Retrouver les enfants congolais non-vaccinés: des acteurs de tout le pays lancent le premier Accélérateur zéro-dose pour renforcer la mise en oeuvre et le suivi

Reda SadkiGlobal health

«Si je réussis mon projet de terrain, je m’attends à avoir au moins vacciné 345 enfants».

Cet engagement n’a pas été pris par un ministre dans la capitale, mais par Jérémie Mpata Lumpungu, infirmier titulaire dans la province du Kasaï.

Il n’était pas seul.

Lundi 10 novembre 2025, un appel a résonné à travers la République démocratique du Congo.

Depuis Kinshasa, le Dr Josaphat-Francois WETSHIKOY, épidémiologiste, a détaillé son objectif pour les 21 prochains jours: «récupérer 30 % des enfants» non vaccinés dans sa zone cible de 230 000.

Barthélemy Daké Saoromou, préparant une stratégie mobile, vise «plus de 500 enfants zéro dose».

Cette détermination palpable, venue de praticiens de tout le pays, a marqué le lancement de l’«Accélérateur d’impact zéro-dose».

Il ne s’agit pas d’une formation ou d’un atelier de plus.

C’est une nouvelle phase d’action, un «système de soutien» pour la mise en oeuvre et le suivi, conçu par la Fondation Apprendre Genève (TGLF), en partenariat avec l’UNICEF, avec le soutien de Gavi, et sous l’égide du Programme Élargi de Vaccination (PEV) de la RDC. En savoir plus…

Vous souhaitez rejoindre la prochaine séance de l’Accélérateur? Suivez ce lien.

C’est, pour ses participants, un «baptême du feu».

Du constat à l’action

Ce nouvel élan pour la vaccination n’est pas né de rien.

Il s’appuie sur les leçons d’un vaste exercice d’apprentissage par les pairs qui a mobilisé plus de 1 600 praticiens congolais pour développer 385 projets de terrain.

Les résultats de cette analyse, présentés au lancement, ont été sans concession.

La découverte la plus importante: le problème des enfants zéro dose en RDC est avant tout «un problème de gestion et de relation».

Les praticiens ont affinée l’explication officielle inscrite dans le plan Mashako, selon laquelle le principal obstacle est que «la mère est trop occupée».

Pour eux, la «véritable cause, la cause racine, c’est un échec du système de santé», c’est-à-dire un système qui «ne réussit pas à adapter ses services […] à la vie réelle et au travail des parents».

Leurs analyses ont aussi pointé un problème de gestion des Relais Communautaires (RECO), qui se sentent «ignorés ou exclus de la planification», et une méfiance qui naît «en réaction à des échecs précis du système de santé», comme la mauvaise gestion des effets secondaires des vaccins.

Une cohorte du niveau national à l’aire de santé

Les voix qui portent ces engagements ne sont pas anonymes.

La force de l’Accélérateur réside dans la diversité de sa cohorte.

Les participants sont des médecins (comme le Dr Derrick Ngoyi MALOBO au Centre de santé de Kenge), des infirmiers et infirmières (comme Marlène KAPINGA MULUMBA au niveau national ou Jérémie Mpata Lumpungu au niveau local), des agents de santé publique (comme Bonnet Leteta en province) et, surtout, un grand nombre d’agents de santé communautaire (comme Martine YOWA NDAYE ou David BINWA dans leurs Aires de santé).

Ils représentent tous les échelons du système: du niveau National à Kinshasa jusqu’au Centre de santé le plus reculé, en passant par la Province et la Zone de santé.

Ils proviennent du Gouvernement (la majorité des participants), mais aussi de la Société civile (ONG) et du Secteur privé.

C’est cette alliance de praticiens, du sommet à la base, qui est maintenant mise en action.

L’action avant vendredi

Le mécanisme de l’Accélérateur est conçu pour être radicalement concret, transformant les constats de terrain en action immédiate.

D’abord, chaque participant doit fixer un «objectif à 30 jours».

Il doit répondre à cinq questions: quelle communauté aider; combien d’enfants zéro dose s’y trouvent; quelles acteurs impliquer; quel est l’obstacle principal; et quel résultat mesurable atteindre en un mois.

Ensuite, et c’est le cœur du réacteur, chaque lundi, le participant doit définir une «action spécifique et réalisable» qu’il s’engage à accomplir avant le vendredi de la même semaine.

Lors du lancement, les engagements pour la semaine à venir étaient tangibles.

Pour Noëlly Zola Watusadisi, médecin dans la zone de santé de Bombay qui gère 12 îlots fluviaux, son action pour la semaine n’est pas de tout faire, mais de commencer: «entrer en contact avec les infirmiers de chaque îlot» et appeler les chefs de quartier pour préparer la sensibilisation.

David Binwa, du Nord-Kivu, a un plan similaire.

Son action d’ici vendredi: tenir une activité avec les RECO d’ici jeudi afin d’«identifier les vrais problèmes» avant de lancer une sensibilisation de masse.

Le rendez-vous: la redevabilité entre pairs

L’efficacité de l’Accélérateur repose sur un dernier pilier: la redevabilité (accountability) entre pairs.

Ce vendredi, chaque participant devra répondre à un formulaire de suivi de trois questions.

La première: «Avez-vous vacciné des enfants à zéro dose cette semaine?»

