Stories

Tag: climate change and health

  • 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: 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

  • A global health framework for Artificial Intelligence as co-worker to support networked learning and local action

    A global health framework for Artificial Intelligence as co-worker to support networked learning and local action

    The theme of International Education Day 2025, “AI and education: Preserving human agency in a world of automation,” invites critical examination of how artificial intelligence might enhance rather than replace human capabilities in learning and leadership. Global health education offers a compelling context for exploring this question, as mounting challenges from climate change to persistent inequities demand new approaches to building collective capability.

    The promise of connected communities

    Recent experiences like the Teach to Reach initiative demonstrate the potential of structured peer learning networks. The platform has connected over 60,000 health workers, primarily government workers from districts and facilities across 82 countries, including those serving in conflict zones, remote rural areas, and urban settlements. For example, their exchanges about climate change impacts on community health point the way toward more distributed forms of knowledge creation in global health. 

    Analysis of these networks suggests possibilities for integrating artificial intelligence not merely as tools but as active partners in learning and action. However, realizing this potential requires careful attention to how AI capabilities might enhance rather than disrupt the human connections that drive current success.

    Artificial Intelligence (AI) partnership could provide crucial support for tackling mounting challenges. More importantly, they could help pioneer new approaches to learning and action that genuinely serve community needs while advancing our understanding of how human and machine intelligence might work together in service of global health.

    Understanding Artificial Intelligence (AI) as partner, not tool

    The distinction between AI tools and AI partners merits careful examination. Early AI applications in global health primarily automate existing processes – analyzing data, delivering content, or providing recommendations. While valuable, this tool-based approach maintains clear separation between human and machine capabilities.

    AI partnership suggests a different relationship, where artificial intelligence participates actively in learning networks alongside human practitioners. This could mean AI systems that:

    • Engage in dialogue with health workers about local observations
    • Help validate emerging insights through pattern analysis
    • Support adaptation of solutions across contexts
    • Facilitate connections between practitioners facing similar challenges

    The key difference lies in moving from algorithmic recommendations to collaborative intelligence that combines human wisdom with machine capabilities.

    A framework for AI partnership in global health

    Analysis of current peer learning networks suggests several dimensions where AI partnership could enhance collective capabilities:

    • Knowledge creation: Current peer learning networks enable health workers to share observations and experiences across borders. AI partners could enrich this process by engaging in dialogue about patterns and connections, while preserving the central role of human judgment in validating insights.
    • Learning process: Teach to Reach demonstrates how structured peer learning accelerates knowledge sharing and adaptation. AI could participate in these networks by contributing additional perspectives, supporting rapid synthesis of experiences, and helping identify promising practices.
    • Local leadership: Health workers develop and implement solutions based on deep understanding of community needs. AI partnership could enhance decision-making by exploring options, modeling potential outcomes, and validating approaches while maintaining human agency.
    • Network formation: Digital platforms currently enable lateral connections between health workers across regions. AI could actively facilitate network development by identifying valuable connections and supporting knowledge flow across boundaries.
    • Implementation support: Peer review and structured feedback drive current learning-to-action cycles. AI partners could engage in ongoing dialogue about implementation challenges while preserving the essential role of human judgment in local contexts.
    • Evidence generation: Networks document experiences and outcomes through structured processes. AI collaboration could help develop and test hypotheses about effective practices while maintaining focus on locally-relevant evidence.

    Applications across three global health challenges

    This framework suggests new possibilities for addressing persistent challenges.

    1. Immunization systems

    Current global immunization goals face significant obstacles in reaching zero-dose children and strengthening routine services. AI partnership could enhance efforts by:

    • Supporting microplanning by mediating dialogue about local barriers
    • Facilitating rapid learning about successful engagement strategies
    • Enabling coordinated action across health system levels
    • Modeling potential impacts of different intervention approaches

    2. Neglected Tropical Diseases (NTDs)

    The fight against NTDs suffers from critical information gaps and weak coordination at local levels. Many communities, including health workers, lack basic knowledge about these diseases. AI partnership could help address these gaps through:

    • Facilitating knowledge flow between affected communities
    • Supporting coordination of control efforts
    • Enabling rapid validation of successful approaches
    • Strengthening surveillance and response networks

    3. Climate change and health

    Health workers’ observations of climate impacts on community health provide crucial early warning of emerging threats. AI partnership could enhance response capability by:

    • Engaging in dialogue about changing disease patterns
    • Supporting rapid sharing of adaptation strategies
    • Facilitating coordinated action across regions
    • Modeling potential impacts of interventions

    Pandemic preparedness beyond early warning

    The experience of digital health networks during recent disease outbreaks reveals both the power of distributed response capabilities and the potential for enhancement through AI partnership. When COVID-19 emerged, networks of health workers demonstrated remarkable ability to rapidly share insights and adapt practices. For example, the Geneva Learning Foundation’s COVID-19 Peer Hub connected over 6,000 frontline health professionals who collectively generated and implemented recovery strategies at rates seven times faster than isolated efforts.

