Two weeks ago at the Insights Learning Forum (ILF) in Abuja, the conversation felt refreshingly practical: what it takes to make digital health work for actual people in actual places. We talked about data that truly moves decisions, local operators who deliver under pressure, and how trust, often built through culture, not only code, decides whether any of it sticks.
As UNGA approaches, the context shifts; the UN’s UN80 plan proposes 15–20 percent Secretariat cuts, including about a fifth of posts, signalling that volatility is now the baseline, AP News.
Compounding that, official development assistance fell in 2024 for the first time in six years, down 7.1 percent in real terms, and the OECD projects a further 9-17 percent decline this year. If you run programmes, that sounds like fewer grants. If you run systems, it means cashflow gaps, paused procurements, and a slower, shakier path to outcomes. OECD+1
Policy shifts in Washington include a rescissions package that would cut foreign assistance by about $8 – 9 billion, affecting some U.N. channels. For African programmes, the practical risk is liquidity; slower disbursements can delay vaccine orders, stretch supply chains, and pause primary care where multilateral pipelines are central. The fix is collaborative: a small, flexible finance buffer and transparent localisation targets to keep delivery steady as budgets move.
So, how do we carry ILF’s grounded momentum into UNGA, where agendas are wide and timelines are tight? Three practical moves African institutions can lead now:
Make finance flexible where it matters most. We don’t need wholesale flexibility, just a predictable buffer that keeps delivery steady when large tranches are delayed. A 10 percent flexible line, for example, within major portfolios, time-bound, results-linked, and locally managed, bridges gaps without diluting accountability. It’s modest for funders and catalytic for implementers.
“Digital public infrastructure, identity, payments, registries, and logistics let countries plug in new tools without ripping out the system.”
Set a clear localisation ratio. Aim for 40 – 50 percent of programme spend through African-led implementers, to align incentives and speed learning where delivery happens. Pair it with transparent, quarterly reporting and open pipelines so partners can see what’s flowing, to whom, and with what results. That turns localisation from aspiration into a performance practice that earns trust with ministries and communities.
Build on the rails we already have. Digital public infrastructure, identity, payments, registries, and logistics let countries plug in new tools without ripping out the system. Standardising on shared rails helps us absorb budget swings, change vendors, and scale what works. ILF surfaced ready-to-scale African use cases; UNGA is our moment to turn those pilots into interoperable networks with partners.
There’s a fourth lever we underplay: creative influence. To shift behaviour, meet people where their attention already is. The edutainment-for-impact initiative we showcased at the Africa Soft Power summit, from youth-led storytelling to social games and chat interfaces, did more than entertain; it shaped intent. In a tighter funding cycle, attention-efficient channels are not extras; they’re how we lower cost-per-influence and protect delivery.
For Nigeria, this is not theoretical. The scaffolding is already here: the Basic Health Care Provision Fund, a maturing digital public infrastructure stack, and state pilots in primary care built around local realities. Our private sector can lay the rails, and our creatives build trust at scale. What we need now is alignment: integrators that braid financing, technology, and cultural credibility into one operating model.
That’s where UNGA week matters. Not for easy funding, especially this year, but for proximity. It brings the decision-makers who can move policy, procurement, and partnerships into the same rooms. It’s a practical window to land three on-the-record commitments;
Invite funders to pilot a flexible, multi-year buffer within 2026 portfolios, to bridge timing gaps without loosening accountability.
Adopt a measurable localisation ratio, with regular, public reporting on flows and results.
Where specifications and value for money are met, prioritise open-standards digital public infrastructure and qualified local vendors in 2026 RFPs.
Are these commitments glamorous? Not really. Are they feasible? Completely. Do they de-risk delivery for ministries and communities? Yes, by smoothing volatility and shortening feedback loops.
Some will say the timing is not ideal, that in a retrenchment year the safest move is to hold the line. I see the opposite; when resources tighten at the centre, it opens space for more strategic innovation at the edge. If UN80 pushes “more with less”, Africa’s answer should be “smarter with what we have”: spending discipline plus institutional design; shared rails over bespoke builds; empowered local operators over extra layers; and fewer showcase panels in favour of measurable, time-bound agreements.
ILF reminded us that progress comes from people who don’t wait for permission. At UNGA, especially in a tighter funding climate, we’re asking for commitments that match that energy. If you’re attending, come ready to move the lever you control (a budget line, a vendor list, a reporting norm, or a story you can elevate).
The U.N. at 80 may run leaner next year, but ambition only shrinks if we let it. Africa’s edge right now is not grandstanding; it’s execution. Let’s lock in the small, practical, system-shifting commitments now, and make ILF 2026 a place where we publish the receipts.
About the author:
Ota Akhigbe is the Director of Partnerships & Programmes at eHealth Africa and a Pan-African systems strategist working at the intersection of digital health, locally led development, and creative influence. She co-convened the Insights Learning Forum 2025 and writes a weekly BusinessDay column on African-led systems change.
