Building Africa’s next generation of resilient health systems

Over the past year, conversations across global development circles have shifted noticeably. From discussions around U.S. aid reductions and evolving trade arrangements to debates about financing models and institutional sustainability, one message is becoming clearer: the global development landscape is changing, and Africa must increasingly shape its own trajectory.

For many of us working at the intersection of health systems, partnerships, and delivery across the continent, these shifts are not abstract policy discussions. There are actual dynamics affecting how programmes are funded, how services reach communities, and how institutions plan for the future.

“External partnerships will continue to play an important role, but the next chapter must increasingly be defined by African institutions capable of sustaining progress regardless of global shifts.”

Yet, amid uncertainty, I see something else emerging, an opportunity to rethink how we build sustainable systems that are less vulnerable to external shocks and more grounded in African leadership, collaboration, and innovation.

The question before us is no longer simply how to mobilise aid or attract projects. It is how we build systems that continue to function, grow, and deliver impact regardless of shifts in global politics or funding cycles.

And in health, this question is especially urgent.

Across Africa, we have seen remarkable progress over the past two decades. Expanded immunisation coverage, improved disease surveillance, stronger supply chains, digital innovations, and community health programmes have saved millions of lives. These gains did not happen by chance; they were the result of deliberate investments, partnerships, and local leadership.

However, much of this progress has also depended heavily on external financing and project-based support. When funding landscapes shift, as we are witnessing now, programmes can stall, systems weaken, and communities feel the impact first.

This moment, therefore, calls for a strategic pivot from program success to system resilience.

One lesson that has become increasingly clear in my own work across partnerships and implementation is that pilots are not our problem. Africa is rich with successful pilots and innovations. What remains harder is translating these successes into nationally integrated, sustainable systems.

Technology, for example, has become central to many health interventions. Digital tools now support data collection, logistics management, disease tracking, telemedicine, and community engagement. Yet too often, digital solutions operate in silos, serving individual programmes rather than strengthening national systems.

The future of digital health in Africa must therefore move beyond innovation alone. It must focus on integration, ensuring that tools, data, and delivery models fit within national architectures and can be sustained by governments long after pilot funding ends.

This is where partnerships become critical.

No single actor, government, donor, private company, or non-profit can scale solutions alone. Sustainable progress requires coordinated partnerships where each actor contributes what they do best, i.e., governments provide policy direction and ownership; private sector partners bring efficiency and innovation; development organisations contribute technical and operational expertise; and communities guide solutions toward real needs.

The strongest progress I have witnessed happens when partnerships move beyond transactions and become long-term collaborations aligned around shared outcomes.

Financing models must also evolve. As global funding patterns shift, African governments and institutions will increasingly need to explore blended financing approaches that combine public resources, private investment, and development capital. Innovative financing mechanisms, impact investment, and stronger domestic resource mobilisation will become essential tools for sustaining health services at scale.

Encouragingly, we are already seeing promising examples. Across the continent, governments are investing more in digital infrastructure, logistics innovations are improving last-mile delivery, and private sector partnerships are expanding access to services in previously underserved areas. New financing platforms are emerging to support innovation beyond traditional aid models.

These developments signal an important transition from externally driven interventions to locally anchored solutions.

But systems are not built by funding or technology alone. They are built by people.

One of the most rewarding aspects of leadership is watching professionals grow, take ownership, and carry lessons forward into new spaces. Institutions strengthen when leadership capacity multiplies, when teams continue to perform and evolve even as individuals move on. This continuity is what ultimately sustains impact.

In the end, resilience in health systems is not just about infrastructure or financing; it is about leadership, collaboration, and shared responsibility. It is about ensuring that solutions are designed with long-term ownership in mind from the start.

Africa’s development story is still being written. External partnerships will continue to play an important role, but the next chapter must increasingly be defined by African institutions capable of sustaining progress regardless of global shifts.

This moment calls not for alarm but for alignment, alignment between governments, implementers, investors, and communities around building systems that endure.

If we focus on integration instead of fragmentation, partnership instead of isolation, and long-term systems instead of short-term projects, the continent will not merely withstand changes in global funding landscapes. It will emerge stronger, more self-directed, and better equipped to deliver health and opportunity for its people.

And perhaps the most important reflection of all is that sustainable impact comes not from reacting to uncertainty but from deliberately building systems designed to last.

Ota Akhigbe is a global health and partnerships executive working at the intersection of digital health, systems strengthening, and cross-sector collaboration across Africa. She currently serves as Director of Partnerships & Programs at eHealth Africa, where she leads large-scale initiatives that support governments and partners to deliver sustainable health impact at scale.

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