La seconde: «Dans quelle mesure avez-vous progressé dans la réalisation de votre action de la semaine?».

Mais le véritable test aura lieu lundi prochain, lors de la prochaine assemblée de la cohorte.

«Lundi prochain à l’Assemblée, déjà, vos collègues vont rechercher, est-ce qu’il est là, celui qui avait déclaré qu’il allait faire telle ou telle chose la semaine dernière», a prévenu Charlotte Mbuh, qui accompagne le groupe. «Et si vous n’êtes pas là, ils vont en faire le constat, mais si vous êtes là, ils vont vous demander est-ce que vous l’avez fait?».

Cette pression n’est pas conçue comme une punition.

L’objectif est de «nourrir l’entraide, de nourrir la solidarité».

Pour soutenir ce «Mouvement congolais pour la vaccination à l’horizon 2030», 167 ambassadeurs de la Fondation ont été intronisés lors de la cérémonie.

Ce sont eux, des praticiens de terrain, qui aideront à animer cette entraide.

L’Accélérateur est lancé.

Les premiers engagements sont pris.

Le compte à rebours avant lundi prochain a commencé.

Image: Collection de la Fondation Apprendre Genève © 2025. L’image «Échos du soin» fait émerger deux visages comme des souvenirs partagés, fragiles mais tenaces. Les formes simples et les couleurs mêlées disent la tendresse, la fatigue, et la force discrète du geste de soin, qui marque durablement celles et ceux qui donnent comme celles et ceux qui reçoivent.

Scalable model for documenting child MHPSS outcomes in a crisis

Beyond outputs, a scalable model for documenting child MHPSS outcomes in a crisis: remarks by Reda Sadki at the 18th European Public Health Conference

Reda SadkiGlobal health

On November 12, 2025, the 18th European Public Health Conference hosted a symposium organized by the International Federation of Red Cross and Red Crescent Societies (IFRC). The session, “The heart of resilience: lessons from mental health support for children and young people affected by conflict in Ukraine,” explored the large-scale mental health and psychosocial support (MHPSS) initiative developed by the IFRC with support from the European Commission.

The panel was moderated by Dr Aneta Trgachevska, who coordinated this initiative at the IFRC Regional Office for Europe. She was joined by four panelists: Emelie Rohdén and Ivan Kryvenko from the Swedish Red Cross Youth, Martina Dugonjić, a primary school teacher from Croatia, and Reda Sadki, Executive Director of The Geneva Learning Foundation (TGLF).

As part of the IFRC-led initiative, TGLF developed the first Certificate peer learning programme on Psychological First Aid (PFA) in support of children affected by the humanitarian crisis in Ukraine. In his remarks, Mr. Sadki explains how this model’s success has led to its transformation from a time-limited project into a self-sustaining digital network proven to improve children’s health and well-being outcomes. Following the completion of the EU4Health project, the Geneva Learning Foundation has committed to supporting this community-driven system for five additional years, until 2030.

The following remarks from Reda Sadki have been edited for clarity and coherence from the panel transcript and expanded with examples from the project’s insights reports.

Aneta Trgachevska: Reda, we heard that enabling environments and peer-to-peer support and learning are very important. The Geneva Learning Foundation has developed a huge and diverse set of tools within the project to support professionals working with children displaced from Ukraine. Can you tell me from your perspective, working with these professionals, what you have noticed? What are the challenges and needs, and how have they managed with this environment and situation?

Reda Sadki: Thank you, Aneta. At The Geneva Learning Foundation, we research, develop, and implement large-scale peer learning systems that really drive change, all the way to health outcomes that can be attributed to the activities involved.

We took on this challenge with IFRC of reaching outside the Red Cross networks to support people who work in education, social work, and health. These are three complementary, but potentially very different groups. The common thread was that they were all involved in supporting Ukrainian children.

How did we start? I think what brought us together with the IFRC was a shared culture of listening and of paying attention to the needs of communities. Rather than presuming, we used that listening to build initiatives.

What that meant is that before launching a peer learning programme, we asked questions. We asked questions about your situation, about your context. What we had within less than four weeks was 873 context-specific descriptions of challenges faced by practitioners, in Ukraine and throughout Europe.

And those 873 descriptions told us a powerful story. The challenges were not abstract. They were immediate and acute: pervasive anxiety and fear, especially in response to air raid sirens; children showing sudden aggression or complete withdrawal; and the profound social isolation of being displaced.

We made some pretty radical changes very quickly based on this listening. The first was language. We had assumed most people would be professionals outside of Ukraine who are supporting displayed children. Our data showed the opposite: 76 percent of participants were in Ukraine itself, and 77 percent preferred to learn in Ukrainian. So, we changed our plan immediately and launched in Ukrainian from day one. That was the most obvious, but one of the most significant, changes.

The second thing we found was the profound sense of professional isolation. The feedback we received was overwhelming on this point. More than any tool, what these practitioners valued was connection. It was the most important thing to them. We heard it in their own words. One participant from Ukraine wrote: “It is very important to know that I am not alone with these problems.”. An English-speaking colleague wrote, “It was so helpful to hear that other teachers are facing the same challenges. It makes you feel less alone.” This sense of community, we found, is a powerful antidote to burnout.

