New York to Kigali: turn health talks into action

Global health dialogues must help build resilient, sovereign health systems that turn commitments into action, writes Githinji Gitahi, group CEO, Amref Health Africa.

[NAIROBI, SciDev.Net] Every global health gathering has its routine: a full programme, strong coffee and a dash to the wrong meeting room. Between New York’s UN General Assembly (UNGA) week and the World Health Summit (WHS) in Berlin, one question stayed with me: are our health systems changing as fast as the global conversation?

In my post-UNGA reflections, I wrote about financing, preparedness, resilience, equity, sovereignty and accountability. The WHS in Berlin brought these questions down to daily delivery: Who sets priorities? Does funding strengthen services? Can communities and workers turn information into action? Who is accountable when plans fail to reach people?

UNGA focused more on global architecture and the distribution of money, power and responsibility. WHS made visible the delivery realities underneath: trust built before emergencies, supported workers, joined-up systems and communities shaping responses. Different emphasis, same direction.

What matters to people?

Communities are not waiting to be invited into health systems; they are already caring for one another and responding to illness. The question is whether institutions recognise that knowledge. Too often, they design the response first and ask communities to deliver it. That may be quick to organise, but slow to earn trust.

One WHS discussion described pastoral communities becoming more open to family-planning conversations when engagement began with the health of their goats and livestock. It echoes Amref’s story of a clinic serving families and their animals together. The lesson is simple: begin with what matters to people. Listening is part of delivery.

Trust cannot be launched with a slogan when a crisis begins. It grows through reliable services, honest explanations and participation. A recommendation will not help if people cannot afford to follow it or reach care. Preparedness means detecting threats and sustaining the services and relationships that make a response credible.

The same test applies to technology and data. A tool is progress only if it fits the work and improves decisions. Community information must connect to clear responsibilities and action. Countries need a meaningful say in how health data is governed and shared. More dashboards will not fix institutions working in separate lanes.

Sovereignty needs cooperation

Health sovereignty does not mean going it alone. It means having the capacity to set priorities, develop expertise, produce essential health products and use data in ways that serve African people. That capacity depends on cooperation across countries and across the health system.

The conversations on financing, local production and research pointed to one lesson: ambition needs an enabling environment. Manufacturers need predictable demand and coherent regulation; researchers need sustained investment and relevant evidence; health workers need fair support and roles shaped by community needs. These are connected parts of a system, not isolated projects.

Climate pressures make the connections clearer. Resilience requires evidence that informs policy, financing that reaches primary care and coordination across sectors. Whether the pressure is an outbreak, extreme weather or chronic disease, the response cannot depend on a parallel structure assembled at the last minute.

From dialogue to delivery

The Africa Health Agenda International Conference (AHAIC) 2027, themed “From Dialogue to Delivery. Redesigning Africa’s Ecosystem for a Healthy, Sovereign Future,” offers a bridge between the questions raised in New York and the delivery realities discussed in Berlin.

AHAIC, which will take place in Kigali (28 February-3 March), can bring governments, communities, researchers, health workers, civil society, investors and partners together around practical priorities. It cannot replace governments’ responsibility to decide, finance and account for results. Its value is in building alignment and relationships that last beyond the conference.

The question for Kigali is not only what to discuss. It is which fragmented systems are we ready to connect? Whose priorities will shape preparedness? What capabilities should countries build together, and who will turn commitments into funded action?

We are good at agreeing that collaboration matters. The harder work is to leave with owners, timelines and resources, then ask whether care became more reliable.

That is when the work begins: after the talking, when systems work better in people’s lives.

This piece was produced by SciDev.Net’s Sub-Saharan Africa desk.

Githinji Gitahi is Group CEO of Amref Health Africa and the former Africa COVID-19 Response Commissioner.