From Recommendations to Reality: What Africa’s Health R&D Debate Still Misses — A Opinion by Dr. Anjo De Heus

 

Recently, I came across an article in Nature Health Springer Nature titled “Six Ways to Empower African Research and Development for Health.” The piece, written by Nicki Tiffin et all, is thoughtful, timely, and important. It articulates — clearly and credibly — many of the structural challenges holding back African-led health innovation, particularly in light of recent disruptions in global health funding.

As someone who has been deeply involved in building health execution platforms across Africa and the GCC, I found myself agreeing with the article to a large extent. In fact, much of what the authors advocate for closely mirrors conversations we have been having for years with governments, institutions, and private-sector partners.

That said, while the article gets the “what” largely right, several critical “how” and “who” questions remain underdeveloped. And those nuances matter — because they are often the difference between progress and perpetual discussion.

Where the article is absolutely right

The authors correctly highlight six foundational areas that must be addressed if Africa is to build a sustainable health R&D ecosystem: product development, financing, human capital, health data, supply chains, and research culture.

In particular, the article is right to emphasize that:

• Africa must move away from donor-shaped research agendas
• R&D must be locally driven, prioritized, and funded
• Workforce development must be tied to real career pathways
• Digital health data systems must be interoperable, ethical, and African-controlled
• Supply chains and logistics are a silent but critical bottleneck

On these points, there is little to disagree with.

Where important nuances are missing

However, the article largely remains at the level of thematic recommendations. It describes what should exist, but less so how it comes into existence under real-world constraints.

Based on hands-on execution experience, a few nuances deserve explicit attention:

1. Execution platforms matter more than frameworks

Africa does not suffer from a lack of strategies, white papers, or policy documents. What is often missing are named, accountable execution platforms — entities with the mandate, partnerships, and commercial logic to turn recommendations into operations.

Without execution vehicles — joint ventures, operating companies, or institutional platforms — recommendations remain aspirational.

2. Workforce capability must be deployment-linked

Training alone does not build systems. Capability is only real when it is tied to deployment, service delivery, and ongoing operations.

Health workforce development must be designed around:

• where people will work,
• what systems they will operate,
• and how those roles are sustained financially.

This is why training institutions must evolve into execution partners, not just educators.

3. Proven solutions scale faster than perpetual pilots

The article acknowledges the need for product development, but underestimates how much time and capital are lost in endless pilots and early-stage experimentation.

In many African contexts, the fastest path to impact is:

• importing proven, market-ready solutions,
• localizing them operationally and culturally,
• and scaling through partnerships and local ownership.

Innovation does not always mean inventing from scratch; often it means executing better.

4. Markets, not grants, ensure sustainability

R&D ecosystems cannot survive on funding alone. They require market logic — revenue flows, procurement mechanisms, and commercial incentives that make systems durable beyond political cycles and donor priorities.

Health systems must be treated as living markets, not permanent aid recipients.

5. Speed is a strategic variable

Finally, the article rightly stresses urgency, but execution requires designing for speed in imperfect environments — where regulation evolves, infrastructure is uneven, and funding can disappear overnight.

The question is not “how do we fix everything first?” It is “how do we move now, responsibly, with what exists?”

From agreement to action

The Nature Health article is an important contribution to the African health R&D discourse. It validates many ideas that practitioners, builders, and operators have been advocating for years.

The next step, however, is to move decisively from recommendation to execution — from frameworks to functioning systems, from thematic alignment to operational delivery.

Africa does not lack vision. What it needs — urgently — are platforms that turn vision into reality.

#AfricaHealth #HealthInnovation #HealthR&D #ExecutionMatters #FromPolicyToPractice #ProvenSolutions #WorkforceCapability #GlobalHealth #AfricanInnovation Nicki Tiffin Yaw Bediako, Ph.D. Gates Foundation Gates Foundation Africa Oasis Diagnostics® Corporation Oludent Health International Queensway Medical Training College 360Disruption / 360Sasa 360SASA LTD. UNDP timbuktoo Africa African Development Bank Group Africa GCC — Council UAE Africa Networking Group African Export-Import Bank (Afreximbank) African Union United Nations AIM Congress Africa CDC

About the author

Dr. Anjo De Heus is an entrepreneur, strategist, and ecosystem builder focused on translating proven healthcare and healthtech solutions into scalable, real-world impact across Africa and the GCC. He works at the intersection of execution platforms, workforce capability, and market-driven health systems, with a strong emphasis on moving beyond pilots toward sustainable delivery models.

Through initiatives such as 360SASA LTD. and 360Disruption / 360Sasa, he partners with governments, training institutions, and private-sector innovators to localize solutions, build operational capacity, and strengthen health ecosystems through execution rather than theory.