We also found was a significant knowledge-to-action gap. Our focus was on Psychological First Aid for children. There is already excellent technical training. But we realized that in some cases, people had been through formal training but had struggled to connect that with application. They wondered, “How do I take that and actually put it to use?”

Our data confirmed this. When we analyzed their plans, we saw a strong preference for practical, concrete support.

Aneta Trgachevska: I really think it is important to have these tools, training, and capacity building, so that the frontline responders that are on the ground can provide adequate and timely, quality Psychological First Aid and mental health support to children.

Reda Sadki: Alongside the knowledge and skills, what I heard from my fellow panelists is also about emotion and connection.

The challenge we took on is that we are looking at how to connect people who may not have anyone to talk to. Who would rather be on a squawky Zoom call than being human together with fellow humans in a physical space? No one, I think. But in some cases, you do not have a choice. It is the only way to connect.

The main result is that alongside the amazing MHPSS infrastructure of the Red Cross, we contributed to building a digital infrastructure that helps people connect.

The first main result is a self-sustaining network. What that looks like is that staff and volunteers from 331 organizations, 76 percent of them from Ukraine, participated in the programme. These partners include large non-governmental organizations and small, locally-led groups working close to the front lines. Together, these organizations represent approximately 10,000 staff and volunteers that are supporting 1 million Ukrainian children.

The network is owned by its members. People volunteered to serve as European PFA focal points in their local area. Pretty much overnight, we found ourselves with 91 very dedicated volunteer leaders from Ukraine and 12 European countries.

Alongside that, we had 20 organizations that joined as formal programme partners. And these partnerships were tailored to their real-world needs. For example, Posmishka UA, one of the largest non-governmental organizations in Ukraine, sent 400 of their staff to join our Impact Accelerator. Or, another partner, SVOJA, an organization in Croatia founded and led by Ukrainian refugee women, needed a flexible programme that aligned with their unique “by refugees, for refugees” mission. This digital infrastructure allowed us to include both.

The key result is really around health outcomes. The capstone activity of our programme is called the PFA Accelerator. This is our “learn-by-doing” model. It is not a traditional course. It follows a simple weekly rhythm: on Monday, you set one specific, practical goal. On Friday, you report on what happened. And you give and receive both feedback and support.

This structure helps practitioners move from vague intentions to concrete action. For example, one participant, Yuliia, moved from an initial goal of “I want to help children with their emotional state” to a specific, measurable goal: “This week I will hold a session for a group of teenagers (6 people) aimed at developing self-help skills. We will practice the grounding technique ‘54321’.”

This weekly reporting cycle, this “learn-by-doing” model, then allows us to measure what really matters: health outcomes for the children. It allowed us to document specific, tangible ways that participation was linked to improvements in a child’s well-being.

We call these “attribution-level outcomes,” which, as many of us in public health know, is the holy grail. We cannot afford to just train professionals and hope for the best. We were able to both document and measure that because of their actions, the children they support showed tangible improvements in their mental health and well-being. For this purpose, Kari Eller, a Ph.D. candidate whose work was supported by The Geneva Learning Foundation, developed a simple, easy-to-use instrument in line with the IASC’s call for tools for busy humanitarian practitioners who lack formal mental health training, but are in fact the only ones there when support is critical for children. This tool was then discussed and improved by practitioners themselves before they began to use it.

I want to share three qualitative examples from our practitioners’ Friday reports. Hundreds of such reports describe how a professional used what they learned from the network, and that led to improvements in the health and well-being of the children they were supporting.

  • One teacher in Kharkiv, working with children who panicked during air raids, taught them the “butterfly hug” self-soothing technique as a way to provide support. She reported: “One girl, who usually cries for 30 minutes after a siren, stopped crying and was able to start her drawing activity. She told me the ‘hug’ helped her ‘bad feelings go away’.”
  • Another practitioner, Юлія, reported on her work with a teenage girl: “During an anxiety attack, the girl began to use the grounding technique we had learned. She was able to calm down on her own. This is a very good result.”
  • And finally, Раїса wrote: “When the children heard the siren, they were able to do breathing exercises on their own… They knew what to do and it gave them confidence. The children began to use the ‘safe place’ exercise on their own when they felt anxious.”

With all the public health professionals in the room, we know that attribution is the challenge. We feel that in a small but significant way, we found a method to document it. Because of the volume of data, which also includes quantitative measurement, we quickly see patterns of outcomes. These practitioners are not just learning theory. They are successfully applying their skills in ways that demonstrably restore a sense of calm, safety, and function for children in crisis.

As one participant, Olha, reflected, “This experience did not just add to my knowledge—it completely redefined the essence of my profession. I no longer just heal wounds; I build oases of safety in the midst of chaos.”

That is the impact we are documenting. Thank you very much.

The initial development and implementation of this programme (2023-2025) was funded by the European Union through a project partnership with the International Federation of Red Cross and Red Crescent Societies (IFRC). All ongoing activities, content, and their delivery from 1 September 2025 are the sole responsibility of The Geneva Learning Foundation (TGLF).