    This networked response capability suggests new possibilities for pandemic preparedness that combines human and machine intelligence. Heightened preparedness could emerge from the interaction between health workers, communities, and AI partners engaged in continuous learning and adaptation.

    Current pandemic preparedness emphasizes early detection through formal surveillance. However, health workers in local communities often observe concerning patterns before these register in official systems.

    AI partnership could enhance this distributed sensing capability while maintaining its grounding in local realities. Rather than simply analyzing reports, AI systems could engage in ongoing dialogue with health workers about their observations, helping to:

    • Explore possible patterns and connections
    • Test hypotheses about emerging threats
    • Model potential trajectories
    • Identify similar experiences across regions

    The key lies in combining human judgment about local significance with AI capabilities for pattern recognition across larger scales.

    The focus remains on accelerating locally-led learning rather than imposing standardized solutions.

    Perhaps most importantly, AI partnership could enhance the collective intelligence that emerges when practitioners work together to implement solutions. Current networks enable health workers to share implementation experiences and adapt strategies to local contexts. Adding AI capabilities could support this through:

    • Ongoing dialogue about implementation challenges
    • Analysis of patterns in successful adaptation
    • Support for rapid testing of modifications
    • Facilitation of cross-context learning

    Success requires maintaining human agency in implementation while leveraging machine capabilities to strengthen collective problem-solving.

    This networked vision of pandemic preparedness, enhanced through AI partnership, represents a fundamental shift from current approaches. Rather than attempting to predict and control outbreaks through centralized systems, it suggests building distributed capabilities for continuous learning and adaptation. The experience of existing health worker networks provides a foundation for this transformation, while artificial intelligence offers new possibilities for strengthening collective response capabilities.

    Investment for innovation

    Realizing this vision requires strategic investment in:

    • Network development: Supporting growth of peer learning platforms that accelerate local action while maintaining focus on human connection.
    • AI partnership innovation: Developing systems designed to participate in learning networks while preserving human agency.
    • Implementation research: Studying how AI partnership affects collective capabilities and health outcomes.
    • Capacity strengthening: Building health worker capabilities to effectively collaborate with AI while maintaining critical judgment.

    Looking forward

    The transformation of global health learning requires moving beyond both conventional practices of technical assistance and simple automation. Experience with peer learning networks demonstrates what becomes possible when health workers connect to share knowledge and drive change.

    Adding artificial intelligence as partners in these networks – rather than replacements for human connection – could enhance collective capabilities to protect community health. However, success requires careful attention to maintaining human agency while leveraging technology to strengthen rather than supplant local leadership.

    7 key principles for AI partnership

    1. Maintain human agency in decision-making
    2. Support rather than replace local leadership
    3. Enhance collective intelligence
    4. Enable rapid learning and adaptation
    5. Preserve context sensitivity
    6. Facilitate knowledge flow across boundaries
    7. Build sustainable learning systems

    Listen to an AI-generated podcast about this article

    🤖 This podcast was generated by AI, discussing Reda Sadki’s 24 January 2025 article “A global health framework for Artificial Intelligence as co-worker to support networked learning and local action”. While the conversation is AI-generated, the framework and examples discussed are based on the published article.

