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Tag: climate and health

  • The future of work: remarks at the 9th 1M1B Impact Summit held at the United Nations in Geneva

    The future of work: remarks at the 9th 1M1B Impact Summit held at the United Nations in Geneva

    On November 7, 2025, Reda Sadki, Executive Director of The Geneva Learning Foundation, joined the panel “The Future of Work: AI and Green Skills” at the 9th 1M1B Impact Summit held at the United Nations in Geneva. Moderated by Elizabeth Saunders, the discussion explored the rapid redefinition of the workforce by artificial intelligence and the green transition. The following is an edited transcript of Mr. Sadki’s remarks.

    Living with artificial intelligence

    Moderator: You have just seen some of these really incredible changemaker ideas and so what skills and mindsets stood out to you and how do you think those can be scaled to build a workforce that is living with AI and not competing with it?

    That is a wonderful question.

    I would answer that the key skill is learning to work with artificial intelligence.

    It is likely that your generation will be the first one learning to work side-by-side with AI as a partner or a co-worker, in the same way my generation learned to navigate the Internet.

    This requires three things.

    First, being ambitious.

    Second, being bold.

    And third, being courageous.

    Things are going to change dramatically in the next three to six years.

    There is a convergence of belief among those building these systems—what some call the “San Francisco Consensus”—that within this short timeframe, AI will fundamentally transform every aspect of human activity.

    We are facing the arrival of a new, non-human intelligence that is likely to have better reasoning skills than humans.

    This is not just about new tools.

    We are already seeing AI automate the routine tasks that make up the first rungs of a professional career.

    Some may tell you AI is not coming for your job, but I struggle to see that as anything other than misleading at best.

    In our programmes at The Geneva Learning Foundation, we have already used AI to replace key functions previously performed by humans.

    So, the sooner we are thinking, learning, and getting ready to navigate those changes, the better.

    The challenge is not to compete with AI in knowledge transmission.

    The risk is what some call “metacognitive laziness”, outsourcing our critical thinking to the machine.

    What is left for humans, and what we must cultivate, is facilitation, interpretation, and uniquely human-centric skills.

    These include creativity, curiosity, critical thinking, collective care, and consciousness.

    We must cultivate judgment, contextual wisdom, and ethical reasoning.

    We are navigating the unknown, and learning to do so together – by strengthening the connections between us, by asking what it means to be connected as humans – will be critical to our survival.

    Peer learning and democratizing access

    Moderator: I have a question for you about your foundation, because you have pioneered peer learning networks that have reached thousands globally. So what can we learn from this model about how to democratize access to AI and green skills, and make lifelong learning more inclusive and action-driven?

    The Geneva Learning Foundation’s mission, since 2016, has been to research, develop, and implement new ways to learn and lead.

    Our initial premise was that our traditional education systems are broken.

    They often rely on a top-down, “transmission model” of learning, where knowledge flows from experts to practitioners.

    This model is too slow, too expensive, and often fails to reach the people and communities that are facing extinction-level threats, whether that is climate change or artificial intelligence.

    In today’s world, these broken systems create significant risks when it comes to the critical threats upon our societies, including climate change and artificial intelligence.

    In the last three years, we have made key breakthroughs in solving four problems:

    • The problem of scale: how do we simultaneously connect tens of thousands of people in a single initiative, rather than one classroom at a time?
    • The problem of speed: how do we share knowledge at the speed problems emerge?
    • The problem of cost: how do we make this affordable?
    • And the problem of sustainability: how do we create systems people will continue to use because they are relevant?

    We have developed a model that we have tested in over 137 countries, working with international partners as well as ministries of health and, most importantly, with people on the ground in local communities.

    The first lesson learned is that in today’s complex, hyper-connected world, where there is an abundance of knowledge, simply knowing things is necessary, but not sufficient.

    The second lesson is recognizing the significance of what people know because they are there every day.

    We operate within knowledge systems that tend to devalue this “experiential knowledge”, often dismissing it as “anecdotal”.

    This is a form of “epistemic injustice”.

    We believe we must value what the health worker knows, what the mother or grandmother knows, and what the youth know, in order to solve the challenges before us.

    The third lesson is the power of digital networks to enable connections.

    In the past, learning from experience was constrained by our local environment.

    With digital networks, you can make connections with people from all over the world.

    This led us to the central piece of our innovation: peer learning mediated through digital networks.

    This could be so much more than the informal chatter and negative feedback loops of social media.

    It is a structured process where participants develop concrete projects addressing real challenges, review each other’s work, and engage in facilitated dialogue to share insights.

    Knowledge flows horizontally, from peer to peer, rather than just vertically.

    This model solves our four problems.

    It gives us scale.

    There is no upper limit.

    It gives us speed.

    It turns out to be incredibly cheap.

    And it is sustainable, because people keep doing it because it is actually helping them solve their needs.

    To give a specific example, in July 2023 we launched our program on climate change and health.

    We started by listening to the voices of thousands of health workers from all over the world, who painted a very scary picture of the impacts of climate change on the health of those they serve.

    But we also found that health workers were being incredibly creative with very limited resources.

    They had already begun to solve the problems they were facing in their communities, but unfortunately, very often with no one helping or supporting them.

    That led us to calculate that if we are able to connect one million health workers to each other to be learning from and supporting each other by 2030, that group of health workers could use the power of those connections to save seven million lives.

    And for the “bean counters” in the room, this would be at a cost of less than two dollars per life saved, which is actually cheaper than vaccination, one of the most effective interventions we have in health today.

    This is such an incredible equation that some of our partners say it sounds too good to be true.

    There is an incredible opportunity to link up health workers with other segments of society, including youth.

    We see the potential from building these coalitions and networks.

    This brings us back to AI.

    We really see peer learning as key to our survival as human beings.

    We may end up working with machines that already exceed our cognitive capacities, and will almost certainly do so definitively in pretty much every area of work within the next three to six years.

    We are going to have to respond to that by strengthening the connections we have as human beings.

    AI systems are trained on global data, but humans possess deep “contextual intelligence”.

    Peer learning is the bridge.

    It is how we learn together how to adapt AI’s powerful analytics to our local realities, cultural contexts, trust networks, and resource constraints.

    We have to think about what it means to be human in the Age of AI, and learning from each other will be very critical, very key to that survival.

    Image: The Geneva Learning Foundation Collection © 2025. Suspended between earth and ether, Cathedral of Circuits and Roots evokes a world where technology and nature, thought and matter, coalesce in fragile harmony. Its oxidized cubes, hues of turquoise, gold, and quiet rust, resemble relics of a civilization both ancient and yet to come. The sculpture’s floating architecture suggests a digital forest, each metallic block a leaf of knowledge, each connection a pulse of shared intelligence. It speaks to the dual call of our age: to grow roots deep in human wisdom, even as we build circuits reaching toward artificial minds. In this shimmering equilibrium, the work asks: can progress be both luminous and humane — and can learning itself become an act of restoration?

    References

  • Development is adaptation: Bill Gates’s shift is actually about linking climate change and health

    Development is adaptation: Bill Gates’s shift is actually about linking climate change and health

    Bill Gates’ latest public memo marks a significant shift in how the world’s most influential philanthropist frames the challenge of climate change. He sees a future in which responding to climate threats and promoting well-being become two sides of the same mission, declaring, “development is adaptation.”

    Gates argues that the principal metric for climate action should not be global temperature or near-term emission reductions alone, but measured improvement in the lives of the world’s most vulnerable populations.

    He argues that the focus of climate action should be on the “greatest possible impact for the most vulnerable people.”

    The suffering of poor communities must take priority, since, in his view, “climate change, disease, and poverty are all major problems. We should deal with them in proportion to the suffering they cause.”

    Climate change is about the health of the most vulnerable

    This position resonates with a core message that has emerged across global health over the past several years: climate change is about health.

    New data from the 2025 Lancet Countdown draw a stark picture:

    • Heat-related mortality has risen 63 percent since the 1990s.
    • Deaths from wildfire smoke and air pollution caused by fossil fuels continue to climb.
    • Food insecurity, driven by erratic weather, is destabilizing health and economies at once.
    • Thirteen out of twenty key health indicators linked to climate impacts now signal urgent action is needed.

    Health professionals, policy coalitions, scientists, and patient advocates have succeeded in bringing this nexus between climate and health squarely to the global agenda, culminating in recent summits where health finally shared the main stage with energy and economics.

    Yet just as the science and advocacy align, political attention risks fragmenting.

    Despite sweeping reports, evidence, and high-level declarations, momentum can ebb.

    There is now a risk that the transformative potential embedded in the climate-health linkage may not be fully realized.

    Here, Gates’s pivot could actually be the inflection point that the field needs.

    The case for health workforce-centered adaptation

    For nearly a decade, The Geneva Learning Foundation (TGLF) has been advocating and demonstrating that meeting complex humanitarian, health, and development challenges requires strengthening not just technical capacities or disease programs, but the underlying connective tissue of the health system: its workforce.

    TGLF’s digital peer-learning platform now connects over 70,000 health workers across more than 130 countries.

    These practitioners – mostly in government service, often in low-resource or crisis-affected settings – are the first to observe, and often the first to respond to, the local impacts of climate change on health.

    Their reports show that health impacts are immediate and multi-faceted: rising malnutrition from crop failures, increases in waterborne diseases following floods, new burdens from air pollution and heat, and psychological distress from repeated disasters.

    What sets this approach apart is its systemic focus.

    Climate change is not a threat that can be “verticalized”.

    It demands responses that are adaptive, distributed, and coordinated across all levels of the health system.

    TGLF’s innovation lies in harnessing a distributed network to surface and scale locally-grounded solutions:

    Data from these initiatives demonstrate that such networked learning delivers results at scale, often with return on investment superior to parallel vertical programs, and increases system resilience and flexibility.

    Development is adaptation: the need for human capital investment

    The urgency and logic of these approaches are reinforced by ongoing policy developments ahead of COP30:

    • WHO’s Global Action Plan on Climate Change and Health, adopted at the World Health Assembly in May 2025, recognizes that without context-sensitive system strengthening, existing approaches are insufficient, and positions knowledge and workforce mobilization as strategic imperatives.
    • The COP30 Belem Health Action Plan establishes adaptation of the health sector to climate change as an international priority, calling for holistic, cross-sectoral strategies, and “community engagement and participation as foundational to implementation.”

    Without empowered and connected health workers, no global action plan will reach those most at risk or maintain public trust.

    A strategic investment imperative: why the next breakthrough must be human-centered

    The philanthropic search for cost-effective, scalable, and measurable impact has built immense legacies in reducing child mortality and combating infectious disease.

