For more than 20 years, I’ve had the privilege, and responsibility, of working across over 100 countries, supporting and implementing more than 500 international development programmes. I’ve worked with governments, multilaterals, NGOs, researchers, and local organisations across the Global South, designing programmes in health, governance, sustainability, workforce development, and systems strengthening.
If there is one lesson that experience has reinforced again and again, it is this:
Innovation without inclusion does not fail accidentally; it fails by design.
Breakthroughs Don’t Automatically Translate Into Impact
Global health funding is often framed around breakthroughs: new technologies, new models, new discoveries. And to be clear; science matters. Research matters. Innovation matters.
But what I have seen repeatedly, from rural health facilities to national policy tables, is that breakthroughs alone do not improve lives.
Too often, funding systems reward novelty over relevance, speed over sustainability, and outputs over outcomes. Decisions about what problems matter, and how they should be solved, are frequently made far from the communities most affected by them.
The result is a familiar pattern:
- Well-funded innovations that never reach scale
- Pilots that end when funding cycles close
- Technologies that exist, but are not trusted
- Systems that look efficient on paper but feel alien on the ground
This isn’t a failure of science. It’s a failure of inclusion.
Communities Are Not Beneficiaries; They Are Co-Designers
Throughout my career, my work has been consistently centred on one principle: communities are not passive beneficiaries of development; they are active partners in it.
Across the programmes we designed and delivered, inclusion was not an add-on or a compliance requirement. It was embedded into how we worked:
- Participatory programme design from the outset
- Community-led needs assessments and solution testing
- Beneficiary feedback and complaints mechanisms built into delivery
- Safeguarding not as policy, but as practice
- Continuous learning loops between communities, implementers, and policymakers
When communities are treated as subjects, programmes may deliver outputs. When communities are treated as partners, programmes deliver impact.
In global health, lived experience is not “soft data.” It is intelligence.
Funding Models Shape Power; And Power Shapes Outcomes
Funding is never neutral. Who controls resources controls priorities, timelines, and definitions of success.
Over the years, I’ve seen how traditional funding models can unintentionally reinforce exclusion:
- Short funding cycles that discourage long-term trust-building
- Rigid logframes that leave little room for community adaptation
- Reporting systems designed for donors, not for learning
- Accountability flowing upward, but rarely downward to communities
When funding structures do not create space for local voice, they silence it.
And when community feedback is absent from decision-making, we end up optimising for systems; not people.
Inclusion Is a Governance Issue, Not a Technical One
Inclusive global health is often framed as a technical challenge: better data, better tools, better indicators.
In reality, it is a governance challenge.
True inclusion requires:
- Shared decision-making power, not just consultation
- Transparency about how priorities are set
- Accountability mechanisms that communities can actually use
- Willingness to fund capacity, not just delivery
- Trust in local institutions, even when it feels uncomfortable
In the programmes I’ve supported, the most sustainable outcomes emerged when governments, communities, and implementers were aligned—not because they were forced to be, but because systems were designed to support collaboration.
Sustainability Is Built Through Ownership
Sustainability does not come from perfect project design. It comes from ownership.
When communities see themselves reflected in programmes—when their knowledge shapes solutions, when feedback leads to change, when safeguarding is real and visible—systems last beyond funding cycles.
I have seen health initiatives continue years after donors exited, not because they were expensive or technologically advanced, but because communities believed in them and governments trusted them.
That is what inclusion makes possible.
Rethinking the Future of Global Health Funding
If we are serious about impact, global health funding must evolve.
That means:
- Funding inclusion as infrastructure, not overhead
- Valuing lived experience alongside scientific expertise
- Designing accountability systems that serve communities, not just funders
- Supporting long-term partnerships instead of short-term projects
- Measuring success by trust, access, and equity—not just scale
At InclusiveAIHub, this thinking shapes how we approach innovation, governance, and systems design. Whether working with technology, data, or policy, our starting point remains the same: people first, systems second.
A Final Reflection
After two decades in international development, I no longer believe the biggest challenge in global health is a lack of innovation.
It is a lack of intentional inclusion.
Innovation that does not shift power will not shift outcomes. Funding that does not centre communities will not create equity. And systems built without trust will always struggle to deliver impact.
Inclusion is not a moral add-on to innovation. It is the condition that makes innovation work.
GEORGE GOPAL OKELLO Programmes Director, #InclusiveAIHub
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