Africa’s health ambitions will be won or lost in the last mile

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Africa's health ambitions will be won or lost in the last mile

August 28, 2026

Some numbers describe a problem, and others should fundamentally change the conversation.

The projected shortage of 5.85 million health workers in the WHO African Region by 2030 belongs firmly in the second category. It is a figure that should concern health ministers and policymakers, as well as pharmaceutical and medtech companies, vaccine manufacturers, diagnostics businesses, investors, research organisations, and everyone working to improve health outcomes across the continent.

At the 76th WHO Regional Committee for Africa (RC76) in Addis Ababa this week, African health ministers endorsed an ambitious new Africa Health Workforce Agenda for 2026-2035, committing countries to plan, educate, employ and retain three million additional health workers by 2035. The scale of that ambition reflects the scale of the challenge: Africa currently has only 46% of the workforce it needs, and under current trends that figure is projected to reach just 51% by 2030.

Yet behind these statistics lies a much bigger story about Africa's health future. It is a story about people, systems and institutions, but also about something we perhaps talk about less often in global health: truth.

The truth about what health systems can currently deliver. The truth about what patients and healthcare professionals experience every day. And the importance of ensuring that the story of African health is increasingly told by the people living, working and innovating within it.

We can train health workers, strengthen regulatory authorities, manufacture medicines locally, and bring new technologies to market. Still, unless we understand the realities of the communities these changes are intended to serve, we risk designing solutions that work on paper rather than in people's lives.

That makes communication far more than the final step in delivering a health programme. Increasingly, it needs to be understood as part of the infrastructure that enables better health.

The numbers tell us this is bigger than a workforce crisis

The State of the Health Workforce in Africa 2026 presents a stark picture. Under current trends, the Region will have only 51% of the workforce it needs by 2030. The projected needs-based shortage is 5.85 million people, while the WHO estimates that 943,000 trained health workers were unemployed in 2024.

That contradiction should make us stop and think. Africa does not simply have a shortage of people willing or able to work in healthcare; it has a much more complex mismatch among training, financing, employment, skills, geography, and retention. Training capacity is expanding, with more than 325,000 graduates annually, yet more than half of new graduates in some countries remain unemployed or in precarious roles.

The impact stretches across the entire health ecosystem. A new diagnostic does little if there are not enough trained professionals to use it. A vaccine cannot protect a population if the workforce and infrastructure required to deliver it are missing. A medicine that successfully navigates regulatory approval still needs clinicians who understand when and how to prescribe it, pharmacists who can supply it and patients who understand what that treatment means for them.

For the private sector, therefore, workforce capacity cannot remain something considered adjacent to market access. It is becoming part of market access itself.

Companies assessing where to invest, launch products, establish clinical trials, or build partnerships in Africa will increasingly need to consider workforce capabilities alongside disease burden, regulatory pathways, reimbursement, and infrastructure. In markets where workforce constraints are significant, successful expansion may require investment in education, laboratory capacity, implementation science, digital support and long-term partnerships with health systems.

But this should not be about industry stepping into the role of government. The more interesting opportunity is to ask how private investment can strengthen the systems already in place, building capabilities that endure long after an individual product launch or programme has finished.

Regulation could redraw Africa's health map

RC76 brings another part of this picture into focus: regulation.

The formal agenda includes a new Regional Strategy on Regulation of Medical Products in the African Region for 2026-2035, alongside the continuing development of the African Medicines Agency and efforts to strengthen national regulatory authorities, reliance, harmonisation and regulatory digitalisation.

This matters enormously for companies operating across the pharmaceutical, vaccine, medtech, and diagnostics sectors. Africa is not one market, and its regulatory landscape remains highly varied. WHO currently identifies only eight countries in the Region with well-functioning, stable regulatory systems capable of effective oversight and quality assurance of health products.

Greater regulatory maturity and convergence have the potential to reduce duplication, improve predictability, and ultimately shorten the journey from innovation to patient access. For the industry, that means regulatory capability should increasingly inform launch sequencing, manufacturing decisions and partnership strategies. For African countries, stronger regulation is also central to something much bigger: the ability to determine and safeguard their own health priorities.

The direction of travel is becoming increasingly clear. WHO's emerging Vision 2035 talks about Africa becoming a shaper, rather than a recipient, of global health and envisages a Region that increasingly finances, governs and delivers its own health.

That is an important language change, and an even more important change in mindset.

Systems have to reflect the truth of people's lives

This is where I think the health community needs to broaden the conversation.

We rightly spend enormous amounts of time discussing supply chains, regulatory pathways, workforce numbers, financing mechanisms and health technologies. They are all essential. But healthcare does not ultimately happen in policy documents, boardrooms or conference halls; it happens between people and within communities.

It happens when a mother decides whether to vaccinate her child, when somebody with symptoms decides whether to seek care or wait, when a healthcare professional explains a diagnosis in a way that makes sense to the person sitting opposite them, or when a community hears about a new medicine, clinical trial or public health programme and tries to work out what it means for them.

These moments are shaped by communication, but not communication conceived simply as campaigns, press releases or materials translated from a global toolkit. They are shaped by language, history, culture, relationships and lived experience.

And that is why local perspective matters so much.

Africa is home to an extraordinary diversity of countries, communities, languages and health systems. A message developed in London, New York or Geneva cannot simply be exported across the continent, translated and expected to resonate. Indeed, a strategy developed for one African market cannot automatically be transplanted into another.

