Africa Cannot Afford To Pay For The Same Digital Learning Curve Twice

By Dr. Mary-Ann Etiebet, President and CEO, Vital Strategies, and Hon. Paul Hinga Tucker, Deputy Minister of Communication, Technology and Innovation, Sierra Leone 

Africa’s public health systems are being asked to do more at precisely the moment the financing available to them is becoming more constrained. Development assistance for health in Africa fell from a COVID-era peak of $25.8 billion in 2021 to around $13 billion in 2025. At the same time, governments are managing growing populations and changing disease burdens while investing in digital public services, connected health information, trusted digital identity, cybersecurity and data governance, and preparing public institutions for artificial intelligence. In this financing environment, African governments cannot afford to repeatedly pay for the same learning curve. 

That does not mean countries should build identical systems or import solutions from their neighbours. But in a period of constrained financing, we should be asking why governments confronting similar implementation challenges are still expected to spend scarce resources testing approaches, negotiating institutional barriers and learning many of the same lessons largely on their own. Africa is not starting this transition from scratch. Governments have spent years building health information systems, systems that count births and deaths, digital identity and digital public infrastructure. 

In  WHO’s African Region, the number of countries using a common digital platform to centralize routine health information increased from 32 in 2019 to 43 in 2023. Yet a 2024 WHO assessment covering 37 countries found overall health information system maturity across the region stood at 58%. The challenge is increasingly not whether digital systems exist, but whether they can work together and whether governments can turn the information they generate into decisions that improve people’s lives. 

Vital Strategies’ Foundations and  Futures analysis of AI readiness across 83 countries, including all 54 countries in Africa, found significant differences in how countries are building the foundations for AI-enabled public health. Some are moving faster on policy, others on digital public infrastructure, and others on integrating new tools into routine public systems. Rather than seeing these different starting points only as a challenge, they also create an opportunity – countries can learn from one another and move faster by building on experience that already exists. 

Sierra Leone, for example, has spent years investing in digital systems across government. The priority now is increasingly to make those investments work together through shared standards, trusted digital identity, stronger data governance and infrastructure that can be reused across government. As one of us has put it, “Our challenge is no longer simply how to digitize. It is how to make what we have digitized work together.” Rwanda shows how foundational systems can begin to connect people to public services: birth registration is linked to the assignment of a national identification number, which can then support access to digital government services. Tanzania is strengthening interoperability across health information systems so that data can move more effectively across the health system, while Liberia is working to integrate community-level digital health information with its national health information system rather than creating additional standalone systems. 

The technology matters, but these experiences also demonstrate that interoperability is not simply a technical exercise. It is also a mindset shift. It depends on institutions being able to work together, shared standards, trust, clear governance, and the type of collaboration that may require giving something up. It requires leadership that is focused and measures success in outcomes, not outputs. 

The problem is not a shortage of experience. It is that experience does not travel easily enough. Too often, reaching another African country requires flying through another continent. Our knowledge and innovation should not have to take the same route when we have so much to learn from one another. Valuable experience already exists across African governments, but knowledge does not move automatically. Strategic coordination is needed to help governments find peers working through comparable problems, connect the officials responsible for solving them, share what is working and what is not, exchange practical tools and resources, and support countries to adapt useful approaches to their own contexts. 

Knowing which institutions needed to work together, where implementation stalled, which standards proved useful, how systems were financed beyond their initial launch and what officials would do differently can save another government both money and implementation time. Peer learning becomes consequential when it changes a procurement decision, an architecture, a governance rule, a budget, or an implementation timeline. 

Development partners and funders should respond accordingly. In a constrained financing environment, the test should not simply be how many new digital solutions are funded, but how much existing knowledge and infrastructure are being put to work. More financing should help governments adapt approaches that have demonstrated value, strengthen reusable public infrastructure, and build institutional capability to sustain them, rather than repeatedly funding standalone solutions. Partners should also invest in the coordination that allows implementation knowledge to travel: making standards, tools and experience accessible, connecting government practitioners working through similar problems, and supporting adaptation to local contexts.  

Initiatives such as PILLARs are one effort to do this – helping countries exchange practical resources, such as interoperability standards or governance approaches, and the implementation lessons that can help another government avoid costly mistakes. The larger shift is to treat the movement of practical knowledge as seriously as the movement of technology. 

The question is no longer whether African countries have experience worth sharing. They do. The question is whether governments, funders and partners will organize differently so that one country’s hard-won lessons can become another country’s head start. In a tighter financing environment, we cannot keep paying to rediscover what is already known. Africa cannot afford to pay for the same digital learning curve twice.