    Gates’ own approach of pioneering “vertical” innovations, optimizing delivery through metrics, and prioritizing technical solutions has been transformative, especially at the intersection of science and delivery.

    However, emerging science show the limits of technical “magic bullets” absent robust, interconnected local systems.

    Trust, legitimacy, and action flow from the relationships health workers build in – and with – their communities.

    If development is adaptation, what does this mean for the next phase in climate-health philanthropy?

    If the measure of climate action’s value is the scale and speed at which lives are improved and disasters averted, investing in the human infrastructure of the health system is the most evidence-based, cost-effective, and legacy-ensuring play available.

    1. Investing in the health workforce is itself a breakthrough technology: It increases the absorptive capacity of low-resource health systems, making innovations stick and catalyzing uptake well beyond single-disease silos or narrow infrastructure projects.
    2. Long-term, system-wide resilience is built by equipping health workers – not simply with technology or training from above, but with platforms for peer learning, rapid response, and locally-driven adaptation coordinated through agile networks.
    3. The network effect is real: A million motivated and networked health practitioners is likely to surface, refine, and implement interventions at a scale and pace that outstrips most top-down models. Digitally-enabled peer learning, tested by TGLF, could link to AI systems to provide distributed AI-human intelligence that supports effective action.

    Without these bridges, even the best technology or policies will fail to gain a durable footprint at community level, especially as climate impacts deepen.

    Health is where climate change action matters most

    The world is waking to the reality that technical solutions alone cannot future-proof health against climate risks.

    We need to focus on the highest-value levers.

    This starts with a distributed, networked workforce at the coalface of the crisis, empowered to adapt, share, and lead.

    In a world of accelerating climate shocks and retreating political will, the boldest, most rational bet for sustained global impact is to go “horizontal” – to invest in the people and the systems that connect them.

    By helping build adaptive, digitally connected networks of health professionals, philanthropy can reinforce the foundation upon which all high-impact innovation rests.

    This is not a departure from the pursuit of technology-driven change, but rather the necessary evolution to ensure every breakthrough finds its mark – and that trust in science and public health stays strong under pressure.

    If ever there was a time for rigorous, data-driven engagement that bridges technology, health, and community resilience, this is it.

    Every indicator – scientific, economic, social – suggests that communities will confront more climate disruptions in the coming years.

    Investing in the people who translate science into health, who stand with their communities in crisis, is the most robust, scalable, and sustainable bet that any philanthropist or society can make.

    By focusing on these vital human connections, the world can ensure that innovation works where it matters most – and that the next chapter of climate action measures true success by the health, security, and opportunity it delivers for all.

    History will honor those whose support creates not only tools and policies, but the living networks of trust and craft upon which community resilience depends.

    That is the climate breakthrough waiting to happen.

    References

    1. COP30 Belém Action Plan. (2025). The Belém Health Action Plan for the Adaptation of the Health Sector to Climate Change. https://www.who.int/teams/environment-climate-change-and-health/climate-change-and-health/advocacy-partnerships/talks/health-at-cop30
    2. Ebi, K.L., et al. (2025). The attribution of human health outcomes to climate change: transdisciplinary practical guidance. Climatic Change, 178, 143. https://doi.org/10.1007/s10584-025-03976-7
    3. Ebi, K.L., Haines, A. (2019). The imperative for climate action to protect health. The New England Journal of Medicine, 380, 263–273. https://doi.org/10.1056/NEJMra1807873
    4. Jacobson, J., Brooks, A., Mbuh, C., Sadki, R. (2023). Learning from frontline health workers in the climate change era. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.7316466
    5. Jones, I., Mbuh, C., Sadki, R., Steed, I. (2024). Climate change and health: Health workers on climate, community, and the urgent need for action (Version 1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.11194918
    6. Romanello, M., et al. (2025). The 2025 report of the Lancet Countdown on health and climate change. The Lancet S0140673625019191. https://doi.org/10.1016/S0140-6736(25)01919-1
    7. Sadki, R. (2024). Health at COP29: Workforce crisis meets climate crisis. The Geneva Learning Foundation. https://doi.org/10.59350/sdmgt-ptt98
    8. Sadki, R. (2024). Strengthening primary health care in a changing climate. The Geneva Learning Foundation. https://doi.org/10.59350/5s2zf-s6879
    9. Sadki, R. (2024). The cost of inaction: Quantifying the impact of climate change on health. The Geneva Learning Foundation. https://doi.org/10.59350/gn95w-jpt34
    10. Sanchez, J.J., et al. (2025). The climate crisis and human health: identifying grand challenges through participatory research. The Lancet Global Health. https://doi.org/10.1016/S2214-109X(25)00003-8
    11. Storeng, K. T. (2014). The GAVI Alliance and the Gates approach to health system strengthening. Global Public Health, 9(8), 865–879. https://doi.org/10.1080/17441692.2014.940362
    12. World Health Organization. (2025). Draft Global Action Plan on Climate Change and Health. Seventy-eighth World Health Assembly. https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_4Add2-en.pdf
  • How the Lancet Countdown illuminates a new path to climate-resilient health systems

    How the Lancet Countdown illuminates a new path to climate-resilient health systems

    The 2025 Lancet Countdown report has begun to acknowledge a critical, often-overlooked source of intelligence to build climate-resilient health systems: the health worker. By including testimonials from health workers alongside formal quantitative evidence, the Lancet cracks open a door, hinting at a world beyond globally standardized datasets. This is a necessary first step. However, the report’s framework for action remains a traditional, top-down model. It primarily frames the health workforce as passive recipients of knowledge—a group that must be “educated and trained” because they are “unprepared”, rather than build on existing evidence that points to health workers as leaders for climate-health resilience.

    The 2025 report confirms that climate change’s assault on human health has reached alarming new levels.

    • Thirteen of 20 indicators tracking health threats are flashing red at record highs.
    • Heat-related mortality, now estimated at 546,000 deaths annually in the 2012-21 period, has climbed 63% since the 1990s.
    • Deaths linked to wildfire smoke pollution hit a new peak in 2024, while fossil fuel combustion overall remained responsible for 2.52 million deaths in 2022 alone.
    • Extreme weather increasingly drives food insecurity.
    • This accelerating health crisis unfolds against a backdrop of faltering political will.
    • The report documents governmental retreats from climate commitments.

    Yet, within this sobering assessment lies a quiet but potentially pivotal shift.

    For the first time, the Countdown’s country profiles integrate direct testimonials from frontline health workers, explicitly acknowledging their “lived experiences as valuable evidence”.

    It is a crucial opening, recognizing that globally standardized data alone cannot capture the full picture or tell the story.

    The Countdown’s inclusion of health worker voices in its country profiles is laudable.

    It hints at bridging what philosopher Donald Schön called the divide between the “high, hard ground” of research-based theory and the “swampy lowlands” of messy, real-world practice.

    Schön argued that the problems of greatest human concern often lie in that swamp, requiring practitioners to rely on experience and intuition – what he termed “knowing-in-action”.

    This promising step creates new possibilities.

    When the reference global report on climate change and health sees the frontline, this illuminates the path to recognize those working there as agents and leaders capable of forging solutions.

    However, the report’s dominant framework still positions the health workforce primarily on the receiving end of knowledge transfer.

    Indicator 2.2.5 meticulously documents gaps in climate and health education, concluding that professionals are left “unprepared”.

    The resulting recommendation?

    Health systems must “[e]ducat[e] and train[…] the health workforce”.

    This framing, while highlighting a genuine need, implicitly casts health workers as passive vessels needing to be filled, rather than as active knowers and problem-solvers.

    This perspective misses an important dimension, one vividly apparent from our direct work at The Geneva Learning Foundation with tens of thousands of health practitioners globally.

    Frontline health workers are already responding – adapting vaccination schedules during heatwaves, managing cholera outbreaks after floods, counseling communities on new health risks – because they must.

    Their daily observations is distinct from “lived experience”, because of their formal health education. 

    The patterns that emerge could form a vital, real-time early warning system, detecting subtle shifts in disease patterns or community vulnerabilities even before formal surveillance systems register them.

    To dismiss this deep experiential knowledge as merely “anecdotal” is to ignore critical intelligence in a rapidly escalating crisis.

    Worse, it reflects an “epistemological injustice” where practical wisdom is systematically devalued.

    Here lies the crucial disconnect.

    The Lancet Countdown rightly presents evidence for “community-led action,” showcasing powerful examples in Panel 6 where farmers or local groups have driven substantial environmental and health gains.

    Yet, it fails to connect this potential explicitly to the health workers embedded within those very communities.

    What does empowering the health workforce truly mean?

    It cannot be limited to providing didactic training, such as webinar lectures about climate science.

    Drawing on our research and practice, it involves concrete actions:

    1. Recognizing health professionals as knowledge creators: Systematically capturing, validating, and integrating their “knowing-in-action” into the evidence base.
    2. Connecting them through peer learning networks: Enabling practitioners facing similar “swampy” problems across diverse contexts to share hyperlocal solutions and build collective intelligence.
    3. Supporting locally-led implementation: Equipping them to design and execute adaptation projects tailored to community needs, often leveraging existing local resources, as demonstrated in TGLF initiatives where the vast majority of participants reported sustaining action without external funding.
    4. Creating feedback loops to policy: Establishing mechanisms for this ground-level knowledge to flow upwards, informing district, national, and even global strategies.

    This approach offers concrete pathways for the academic research community.

    These networks function as distributed, real-world laboratories.

    They generate rich qualitative and quantitative data on context-specific climate impacts, the practicalities of implementing adaptation strategies, barriers encountered, and observed outcomes.

    They offer fertile ground for implementation science, participatory action research, and validating citizen science methodologies at scale.

    Rigorous study of these networks themselves – how knowledge flows, how solutions spread, how collective capacity builds – can advance our understanding of learning and adaptation in complex systems.

    This vision of an empowered, networked health workforce directly supports emerging global policy.

    WHO’s Global Plan of Action on Climate Change and Health, and the Belém Health Action Plan (BHAP) under development for COP30, both stress social participation, capacity building, and the integration of local knowledge.

    Peer learning networks provide a practical, field-tested engine to translate these principles into action, connecting the ambitions of Belém with the realities faced by a nurse in Bangladesh, a community health worker in Kenya, or a community health doctor in India.

    Furthermore, this approach may represent one of the most effective investments available.

    Preliminary analysis by The Geneva Learning Foundation suggests that supporting local action health workers through networked peer learning could yield substantial health gains.