    Framework: AI partnership for learning and local action in global health

    DimensionCurrent StateAI as ToolsAI as PartnersPotential Impact
    Knowledge creationHealth workers share observations and experiences through peer networksAI analyzes patterns in shared dataAI engages in dialogue with health workers, asking questions, suggesting connections, validating insightsNew forms of collective intelligence combining human and machine capabilities
    Learning processStructured peer learning through digital platforms and networksAI delivers content and analyzes performanceAI participates in peer learning networks, contributes insights, supports adaptationAccelerated learning through human-AI collaboration
    Local leadershipHealth workers develop and implement solutions for community challengesAI provides recommendations based on data analysisAI works alongside local leaders to explore options, model scenarios, validate approachesEnhanced decision-making combining local wisdom with AI capabilities
    Network formationLateral connections between health workers across regionsAI matches similar profiles or challengesAI actively facilitates network development, identifies valuable connectionsMore effective knowledge networks leveraging both human and machine intelligence
    Implementation supportPeer review and structured feedback on action plansAI checks plans against best practicesAI engages in iterative dialogue about implementation challenges and solutionsImproved implementation through combined human-AI problem-solving
    Evidence generationDocumentation of experiences and outcomes through structured processesAI analyzes implementation dataAI collaborates with health workers to develop and test hypotheses about what worksNew approaches to generating practice-based evidence

    Image: The Geneva Learning Foundation Collection © 2024

  • Why guidelines fail: on consequences of the false dichotomy between global and local knowledge in health systems

    Why guidelines fail: on consequences of the false dichotomy between global and local knowledge in health systems

    Global health continues to grapple with a persistent tension between standardized, evidence-based interventions developed by international experts and the contextual, experiential local knowledge held by local health workers. This dichotomy – between global expertise and local knowledge – has become increasingly problematic as health systems face unprecedented complexity in addressing challenges from climate change to emerging diseases.

    The limitations of current approaches

    The dominant approach privileges global technical expertise, viewing local knowledge primarily through the lens of “implementation barriers” to be overcome. This framework assumes that if only local practitioners would correctly apply global guidance, health outcomes would improve.

    This assumption falls short in several critical ways:

    1. It fails to recognize that local health workers often possess sophisticated understanding of how interventions need to be adapted to work in their contexts.
    2. It overlooks the way that local knowledge, built through direct experience with communities, often anticipates problems that global guidance has yet to address.
    3. It perpetuates power dynamics that systematically devalue knowledge generated outside academic and global health institutions.

    The hidden costs of privileging global expertise

    When we examine actual practice, we find that privileging global over local knowledge can actively harm health system performance:

    • It creates a “capability trap” where local health workers become dependent on external expertise rather than developing their own problem-solving capabilities.
    • It leads to the implementation of standardized solutions that may not address the real needs of communities.
    • It demoralizes community-based staff who see their expertise and experience consistently undervalued.
    • It slows the spread of innovative local solutions that could benefit other contexts.

    Evidence from practice

    Recent experiences from the COVID-19 pandemic provide compelling evidence for the importance of local knowledge. While global guidance struggled to keep pace with evolving challenges, local health workers had to figure out how to keep health services going:

    • Community health workers in rural areas adapted strategies.
    • District health teams created new approaches to maintain essential services during lockdowns.
    • Facility staff developed creative solutions to manage PPE shortages.

    These innovations emerged not from global technical assistance, but from local practitioners applying their deep understanding of community needs and system constraints, and by exploring new ways to connect with each other and contribute to global knowledge.

    Towards a new synthesis

    Rather than choosing between global and local knowledge, we need a new synthesis that recognizes their complementary strengths. This requires three fundamental shifts:

    1. Reframing local knowledge

    • Moving from viewing local knowledge as merely contextual to seeing it as a source of innovation.
    • Recognizing frontline health workers as knowledge creators, not just knowledge recipients.
    • Valuing experiential learning alongside formal evidence.

    2. Rethinking technical assistance

    • Shifting from knowledge transfer to knowledge co-creation.
    • Building platforms for peer learning and exchange.
    • Supporting local problem-solving capabilities.

    3. Restructuring power relations

    • Creating mechanisms for local knowledge to inform global guidance.
    • Developing new metrics that value local innovation.
    • Investing in local knowledge documentation and sharing.

    Practical implications

    This new synthesis has important practical implications for how we approach health system strengthening:

    Investment priorities

    • Funding mechanisms need to support local knowledge creation and sharing
    • Technical assistance should focus on building local problem-solving capabilities
    • Technology investments should enable peer learning and knowledge exchange

    Capacity building

    Knowledge management (KM)

    New paths forward

    Moving beyond the false dichotomy between global and local knowledge opens new possibilities for strengthening health systems. By recognizing and valuing both forms of knowledge, we can create more effective, resilient, and equitable health systems.

    The challenges facing health systems are too complex for any single source of knowledge to address alone. Only by bringing together global expertise and local knowledge can we develop the solutions needed to improve health outcomes for all.