Image: The Geneva Learning Foundation Collection © 2025. In Seed of Silence, the artist captures a moment of profound stillness, the fragile intersection of innocence, nature, and transformation. The child’s face, serene and introspective, is encircled by sculpted layers resembling petals or scales, evoking both protection and metamorphosis. The materiality of the form, textured, earthen, and softly colored, blurs the boundary between organic and human, suggesting that resilience and renewal are rooted in both. The muted palette of ochre, rust, and blue recalls soil, flame, and sky: elemental forces that cradle life even amid crisis. This image resonates deeply with the work of those documenting children’s mental health and psychosocial well-being in humanitarian contexts. Here, art becomes a quiet witness, not to trauma itself, but to the enduring capacity for growth, reflection, and rebirth. Through silence, the piece speaks of healing.

References

  1. Sadki, R., 2025. How practitioners in Ukraine and across Europe built a self-sustaining peer learning network to support children. https://doi.org/10.59350/25pa2-ddt80
  2. Sadki, R., 2025. PFA Accelerator: across Europe, practitioners learn from each other to strengthen support to children affected by the humanitarian crisis in Ukraine. https://doi.org/10.59350/redasadki.21155
  3. Sadki, R., 2025. Peer learning for Psychological First Aid: New ways to strengthen support for Ukrainian children. https://doi.org/10.59350/dgpff-n9d63
  4. Sadki, R., 2024. Support of children affected by the humanitarian crisis in Ukraine: Bridging practice and learning through the sharing of experience. https://doi.org/10.59350/zbb4v-hay69
  5. The Geneva Learning Foundation and the International Federation of Red Cross and Red Crescent Societies, 2025. Діти у кризових ситуаціях, спільноти підтримки – Застосування першої психологічної допомоги для підтримки дітей, які постраждали від гуманітарної кризи в україні. https://doi.org/10.5281/ZENODO.14901474
  6. The Geneva Learning Foundation, International Federation of Red Cross and Red Crescent Societies, 2025. Children in Crisis, Communities of Care – Psychological first aid for children affected by the humanitarian crisis in Ukraine. https://doi.org/10.5281/ZENODO.14732092
  7. The Geneva Learning Foundation and the International Federation of Red Cross and Red Crescent Societies, 2024. Перша психологічна допомога дітям, які постраждали внаслідок гуманітарної кризи в Україні – Досвід дітей, опікунів та помічників. https://doi.org/10.5281/ZENODO.13730132
  8. The Geneva Learning Foundation and the International Federation of Red Cross and Red Crescent Societies, 2024. Psychological first aid in support of children affected by the humanitarian crisis in Ukraine: Experiences of children, caregivers, and helpers. https://doi.org/10.5281/ZENODO.13618862
Green skills and artificial intelligence

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

Reda SadkiArtificial intelligence, Global health

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

Bill Gates

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

Reda SadkiGlobal 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
20251029.CLIMATE Lancet Countdown 2025.005.1600

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

Reda SadkiGlobal health

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://redasadki.me/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://redasadki.me/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://redasadki.me/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://redasadki.me/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

20251029.CLIMATE Lancet Countdown 2025.008.1600

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

Reda SadkiGlobal health

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

Old poison in new bottles

How do we stop AI-generated ‘poverty porn’ fake images?

Reda SadkiArtificial intelligence, Global health

There is an important and necessary conversation happening right now about the use of generative artificial intelligence in global health and humanitarian communications.

Researchers like Arsenii Alenichev are correctly identifying a new wave of “poverty porn 2.0,” where artificial intelligence is used to generate stereotypical, racialized images of suffering – the very tropes many of us have worked for decades to banish.

The alarms are valid.

The images are harmful.

But I am deeply concerned that in our rush to condemn the new technology, we are misdiagnosing the cause.

The problem is not the tool.

The problem is the user.

Generative artificial intelligence is not the cause of poverty porn.

The root cause is the deep-seeded racism and colonial mindset that have defined the humanitarian aid and global health sectors since their inception.

This is not a new phenomenon.

It is a long-standing pattern.

In my private conversations with colleagues and researchers like Alenichev, I find we often agree on this point.

Yet, the public-facing writing and research seem to stop short, focusing on the technological symptom rather than the systemic illness.

It is vital we correct this focus before we implement the wrong solutions.

The old poison in a new bottle

Long before Midjourney, large organizations and their communications teams were propagating the worst kinds of caricatures.

I know this.

Many of us know this.

We remember the history of award-winning photographers being sent from the Global North to “find… miserable kids” and stage images to meet the needs of funders. Organizations have always been willing to manufacture narratives that “show… people on the receiving end of aid as victims”.

These working cultures — which demand images of suffering, which view Black and Brown bodies as instruments for fundraising, and which prioritize the “western gaze” — existed decades before artificial intelligence.

Artificial intelligence did not create this impulse.

It just made it cheaper, faster, and easier to execute.

It is an enabler, not an originator.

If an organization’s communications philosophy is rooted in colonial stereotypes, it will produce colonial stereotypes, whether it is using a 1000-dollar-a-day photographer or a 30-dollar-a-month software subscription.

The danger of a misdiagnosis

If we incorrectly identify artificial intelligence as the cause of this problem, our “solution” will be to ban the technology.

This would be a catastrophic mistake.

First, it is a superficial fix.

It allows the very organizations producing this content to performatively cleanse themselves by banning a tool, all while eluding the fundamental, painful work of challenging their own underlying racism and colonial impulses.

The problem will not be solved; it will simply revert to being expressed through traditional (and often staged) photography.

Second, it punishes the wrong people.