    With a critical mass of one million health workers connected to learn from and support each other, the potential is to save seven million lives, at a cost lower than that of immunization.

    This is not just about doing good.

    It is about smart investment in resilience.

    The 2025 Lancet Countdown acknowledges the view from the ground.

    The challenge now is to fully integrate that perspective into research and policy, by supporting and amplifying existing, community-led local action.

    We must move beyond framing health workers as recipients of knowledge or vulnerable populations needing protection, and recognize their indispensable role as knowledgeable, capable leaders.

    Harnessing their “knowing-in-action” through structured, networked peer support is not merely an alternative approach. 

    It is essential for building the adaptive, equitable, and effective health responses this escalating climate crisis demands.

    The wisdom needed to navigate the swamp often resides within it.

    References

    1. Romanello M, Walawender M, Hsu S-C, et al. The 2025 report of the Lancet Countdown on health and climate change. Lancet 2025; published online Oct 29. https://doi.org/10.1016/S0140-6736(25)01919-1.
    2. Sadki, R., 2025a. Climate change and health: a new peer learning programme by and for health workers from the most climate-vulnerable countries. https://doi.org/10.59350/redasadki.21339
    3. Sadki, R., 2025b. WHO Global Conference on Climate and Health: New pathways to overcome structural barriers blocking effective climate and health action. https://doi.org/10.59350/redasadki.21322
    4. Sadki, R., 2024a. Critical evidence gaps in the Lancet Countdown on health and climate change. https://doi.org/10.59350/nv6f2-svp12
    5. Sadki, R., 2024b. Health at COP29: Workforce crisis meets climate crisis. https://doi.org/10.59350/sdmgt-ptt98
    6. Sadki, R., 2024c. Strengthening primary health care in a changing climate. https://doi.org/10.59350/5s2zf-s6879
    7. Sadki, R., 2024d. The cost of inaction: Quantifying the impact of climate change on health. https://doi.org/10.59350/gn95w-jpt34
    8. Sadki, R., 2024e. Why guidelines fail: on consequences of the false dichotomy between global and local knowledge in health systems. https://stories.learning.foundation/2024/11/26/why-guidelines-fail-on-consequences-of-the-false-dichotomy-between-global-and-local-knowledge-in-health-systems/
    9. Sadki, R., 2024f. Anecdote or lived experience: reimagining knowledge for climate-resilient health systems. https://stories.learning.foundation/2024/11/11/anecdote-or-lived-experience-reimagining-knowledge-for-climate-resilient-health-systems/
    10. Sadki, R., 2024g. Knowing-in-action: Bridging the theory-practice divide in global health. https://stories.learning.foundation/2024/12/14/knowing-in-action-bridging-the-theory-practice-divide-in-global-health/
    11. Sadki, R., 2023a. Investing in the health workforce is vital to tackle climate change: A new report shares insights from over 1,200 on the frontline. https://doi.org/10.59350/3kkfc-9rb27
    12. Sadki, R., 2023b. Climate change is a threat to the health of the communities we serve: health workers speak out at COP28. https://stories.learning.foundation/2023/12/11/climate-and-health-health-workers-trust/
    13. Sanchez, J.J., Gitau, E., Sadki, R., Mbuh, C., Silver, K., Berry, P., Bhutta, Z., Bogard, K., Collman, G., Dey, S., Dinku, T., Dwipayanti, N.M.U., Ebi, K., Felts La Roca Soares, M., Gudoshava, M., Hashizume, M., Lichtveld, M., Lowe, R., Mateen, B., Muchangi, M., Ndiaye, O., Omay, P., Pinheiro dos Santos, W., Ruiz-Carrascal, D., Shumake-Guillemot, J., Stewart-Ibarra, A., Tiwari, S., 2025. The climate crisis and human health: identifying grand challenges through participatory research. The Lancet Global Health 13, e199–e200. https://doi.org/10.1016/s2214-109x(25)00003-8
    14. Schön, D.A., 1995. Knowing-in-action: The new scholarship requires a new epistemology. Change: The Magazine of Higher Learning 27, 27–34. https://doi.org/10.1080/00091383.1995.10544673
    15. The Geneva Learning Foundation, 2023. On the frontline of climate change and health: A health worker eyewitness report. The Geneva Learning Foundation. https://doi.org/10.5281/ZENODO.10204660

    Image: The Geneva Learning Foundation Collection © 2025

  • Climate change and health: what the Lancet Countdown says about the value and significance of local knowledge and action

    Climate change and health: what the Lancet Countdown says about the value and significance of local knowledge and action

    Here is everything that the new Lancet Countdown says about the value and significance of indigenous and other forms of local knowledge, as well as their value for community-led action to respond to the impacts of climate change on health.

    Why does this matter? Read our article: How the Lancet Countdown illuminates a new path to climate-resilient health systems

    On the value of community-led action and the significance of local knowledge

    Defining community-led action by its local context and empowerment

    “Community-led actions are those spearheaded by self-organised individuals within a community, working together for a common goal. Rooted in local societal, cultural, and economic contexts, they can promote equity, empower local actors, and strengthen climate resilience.”

    Community-led action as a driver of meaningful progress

    “Individual, community-led, and civil society actions can drive meaningful progress with substantial health benefits.”

    Grassroots activities growing into formal organizations

    “These grassroots activities can grow into formal organisations with national or international influence.”

    The dependence of community-led initiatives on local actors

    “Despite their capacity to enact change, community-led initiatives depend on the willingness and possibilities of local actors.”

    The advantages of community-led actions over top-down interventions

    “Tailored to local needs, community-led actions are more likely than top-down interventions to maximise health benefits, bypass the limitations of implementing top-down solutions, and can help avoid unintended harms such as gentrification or increased inequalities.”

    The co-benefits of community-led action on mental health and awareness

    “Community-led actions can also foster agency, increase attachment to the local environment, and promote social interactions, all of which help reduce the mental health impacts of climate change and increase awareness.”

    Recommendation for individuals and civil society: Engage in community-led action

    “Engaging in community-led action on health and climate change, supporting equitable inclusion of marginalised communities.”

    Recommendation for individuals and civil society: Create community platforms for collective resilience

    “Creating community platforms on climate change and health, including citizen groups, to safely exchange ideas and concerns, build collective resilience and adaptive capacity, and enable engagement with decision makers.”

    Value of local knowledge: We need more examples of community-led action

    Example of local community and indigenous peoples’ forest management

    “In Nepal, community forests user groups have grown into a state-sponsored and legally mandated initiative, under which local communities, including Indigenous Peoples, manage 37-7% of national forests—augmenting carbon sinks, enhancing food access, and improving livelihoods.”

    Example of farmer-led interventions improving health outcomes

    “Across the Sahel, farmers have implemented Farmer Managed Natural Regeneration… These farmer-led interventions resulted in increased tree coverage, crop yields, drought resistance, and access to traditional medicines, contributing to improved health outcome and poverty reduction.”

    Environmental defenders need protection

    The disproportionate killing of indigenous and minoritized environmental defenders

    “A Global Witness report found that 196 activists were killed in 2023 (57% in Latin America), with minoritised and Indigenous groups disproportionately affected.”

    Protecting environmental defenders to enable community-led interventions

    “Protecting environmental defenders in line with international conventions is critical to enabling community-led interventions, and providing a fertile ground for grassroots initiatives to deliver life-saving progress on health and climate change.”

    On the need for community-led action amid waning political engagement

    The role of health framing in driving community-led action

    “This [health framings of climate change] can be a crucial driver for individual-led and community-led action, especially amid waning engagement from political leaders.”

    Community and individual action as essential when national engagement wanes

    “When national government engagement wanes (indicator 5.4.1), action by subnational governments, corporations, civil society organisations, communities, and individuals can contribute to keeping the planet within inhabitable limits.”

    Recommendation for funders on the significance of local knowledge:

    Recommendation for funders: Support community initiatives to scale action

    “…supporting governmental bodies, civil society organisations, and community initiatives to scale-up health-promoting and inclusive climate change action.”

    On the value of indigenous knowledge

    Respecting indigenous knowledge in global health action

    “To support global health, these actions need to be delivered in ways that are gender-responsive, reduce health inequities, respect and promote the rights and knowledge of Indigenous People, and account for the protection of vulnerable and underserved communities.”

    Recommendation for national governments: Integrate community and indigenous perspectives in policy design

    “Including community perspectives in the design of climate and health policies, with particular focus on the most vulnerable communities and Indigenous people.”

    Recommendation for city governments: Prioritize indigenous knowledge and community-led initiatives

    “Reducing inequities and avoiding unintended harms by integrating community perspectives in all climate change actions and supporting community-led initiatives, with particular focus on vulnerable communities and the priorities and knowledge of Indigenous people.”

    On the need to refocus the apparatus of science on the most vulnerable people and communities

    Scientific evidence generation is concentrated in high-HDI countries, not where impacts are highest

    “Scientific evidence generation is still concentrated in higher HDI countries rather than those most exposed to the health impacts of climate change.”

    Data gaps obscuring the impacts on indigenous people

    “This lack of disaggregated data makes it difficult to capture the disproportionate impacts of climate change on Indigenous people, such as those living in the circumpolar region, which is heating nearly four times faster than the global average.”

    Conflict analysis must be shaped by local dynamics

    “This relationship [between climate change and conflict] is now widely recognised as a complex, multicausal phenomenon shaped by local social and cultural dynamics, economic fluctuations, and geopolitical forces at both the domestic and international levels.”

    On ensuring the relevance of science to support local action

    Harnessing local knowledge for regional stakeholders

    “…harnessing local knowledge and translating findings to meet the needs of local stakeholders.”

    Advancing the local generation of evidence

    “…to advance the local generation of evidence to inform action in one of the world’s most vulnerable regions.”

    Informing action at the local level

    “…make their findings available to inform action at the national and local levels.”

    References

    1. Romanello, M., et al., 2025. The 2025 report of the Lancet Countdown on health and climate change. The Lancet S0140673625019191. https://doi.org/10.1016/S0140-6736(25)01919-1
    2. Sadki, R., 2024. Critical evidence gaps in the Lancet Countdown on health and climate change. https://doi.org/10.59350/nv6f2-svp12

    Image: The Geneva Learning Foundation Collection © 2025

  • Colonization, climate change, and indigenous health: from Algiers to Acre

    Colonization, climate change, and indigenous health: from Algiers to Acre

    I sat in a conference hall in Rio Branco, Acre State, Brazil.

    My mind was in a sanatorium of Algiers, Algeria.

    This was where my mother was sent as a girl.

