Last week in Kigali, at the Africa HealthTech Summit 2025, one theme echoed across plenaries, side meetings, and private dialogues: Africa does not need more aid. It needs more strategic systems.
That point was underscored the very next day in Washington, when Dr Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention (Africa CDC), declared that 60 percent of traditional health aid to Africa has been effectively wasted. His message was not one of cynicism but of conviction: that Africa’s health systems can, and must, extract more value from fewer dollars through coordination, accountability, and digital infrastructure that works.
In Kigali, you could feel that shift happening in real time. Conversations were no longer about pilots, apps, or donor cycles. They were about platforms, standards, and partnerships that embed innovation within government systems rather than around them.
“It was a refreshing maturity, a recognition that Africa’s digital health architecture must evolve from fragmented efforts to interoperable ecosystems.”
It was a refreshing maturity, a recognition that Africa’s digital health architecture must evolve from fragmented efforts to interoperable ecosystems.
The power equation = connectivity + standards + trust
From sessions led by the Africa Business Coalition for Health to the Africa Digital Health Networks and the Youth Ministerial Breakfast, among several others, the refrain was clear: Power + Connectivity + Standards = Health Systems that Work.
Power, because even the most advanced health applications collapse without reliable electricity at the primary care level.
Connectivity, because data can only drive decisions when systems talk to one another.
And standards, because without shared digital languages, we only multiply inefficiencies.
As countries like Rwanda, Kenya, and Nigeria deepen their national digital health strategies, there’s a growing consensus that the next frontier is interoperability by design, not as an afterthought but as the foundation for all future investment. What I found remarkable at AHTS 2025 was how aligned both public and private actors have become around this goal. Africa CDC’s leadership has provided not only technical vision but also political coherence across regions.
Aid efficiency and the “Accra Reset”
The conversation about wasted aid can easily slip into frustration. But as former Ethiopian Health Minister Lia Tadesse observed, inefficiency is not just an African problem; it’s a design problem. For decades, the logic of global health assistance often emphasised disbursement over durability. Projects multiplied, but systems stagnated.
Today, the decline in foreign aid is forcing an overdue reset. Ghana’s President John Dramani Mahama calls it the “Accra Reset”, a move toward health sovereignty, where Africa owns both the design and destiny of its health systems.
This is not isolationism; it is collaboration on new terms.
It means that when external partners bring funding, they also align under one national plan, one governance framework, and one shared accountability model. It’s about moving from dependency to interdependence.
The World Bank’s Axel van Trotsenburg captured this spirit at the recent IMF meetings when he observed that “donors won’t just write cheques anymore.”
And that’s a good thing. Because accountability is not punishment, it is partnership. The actual test now is whether African institutions and their partners can show that every dollar works harder, not through austerity, but through more strategic design, stronger governance, and shared ownership of results.
Read also: What the Africa HealthTech Summit 2025 must mean for Africa’s health future
Digital public infrastructure for health
That’s where digital health enters the equation, not as a shiny add-on, but as a core enabler of efficiency and equity.
Across Africa, we’re already seeing the outlines of a more connected health future, where a person’s health record can travel with them from Lagos to Kigali to Nairobi; where countries can pool their strengths to buy smarter, spend better, and stretch every health investment further; and where ministries can see, in real time, how vaccines move, how clinics stay powered, and what the data says before the next crisis hits.
This is not science fiction. It is the very work being accelerated by initiatives like the African Digital Health Network (ADHN), Africa CDC’s interoperability blueprint, and the growing coalition of partners, from GSMA to PSI to eHealth Africa, who are helping countries translate policy into operational systems.
The Kigali Summit made it clear: Africa’s strength will not lie in imported models but in localised innovation that scales. The question is no longer whether Africa can leapfrog. It’s how fast, how inclusively, and with what safeguards of trust and governance.
From pilots to platforms
One of the most telling shifts I observed was the humility in the room.
Global actors and African innovators alike acknowledged that the continent is entering a new phase, which is less about proof of concept and more about proof of scale.
Pilots may showcase possibility, but platforms deliver permanence.
To get there, we need three things – embedded partnerships, aligned standards, and sustained local capacity.
Africa’s health future will not be built by siloed programmes, but by interoperable systems co-owned by governments, private innovators, and communities.
That is the true promise of digital transformation, when technology stops being the story and starts being the system.
The way forward
The post-aid era should not frighten us; it should focus us.
If 60 percent of aid was wasted, the lesson is not to retreat but to redesign.
Efficiency, governance, and accountability are not bureaucratic burdens; they are acts of stewardship.
And as the world shifts from grants to guarantees and from pledges to performance, Africa’s advantage will lie in how well we integrate our own institutions, data, and infrastructure.
What Kigali reminded us is that Africa’s health-tech future isn’t ahead of us; it’s already being built, together.
The work now is to make sure it is governed, sustained, and owned by those who call this continent home.
Ota Akhigbe is the Director of Partnerships & Programmes at eHealth Africa and a weekly columnist for BusinessDay. She writes on leadership, systems innovation, and Africa’s health and development transformation.
