Ethics and Governance of AI in Healthcare: Bridging the Mediterranean Divide  

Artificial Intelligence is rapidly transforming healthcare. From diagnosing diseases through medical imaging to predicting patient outcomes, AI has become a powerful ally in advancing healthcare innovation. However, these breakthroughs come with critical ethical and governance challenges. The question is no longer just what AI can do in healthcare but how it should be developed and deployed, especially across regions with different regulatory frameworks, technological capacities, and societal needs. This is particularly relevant in the Euro-Mediterranean context, where AI in healthcare unfolds across diverse settings in the North and South. Nearly thirty years after the launch of the Barcelona Process, which aimed to strengthen cooperation between Europe and its Mediterranean partners, the time has come to address the digital dimension of this relationship. While trade, infrastructure, and academic cooperation have been foundational, the growing impact of AI demands a new layer of partnership grounded in ethical governance, shared standards, and equitable innovation. With growing global competition between tech powers, the Euro-Mediterranean region must take ownership of its digital future, especially in healthcare where the risks of exclusion and harm are high.  

Europe has moved decisively in this direction with initiatives like the EU AI Act and the General Data Protection Regulation. These frameworks emphasize transparency, explainability, human oversight, and risk classification for AI systems in health. Meanwhile, Southern Mediterranean countries, such as Morocco, are implementing foundational legislation, including Law No. 09-08 on personal data protection, and seeking alignment with global standards. However, differences remain. The absence of AI-specific healthcare governance in many parts of the South leads to fragmentation and inconsistent safeguards. This divide is evident when multinational AI providers develop tools under EU or US regulations but deploy them in contexts with weaker oversight. AI systems trained on Western data may not perform reliably in diverse environments. Without inclusive datasets, adapted interfaces, and local validation, there is a risk of medical inequality. Yet these challenges also present opportunities. Cross-Mediterranean cooperation can foster shared ethical guidelines, joint research, and public engagement that bridge gaps and ensure AI is fair and culturally relevant.  

Morocco offers a compelling case. With a growing ecosystem of digital health startups and strong commitment to regional cooperation, Morocco can serve as a model for ethical AI deployment. National authorities such as the CNDP help align progress with rights-based protections. The integration of European and Moroccan frameworks can offer a roadmap for innovation that respects both international obligations and local values. As this policy paper argues, what is needed now is not just regulatory alignment but a broader commitment to co-creation. Policymakers, engineers, healthcare professionals, and civil society must work together to shape a future where AI in healthcare works for everyone. This means investing in digital literacy, funding ethical research, and ensuring that legal frameworks are responsive to real needs on both shores of the Mediterranean.  

In this spirit, we call on stakeholders across the Euro-Mediterranean region to move from declarations to action. Let ethical governance of AI in healthcare become the next chapter of the Barcelona Process. Let it symbolize not only technological advancement but also our shared responsibility to protect public health and build a future rooted in trust, equity, and cooperation.