Generative AI, cyberchondria, and digital health inequality: a public health challenge for Somalia and other fragile health systems

Generative artificial intelligence (GenAI) is transforming access to health information through rapid, personalized, and conversational responses. While this may improve health education and reduce information barriers, it may also increase exposure to misinformation, uncertainty, misplaced trust, and health anxiety. This Perspective examines the potential relationship between GenAI-mediated health-information seeking, cyberchondria, digital health inequality, and health-system vulnerability, using Somalia as an important context for examining how these dynamics may unfold in a fragile health system. We argue that conversational AI may reinforce existing patterns of repeated symptom searching and reassurance seeking, although direct evidence linking GenAI to cyberchondria remains limited. Somalia-specific evidence on GenAI-mediated health-information seeking is currently unavailable; therefore, the Somali context is considered through structural conditions, including unequal digital access, constrained healthcare access, and limited local health-information infrastructure. Safe and equitable adoption requires Somali-language validation, digital-health literacy, human oversight, data protection, and local research capacity.