    References

    Braithwaite, J., Churruca, K., Long, J.C., Ellis, L.A., Herkes, J., 2018. When complexity science meets implementation science: a theoretical and empirical analysis of systems change. BMC Med 16, 63. https://doi.org/10.1186/s12916-018-1057-z

    Farsalinos, K., Poulas, K., Kouretas, D., Vantarakis, A., Leotsinidis, M., Kouvelas, D., Docea, A.O., Kostoff, R., Gerotziafas, G.T., Antoniou, M.N., Polosa, R., Barbouni, A., Yiakoumaki, V., Giannouchos, T.V., Bagos, P.G., Lazopoulos, G., Izotov, B.N., Tutelyan, V.A., Aschner, M., Hartung, T., Wallace, H.M., Carvalho, F., Domingo, J.L., Tsatsakis, A., 2021. Improved strategies to counter the COVID-19 pandemic: Lockdowns vs. primary and community healthcare. Toxicology Reports 8, 1–9. https://doi.org/10.1016/j.toxrep.2020.12.001

    Jerneck, A., Olsson, L., 2011. Breaking out of sustainability impasses: How to apply frame analysis, reframing and transition theory to global health challenges. Environmental Innovation and Societal Transitions 1, 255–271. https://doi.org/10.1016/j.eist.2011.10.005

    Salve, S., Raven, J., Das, P., Srinivasan, S., Khaled, A., Hayee, M., Olisenekwu, G., Gooding, K., 2023. Community health workers and Covid-19: Cross-country evidence on their roles, experiences, challenges and adaptive strategies. PLOS Glob Public Health 3, e0001447. https://doi.org/10.1371/journal.pgph.0001447

    Yamey, G., 2012. What are the barriers to scaling up health interventions in low and middle income countries? A qualitative study of academic leaders in implementation science. Global Health 8, 11. https://doi.org/10.1186/1744-8603-8-11

  • International Nurses Day: Climate change and health

    International Nurses Day: Climate change and health

    English version | Version française

    On International Nurses Day, The Geneva Learning Foundation stands in solidarity with the over 28 million nurses worldwide who form the backbone of health systems globally.

    As an organization dedicated to researching, developing, and implementing new approaches to learning and leadership for health, we recognize the vital role of nurses in driving progress towards global health goals, including the health-related Sustainable Development Goals and Universal Health Coverage.

    Nurses represent a significant proportion of participants in our Teach to Reach peer learning programme, which exemplifies commitment to lifelong learning and desire to connect with and learn from colleagues around the world to improve practice.

    Teach to Reach is the world’s largest health peer learning event, bringing together tens of thousands of health professionals, primarily from low- and middle-income countries, in dynamic digital convenings. Request your invitation

    It exemplifies our vision of empowering health workers as agents of change through digitally-enabled collaborative learning and knowledge sharing.

    For its tenth edition on 20-21 June 2024, Teach to Reach focused on the critical issue of climate change and health.

    Nurses are already finding themselves on the frontlines in supporting communities to navigate the increasing health risks posed by a changing climate.

    As trusted members of the communities they serve, nurses are uniquely positioned to strengthen resilience and lead adaptations to protect health.

    Through platforms like Teach to Reach, The Geneva Learning Foundation aims to elevate nurses’ voices and insights, facilitating the rapid exchange of locally-tailored solutions to shared challenges.

    We call on global health leaders to recognize the expertise that nurses hold as a result of their proximity to communities, and to systematically include nurses in policy dialogues and decision-making on the health impacts of climate change.

    On this International Nurses Day, we reaffirm our commitment to leveraging the power of digital networks and innovative learning approaches to support nurses in their vital work to protect and promote health.

    Through strong partnerships and by empowering nurses as leaders, we believe it is possible to build resilient, equitable and sustainable health systems in a changing climate.

  • Visual storytelling for health

    Visual storytelling for health

    Do you work for health? Your are invited to a visual storytelling workshop with health care workers from 44 countries. The Geneva Learning Foundation’s first Fellow of Photography, Chris de Bode, will lead this workshop.

    544 health care workers from 44 countries have already confirmed their participation. 80% of participants are sub-national staff working in fragile contexts. Most work for their country’s ministry of health.

    Chris deBode spent decades on assignments, traveling around the globe for various NGOs, magazines, and newspapers.

    Now, he has partnered with the Geneva Learning Foundation (TGLF) to share his experience with health practitioners who are there every day, as they learn to tell their own visual stories about immunization, the impacts of climate change on health, and other issues that matter for the communities they serve.

