sphere as part of governance: proactive engagement and rapid clarification now shape institutional survival as much as formal rule-making.

Conclusion

Eurovision 2026 is not simply a cultural controversy with political noise attached. It is a case study in how identity, norms, and digital activism are reshaping Europe’s cultural diplomacy. Constructivism helps explain why withdrawal became not only possible but, for some, necessary: it aligned state-linked institutions with the moral expectations of their publics.

Eurovision was built to bridge Europe after war. Ironically, its newest crisis shows that unity today is conditional: audiences increasingly expect cultural institutions to be transparent, consistent, and ethically credible, especially when global suffering is impossible to ignore.