    They told her she got tuberculosis because she was an “indigène musulman”.

    In 1938, the year of my mother’s birth and after over a century of colonization, about 5 out of every 100 Algerian people got infected with tuberculosis each year.

    French colonial reports show that Algerians died from tuberculosis at much higher rates than French settlers.

    They claimed the disease was endemic due to the supposed inferiority of our people.

    And that she was going to die.

    Colonialism is a liar.

    She survived.

    And it took less than eight years for an independent Algeria, free of the scourge of colonialism, to eradicate the scourge of TB.

    Listening to the leaders at Brazil’s First National Seminar on Indigenous Health and Climate Change, I heard that same lie being dismantled.

    The body of the territory, the body of the people

    I listened.

    I heard a diagnosis specific to their lands and histories, and recognized a familiar pattern.

    The territory is a living body, they said.

    When it is sick, we are sick.

    Ceiça Pitaguary is an indigenous leader and activist from the Pitaguary people in Brazil.

    The crisis, she explained, is a daily reality of “prolonged droughts, devastating floods, intense storms, and the rise in temperatures” that represents “real losses experienced in the body and on the territory”.

    This is a wound with many layers.

    There are the physical symptoms an epidemiologist would recognize: respiratory illnesses from fire and waterborne diseases from floods.

    But the deeper sickness that speakers diagnosed, one after another, is a systemic decay.

    I listened as Wallace Apurinã stated that when the floods come, “traditional medicine, which is such an important and fundamental knowledge for our subsistence… this ends”.

    It is a crisis that creates what Elisa Pankararu named a “collective sadness”.

    “Our people are sad,” she said, because the world is in imbalance.

    This is a spiritual wound, like the one Juliana Tupinikim described.

    She said the Krenak people lost not just a river to a mining disaster, but “fundamental elements of their spirituality and cultural identity”.

    The crisis, Gemina Shanenawá insisted, is not abstract.

    “It has a face, a name, and a territory: the face of Indigenous women”.

    She gave voice to their struggle: “‘I lost everything, I lost my house, I lost my pigs, my chickens. And now? What am I going to do?’”.

    The architecture of failure

    There is a pathogen worse than fossil fuel.

    It is colonialism.

    I recognized its stench in the testimony of the leaders.

    It is a system designed to fail its most vulnerable.

    Weibe Tapeba, Brazil’s Secretary of Indigenous Health, described the paralysis.

    “Today, our Indigenous territories are not understood as federal units,” he said.

    This means that they are unable to issue crucial decrees themselves, which severely hinders their ability to prepare for, respond to, and recover from increasingly frequent catastrophic events.

    “We do not have the autonomy to issue such a decree ourselves”.

    This intentional powerlessness leaves communities exposed.

    It creates the chain reaction that researcher Renata Gracie detailed in the Yanomami territory, where illegal mining leads directly to “an enormous increment in the occurrence of malaria, trachoma, measles, tuberculosis, malnutrition”.

    The state’s response—culturally inappropriate food baskets were one example I heard—is changing.

    It was impressive to see how government, with leadership from Tapeba and others, engages in meaningful, open dialogue by and for indigenous communities.

    What you call anecdote, we call ancestral science

    An invisible but profound violence of colonization is the dismissal of a people’s way of knowing.

    Your science is ’data’.

    Ours is ’folklore’.

    The entire seminar was a rebellion against this lie.

    In my own talk, I spoke about how health workers’ expertise – what they know because they are there every day – is often devalued as mere “anecdote”.

    Putira Sacuena provided the most powerful rebuttal.

    She spoke of a small frog in the Xingu territory.

    “We stopped hearing its sound in the territory”, she explained.

    The frog’s silence predicted the rise in respiratory illness and diarrhea.

    She said: this is ancestral science.

    It is a signal from a highly sophisticated, multi-generational system of environmental monitoring.

    Our existing systems do not just miss this data.

    They are structurally incapable of recognizing it as data in the first place.

    The challenge, then, is to begin the work of unlearning the colonial biases that prevent us from seeing the knowledge that is right in front of us.

    It requires us to abandon the “high, hard ground” of our self-referential expertise.

    The fight for health here is, more than we realized, a fight for cognitive justice, a demand that such knowledge be seen not as a cultural artifact, but as essential data.

    As Ceiça Pitaguary declared, “The fight against the climate crisis will not be won without Indigenous peoples”.

    That is not a political slogan.

    It is a vital, scientific truth of our time.

    It demands that we, in our institutions and our fields of practice, dismantle the systems that are causing this devastation.

    References

    1. Bentata, K., Alihalassa, S., Gharnaout, M., Bennani, M.A., Berrabah, Y., 2025. Algerian Tuberculosis Control Program: 60 Years of Successful Experience. Cureus. https://doi.org/10.7759/cureus.86357
    2. Brubacher, L.J., Peach, L., Chen, T.T.-W., Longboat, S., Dodd, W., Elliott, S.J., Patterson, K., Neufeld, H., 2024. Climate change, biodiversity loss, and Indigenous Peoples’ health and wellbeing: A systematic umbrella review. PLOS Glob Public Health 4, e0002995. https://doi.org/10.1371/journal.pgph.0002995
    3. Ellwanger, J.H., others, 2020. Beyond diversity loss and climate change: Impacts of Amazon deforestation on infectious diseases and public health. Anais da Academia Brasileira de Ciencias. https://doi.org/10.1590/0001-3765202020191010
    4. Ford, J.D., 2012. Indigenous Health and Climate Change. Am J Public Health 102, 1260–1266. https://doi.org/10.2105/AJPH.2012.300752
    5. Grande, A.J., Dias, I.M.A.V., Jardim, P.T.C., Aparecida Vieira Machado, A., Soratto, J., Da Rosa, M.I., Ceretta, L.B., Zourntos, X., Suares, R.O., Harding, S., 2024. Environmental degradation, climate change and health from the perspective of Brazilian Indigenous stakeholders: a qualitative study. BMJ Open 14, e083624. https://doi.org/10.1136/bmjopen-2023-083624
    6. Jones, R., Macmillan, A., Reid, P., 2020. Climate Change Mitigation Policies and Co-Impacts on Indigenous Health: A Scoping Review. IJERPH 17, 9063. https://doi.org/10.3390/ijerph17239063
    7. Kramer, C.K., Leitão, C.B., Viana, L.V., 2022. The impact of urbanisation on the cardiometabolic health of Indigenous Brazilian peoples: a systematic review and meta-analysis, and data from the Brazilian Health registry. The Lancet 400, 2074–2083. https://doi.org/10.1016/S0140-6736(22)00625-0
    8. Lavallee, L.F., Poole, J.M., 2010. Beyond Recovery: Colonization, Health and Healing for Indigenous People in Canada. Int J Ment Health Addiction 8, 271–281. https://doi.org/10.1007/s11469-009-9239-8
    9. Lin, C.Y., Loyola-Sanchez, A., Boyling, E., Barnabe, C., 2020. Community engagement approaches for Indigenous health research: recommendations based on an integrative review. BMJ Open 10, e039736. https://doi.org/10.1136/bmjopen-2020-039736
    10. Pontes, A.L., others, 2020. Health reform and Indigenous health policy in Brazil. Health Policy and Planning. https://doi.org/10.1093/heapol/czaa116
    11. Rankoana, S.A., 2022. Climate change impacts on indigenous health promotion: the case study of Dikgale community in Limpopo Province, South Africa. Glob Health Promot 29, 58–64. https://doi.org/10.1177/17579759211015183
    12. Reading, C., Wien, F., 2009. Health inequalities and the social determinants of Aboriginal health. National Collaborating Centre for Aboriginal Health.
    13. Redvers, N., Celidwen, Y., Schultz, C., Horn, O., Githaiga, C., Vera, M., Perdrisat, M., Mad Plume, L., Kobei, D., Kain, M.C., Poelina, A., Rojas, J.N., Blondin, B., 2022. The determinants of planetary health: an Indigenous consensus perspective. The Lancet Planetary Health 6, e156–e163. https://doi.org/10.1016/S2542-5196(21)00354-5
    14. Rieger, K.L., Horton, M., Copenace, S., Bennett, M., Buss, M., Chudyk, A.M., Cook, L., Hornan, B., Horrill, T., Linton, J., McPherson, K., Rattray, J.M., Murray, K., Phillips-Beck, W., Sinclair, R., Slavutskiy, O., Stewart, R., Schultz, A.S., 2023. Elevating the Uses of Storytelling Methods Within Indigenous Health Research: A Critical, Participatory Scoping Review. International Journal of Qualitative Methods 22, 16094069231174764. https://doi.org/10.1177/16094069231174764
    15. Roher, S.I.G., Yu, Z., Martin, D.H., Benoit, A.C., 2021. How is Etuaptmumk/Two-Eyed Seeing characterized in Indigenous health research? A scoping review. PLoS ONE 16, e0254612. https://doi.org/10.1371/journal.pone.0254612
    16. Sadki, R., 2025. Climate change and health: a new peer learning programme by and for health workers from the most climate-vulnerable countries. https://doi.org/10.59350/redasadki.21339
    17. Sadki, R., 2001. Colonialism and disease: tuberculosis in Algeria. https://doi.org/10.59350/jhbhx-zm765
    18. Sadki, R., 2024. Knowing-in-action: Bridging the theory-practice divide in global health. https://doi.org/10.59350/4evj5-vm802
    19. Sadki, R., 2024. Strengthening primary health care in a changing climate. https://doi.org/10.59350/5s2zf-s6879
    20. Sadki, R., 2025. WHO Global Conference on Climate and Health: New pathways to overcome structural barriers blocking effective climate and health action. https://doi.org/10.59350/redasadki.21322
    21. Sanchez, J.J., Gitau, E., Sadki, R., Mbuh, C., Silver, K., Berry, P., Bhutta, Z., Bogard, K., Collman, G., Dey, S., Dinku, T., Dwipayanti, N.M.U., Ebi, K., Felts La Roca Soares, M., Gudoshava, M., Hashizume, M., Lichtveld, M., Lowe, R., Mateen, B., Muchangi, M., Ndiaye, O., Omay, P., Pinheiro dos Santos, W., Ruiz-Carrascal, D., Shumake-Guillemot, J., Stewart-Ibarra, A., Tiwari, S., 2025. The climate crisis and human health: identifying grand challenges through participatory research. The Lancet Global Health 13, e199–e200. https://doi.org/10.1016/s2214-109x(25)00003-8
    22. Sahu, M., others, 2022. Measuring Impact of Climate Change on Indigenous Populations’ Health: A Global Review. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph192315592
    23. Sanson‐Fisher, R.W., Campbell, E.M., Perkins, J.J., Blunden, S.V., Davis, B.B., 2006. Indigenous health research: a critical review of outputs over time. Medical Journal of Australia 184, 502–505. https://doi.org/10.5694/j.1326-5377.2006.tb00343.x
    24. Santos, H.C.D., Mill, J.G., 2024. Multimorbidity and associated factors in the adult Indigenous population living in villages in the municipality of Aracruz, Espírito Santo, State, Brazil. Cad. Saúde Pública 40, e00135323. https://doi.org/10.1590/0102-311xen135323
    25. Silva-Junior, C.H.L., others, 2023. Brazilian Amazon indigenous territories under climate and deforestation pressure: an analysis of 2013-2021 period. Scientific Reports. https://doi.org/10.1038/s41598-023-31570-y
    26. Smallwood, R., Woods, C., Power, T., Usher, K., 2021. Understanding the Impact of Historical Trauma Due to Colonization on the Health and Well-Being of Indigenous Young Peoples: A Systematic Scoping Review. J Transcult Nurs 32, 59–68. https://doi.org/10.1177/1043659620935955
    27. Soares, G.H., Jamieson, L., Biazevic, M.G.H., Michel-Crosato, E., 2022. Disparities in Excess Mortality Between Indigenous and Non-Indigenous Brazilians in 2020: Measuring the Effects of the COVID-19 Pandemic. J. Racial and Ethnic Health Disparities 9, 2227–2236. https://doi.org/10.1007/s40615-021-01162-w
    28. Thebaud, A., Lert, F., 1985. Maladie subie, maladie dominee, industrialisation et technologie medicale: Le cas de la tuberculose. Social Science & Medicine 21, 129–137. https://doi.org/10.1016/0277-9536(85)90081-4
    29. Thomas, A., 2024. Colonization as a Determinant of Health. Western University Global Health Equity.
    30. US Environmental Protection Agency, 2025. Climate Change and the Health of Indigenous Populations. EPA.
    31. World Health Organization, 2025. Global Plan of Action for Health of Indigenous Peoples. WHO.