    “Technical knowledge is not decisive in making your picture”, says Chris. “The person behind the camera makes the difference. You are the source of your image.”

    The workshop is reserved for health professionals who contributed photos to the 2022 and 2023 Immunization Agenda 2030 (IA2030) Movement’s International Photo Exhibitions for World Immunization Week. However, it will also be livestreamed for everyone who has not previously been able to participate.

    In 2022 and 2023, over 2,000 photos were shared by immunization staff from all over the world.

    On 18 March 2024, health professionals from the following countries will be participating: Afghanistan, Angola, Bangladesh, Belgium, Benin, Burkina Faso, Burundi, Cameroon, Canada, Central African Republic, Chad, Comoros, Congo, Costa Rica, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, France, Gabon, Gambia, Germany, Ghana, Guinea, Guinea-Bissau, Haiti, India, Indonesia, Kenya, Lebanon, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Morocco, Niger, Nigeria, Pakistan, Saudi Arabia, Senegal, Sierra Leone, Somalia, South Africa, South Sudan, Sri Lanka, Sudan, Tanzania, Togo, Tunisia, Turkey, Uganda, United States, Zambia, Zimbabwe.

    Photo by Chris deBode: Eleven-year-old Wilberforce runs along an unpaved road near his home in Gulu, Northen Uganda where he lives with his parents and 6 siblings. He says: “I want to be the fastest. I want my parents, my school and country to be proud of me. Every day I run. I dream of coming home with the biggest trophy.”

    Watch the inauguration of the First International Photography Exhibition for Immunization Agenda 2030

    Watch the Special Event: World Immunization Week 2023

    Watch the Special Event: World Immunization Week 2022

  • Become a Teach to Reach 10 Partner: Help amplify frontline voices at the world’s largest health peer learning event

    Become a Teach to Reach 10 Partner: Help amplify frontline voices at the world’s largest health peer learning event

    The Geneva Learning Foundation is pleased to announce the tenth edition of Teach to Reach, to be held 20-21 June 2024.

    Teach to Reach is a massive, open peer learning event where health professionals network, and learn with colleagues from all over the world. Request your invitation…

    Teach to Reach 10 continues a tradition of groundbreaking peer learning started in 2020, when over 3,000 health workers from 80 countries came together to improve immunization training.

    17,662 health professionals – over 80% from districts and facilities, half working for government – participated in Teach to Reach 9 in October 2023. Participants shared 940 experiences ahead of the event. See what we learned at Teach to Reach 9 or view Insights Live with Dr Orin Levine.

    Teach to Reach is a platform, community, and network to amplify voices from lower-resource settings bearing the greatest burden of disease.

    Teach to Reach 10 will focus on the impacts of climate change on health, following the publication of a ground-breaking report sharing insights of over 1,200 health workers.

    In the video below, learn from the experiences of 4,700 participants in our Special Event: From community to planet: Health professionals on the frontlines of climate change.

    Poor connectivity? You will find the videos on this page in the low-bandwidth, audio-only Teach to Reach podcast on Apple, Spotify, Google, or Amazon Podcasts.

    Alongside this theme, other critical health challenges selected by participants for this tenth edition include the Movement for Immunization Agenda 2030 (IA2030), neglected tropical diseases (NTDs), and neglected needs of women’s health.

    In this video of a Teach to Reach session, learn about local action led by community-based health workers to tackle Female Genital Schistosomiasis (FGS), a neglected tropical disease that affects an estimated 56 million women and girls.

    In the run-up to Teach to Reach 10, participants will share their real-world experience. Every success, lessons learned, and challenge will be shared back with the community and brought to the attention of partners.

    The Manifesto for investment in health workers, a visionary statement elaborated by over 1,300 health workers, will be launched at Teach to Reach 10.

    A diverse range of over 50 global organizations have partnered with Teach to Reach since 2020, including Gavi the Vaccine Alliance, the Wellcome Trust, and UNICEF.

    The next video is a session with UNICEF on reaching zero-dose children in urban settings.

    Alongside global partners and ministries of health, local community-based organizations will also be invited to become Teach to Reach partners.

    Partners are invited to join the first Partner Briefing on Monday 4 March 2024, bringing together global health organizations with a commitment to listening and learning from health workers and the communities they serve.

    Illustration: The Geneva Learning Foundation © 2024