For local actors and other small organizations, generative artificial intelligence is not necessarily a tool for creating poverty porn.

It is a tactical advantage in a fight for survival.

Such organizations may lack the resources for a full communication team.

They are then “punished by algorithms” that demand a constant stream of visuals, burying stories of organizations that cannot provide them.

Furthermore, some organizations committed to dignity in representation are also using artificial intelligence to solve other deep ethical problems.

They use it to create dignified portraits for stories without having to navigate the complex and often extractive issues of child protection and consent.

They use it to avoid exploiting real people.

A blanket ban on artificial intelligence in our sector would disarm small, local organizations.

It would silence those of us trying to use the tool ethically, while allowing the large, wealthy organizations to continue their old, harmful practices unchanged.

The real work ahead

This is why I must insist we reframe the debate.

The question is not if we should use artificial intelligence.

The question is, and has always been, how we challenge the racist systems that demand these images in the first place.

My Algerian ancestors fought colonialism.

I cannot separate my work at The Geneva Learning Foundation from the struggle against racism and fighting for the right to tell our own stories.

That philosophy guides how I use any tool, whether it is a word processor or an image generator.

The tool is not the ethic.

We need to demand accountability from organizations like the World Health Organization, Plan International, and even the United Nations.

We must challenge the working cultures that green-light these campaigns.

We should also, as Arsenii rightly points out, support local photographers and artists.

But we must not let organizations off the hook by allowing them to blame a piece of software for their own lack of imagination and their deep, unaddressed colonial legacies.

Artificial intelligence is not the problem.

Our sector’s colonial mindset is.

References

Image: The Geneva Learning Foundation Collection © 2025

State of AI report

What the 2025 State of AI Report means for global health and humanitarian action

Reda SadkiArtificial intelligence, Global health

The 2025 State of AI Report has arrived, painting a picture of an industry being fundamentally reshaped by “The Squeeze.”

This is a critical, intensifying constraint on three key resources: the massive-scale compute (processing power) required for training, the availability of high-quality data, and the specialized human talent to build frontier models.

This squeeze, the report details, is accelerating a consolidation of power.

It favors the “hyperscalers”—the handful of large technology corporations that can afford to build their own power plants to run their data centers.

For leaders in global health and humanitarian action, the report is essential reading.

However, it must be read with a critical eye.

The report’s narrative is, in many ways, the narrative of the hyperscalers.

It focuses on the benchmarks they dominate, the closed models they are building, and the resource problems they face.

This “view from the top” is valuable, but it is not the only reality.

What does this consolidation of power mean for our sector, and where should we be focusing our attention?

The new AI divide: A focus on closed-model dominance

The report documents a clear trend: closed, proprietary models are pulling ahead of open-source alternatives in raw performance benchmarks.

This is a direct result of the compute squeeze.

When training costs become astronomical, only the wealthiest organizations can compete at the frontier.

This focus on state-of-the-art performance, while informative, can be a distraction.

For humanitarian action, the “best” model is not necessarily the one that tops a leaderboard, but the one that is affordable, adaptable, and deployable in low-resource settings.

The true implication for our sector is the emergence of a new “AI divide”.

This divide is not just about access but about capability.

We may face a future where Global North institutions may license “PhD-level” specialized AI agents at cost lower than their human counterparts, while practitioners in the Global South are left with rudimentary or geolocked tools.

This dynamic threatens to reinforce, rather than disrupt, existing knowledge power imbalances and risks a new era of “digital colonialism”, where the sector becomes entirely dependent on a few private companies for its most critical technology.

Opportunities in the State of AI: Breakthroughs in science and health

The most unambiguous good news in the 2025 report is the dramatic acceleration of AI in science and medicine.

AI is no longer just a research assistant; it is demonstrating expert-level accuracy in diagnostics and is actively designing novel therapeutics.

This is a profound opportunity for global health.

Where the report’s perspective is incomplete, however, is on the gap between this capability and its real-world application.

An AI can provide a brilliant medical insight, but it lacks the “contextual intelligence” of a local practitioner.

An AI model may not know that people in a specific district avoid the clinic on Tuesdays because it is market day – unless humans are working side-by-side with the model to share such qualitative and experiential data.

Read more: Why peer learning is critical to survive the Age of Artificial Intelligence

Therefore, the report’s findings on medical AI should not prompt us to simply buy new tools.

It should prompt us to invest in the human infrastructure—like structured peer learning networks —where health workers can collectively learn how to blend AI’s power with their deep understanding of local realities.

The State of AI report’s risks and our own

The 2025 report rightly identifies a shift in risk, moving from passive issues like model bias to active, malicious threats like accelerated cyber capabilities and new “bio-risks.”

These are critical concerns for the health and humanitarian sectors.

But the report misses the most immediate barrier to AI adoption in our field: our own organizational culture.

Many of our institutions operate within “highly punitive accountability systems”.

These systems, which tie performance evaluation directly to funding, create an environment where experimentation carries significant personal and institutional risk.

This leads to a “transparency paradox”.

Health workers and field staff are already experimenting with AI, but they are forced to hide their use.

If they disclose that a report was AI-assisted, they risk having their work subjected to “automatic devaluation,” regardless of its quality.

This punitive culture prevents open discussion and makes collective learning difficult.