    Image: The Geneva Learning Foundation Collection © 2025

  • Gender in emergencies: a new peer learning programme from The Geneva Learning Foundation

    Gender in emergencies: a new peer learning programme from The Geneva Learning Foundation

    This is a critical moment for work on gender in emergencies.

    Across the humanitarian sector, we are witnessing a coordinated backlash.

    Decades of progress are threatened by targeted funding cuts, the erasure of essential research and tools, and a political climate that seeks to silence our work.

    Many dedicated practitioners feel isolated and that their work is being devalued.

    This is not a time for silence.

    It is a time for solidarity and for finding resilient ways to sustain our practice.

    In this spirit, The Geneva Learning Foundation is pleased to announce the new Certificate peer learning programme for gender in emergencies.

    We offer this programme to build upon the decades of vital work by countless practitioners and activists, seeing our role as one of contribution to the collective effort of all who continue to champion gender equality in emergencies.

    Learn more and request your invitation to the programme and its first course here.

    Our approach: A programme built from the ground up

    This programme was built from scratch with a distinct philosophy.

    We did not start with a pre-packaged curriculum.

    Instead, we turned to two foundational sources of knowledge.

    • First, we listened to the most valuable resource we have: the firsthand experiences of thousands of practitioners in our global network. Their stories of what truly happens on the front lines—what works, what fails, and why—form the living heart of this programme.
    • Second, we grounded our approach in the deep insights of intersectional, decolonial, and feminist scholarship. These perspectives challenge us to move beyond technical fixes and to analyze the systems of power that create gender inequality in the first place.

    This unique origin means our programme is a dynamic space co-created with and for practitioners who are serious about transformative change.

    Gender in emergencies: Gender through an intersectional lens

    Our focus is squarely on gender in emergencies.

    We start with gender analysis because it is a fundamental tool for effective humanitarian action.

    However, we use an intersectional lens.

    We recognize that a person’s experience is shaped not by gender alone, but by how their gender compounds with their age, disability, ethnicity, and other aspects of their identity.

    This lens does not replace gender analysis.

    It makes it stronger.

    It allows us to see how power works differently for different women, men, girls, and boys, and helps us to design solutions that do not inadvertently leave behind the people marginalized by something other than their gender.

    Gender in emergencies requires learning at the speed of crisis

    Humanitarian response must be rapid, and so must our learning.

    A slow, top-down training model cannot keep pace with the reality of a crisis.

    The Geneva Learning Foundation’s Impact Accelerator is a peer learning-to-action model built for the speed and complexity of humanitarian settings.

    It is a ‘learn-by-doing’ experience where your frontline experience is the textbook.

    The model is designed to quickly turn your individual insights into collective knowledge and practical action.

    You analyze a real challenge from your work, share it with a small group of global peers, and use their feedback to build a concrete plan.

    This process accelerates the development of context-specific solutions that are grounded in reality, not just theory.

    Your first step: The foundational primer for gender in emergencies

    We are starting this new programme with a free, open-access foundational course.

    Enrollment is now open.

    The course is a quick primer that introduces core concepts of gender, intersectionality, and bias through the real-world stories of practitioners.

    It provides the shared language and practical tools to begin your journey of reflection, peer collaboration, and action.

    Building a resilient community

    This is more than a training programme.

    It is an invitation to join a global community of practice.

    In a time of backlash and division, creating spaces where we can learn from each other, share our struggles, and find solidarity is a critical act of resistance.

    If you are ready to deepen your practice and connect with colleagues who share your commitment, we invite you to join us.

    Image: The Geneva Learning Foundation © 2025

  • Against chocolate-covered broccoli: text-based alternatives to expensive multimedia content

    Against chocolate-covered broccoli: text-based alternatives to expensive multimedia content

    The great multimedia content deception

    Learning teams spend millions on dressing up content with multimedia.

    The premise is always the same: better graphics equal better learning.

    The evidence tells a different story.

    The focus on the presentation and transmission of content represents a fundamental misunderstanding of how learning actually works in our complex world.

    Multimedia content: the stakes have changed

    In a world confronting unprecedented challenges—from climate change to global health crises, from artificial intelligence to geopolitical instability—the stakes for learning have never been higher.

    We need citizens and professionals capable of critical thinking, navigating uncertainty, grappling with complex systems, and collaborating effectively with artificial intelligence as a co-worker.

    Yet much of our educational technology investment continues to chase the glittering promise of multimedia enhancement, as if adding more visual stimulation and interactive elements will somehow transform passive consumers into active knowledge creators.

    The traditional transmissive model—knowledge flowing one-way from expert to learner—has become counterproductive.

    In a world where information is abundant but wisdom is scarce, the critical question is not how to transmit information efficiently, but how to create environments that cultivate higher-order capabilities.

    If not multimedia content, then what?

    Bill Cope and Mary Kalantzis identify seven affordances that distinguish effective digital learning from traditional instruction.

    None involve multimedia enhancement.

    Instead, they emphasize ubiquitous learning that transcends boundaries; active knowledge production by learners themselves; recursive feedback that transforms assessment into dialogue; collaborative intelligence that emerges from structured interaction; metacognitive reflection that builds learning capacity; and differentiated pathways that personalize without sacrificing community.

    This framework reframes education’s purpose: not delivering content, but designing ecologies for knowledge creation.

    Consuming multimedia content is not learning

    The critical distinction lost in educational technology discussions is between learning resources and learning processes.

    A video or simulation is content—not learning itself.

    Learning is the activity that the learner does.

    At The Geneva Learning Foundation, we work with over 70,000 health practitioners globally using a structured cycle of action and reflection.

    The main medium is text.

    But the role of text is far more profound than content delivery.

    In our climate and health programme, for example, the primary learning resource is a collection of text-based eyewitness accounts from learners in our Teach to Reach programme.

    A practitioner in Nigeria shares a written story of how extreme heat forces people to sleep outdoors, increasing their exposure to malaria-carrying mosquitoes.

    Learners read this and many other real-world experiences.

    The learning activity is not to memorize this fact.

    Instead, a learner in Brazil will analyze a “chain reaction” from change in climate to health consequences in writing, grounded in their own experience with flooding and diarrheal disease.

    Then, she will receive structured, written feedback from colleagues in Chad, Ghana, and India, guided by a detailed rubric.

    The “content” is the collective written experience of the peer group.

    Similarly, in our 16-day peer learning exercise on health equity, learners do not study abstract theories of justice from a textbook.

    Instead, they write a detailed project analyzing a real-world inequity they face.

    A health worker might document how their system’s design consistently fails to reach nomadic pastoralist communities.

    The learning happens in the subsequent, text-based peer review, where colleagues use a rubric to help the author deepen their root cause analysis and refine their action plan.

    In both cases, the engine of learning is the activity—creating, analyzing, evaluating, collaborating—and text is the medium for that activity.

    We do not invest in costly multimedia production because the engagement happens in robust, structured peer interactions that drive authentic learning.

    The experiences shared by learners, what they construct individually, becomes the collective corpus through which learning becomes continuous – and helps turn knowledge into action.

    The cognitive case for the superiority of text over multimedia content

    Cognitive Load Theory explains that working memory—where we process new information—is extremely limited.

    This mental capacity has three components: intrinsic load (the material’s inherent difficulty), extraneous load (effort wasted on poorly designed instruction), and germane load (productive effort leading to deep learning).

    Critical thinking, analysis, and metacognition have very high intrinsic loads.

    Learners are already engaged in demanding mental work.

    Any instructional element adding unnecessary complexity steals finite cognitive resources from actual learning.

    Multimedia “enhancements”—distracting animations, irrelevant images, redundant text—do precisely this.

    They may feel engaging, but research shows this perceived engagement does not translate to better outcomes and can be detrimental.

    Well-structured text is cognitively “quiet.”

    It presents information cleanly, allowing learners to dedicate maximum mental energy to understanding and applying complex ideas.

    The unique affordances of text

    Text possesses structural characteristics exceptionally suited for higher-order thinking.

    Its linear nature builds coherent, sequential, evidence-based arguments, modeling logical reasoning processes.

    Unlike transient video or audio, text is stable—it can be revisited, scrutinized, annotated, and cross-referenced at the learner’s pace, enabling the deep analysis required by our peer review rubrics.

    Written language excels at conveying abstract concepts, nuanced theories, and complex principles—the building blocks of fields requiring sophisticated thinking and “thick knowledge”.

    Studies consistently show writing improves critical thinking skills like analysis and inference.

