Last week, I wrote about the need to move from more aid to more strategic systems. This week, the conversation is inevitably turning to a new frontier reshaping every sector, Artificial Intelligence (AI), and, more importantly, to the questions of trust and equality sitting quietly beneath the hype.
At the recent AI for Development (AI4D) conference in Barcelona, something powerful happened. For once, the story wasn't about shiny algorithms or billion-parameter models. It was about people and a reminder that technology, no matter how advanced, still depends on the objectivity of the systems and data that shape it.
As Emmanuel Lubanzadio, Africa Lead at OpenAI, said, “To get AI right, it must be a right.” That statement stands. Because in many parts of the world, including Africa, technology access, literacy and trust still depend on who is invited to the table.
who shapes the future
When global organizations talk about AI, there is often an assumption that innovation comes from the top. Yet, as the World Food Program's AI leadership noted, 95 percent of organizations are failing to effectively scale AI. Why? Because data, design, and deployment rarely start with the end user in mind.
In health systems, this failure is particularly costly. Algorithms trained on non-representative data may misdiagnose African patients or exclude important environmental variables that drive health outcomes in our context. The result is not just inefficiency; This is inequality coded on the scale.
As someone who leads partnerships across Africa's health ecosystem, I see this tension every day. The technology exists. The real challenge is translation, taking innovation from the lab to life in ways that reflect local realities, languages, and lived experiences.
lack of trust
AI4D discussions echoed a truth that developers often overlook: trust, not technology, is the real infrastructure difference. It is trust between governments and innovators, between communities and the data systems that serve them, and between donors and the people implementing solutions on the ground. Without it, even the most advanced tools will fail to deliver meaningful or lasting change.
Without that trust, even the best-funded pilots are stuck at “proof of concept.”
This is why I believe Africa's next big advantage will not come from importing AI models; This trust will come from building architectures, governance frameworks, data standards and ethical norms that let technology serve people, not replace them.
AI is as fair as its creators
Lindsey Moore of DevelopMetrics made a sharp observation: “If male-dominated AI is providing the answers, we will lose incredible diversity of perspective.” This applies far beyond gender. It's about who imagines the solution.
We often celebrate innovation hubs and hackathons, but real innovation happens when a rural nurse in Kano or a field officer in Garissa uses technology to solve an old problem in a new way. If AI doesn't learn from them, it will continue to miss out on success.
That's why initiatives like Take to the Rescue, which runs AI literacy bootcamps before NGOs adopt new tools, matter. They remind us that inclusion is not a checkbox; It is a process.
From smart tools to smart systems
At eHealth Africa, we have learned that embedding AI or digital tools into real government systems requires not just funding, but also humility. We are currently exploring an AI-enabled voice-to-text triage system that works in Hausa and English, not because it sounds futuristic, but because it helps real people access care faster.
When I sat in on sessions this month on digital health architecture and primary health systems, a pattern emerged: Africa doesn't need more pilots; It needs interoperable platforms that talk to each other. This principle applies equally to AI.
To move from promise to progress, AI in development must be integrated into existing workflows, national data systems, public-private partnerships and local capacity, rather than working in silos.
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Leadership in the Age of Systems
As we move into the final quarter of 2025, I am confident that the most transformational global leaders will not be those who simply use technology, but those who can command its purpose.
The next level of leadership for me and many African professionals is now rising to what I call Global Systems Leadership, that is, the ability to link technology, trust and change across sectors and borders.
Global system leaders do not chase trends; They create coherence. They understand that a health system is not just hospitals and data, but also the politics of financing, the culture of delivery, and the power of partnerships. They believe that digital does not replace human systems; It makes them stronger when designed with empathy.
reclaiming the story
There is a growing danger that Africa will again become a passive consumer of technology, a place where innovation is “tested”, not owned. But the continent has already proven it can take the lead in everything from mobile money to drone logistics. The next frontier is ethical AI and locally relevant digital governance.
To achieve this, three important changes are required. First, Africa must move away from importing tools and toward defining its own standards, data ethics, interoperability rules, and shaping AI governance frameworks that reflect local realities. Second, from pilots to platforms, as scale occurs only when we move beyond donor-funded trials to country-led systems, partners like us help bridge that transition. And finally, from enthusiasm to evidence, every AI initiative must answer this simple question: Does it make systems stronger and people's lives better?
a concluding reflection
At its best, technology reminds us of what connects us: our shared desire for dignity, efficiency, and trust. But at worst, it may reflect the inequities we have failed to fix.
If the future of global development depends on AI, Africa's contribution must be more than data points; It must be leadership, insight and ownership.
The world doesn't just need smart systems. It needs impartial people. And making them happen will take what technology alone can't provide: human intelligence, integrity, and the courage to slow down enough to get it right.
Ota Akhigbe is the Director of Partnerships and Programs at eHealth Africa and a global systems leader shaping the intersection of health, technology and partnerships across Africa. She writes weekly on leadership, innovation and systems change for BusinessDay.