The people closest to a health challenge frequently understand dimensions of it that will never appear in a global strategy. They understand why a particular intervention may face resistance, what language people actually use to describe an illness, where misinformation is spreading, which community voices carry credibility, and why something that makes complete sense on paper may struggle in practice.

Good communication starts by understanding those truths rather than arriving with the story already written.

Africa should be telling its own health story

There is another dimension to this that deserves far more attention: who gets to tell the story of African health?

For too long, much of the external narrative has been constructed around what Africa lacks: health workers, infrastructure, medicines, financing and capacity. Those challenges are real; the workforce figures discussed at RC76 make it impossible to deny, and good communication should never attempt to disguise uncomfortable facts.

But deficit cannot be the only lens through which African health is understood.

The Africa Health Media Trends Report 2026 reinforces this point that journalists across the continent are calling for African experts to lead African health narratives, with one Ghanaian health editor putting it simply, "Africans tell their own stories the African way."

There is another story unfolding alongside it. African governments are strengthening regulatory systems. Scientists are leading world-class research. Entrepreneurs are developing new health technologies. Manufacturers are expanding their pharmaceutical, vaccine, and diagnostics capabilities. Health professionals are innovating in incredibly constrained environments, while communities are developing solutions rooted in their own knowledge and experience.

The African Medicines Agency is part of that changing landscape, as are moves towards regulatory harmonisation, local manufacturing and pooled procurement. WHO reports that pooled procurement initiatives established through regional economic communities and Small Island Developing States are already achieving estimated price reductions of around 40% for quality essential medicines.

These are not stories about an Africa waiting for solutions to arrive from elsewhere. They are stories of a continent increasingly developing, shaping and governing its own health future.

Our communication needs to catch up with that reality.

That means moving beyond narratives about Africa towards narratives developed with and from Africa. It means making local expertise visible internationally while ensuring global organisations listen locally. Most importantly, it means recognising that storytelling is not about finding a more positive way of presenting difficult realities. The strongest stories are rooted in truth, including the truths that may be inconvenient for governments, businesses or international organisations.

If we want people to believe what we communicate about health, we first have to be prepared to communicate what is actually happening.

Communication isn't the final step. It's part of the infrastructure

This has practical consequences for governments, industry and global health organisations.

Communication should not begin when a strategy has been approved or when a product is ready to launch. It needs to begin much earlier, helping organisations understand the environment into which that policy, programme or innovation will arrive.

What do communities believe about the disease? What are healthcare professionals experiencing on the frontline? Which barriers are clinical and which are cultural, economic or informational? Who is being listened to? What language do people actually use when talking about their health? And what conversations are already happening that an organisation needs to understand before adding its own voice?

Those are communication questions, but they are also implementation questions. Increasingly, they are business questions too.

A company can achieve regulatory approval and still fail to achieve meaningful uptake. A government can procure vaccines and find that people do not want them. A health system can introduce a new diagnostic pathway that clinicians do not consistently use. A beautifully designed health programme can fail because the people it was intended to serve were never meaningfully involved in its development.

Communication cannot solve structural weaknesses in a health system, and we should be wary of pretending otherwise. But communication grounded in local truth can expose barriers earlier, bring different voices into decision-making and help turn access on paper into meaningful adoption in people's lives.

Partnership needs to start with listening

For those of us working across health, policy and communications at FINN Partners Africa, we believe this changes what a good partnership should look like.

Our role cannot simply be helping organisations tell their story louder. Often, the most valuable contribution is helping them understand the stories already being told around them: by patients, healthcare professionals, policymakers, advocates, researchers, communities and local partners.

Working across markets gives us a broader view of how health policy, regulation, innovation and reputation are changing. But a global perspective only has real value when it connects with people who understand local realities, because no one sitting thousands of miles away can understand a community better than the people living and working within it.

The future of health communication in Africa, therefore, cannot be built by creating global narratives and localising them at the end. It needs to work in the opposite direction too: local insight shaping regional and global thinking from the beginning.

That requires a different kind of partnership and a different kind of communications counsel - one that understands policy, health systems, patient behaviour, regulatory change and the commercial environment, but never loses sight of the human beings connecting all of them.

The last mile may be the most important one

There is a tendency in global health to think about the last mile as a distribution problem: how we get a vaccine, medicine, diagnostic or health worker to the person who needs them.

Perhaps we need to think about it more broadly. The last mile is also the distance between availability and acceptance, policy and lived experience, scientific evidence and human behaviour, and global ambition and local reality. Closing that distance requires infrastructure, investment and people, but it also requires us to listen differently and communicate differently.

Africa's health agenda over the coming decade will need more health workers, stronger regulators, sustainable financing, better infrastructure and continued innovation. RC76 is rightly putting many of those building blocks at the centre of the conversation, while the scale of the workforce challenge demonstrates how much work remains.

But building stronger health systems is not only an institutional or commercial challenge. It is a profoundly human one. If Africa is to increasingly finance, govern and deliver its own health, African voices, expertise, experiences and stories need to be central to how that future is shaped and understood. Governments, businesses and global health organisations need to get closer to the communities they are trying to serve, listen before speaking and be prepared to hear truths that do not always fit comfortably within an existing strategy.

That is not communication sitting alongside the health agenda. Communication helps make the health agenda work.

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POSTED BY: Darren Jones