    Comparative studies in Problem-Based Learning (PBL) reveal that adding multimedia does not reliably improve outcomes.

    Some find no significant difference between text-based and multimedia-enhanced cases.

    Others find video actively hinders learning by making it harder to identify and review key information during collaborative analysis.

    The virtual reality paradox

    Some education innovators continue to be mesmerized by the promise of virtual or augmented reality.

    They are often the same individuals who previously touted “gamification” as a panacea for learning.

    Virtual reality represents the ultimate multimedia format, promising immersive simulations that proponents claim will revolutionize education.

    Yet the biggest investments so far have been spectacular failures.

    For example, Mark Zuckerberg’s massive bet on virtual learning environments, despite billions invested, failed to demonstrate educational superiority over traditional methods.

    The pattern repeats across educational technology: the more immersive and visually impressive the technology, the more it distracts from the cognitive work learning requires.

    This helps to understand why, by contrast, text-based generative AI chatbots so rapidly became part of teaching and learning.

    Students may be amazed by virtual experiences, but amazement does not translate to learning outcomes.

    The AI factor

    As artificial intelligence becomes capable of generating sophisticated multimedia content, human learners need complementary skills: critical analysis of AI-generated materials, collaborative meaning-making across perspectives, and creative synthesis of complex information.

    Text-based learning environments naturally develop these capabilities.

    When students analyze written arguments, provide peer feedback through structured rubrics, and revise thinking based on diverse perspectives, they practice the analytical and collaborative thinking that will distinguish them in an AI-enhanced world.

    The economic dead end of multimedia content

    Multimedia content may become obsolete quickly, requiring constant updates.

    A typical multimedia learning module is expensive to develop and maintain.

    A thoughtfully structured text-based peer review process costs a fraction of that amount but creates value every time learners engage with it, building individual skills and collective knowledge that compound over time.

    In our programmes spanning multiple continents and diverse health contexts—from emergency response training to climate health education—we demonstrate measurably better learning outcomes with text-based approaches.

    Our methodology focuses on evidence-based peer learning emphasizing learner autonomy, competence, and community connection—outcomes that text-based environments support more effectively than multimedia alternatives.

    Beyond the false choice

    This argument does not advocate technological poverty in education.

    Digital platforms enable collaboration and knowledge sharing impossible in previous eras.

    Innovation and investment are vital.

    The key lies in distinguishing between technology that amplifies human interaction and technology that attempts to substitute for it.

    Text-based learning environments scale to support thousands while maintaining human connections essential for deep learning.

    They accommodate diverse learning styles without sacrificing intellectual rigor.

    They integrate seamlessly with AI tools that help organize and synthesize ideas without replacing human judgment and creativity.

    Most importantly, they focus investment where learning happens: in structured interaction between learners, feedback loops that refine understanding, collaborative processes that create knowledge, and metacognitive reflection that builds learning capacity.

    The path forward

    The multimedia deception persists because it aligns with intuitive but erroneous beliefs about learning and technology.

    More sophisticated presentations seem like obvious improvements.

    But learning operates by different rules than information processing.

    Institutions serious about educational effectiveness should reject the multimedia mirage.

    This means redirecting technology budgets from content production to learning infrastructure.

    It means training experts to facilitate text-based dialogue scaffolded by rubrics and experience, rather than spend time building multimedia presentations.

    It means measuring learning outcomes rather than student satisfaction scores.

    In a world demanding critical thinking, systems awareness, and collaborative intelligence, we need approaches that develop these capabilities directly.

    The multimedia bells and whistles that capture our attention and resources actively impede the kind of learning our complex world requires.

    The future of educational technology lies in thoughtful structuring of human interaction and knowledge creation.

    Text provides the foundation precisely because it demands the active cognitive engagement that multimedia often circumvents.

    References

    1. Berrocal, Y., Regan, J., Fisher, J., Darr, A., Hammersmith, L., Aiyer, M., 2021. Implementing Rubric-Based Peer Review for Video Microlecture Design in Health Professions Education. Med.Sci.Educ. 31, 1761–1765. https://doi.org/10.1007/s40670-021-01437-1
    2. Cope, B., Kalantzis, M., 2013. Towards a New Learning: The Scholar Social Knowledge Workspace, in Theory and Practice. E-Learning and Digital Media 10, 332–356. https://doi.org/10.2304/elea.2013.10.4.332
    3. Cope, B., & Kalantzis, M. (Eds.). (2016). e-Learning Ecologies: Principles for New Learning and Assessment. Routledge. https://doi.org/10.4324/9781315699935
    4. Feenberg, A., 1989. The written world: On the theory and practice of computer conferencing, in: Mason, R., Kaye, A. (Eds.), Mindweave: Communication, Computers, and Distance Education. Pergamon Press, pp. 22–39.
    5. Fenesi, B., Sana, F., Kim, J. A., & Shore, D. I. (2014). Learners misperceive the benefits of redundant text in multimedia learning. Frontiers in Psychology, 5, 710. https://doi.org/10.3389/fpsyg.2014.00710
    6. Mayer, R. E. (2008). Applying the science of learning: Evidence-based principles for the design of multimedia instruction. American Psychologist, 63(8), 760-769. https://doi.org/10.1037/0003-066X.63.8.760
    7. Pereles, A., Ortega-Ruipérez, B., Lázaro, M. (2024). The power of metacognitive strategies to enhance critical thinking in online learning. Journal of Technology and Science Education, 14(3), 831-843. https://doi.org/10.3926/jotse.2721
    8. Rivas, S. F., Saiz, C., & Ossa, C. (2022). Metacognitive strategies and development of critical thinking in higher education. Frontiers in Psychology, 13, 913219. https://doi.org/10.3389/fpsyg.2022.913219
    9. Sweller, J. (2005). Implications of cognitive load theory for multimedia learning. In R. E. Mayer (Ed.), The Cambridge Handbook of Multimedia Learning (pp. 19-30). Cambridge University Press. https://doi.org/10.1017/CBO9780511816819.003
    10. Sweller, J., Ayres, P., & Kalyuga, S. (2011). Cognitive Load Theory. Springer. https://doi.org/10.1007/978-1-4419-8126-4
    11. Tarchi, C. (2021). Learning from text, video, or subtitles: A comparative analysis. Computers & Education, 160, 104034. https://doi.org/10.1016/j.compedu.2020.104034

    Image: The Geneva Learning Foundation Collection © 2025

  • Richard Mayer’s research on multimedia for learning actually proves text works better

    Richard Mayer’s research on multimedia for learning actually proves text works better

    Educational technology professionals cite Richard Mayer’s 2008 study more than any other research on multimedia instruction.

    They are citing the wrong conclusion.

    Mayer did not prove multimedia enhances learning.

    He proved multimedia creates cognitive problems requiring ten different workarounds – and accidentally built the case for text-based instruction.

    What Richard Mayer actually found

    Through hundreds of controlled experiments, Richard Mayer identified ten principles for multimedia design.

    The pattern is striking: most principles involve removing elements from presentations.

    Five principles focus on reducing “extraneous processing” – cognitive waste that multimedia creates.

    1. Remove irrelevant material.
    2. Highlight essential information buried among distractions.
    3. Eliminate simultaneous animation, narration, and text because learners perform better with only two elements.
    4. Place corresponding words and pictures close together.
    5. Present them simultaneously, not sequentially.

    Three principles manage “essential processing” when content is complex.

    1. Break presentations into learner-controlled segments.
    2. Use spoken rather than printed text with graphics.
    3. Provide pre-training before complex multimedia instruction.

    Two principles foster deeper learning.

    1. Combine words and pictures rather than words alone.
    2. Use conversational rather than formal language.

    The hidden message: multimedia instruction is so cognitively demanding that it requires ten specialized principles to avoid harming learning.

    Richard Mayer’s split attention revelation

    Mayer’s modality principle seems to endorse multimedia: learners perform better with graphics plus spoken text than graphics plus printed text.

    Educational technologists celebrate this as proof that multimedia works.

    They miss the real insight.

    Graphics with printed text create split attention – learners cannot simultaneously look at pictures while reading words.

    They must constantly switch between visual elements, wasting cognitive resources on coordination rather than learning.

    Richard Mayer’s solution uses different channels: visual graphics with auditory narration.

    But this still requires complex mental coordination between multiple input streams while maintaining focus on learning objectives.

    Text-based instruction eliminates split attention entirely.

    (There are deeply-rooted cultural and historical reasons for the distrust of text.)

    Learners process information through one coherent channel that naturally supports sequential, analytical thinking.

    The damage control principles in Richard Mayer’s principles

    Step back from individual findings and Mayer’s principles reveal themselves as damage control.

    The coherence principle removes distractions that multimedia introduces.

    The redundancy principle eliminates conflicts between competing inputs.

    The segmenting principle provides control that multimedia complexity demands.

    The pre-training principle prepares learners for cognitive challenges that simpler instruction avoids.

    Each principle represents additional design constraints requiring specialized expertise and extensive testing.

    They exist because multimedia instruction is fundamentally problematic.

    Text extends Richard Mayer’s logic

    At The Geneva Learning Foundation, we work with 70,000 health practitioners using text-based peer learning.

    Nigerian practitioners write about extreme heat forcing people to sleep outdoors, increasing malaria exposure.

    Colleagues in Brazil, Chad, Ghana, and India read these accounts, analyze climate-health connections, and provide structured feedback through expert-designed rubrics.

    No graphics.

    No audio coordination.

    No split attention problems.

    Read our article: Against chocolate-covered broccoli: text-based alternatives to expensive multimedia content

    Direct engagement with content that supports rather than complicates learning.

    This approach achieves Richard Mayer’s goals through elimination rather than optimization.

    Ultimate coherence by presenting only essential information.

    Zero redundancy through single-channel processing.

    Natural segmenting through text’s inherent reader control.

    No pre-training needed because text presents information in logical, sequential structures.

    The multimedia principle reconsidered

    Mayer’s most famous finding – people learn better from words and pictures than words alone – deserves scrutiny.

    This emerged from comparing passive multimedia consumption to passive text reading.

    It equates learning with recall.

    Neither condition included structured peer interaction, collaborative analysis, or iterative revision that characterize more complex learning.

    When learners create knowledge through text-based peer learning, they achieve outcomes that passive consumption of any media cannot match.

    The effect size for active text-based learning exceeds Mayer’s multimedia findings while avoiding cognitive coordination problems.

    The economic evidence

    Mayer’s ten principles exist because multimedia design is expensive and complex.

