SRI Executive, in partnership with the Baobab Institute, hosted the first webinar in a series exploring the topic of localisation and shifting power. Our host was Pape Gaye, founder of the Baobab Institute, which supports local organisations and works with all global actors to close the equity gap. He was joined in conversation by Prof. Peter Piot and Magda Robalo Correia Silva.
Pape Gaye, a visionary leader in the global health sphere, brought his expertise and knowledge of creating positive change and unparalleled insights to the discussion. Pape Gaye held a fireside chat with Prof. Peter Piot, Special Advisor to EC President von der Leyen on European and Global Health Security, Professor of Global Health at the London School of Hygiene & Tropical Medicine, of which he was the Director from 2010 to 2022. He was also the inaugural head of UNAIDS , and under-secretary-general of the United Nations,. He is also an advisor to the Bill & Melinda Gates Foundation. Their conversation was complemented by speaker Magda Robalo Correia Silva, President and Co-Founder of The Institute of Global Health and Development, Board member of the Global Fund, public health physician and infectious disease expert, whose career spans over 30 years in the global health ecosystem.
Whilst the topics covered during the webinar spanned from terminology and the use of the word localisation to capturing learnings from what has and has not worked in shifting power, there were a few themes that stood out:
- Grounding localisation in the local movement
- The use of AI and digitalisation
- Post COVID-19 Global Health Architecture
Grounding localisation in the local movement
During the fireside chat between Pape and Peter, the two Global Health experts spoke about where the localisation debate is being driven from. They comment that the formal localisation debate is being driven by international donors, the funding source for many. At the same time, there is a real movement in Africa to take control of development. Critically, though, for there to be long-term change, the conversation must happen on the ground, where the needs are.
The funding environment has changed tremendously; international funding for health peaked in COVID-19 but now competes with funding going elsewhere as there are more pressing needs for emergency funding. This has raised the issue of long-term impact; granted, vertical programs can make a considerable difference where there are emergencies. However, the issues many face today are long-term and chronic conditions that cannot be dealt with through a few short-term interventions. To sufficiently deal with these, the long-term support needs to consider the local community in the solutions.
Peter commented that the classical technical support provided by ex-pats through multilateral organisations is not necessary in the way that it used to be. Centres of excellence are vital throughout the African continent, providing the necessary technical knowledge and capability, changing the centre of gravity of research, development, and science. He added that there is an opportunity to grow and strengthen the regional bodies, such as the African CDC, to drive solutions and allow the decision-making to move closer to the problems they are trying to solve.
The use of AI and digitalisation
Peter raised three health trends that he expects to see globally, including on the African continent: climate change, a demographic shift (life expectancy increasing and ageing of the population, while fertility is declining), and digital transformation. The latter can create enormous opportunities. At the Grand Challenges event in Dakar in October he saw many examples of innovation being deployed by young people across the continent to apply artificial intelligence and digital transformation to make health more accessible. The lack of human resources in some parts could be alleviated by effectively excluding the middleman through artificial intelligence, and freeing up time for other, much needed tasks in health care and prevention.
Effective and equitable artificial intelligence will require a database to feed the algorithms; for this to succeed, solutions must be grounded in African data, even more so at a sub-regional level. It is insufficient to gather data from the Global North and expect it to apply to people in various African regions. There is an opportunity for international organisations to support digitalisation efforts, providing the technology used for global health to allow those in regions and countries to build platforms that serve their needs. 
Post COVID-19 Global Health Architecture
The localisation discourse has grown and is still growing since the COVID-19 pandemic. In the context of health and sovereignty, the global pandemic highlighted the vulnerability of countries in the Global South vis a vis the health access for their populations. For the first time at a political and continental level across Africa, leaders came together to ensure access to health interventions and manufacturing essential goods on the continent, not waiting for charity from the wealthier countries and global organisations. The further strengthening of Africa CDC and the role of the AU in health are prime examples.
Many tend to think of localisation in a unilateral sphere, where power shifts from one geography to another. Still, the shift of power, or perhaps more appropriately, greater circulation of power, must also include the shareholders who currently hold the power. During her talk, Magda Robalo raised the question of who currently controls the agenda of producing health goods; how will the free trade systems that have guided globalisation and the mantra of current architectures react to localisation? Additionally the context of gender must also be considered, Magda comments that gender inequality and access to power is still an issue that proves relevant in this discussion, there must also be a transfer of power within communities and countries, that create greater redistribution, beyond Global North to Global South.
Magda noted that for those sitting around the table discussing localisation, members will need to have the appropriate risk appetite and articulate future scenarios in a holistic way that can build courageous foresight. It is also high time that global health organisations include a far stronger proportion of representatives from low and middle income countries than is currently the case.
What next?
The first instalment in the Localisation Webinar series has left the teams at SRI Executive and Baobab Institute percolating with ideas and excited to host the next webinar to discuss the operationalisation of localisation in a meaningful way.
We look forward to launching the next instalment and hope you can join us. If you would like to continue the conversation on these or any other topics about localisation, please get in touch. To sign up to be the first to receive an invite to the next webinar sign up here.
SRI Executive continues to work with organisations to deploy various tools internally and externally (with INGO clients in particular) to support organisational reflections on localisation. Some examples of how we could support your organisation with a custom approach to shifting power include:
- Facilitating a “Stop and Think” workshop to create a dedicated space to define what localisation means for your organisation and steps you can take to shift the centre of gravity internally (within your organisation) and externally (with partners)
- Capability mapping & recruitment services
- Map current skills and their location in the organisation to assess where capacity and ownership sit today and where there may be gaps;
- Identify key internal talent and create clear and articulated career progression processes;
- Offer new approaches to hiring talent using unique additional “cultural nuance tools”. This supports the traditional technical and behavioural skills assessments by ensuring a fully holistic path of candidate selection;
- Review of organisational development, including strategy, people and processes
- Support an assessment or mapping of where ownership and decision-making happen today through an organisational diagnostic process;
- Review values and how they connect to or reflect localisation goals and aspirations