State of AI: A strategic response to the squeeze

The 2025 State of AI Report confirms that we cannot compete in the compute squeeze.

Our strategy must therefore be one of smart adaptation and collective action.

For global health and humanitarian leaders, key takeaways include:

  1. Do not be distracted by the “SOTA” race. Our goal is not to have the highest-performing model, but the most applicable and equitable one.
  2. Invest in human networks, not just technology. The greatest gains will come from building the collaborative capacity of our workforce to use AI tools effectively in context.
  3. Fix our internal culture. We must create environments where staff can experiment with AI openly and safely, without fear of reprisal. We cannot adapt to this technology if we are punishing our innovators.
  4. Unite for collective power. The report’s theme of consolidation is a warning. As individual non-governmental organizations, we have no power to negotiate with hyperscalers. We must explore forming a “cooperative” to gain a “seat at the table” and co-shape an AI ecosystem that serves the public interest, not just corporate agendas.

These risks and opportunities are part and parcel of why The Geneva Learning Foundation is offering the AI4Health certificate programme. Learn more here: https://www.learning.foundation/ai.

References

Empower Learners for the Age of AI conference

The great unlearning: notes on the Empower Learners for the Age of AI conference

Reda SadkiArtificial intelligence

Artificial intelligence is forcing a reckoning not just in our schools, but in how we solve the world’s most complex problems. 

When ChatGPT exploded into public consciousness, the immediate fear that rippled through our institutions was singular: the corruption of process.

The specter of students, professionals, and even leaders outsourcing their intellectual labor to a machine seemed to threaten the very foundation of competence and accountability.

In response, a predictable arsenal was deployed: detection software, outright bans, and policies hastily drafted to contain the threat.

Three years later, a more profound and unsettling truth is emerging.

The Empowering Learners AI 2025 global conference (7-10 October 2025) was a fascinating location to observe how academics – albeit mostly white men from the Global North centers that concentrate resources for research – are navigating these troubled waters.

The impacts of AI in education matter because, as the OECD’s Stefan Vincent-Lancrin explained: “performance in education is the learning, whereas in many other businesses, the performance is performing the task that you’re supposed to do.” 

The problem is not that AI will do our work for us.

The problem is that in doing so, it may cause us to forget how to think.

This is not a distant, dystopian fear.

It is happening now.

A landmark study presented by Vincent-Lancrin delivered a startling verdict: students who used a generic, answer-providing chatbot to study for a math exam performed significantly worse than those who used no AI at all.

The tool, designed for efficiency, had become a shortcut around the very cognitive struggle that builds lasting knowledge.

Jason Lodge of the University of Queensland captured the paradox with a simple analogy.

“It’s like an e-bike,” he explained. “An e-bike will help you get to a destination… But if you’re using an e-bike to get fit, then getting the e-bike to do all the work is not going to get you fit. And ultimately our job… is to help our students be fit in their minds”.

This phenomenon, dubbed “cognitive offloading,” is creating what Professor Dragan Gasevic of Monash University calls an epidemic of “metacognitive laziness”.

Metacognition – the ability to think about our own thinking – is the engine of critical inquiry.

Yet, generative AI is masterfully engineered to disarm it.

By producing content that is articulate, confident, and authoritative, it exploits a fundamental human bias known as “processing fluency,” our tendency to be less critical of information that is presented cleanly. 

“Generative AI articulates content… that basically sounds really good, and that can potentially disarm us as the users of such content,” Gasevic warned.

The risk is not merely that a health worker will use AI to draft a report, but that they will trust its conclusions without the rigorous, critical validation that prevents catastrophic errors.

Empower Learners for the Age of AI: the human algorithm

If AI is taking over the work of assembling and synthesizing information, what, then, is left for us to learn and to do?

This question has triggered a profound re-evaluation of our priorities.

The consensus emerging is a radical shift away from what can be automated and toward what makes us uniquely human.

The urgency of this shift is not just philosophical.

It is economic.

Matt Sigelman, president of The Burning Glass Institute, presented sobering data showing that AI is already automating the routine tasks that constitute the first few rungs of a professional career ladder.

“The problem is that if AI overlaps with… those humble tasks… then employers tend to say, well, gee, why am I hiring people at the entry level?” Sigelman explained.

The result is a shrinking number of entry-level jobs, forcing us to cultivate judgment and adaptive skills from day one.

This new reality demands a focus on what machines cannot replicate.

For Pinar Demirdag, an artist and co-founder of the creative AI company Cuebric, this means a focus on the “5 Cs”: Creativity, Curiosity, Critical Thinking, Collective Care, and Consciousness.

She argues that true creativity remains an exclusively human domain. “I don’t believe any machine can ever be creative because it doesn’t lie in their nature,” she asserted.

She believes that AI is confined to recombining what is already in its data, while human creativity stems from presence and a capacity to break patterns.

This sentiment was echoed by Rob English, a creative director who sees AI not as a threat, but as a catalyst for a deeper humanity.

“It creates an opportunity for us to sort of have to amplify the things that make us more human,” he argued.

For English, the future of learning lies in transforming it from a transactional task into a “lifestyle,” a mode of being grounded in identity and personal meaning.

He believes that as the value of simply aggregating information diminishes, what becomes more valuable is our ability “to dissect… to interpret or to infer”.