    Each principle represents additional constraints demanding specialized expertise.

    Typical multimedia modules are expensive.

    Text-based peer learning costs a fraction of this amount while producing superior outcomes.

    Resources should flow toward learning infrastructure such as expert rubrics and facilitated dialogue – elements that actually drive learning rather than manage cognitive problems.

    The real choice

    Educational technology leaders face a fundamental decision: invest in managing multimedia’s problems or adopt approaches that avoid those problems entirely.

    Mayer’s research illuminates multimedia’s cognitive costs.

    His ten principles represent sophisticated damage control, not learning enhancement.

    They minimize harm rather than maximize potential.

    Text-based instruction honors Mayer’s deeper insights while rejecting surface implications.

    It achieves the cognitive efficiency his principles attempt to restore to multimedia environments.

    References

    1. Berrocal, Y., Regan, J., Fisher, J., Darr, A., Hammersmith, L., Aiyer, M., 2021. Implementing Rubric-Based Peer Review for Video Microlecture Design in Health Professions Education. Med.Sci.Educ. 31, 1761–1765. https://doi.org/10.1007/s40670-021-01437-1
    2. Clark, R.C., Mayer, R.E. (Eds.), 2016. e‐Learning and the Science of Instruction: Proven Guidelines for Consumers and Designers of Multimedia Learning, 1st ed. Wiley. https://doi.org/10.1002/9781119239086
    3. Feenberg, A. The written world: On the theory and practice of computer conferencing. Mindweave: Communication, computers, and distance education 22–39 (1989).
    4. Mayer, R.E., 2008. Applying the science of learning: Evidence-based principles for the design of multimedia instruction. American Psychologist 63, 760–769. https://doi.org/10.1037/0003-066X.63.8.760
    5. Mayer, R.E., 2005. Cognitive Theory of Multimedia Learning, in: Mayer, R. (Ed.), The Cambridge Handbook of Multimedia Learning. Cambridge University Press, pp. 31–48. https://doi.org/10.1017/CBO9780511816819.004
    6. Mayer, R.E., Heiser, J., Lonn, S., 2001. Cognitive constraints on multimedia learning: When presenting more material results in less understanding. Journal of Educational Psychology 93, 187–198. https://doi.org/10.1037/0022-0663.93.1.187
    7. Mayer, R.E., Moreno, R., 2003. Nine Ways to Reduce Cognitive Load in Multimedia Learning. Educational Psychologist 38, 43–52. https://doi.org/10.1207/S15326985EP3801_6
    8. Mayer, R.E., Moreno, R., 2002. Animation as an Aid to Multimedia Learning. Educational Psychology Review 14, 87–99. https://doi.org/10.1023/A:1013184611077
    9. Plass, J.L., Chun, D.M., Mayer, R.E., Leutner, D., 2003. Cognitive load in reading a foreign language text with multimedia aids and the influence of verbal and spatial abilities. Computers in Human Behavior 19, 221–243. https://doi.org/10.1016/S0747-5632(02)00015-8
    10. Sweller, J., 2005. Implications of Cognitive Load Theory for Multimedia Learning, in: Mayer, R. (Ed.), The Cambridge Handbook of Multimedia Learning. Cambridge University Press, pp. 19–30. https://doi.org/10.1017/CBO9780511816819.003

    Image: The Geneva Learning Foundation Collection © 2025

  • From Murang’a to the world: remembering Joseph Ngugi, champion of peer learning for community health

    From Murang’a to the world: remembering Joseph Ngugi, champion of peer learning for community health

    “What keeps me going now is the excitement of the clients who receive the service and the sad faces of those clients who need the services and cannot get them.” Joseph Mbari Ngugi shared these words on May 30, 2023, capturing the profound empathy and dedication that defined his life’s work. This commitment to serving those most in need—and his deep awareness of those still unreached—characterized not only his career as a senior community health officer and public health specialist in Kenya’s Murang’a County, but also his extraordinary five-year journey through the Geneva Learning Foundation’s most rigorous learning programmes.

    It was the morning of the first day of August, 2025. The message from his daughter was simple and devastating: “Hello this is Wanjiru Mbari Ngugi’s Daughter. I am the one currently with his phone. This is to inform you that Dad passed away this morning.”

    Joseph’s passing represents more than the loss of a dedicated health worker in Kenya’s Murang’a County. It marks the end of an extraordinary journey that saw him evolve from participant to peer mentor within the Geneva Learning Foundation’s learning networks—a community where over 60,000 practitioners now connect across country borders and between continents to learn from and support each other to solve problems and drive change from the ground up.

    Joseph Ngugi: The making of a global health scholar

    Over the years, Joseph shared his personal story. His path to leadership in this global community began with family tragedy. “When I was young, my sister contracted malaria number of times, leading to numerous hospital visits and long periods of missed school,” he told us. “These experiences were not only distressing but also financially draining for my family, as medical costs piled up and my parents had to take time off work to care for her.” That childhood experience of watching illness devastate a family became the foundation for his professional mission. 

    In November 2020, when the world was grappling with the challenges of the COVID-19 pandemic, Joseph joined the Foundation’s COVID-19 Peer Hub—a groundbreaking initiative launched in April 2020 that connected over 6,000 health professionals from 86 countries to face the early consequences of the pandemic. Unlike traditional training programmes that positioned experts as sole knowledge sources, the Peer Hub recognized that frontline workers like Joseph possessed crucial insights about overcoming vaccine hesitancy that needed to be shared across borders.

    The timing was significant. When news of the first vaccines came, participants decided to examine how they had previously helped communities move “from hesitancy to acceptance of a vaccine.” Joseph’s case study, developed through peer collaboration between November and December 2020, drew on his extensive experience with routine immunization programs in Murang’a County. His documented approach to building trust with communities became a teaching resource for colleagues across Africa and beyond—knowledge that would prove invaluable when COVID-19 vaccines began arriving in Africa months later, starting with Ghana and Côte d’Ivoire in March 2021.

    Joseph Ngugi: The Scholar’s progression

    Joseph’s engagement with what would become the Movement for Immunization Agenda 2030 (IA2030) reflected his deepening sophistication as both learner and teacher. The Movement initiative, launched globally in support of the ambitious aims of the world’s immunization strategy to leave no one behind, required more than technical knowledge—it demanded practitioners who could analyze complex local challenges and adapt global strategies to diverse contexts.

    Starting with the WHO Scholar Level 1 certification in 2021, Joseph mastered the Foundation’s approach to structured problem-solving. But it was his progression to the 2022 Full Learning Cycle, where he earned certification with distinction, that revealed his true analytical capabilities. His systematic deconstruction of vaccine storage challenges in Murang’a County exemplified this growth.

    Rather than accepting equipment failures as inevitable, Joseph deployed rigorous root cause analysis: “Why are vaccines not stored properly? Because the refrigeration units are often outdated or malfunctioning.” But he didn’t stop there. Through five levels of inquiry, he traced the problem to its fundamental source: “The most important root cause: inadequate training and information dissemination among healthcare workers and administrators.”

    This insight—that knowledge gaps, not resource constraints, lay at the heart of vaccine storage failures—helped colleagues in other countries to address similar challenges in very different contexts.

    Joseph Ngugi: From local practice to global knowledge

    Joseph’s work exemplified how the Foundation’s network transforms individual insights into collective wisdom. His malaria prevention campaigns in Murang’a County carried particular personal significance—having witnessed his sister’s repeated malaria infections as a child, he understood intimately how the disease devastated families. Now, as a health professional, he could take systematic action to prevent other families from experiencing similar suffering.

    “Local leaders, health workers, and volunteers went door-to-door distributing nets and educating families about their importance,” he shared. “The project was successful due to the collaborative effort and the support of local influencers who championed the cause. This grassroots approach helped build trust and ensured widespread adoption of bed nets.” The boy who had watched helplessly as his sister endured “numerous hospital visits and long periods of missed school” had become the health worker who could mobilize entire communities for prevention.

    Meanwhile, his immunization work achieved impressive results by using lessons learned and shared across the network. His measurable success spoke to the power of peer-tested approaches: “My county was listed in 2nd position with 95% with the highest percentage of children (aged 12-23 months) who are fully vaccinated for basic antigens as per basic schedule compared with the leading at 96% and the lowest with 23%.”

    Through peer learning that he helped facilitate – giving and receiving feedback– both his malaria prevention methods and immunization strategies became available to thousands of colleagues facing similar challenges. When global immunization leaders engaged with TGLF’s network, asking for feedback on a new framework to support integration of immunization into primary health care, Joseph’s feedback illustrated this knowledge multiplication effect. “I have referred to [the] framework more than once and shared with my colleagues and supervisors and it has been very useful,” he reported. “My colleagues were excited to know such a tool existed and were ready to use it. The framework made a difference in solving the vaccine advocacy as it has the solutions to most of my challenges.”

    Joseph Ngugi: Crisis leadership in a changing climate

    When Kenya’s devastating 2019 floods tested every assumption about health service delivery, Joseph emerged as an innovative crisis leader whose documented responses became learning resources for the Foundation’s growing focus on climate change and health. His detailed accounts revealed both the scale of climate disruption and the ingenuity required to maintain health services under extreme conditions.

    Working with local government and humanitarian agencies, Joseph helped coordinate emergency airlifts using helicopters to deliver essential medical supplies to isolated communities, with the Kenya Red Cross playing a critical coordination role. When helicopter transport was unavailable, his team improvised: “We resorted to unconventional means, such as using motorbikes and porters to deliver medicines to stranded populations.”

    His documentation captured both community solidarity and the chaos of disaster response: “People were incredibly supportive, offering shelter and food to those displaced. Local youth groups helped clear debris from roads, making some areas passable. On the other hand, there were instances of looting of medical supplies during the chaos, which slowed down our efforts.”

    Joseph’s prescient observations about the health impact of climate patterns became increasingly relevant: “Over the years, I’ve noticed that such weather-related disruptions have become more frequent and severe, a clear sign of climate change. The rainy seasons are no longer predictable, and their intensity often overwhelms existing infrastructure.” His first-hand accounts became part of a growing body of evidence showing how health workers worldwide are witnessing climate change impacts firsthand—knowledge that often precedes formal scientific documentation by years.

    Joseph Ngugi, the equity advocate

    Perhaps nowhere was Joseph’s moral clarity more evident than in his systematic approach to health equity challenges. When he witnessed an elderly rural woman being ignored at a hospital registration desk while younger, well-dressed patients received immediate attention, he documented both his direct intervention and his proposed systemic solutions.

