On the 3^rd of July 2025, the School of Health Systems and Public Health (SHSPH), Faculty of Health Sciences at the University of Pretoria, hosted its annual Research Day under the theme “Navigating the Grey Zones: Ethics and AI in Public Health Research”. As public health rapidly integrates digital tools, the research day highlighted the crucial intersection between innovation and ethical responsibility, an issue shaping both local and global health systems.

Throughout the day, the research programme highlighted diverse postgraduate student presentations on themes including environmental and occupational health, health systems strengthening, epidemiology, and biostatistics. These presentations demonstrated how public health research at SHSPH is engaging with digital technologies to solve complex problems, from disease surveillance and early diagnosis to monitoring and evaluation.

Framing the day’s theme was a thought-provoking ethics lecture by Dr Camille Castelyn titled “What is automation complacency in the age of AI and why it matters?” Drawing from her research on cognitive bias and AI decision-support systems, Dr Castelyn interrogated the growing reliance on automated tools in healthcare. Her lecture underscored the concept of “automation complacency”, the risk of healthcare professionals abdicating decision-making to AI, which can lead to ethical lapses, diagnostic inaccuracies, and diminished accountability. Central to the lecture was a provocative ethical question: Do healthcare professionals have a duty to disclose their use of AI in diagnostics or screening to patients? Dr Castelyn argued that transparency is critical to preserving trust in the doctor-patient relationship, especially as AI tools are being utilized more frequently. These concerns resonate deeply within South Africa’s public health context, where health equity, digital literacy, and algorithmic bias require urgent attention.

The SHSPH research day highlighted the alignment of ethical AI integration with global health agendas. The World Health Organization and United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities), emphasize responsible innovation that prioritizes equity, transparency, and data privacy. The SHSPH reaffirmed its commitment to these goals by positioning ethical deliberation not as a barrier to progress but as its foundation. To continue navigating the grey zones, external exhibitors such as the National Institute for Communicable Diseases (NICD), the South African Medical Research Council (MRC), Health Systems Trust (HST), and groundWork will host follow-up webinars that further explore the grey zones in public health research that call for ongoing investigation.

As the digital era reshapes public health, the SHSPH’s Research Day served as a timely reminder that ethical vigilance must accompany technological advancement. Through embracing this balance, South Africa, and the global public health community can ensure that AI enhances, rather than erodes, the human foundations of care.