In this new landscape, the purpose of learning – whether for a student or a seasoned professional – shifts from knowledge transmission to the cultivation of human-centric capabilities.

It is no longer enough to know things.

The premium is on judgment, contextual wisdom, ethical reasoning, and the ability to connect with others – skills forged through the very intellectual and social struggles that generic AI helps us avoid.

Empower Learners for the Age of AI: Collaborate or be colonized

While the pedagogical challenge is profound, the institutional one may be even greater.

For all the talk of disruptive change, the current state in many of our organizations is one of inertia, indecision, and a dangerous passivity.

As George Siemens lamented after investing several years in trying to move the needle at higher education institutions, leadership has been “too passive,” risking a repeat of the era when institutions outsourced online learning to corporations known as “OPMs” (online programme managers) that did not share their values: “I’m worried that we’re going to do the same thing with AI, that we’re just going to sit on our hands, leadership’s going to be too passive… and the end result is we’re going to be reliant down the road on handing off the visioning and the capabilities of AI to external partners.”

The presidents of two of the largest nonprofit universities in the United States, Dr. Mark Milliron of National University and Dr. Lisa Marsh Ryerson, president of Southern New Hampshire University, offered a candid diagnosis of the problem.

Ryerson set the stage: “We don’t see it as a tool. We see it as a true framework redesign for learning for the future.” 

However, before any institution can deploy sophisticated AI, it must first undertake the unglamorous, foundational work of fixing its own data infrastructure.

“A lot of universities aren’t willing to take two steps back before they take three steps forward on this,” Dr. Milliron stated. “They want to jump to the advanced AI… when they actually need to go back and really… get the basics done”.

This failure to fix the “plumbing” leaves organizations vulnerable, unable to build their own strategic capabilities.

Such a dynamic is creating what keynote speaker Howard Brodsky termed a new form of “digital colonialism,” where a handful of powerful tech companies dictate the future of critical public goods like health and education.

His proposed solution is for institutions to form a cooperative, a model that has proven successful for over a billion people globally.

“I don’t believe at the current that universities have a seat at the table,” Brodsky argued. “And the only way you get a seat at the table is scale. And it’s to have a large voice”.

A cooperative would give organizations the collective power to negotiate with tech giants and co-shape an AI ecosystem that serves public interest, not just commercial agendas.

Without such collective action, the fear is that our health systems and educational institutions will become mere consumers of technologies designed without their input, ceding their agency and their future to Silicon Valley.

The choice is stark: either become intentional builders of our own solutions, or become passive subjects of a transformation orchestrated by others.

The engine of equity

Amid these profound challenges, a powerfully optimistic vision for AI’s role is also taking shape.

If harnessed intentionally, AI could become one of the greatest engines for equity in our history.

The key lies in recognizing the invisible advantages that have long propped up success.

As Dr. Mark Milliron explained in a moment of striking clarity: “I actually think AI has the potential to level the playing field… second, third, fourth generation higher ed students have always had AI. They were extended families… who came in and helped them navigate higher education because they had a knowing about it.”

For generations, those from privileged backgrounds have had access to a human support network that functions as a sophisticated guidance system.

First-generation students and professionals in under-resourced settings are often left to fend for themselves.

AI offers the possibility of democratizing that support system.

A personalized AI companion can serve as that navigational guide for everyone, answering logistical questions, reducing administrative friction, and connecting them with the right human support at the right time.

This is not about replacing human mentors.

It is about ensuring that every learner and every practitioner has the foundational scaffolding needed to thrive.

As Dr. Lisa Marsh Ryerson put it, the goal is to use AI to “serve more learners, more equitably, with equitable outcomes, and more humanely”.

This vision recasts AI not as a threat to be managed, but as a moral imperative to be embraced.

It suggests that the technology’s most profound impact may not be in how it changes our interaction with knowledge, but in how it changes our access to opportunity.

Technology as culture

The debates from the conference make one thing clear.

The AI revolution is not, at its core, a technological event.

Read the article: Why learning technologists are obsolete

It is a pedagogical, ethical, and institutional one.

It forces us to ask what we believe the purpose of learning is, what skills are foundational to a flourishing human life, and what kind of world we want to build.

The technology will not provide the answers.

It will only amplify the choices we make.

As we stand at this inflection point, the most critical task is not to integrate AI, but to become more intentional about our own humanity.

The future of our collective ability to solve the world’s most pressing challenges depends on it.

Do you work in health?

As AI capabilities advance rapidly, health leaders need to prepare, learn, and adapt. The Geneva Learning Foundation’s new AI4Health Framework equips you to harness AI’s potential while protecting what matters most—human experience, local leadership, and health equity. Learn more: https://www.learning.foundation/ai.

References

Image: The Geneva Learning Foundation Collection © 2025

Pour retrouver les enfants congolais non vaccinés, il est question des fumoirs à poisson et du dialogue inter-religieux

Reda SadkiGlobal health

Au deuxième jour de leurs travaux en direct, les professionnels de la santé congolais sont passés de la découverte à l’exploration des causes profondes qui laissent des centaines de milliers d’enfants exposés aux maladies évitables par la vaccination. Ils découvrent que les racines du problème sont souvent là où personne ne les attend: dans l’économie de la pêche, le dialogue avec les églises ou la gestion des camps de déplacés.