    “I later engaged hospital staff in a discussion about unconscious bias and the need to treat all patients with dignity,” he explained. His characteristically systematic solution—implementing a token system for patient queuing that would ensure first-come, first-served service regardless of appearance or language—provided concrete guidance that colleagues could adapt to their own contexts.

    Joseph’s approach to neglected tropical diseases demonstrated similar principled persistence. Working on lymphatic filariasis in Murang’a County, he documented comprehensive community intervention approaches that included support groups for affected patients and collaboration with traditional healers to address cultural misconceptions. “Building partnerships and fostering ownership within the community were crucial in sustaining our efforts and driving positive change,” he noted—an insight that resonated across the Foundation’s network of practitioners facing similar challenges with stigmatized conditions.

    A family committed to learning

    Joseph’s commitment to collaborative learning extended to his household. His wife Caroline participated alongside him in Foundation activities, making their home a center of both local health advocacy and global knowledge sharing. Caroline documented her own community engagement successes: “Positive response from the community on the importance of taking their children for immunization. Able to reach pregnant mothers and sensitized them the importance of starting antenatal care clinic early.”

    Their partnership embodied the Foundation’s philosophy that effective global health work requires both deep local engagement and broad network connections. Joseph’s honest assessment of community health work captured both its frustrations and profound rewards: “The worst part of my job is when you reach out to the community for services and [they] are not willing. The best part is when you reach the community members and they listen to you and hear what you have brought in the ground.”

    The pioneer’s final exploration

    Even in his final months, Joseph continued pushing boundaries in ways that reflected his lifelong commitment to innovation. His recent exploration of artificial intelligence tools as potential aids to health work represented not disengagement from human learning but rather his latest attempt to incorporate emerging capabilities into community health practice—a continuation of the innovative thinking that had characterized his entire journey with the Foundation.

    For The Geneva Learning Foundation’s Executive Director Reda Sadki, Joseph was “a pioneer exploring the use of artificial intelligence” within global health contexts, demonstrating how practitioners could thoughtfully experiment with new technologies while maintaining focus on community needs.

    A voice that bridged worlds

    From November 2020 through August 2025, Joseph Ngugi completed an extraordinary progression through the Foundation’s most demanding programmes: the COVID-19 Peer Hub, WHO Scholar Level 1 certification, the Movement for Immunization Agenda 2030’s first Full Learning Cycle with distinction, Impact Accelerator certifications, and advanced collaborative work with the Nigeria Movement for Immunization Agenda 2030, which connected over 4,000 participants across Nigeria’s diverse health system.

    His Nigeria collaborative work, completed in July 2024, demonstrated his evolution into a mentor for colleagues in countries other than his own, facing similar challenges. Through structured peer review processes and collaborative root cause analyses, Joseph helped dozens of Nigerian health workers develop their own systematic approaches to immunization challenges—knowledge that will continue influencing practice long after his passing.

    “What I have learned from sharing photos and seeing photos from colleagues: we share common challenges, challenges are everywhere, love for human being is universal, health is wealth, immunization is the best investment in the world,” he wrote, capturing the spirit of global solidarity that sustained his work and connected him to practitioners worldwide.

    A legacy of networked learning

    Joseph Mbari Ngugi’s death leaves a profound void in a global learning network where his thoughtful analyses, generous mentorship, and systematic documentation created lasting value for thousands of colleagues. His comprehensive body of work—from detailed root cause analyses to innovative crisis responses, from equity advocacy to climate adaptation strategies—represents one of the most complete records of how a dedicated practitioner can evolve into a sophisticated analyst and effective advocate through structured peer learning.

    His progression from childhood dreams inspired by witnessing healthcare compassion to becoming a leader in global health networks demonstrates the transformative potential of connecting local practice with worldwide learning communities. In an era of unprecedented health challenges—from climate change to emerging diseases to persistent inequities—Joseph’s documented approach offers a roadmap for practitioners worldwide seeking to make systematic change while remaining deeply rooted in their communities.

    Joseph Ngugi’s voice may now be silent, but his contributions continue speaking through the colleagues he mentored, the frameworks he helped refine, and the thousands of health workers who will encounter his insights through the Foundation’s ongoing work. His legacy reminds us that the most effective global health leadership often emerges not from traditional hierarchies but from practitioners who combine deep local knowledge with the courage to share their experiences across borders, creating networks of learning that can respond to our world’s most pressing challenges with both precision and compassion.

    Photo credit: Matiba Eye and Dental Hospital, Murang’a County Kenya. Joseph Mbari Ngugi submitted this photo for World Immunization Week in 2023. Here is what he told us about the image: “This is me, and Grace M Kihara, nursing officer, on the 15th of March 2023 at the Kenneth Matiba Eye and Dental Hospital in Murang’a County, Kenya. My work includes explaining to clients the importance of measles immunization and other vaccines, and advocating for immunization.”

    Fediverse Reactions
  • Climate change and health: a new peer learning programme by and for health workers from the most climate-vulnerable countries

    Climate change and health: a new peer learning programme by and for health workers from the most climate-vulnerable countries

    GENEVA, Switzerland, 23 July 2025 (The Geneva Learning Foundation) –Today, The Geneva Learning Foundation (TGLF) announces the launch of “Learning to lead change on the frontline of climate change and health,” the inaugural course in a new certificate programme designed by and for professionals facing climate change impacts on health.

    Enrollment is now open. The course will launch on 11 August 2025.

    Two years ago today, nearly 5,000 health professionals from across the developing world gathered online for an unprecedented conversation. They shared something most climate scientists had never heard: detailed, firsthand accounts of how rising temperatures, extreme weather, and environmental changes were already devastating the health of their communities.

    The stories were urgent and specific. A nurse in Ghana described managing surges of malaria after unprecedented flooding. A community health worker in Bangladesh explained how cholera outbreaks followed every major storm. A pharmacist in Nigeria watched children suffer malnutrition as crops failed during extended droughts.

    “I can hear the worry in your voices,” one global health partner told participants during those historic July 2023 events, “and I really respect the time that you are giving to tell us about what is happening to you directly.”

    Connecting the dots from individual impact to systemic crisis

    While climate change dominates headlines for its environmental and economic impacts, a parallel health crisis has been quietly unfolding in clinics and hospitals across Africa, Asia, and Latin America. Health workers have become first-hand witnesses to climate change’s human toll.

    Dr. Seydou Mohamed Ouedraogo from Burkina Faso described devastating floods that “really marked the memory of the inhabitants” and led to cascading health impacts.

    Felix Kole from Gambia reported that “wells have turned to salty water” due to rising sea levels, while extreme heat meant “people are no longer sleeping inside their houses,” creating new security and health complications.

    Rebecca Akello, a public health nurse from Uganda, documented malnutrition impacts directly: “During dry spells where there is no food, children come and their growth monitoring shows they really score low weight for age.”

    Health professionals like Dr. Iktiyar Kandaker from Bangladesh already get that this is a systemic challenge: “Our health system is not prepared to actually address these situations. So this is a combined challenge… but it requires a lot of time to fix it.”

    These health workers serve as what TGLF calls “trusted advisors”—over half describe themselves as being like “members of the family” to the populations they serve. Yet until now, they have had no structured way to learn from each other’s experiences or develop coordinated responses to climate health challenges.

    Learning from those who know because they are there every day

    “It is something that all of us have to join hands to be able to do the most we can to educate our communities on what they can do,” said Monica Agu, a community pharmacist from Nigeria who participated in the founding 2023 events. Her words captured the collaborative spirit that has driven the programme’s development.

    The new certificate programme employs TGLF’s proven peer learning methodology, recognizing that health workers are already implementing life-saving climate adaptations with limited resources. During the 2023 events, participants shared examples of modified immunization schedules during heat waves, cholera outbreak management after flooding, and maintaining health services during extreme weather events.

    “We believe that investing in health workers is one of the best ways to accelerate and strengthen the response to climate change impacts on health,” explains TGLF Executive Director Reda Sadki.

    The programme has been developed from comprehensive analysis of health worker experiences documented since 2023. Most observations come from small and medium-sized communities in the most climate-vulnerable countries.

    For health, a different kind of climate action

    Unlike traditional climate programmes focused on policy or infrastructure, this initiative recognizes that effective climate health responses must be developed by those experiencing the impacts firsthand. The course enables health workers to share their own experiences, learn from colleagues facing similar challenges, and develop both individual and collective responses.

    Dr. Eme Ngeda from the Democratic Republic of Congo captured this approach during the 2023 events: “We are all responsible for these climate disruptions. We must sensitize our populations in waste management and sensitize how to reform our healthcare providers to face resilience, face disasters.”

    The programme connects leaders from more than 4,000 locally-led health organizations through TGLF’s REACH network, enabling them to become programme partners supporting their health workers in developing climate-health leadership skills.

    Building global solutions by connecting local, indigenous knowledge and expertise

    The inaugural course offers health professionals worldwide the opportunity to learn from documented experiences of colleagues who are facing unprecedented consequences of climate change on health. Rather than lectures or theoretical frameworks, the programme employs structured reflection and peer feedback cycles, enabling participants to develop actionable implementation plans informed by peer knowledge and global guidance.

    The course covers four key areas based on health worker experiences:

    • Climate and environmental changes: Recognizing connections between climate and health in local communities.
    • Health impacts on communities: Understanding direct health impacts, food security, and mental health effects.
    • Changing disease patterns: Managing infectious diseases, respiratory conditions, and healthcare access challenges.
    • Community responses and adaptations: Implementing local solutions and innovations from peer experiences.

    Participants earn verified certificates aligned to professional development competency frameworks. Upon completion, they join TGLF’s global community of health practitioners for ongoing peer support and collaboration.

    The urgency of now

    The programme launches at a critical moment. Climate change impacts on health are accelerating, particularly in low- and middle-income countries where health systems are least equipped to respond. Yet these same regions are producing innovative, resource-efficient solutions that could benefit communities worldwide.

    As one health worker reflected during the 2023 events: “Although climate change is a global phenomenon, it is affecting very, very locally people in very different ways.” The new programme acknowledges this reality while creating pathways for local solutions to inform global responses.

    The course is available in English and French, designed to work on mobile devices and basic internet connections. It is free for health workers in participating countries.

    For health workers who have been managing climate impacts in isolation, the programme offers something unprecedented: the chance to learn from colleagues who truly understand their challenges and to contribute their own expertise to a growing global knowledge base.

    As the climate health crisis deepens, the solutions may well come from those who have been living with its impacts longest—if we finally give them the platforms and recognition they deserve.

    Image: The Geneva Learning Foundation Collection © 2025