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Africa: Accelerating Universal Health Coverage in the Digital Age – The Roadmap to 2030


Over the past two decades, the world has witnessed remarkable progress in global health. Since the early 2000s, millions more people have gained access to essential services; maternal and child mortality have declined dramatically; access to HIV treatment has transformed lives and life expectancy; and communities have benefited from historic investments in primary health care. These achievements reflect an extraordinary collective effort by governments, civil society, health workers, and global partnerships. Together, they form the foundation of the promise enshrined in the Sustainable Development Goals (SDGs): that all people, everywhere, should be able to obtain the health services they need without financial hardship.

Yet today, with less than five years left to achieve the SDGs, momentum toward universal health coverage (UHC) has stalled – 4.6 billion people worldwide still lacked access to essential health services in 2023. In many countries, health systems remain underfunded, understaffed, and/or fragmented. Economic pressures, demographic change, protracted conflicts, and an escalating climate crisis are stretching systems beyond their limits. The COVID-19 pandemic exposed longstanding weaknesses and diverted resources away from essential services. Millions of people are being pushed back into poverty due to health expenses, leading to widening inequalities. Despite the progress of the early 21st century, the world is not on track to achieve SDG 3.8 on UHC by 2030. As per the UHC global monitoring report 2025, the global UHC service coverage index will remain below 80, and close to 1 in 4 people globally will continue to face health-related financial hardship in 2030

This is not because UHC is unachievable. It is because the systems designed to deliver it have not kept pace with the complexity and scale of today’s health challenges.

Digital Health: A Renewed Opportunity to Accelerate UHC


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The rapid evolution of digital technologies offers a transformational opportunity to regain momentum. Digital health, when implemented responsibly and equitably, can strengthen primary health care, improve service quality, support health workers, increase system efficiency, and extend care to underserved communities. Digital technologies are reshaping how countries advance toward UHC, through better data systems, stronger support for frontline workers, and AI-enabled earlier diagnosis and outbreak detection.

But the promise of digital health will only be realised if countries create the right conditions for it to succeed. Technology alone cannot transform health systems. Digital transformation is not merely a technical issue, it requires political leadership.

Why Progress on Digital Transformation Has Been Slow

Despite increasing interest and investment, many countries have struggled to integrate digital solutions at scale. Fragmented systems, weak governance, misaligned donor investments, insufficient regulation, and limited long-term financing have kept digital health initiatives small, pilot-driven, and unable to deliver national impact. Too often, digital tools are introduced without being integrated into routine services, without the skills or capacity needed for sustained use, and/or without the policies that protect people’s rights and data.

These barriers are not technological, they are structural and political, the result of decision making and prioritisation within different government departments, ministries and state structures (such as the legislature and the judiciary). Achieving UHC in the digital age requires leadership, legislation, regulation, financing, and accountability.

“Technology feels like magic because it promises shortcuts – but in digital health, skipping steps creates fragility. Strong governance and enforceable regulation are the real superpowers that help systems withstand political and technological change. That’s why the Transform Health Roadmap stands out! It sequences the true building blocks of transformation, especially those strengthening regulation and governance.” ~ Al Shiferaw, Senior Program Officer, Digital Africa, Gates Foundation

It requires coordination across ministries, alignment between national and subnational authorities, and meaningful participation from civil society, communities, and health workers. Without this enabling environment, digital tools risk reinforcing the very inequities and inequitable systems they are meant to address and reduce.

Introducing the Roadmap to 2030: Health for All in the Digital Age

This is where the Roadmap to 2030: Health for All in the Digital Age plays a vital role (read and endorse the Roadmap).  Developed through an inclusive, multi-sector process, engaging governments, civil society, youth organisations, health workers, and global experts, the Roadmap outlines a collective agenda for how digital transformation can accelerate progress toward UHC.

“Digital health is inherently chaotic – and that’s not a bad thing. Chaos sparks experimentation. But without alignment, it also fuels fragmentation and duplication. The Roadmap gives us shared language and a practical way to turn that chaos into collective progress.”

~Caroline Mbindyo, CEO, Amref Health Innovations, Amref Health Africa

The Roadmap, launched on 12th December as we celebrate UHC Day. It was officially introduced to the global community through the closing plenary session during the Global Digital Health Forum 2025, where it was well received. It provides countries, and others, with a clear, coherent framework for creating the enabling environment necessary to scale digital health solutions safely, equitably, and effectively. It highlights the policy reforms, regulatory foundations, financing strategies, and governance arrangements required to integrate digital technologies into health systems in ways that protect rights, enhance quality, and improve access. And it emphasises that digital transformation must be country-owned, people-centred, and grounded in principles of equity, trust, and accountability.

Critically,  it positions UHC and digital transformation as inherently political commitments, not technical undertakings. Both require sustained national leadership, long-term investment, and coordinated action across sectors and stakeholders. Progress towards UHC through digital technology also demands that governments take responsibility for shaping systems that serve everyone, including the most marginalised.

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A Call to Political Leaders, Digital Health Champions, and Civil Society

The Roadmap is designed for those who shape national priorities and global strategies: political leaders, ministries of health and finance, digital-health authorities, civil society organisations, regulators, donors, and the innovators designing the next generation of digital tools. It invites all of us to work together to ensure that digital health becomes a driver of health system transformation to deliver UHC by 2030.

The next five years will determine whether the world moves closer to health for all, or whether inequalities deepen further. By adopting and implementing the Roadmap to 2030, countries can strengthen their foundations for UHC, build resilient and future-ready health systems, and ensure that digital transformation contributes to the promise of the Sustainable Development Goals.

The opportunity is still within reach. With the right political will, aligned investments, strong governance, and an unwavering commitment to equity and inclusion, digital health can help deliver what the world promised in 2015: that no one, anywhere, will be left behind.

Mathilde Forslund is the founding CEO of Transform Health – a multi-sector coalition that sets out to harness digital technology and data to accelerate progress towards universal health coverage (UHC). Dr. Magda Robalo is the UHC2030 co-chair and interim executive director of Women in Global Health.

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