Lire également: En République démocratique du Congo, la traque des enfants « zéro dose » passe par l’intelligence collective des acteurs de la santé

Les analyses, plus fines, révèlent des leviers d’action insoupçonnés, démontrant la puissance d’une méthode qui transforme les soignants en stratèges.

« La séance d’hier, c’était une séance de découverte, mais aujourd’hui, c’était une séance d’exploration. Explorer, c’est aller en profondeur. Il faut sonder ».

Ces mots de Fidèle Tshibanda Mulangu, un participant congolais, résument la bascule qui s’est opérée ce mercredi 8 octobre.

Après une première journée consacrée au partage des défis, la dynamique a changé.

L’objectif n’était plus seulement d’identifier les problèmes, mais de les disséquer avec une précision accrue.

Dans le cadre de l’initiative menée par La Fondation Apprendre Genève et ses partenaires — le ministère de la Santé de la RDC, l’UNICEF et Gavi — les participants ont été invités à appliquer une deuxième fois la méthode d’analyse des causes profondes.

L’effet a été immédiat.

« La séance d’hier m’a permis de comprendre que ce que je pensais être une cause profonde n’était qu’une cause intermédiaire », a ainsi partagé Hermione Raissa Tientcheu Ngounou, illustrant la sophistication croissante des analyses.

Le dialogue rompu entre la foi et la santé publique

Au cœur du Kasaï, un groupe de travail a de nouveau abordé la question des églises de réveil hostiles à la vaccination.

Mais cette fois, l’analyse a dépassé le constat d’un obstacle religieux. « Les fidèles, lorsqu’ils tombent malades, ne vont pas dans les structures sanitaires, mais ils préfèrent rester dans des centres de prière », a expliqué le rapporteur du groupe, décrivant une rupture de confiance avec le système de santé formel.

En poussant la réflexion, les participants ont conclu que le vrai problème était « l’absence d’un cadre de concertation formel entre le système de santé et les confessions religieuses ».

La cause profonde n’était donc pas la foi, mais une faillite institutionnelle.

Une prise de conscience qui a immédiatement fait émerger des solutions.

« Dans le contexte des églises de réveil, les leaders de ces églises doivent être nos alliés », a insisté un participant, Mwamialumba Fidel.

Vacciner dans le chaos de la guerre

Dans le Nord-Kivu, une autre discussion a porté sur la vaccination des populations déplacées.

Confrontés à une cause première comme la guerre, hors de leur portée, les soignants ont fait preuve d’un pragmatisme remarquable.

L’analyse ne s’est pas enlisée dans un sentiment d’impuissance.

Le groupe a rapidement identifié une faille concrète dans le système.

« Pour les déplacés, le grand problème est que les enfants arrivent sans carnet de vaccination, et on ne sait pas comment les intégrer dans le PEV de routine », a partagé Clémence Mitongo.

La cause racine n’était donc plus le conflit, mais « le manque de stratégie spécifique pour la prise en charge de ces enfants » une fois en sécurité.

Le groupe a ainsi transformé un problème insoluble en un défi organisationnel sur lequel il est possible d’agir.

Au-delà des frontières, une leçon d’économie locale

La richesse des échanges a été amplifiée par la participation de professionnels d’autres pays.

Un des cas les plus édifiants est venu de Madagascar, où 93 enfants d’un village de pêcheurs n’étaient pas vaccinés.

« Les femmes sont obligées d’accompagner les hommes pour la vente du poisson. Et quand elles reviennent, nos équipes sont déjà parties », a expliqué le rapporteur du groupe.

La cause profonde, révélée par l’analyse, n’avait rien de sanitaire.

C’était l’absence d’un fumoir pour conserver le poisson, qui forçait les femmes à s’absenter.

L’impact de cet exemple a été puissant.

« Ce cas du Madagascar est très édifiant et illustre parfaitement la pertinence de l’analyse approfondie », a commenté Alphonse Kitoga.

Une pédagogie de l’action

Ces cas pratiques illustrent la maturation rapide des participants.

La méthode des « cinq pourquoi », introduite la veille, est devenue un outil maîtrisé, un réflexe analytique.

« C’est une nouvelle approche pour nous », a affirmé Baudouin Mbase Bonganga. « Le fait de travailler en groupe, de partager les expériences, ça nous a vraiment enrichis ».

L’exercice ne vise pas à transmettre un savoir, mais à cultiver une compétence: la capacité de chaque professionnel à devenir un fin diagnosticien des problèmes de sa communauté et un architecte de solutions adaptées.

De l’analyse à l’action

Cette journée d’exploration intensive n’est qu’une étape.

Les participants ont jusqu’au vendredi 10 octobre pour soumettre la première version de leur projet de terrain, où ils appliqueront ces analyses à leurs propres communautés.

L’initiative démontre qu’en s’appropriant les bons outils, les acteurs de terrain peuvent rapidement monter en puissance.

Comme l’a brillamment résumé Papa Gorgui Samba Ndiaye: « Cette méthode permet de contextualiser réellement les problèmes, et ce qui est bien, c’est qu’on sort des solutions toutes faites… Ça nous amène à innover ».

Le mouvement est en marche, et il est porté par ceux qui, chaque jour, sont en première ligne.

Image: Peer learning exercise, as seen from The Geneva Learning Foundation’s livestreaming studio.