This paper examined how leadership and management practices influence Maternal, newborn, and child health (MNCH) outcomes in Sub-Saharan Africa (SSA). Thirteen studies from seven countries and one multi-country analysis were included. Leadership approaches clustered around three domains, ie: leadership capacity building and supportive supervision, participatory and accountable governance, and community engagement mechanisms; were consistently associated with measurable improvements in antenatal care utilization, skilled birth attendance, and immunization completion rate. Management practices including mentorship, routine monitoring, and data-driven decision-making strengthened provider performance, coordination, and service delivery efficiency. The authors argue that strengthening leadership and management capacity within primary health care systems represents a high-impact strategy for improving service delivery and accelerating progress toward MNCH targets in SSA.
Governance and participation in health
The authors used semi-structured interviews with 11 purposively selected health professionals in the Ibanda Health Zone, DRC and findings of a critical narrative review of 56 scientific and grey-literature documents from the DRC, Rwanda, Kenya, and South Africa to examine artificial intelligence (AI) -related practices and implementation readiness in an urban health zone in the Democratic Republic of Congo (DRC) and to provide African experience to contextualize the findings. No institutionally implemented clinical AI system was identified in Ibanda. Some professionals reported informal use of consumer generative AI, and Google Search and DHIS2. Participants perceived potential benefits for diagnosis, laboratory turnaround, and data management, but reported major barriers related to training, connectivity, paper records, regulation, and governance. The combined evidence suggested that any future deployment should be gradual, locally validated, and preceded by investment in data systems, infrastructure, workforce capacity, and accountable governance.
The authors explored experiences of 14 Ebola survivors during and after the recovery period through a descriptive qualitative study in central Uganda in 2024. Participants were initially hesitant to seek care, but they eventually agreed with their Ebola diagnosis and complied with medical treatment. Ebola survivors had conspiracy theories regarding Ebola which persisted even after survival. Ebola was attributed to witchcraft, while others thought it was introduced to reduce their population size and as a vehicle for organ donation. Survival was attributed to trade-offs with government and pretence of being sick. Ebola patients and survivors had formal and informal support from government and non-governmental organization which helped meet their social, physical and emotional needs during and after admission. Ebola patients and survivors had emotional, social, and physical challenges during admission and after discharge. They experienced enormous emotional trauma related to worries of survival. Emotional and physical challenges persisted after discharge due to stigma, discrimination, financial constraints, marital problems and persisting physical ailments. EVD survivors experience significant health concerns and poor coping mechanisms, and the authors note that this calls for community-based mental health and psychosocial interventions integrated within a broader package of care for them.
Following COVID-19, the African Union elevated the Africa Centres for Disease Control and Prevention (Africa CDC) to autonomous status, empowering it to declare Public Health Emergencies of Continental Concern (PHECs). This mechanism was first operationalised in August 2024 in response to sustained mpox transmission across 13 AU member states — where 17,541 cases and 517 deaths had been recorded, representing a 160% rise in cases compared to the same period in 2023 — despite the WHO's earlier lifting of its own PHEIC. Applying the Critique, Reform, Withdrawal, and Transformation (CRWT) framework, this commentary argues that the PHECs represent both a strategic withdrawal from overreliance on the WHO PHEIC system and a transformative effort to embed African-led governance rooted in Pan-African solidarity. The mechanism mobilised USD 10.4 million in emergency AU funding and a tripartite vaccine distribution agreement, demonstrating its capacity for rapid resource mobilisation. Key recommendations include a tiered activation system for early response, a Pandemic Peer Review Mechanism modelled on the African Peer Review Mechanism, a dedicated AU Health Protocol to formalise Africa CDC's authority, and closer integration with continental financial instruments. The authors argue that PHECs represent a critical reconfiguration of Africa's role in global health — from recipient of external interventions to architect of regional norms and accountability — not by rejecting multilateralism, but by recalibrating it on African terms.
Drawing on two case studies, the authors argue that ethical participatory research on climate change and health requires ongoing negotiation of power, participatory priority-setting, and holistic risk assessment. The first case study, an impact evaluation of climate adaptation actions in rural Zimbabwe (2019–2022), found that researchers needed to revise their initial selection of adaptation interventions after community consultation revealed that psychosocial distress from droughts was a more pressing local concern than the externally identified priorities. The second case study examined informal outdoor workers in Viet Nam facing heatwaves and extreme rainfall, identifying ethical risks including potential reprisals from employers for worker empowerment activities, the overshadowing of immediate socioeconomic concerns, and difficulties translating findings into policy. The authors identify three core ethical dilemmas: i. whose priorities shape the research agenda; ii. how to balance scientific rigour with participatory integrity; and iii. how to manage the tension between urgent climate timelines and the time required for meaningful community engagement. The authors conclude that ethical participatory research in climate and health must go beyond procedural compliance, to recognise communities as knowledge producers, address structural inequities, and ensure that research outcomes deliver tangible benefits to participants.
As world leaders gathered at the World Economic Forum in Davos in January 2026, the author argued that the Forum — despite its rhetoric of dialogue and shared problem-solving — serves the interests of a wealthy elite without delivery for the global majority. The wealthiest 0.001% now control three times more wealth than half of humanity combined, yet WEF's political influence perpetuates corporate tax reductions, regressive consumption taxes, and the thriving of tax havens. The author contrasts this with the 'We the 99 People's Summit' held in Johannesburg in November 2025, where movements from across the world adopted a ten-point, people-centred roadmap calling for taxing the super-rich and big tech, closing tax havens and shell companies, protecting civic and cultural rights, and ending occupation and genocide. At a time when multilateralism is being increasingly undermined, the author rejects substitutes for democratic global governance and argues that legitimacy comes from people, participation, and collective power.
In a rapidly expanding network of bilateral health agreements the United States has been negotiating across Africa under its America First Global Health Strategy, more than 20 memoranda of understanding are already signed with African governments and total commitments approaching $20 billion. The author notes that Zimbabwe withdrew from a proposed $367 million agreement after describing it as an unequal exchange; Kenya's High Court suspended a $2.5 billion agreement on data protection grounds; and Zambia's proposed $1 billion partnership reportedly included a clause linking termination to a separate minerals compact covering copper and cobalt. The author situates these arrangements within a longer history of colonial medical exploitation — from forced drug trials during sleeping sickness campaigns in French Equatorial Africa to Pfizer's controversial 1996 meningitis trial in Nigeria — and warns that bilateral agreements risk undermining the WHO Pandemic Agreement's pathogen access and benefit-sharing framework. The author calls on African governments to negotiate collectively through the African Union and Africa CDC rather than accept fragmented, asymmetric bilateral pacts that risk reproducing colonial extraction in new scientific form.
Artificial intelligence (AI) is transforming traditional, complementary, and integrative medicine by enhancing patient-centred care, diagnostics, personalized treatment, and knowledge digitization across four domains: end users, practitioners, practices, and interventions. AI applications include machine learning for syndrome classification, deep learning for tongue and facial diagnostics, clinical decision support systems for personalized prescriptions, and digitization initiatives like India's Traditional Knowledge Digital Library. However, critical challenges persist: regulatory complexities and legal accountability, ethical concerns regarding intellectual property and cultural sensitivity, data privacy and security risks, scarcity of standardized data, preservation of human-centred care relationships, and need for global collaboration. This paper proposes comprehensive policy strategies including adapted regulatory frameworks, protection of traditional knowledge through mechanisms like the Nagoya Protocol, robust data governance aligned with global standards, standardized data infrastructure, practitioner capacity building, and multistakeholder collaboration through organizations like WHO's Global Centre for Traditional Medicine. Responsible AI integration requires balancing technological innovation with respect for cultural heritage, ecological values, and ethical standards to advance equitable and sustainable global health outcomes.
Artificial intelligence (AI) solutions are being adopted across the globe, including the Global South, to address health needs and strengthen health systems. The rapid adoption of AI solutions provides tremendous potential to redress health inequities and strengthen health systems. It also entails substantial risks of deepening inequities, creating new forms of exclusion and weakening fragile health systems. Drawing on field-based case studies and interdisciplinary consultations, this paper presents an emergent research landscape that prioritizes health equity, gender equality, ethical safeguards, inclusive governance and Global South leadership.
This paper draws on 40 in-depth interviews with current and former medication for opioid use disorder clients and four focus groups with 35 current clients at an opioid treatment clinic in Dar es Salaam, Tanzania. Transcripts were thematically analyzed to explore how stigma influenced medication for opioid use disorder adherence and retention. Five themes emerged: stigma encountered while using public transportation; employment-related stigma; lack of family support due to misinformation; institutional stigma within the treatment setting; and stigma management strategies, including altering appearance and distancing from peers. Gendered expectations intensified stigma for women, while assumptions of untrustworthiness shaped client interactions across settings. These experiences posed significant barriers to consistent treatment engagement. To support medication for opioid use disorder retention, the authors propose integrating stigma reduction through expanded family engagement, more flexible clinic policies, client-informed approaches and public education.