The real work begins when the room empties

Last week in Toronto, at the close of a roundtable I had the privilege of moderating at the Africa HealthTech Summit, something happened that I have not been able to stop thinking about.

We had run well over time. Other sessions had already started. By every rule of conference logic, people should have slipped out to catch the next thing. Instead, almost everyone stayed. And nearly all of them stayed to say a version of the same sentence – please, let us not let this be just another good conversation. Let us stay connected.

I have sat in many rooms over the years. That instinct – to hold on to one another after the formal programme ends – is, I am convinced, where the real work actually lives.

I was reminded of this again reading about Seth Cochran, the global health entrepreneur known to some as “The Fistula Guy”, and the gathering model he has built called The Sidebar. His premise is disarmingly simple – the most important conversations at our big global events are rarely the ones on the main stage. They happen in the corridors, the coffee lines, and the unplanned exchanges. And too often, the people closest to the problems we are trying to solve are the ones least visible in the rooms meant to solve them.

He is right. And for those of us working on Africa’s health systems, that observation is not a curiosity. It is the whole game.

Let me say something I believe firmly, having spent this past week in room after room with founders, funders, governments and implementers from across Africa and Canada – Africa does not have an innovation problem. We have the founders. We have the talent. We have the ideas and the technical skill. We have communities that were solving their own problems long before any of us arrived with a pilot.

What we are still learning to do well is everything that comes after the pilot works. The financing does not vanish when the grant ends. The government that sees itself in what was built. The procurement pathways, the interoperability, the local ownership, the trust. A pilot only becomes meaningful when it can survive inside a real health system – and that survival is an act of orchestration, not of technology, funding or policy alone.

This is the less photogenic part of our work, and it is precisely the part the corridor understands. Two things, in particular, tend to surface there that rarely make it to the stage.

The first is access. The brilliant nurse running a programme in a rural district, the founder who has proven something significant but has no idea how to reach the right desk in a ministry – these are often the people furthest from the funders and decision-makers shaping the sector. If our gatherings only amplify the voices already amplified, we miss the very people whose buy-in determines whether anything lasts. Designing with them, from the beginning, is not a nicety. It is the difference between a solution that endures and one that is silently abandoned the moment attention moves on.

The second is harder, and I want to name it gently, because it is a shared challenge rather than anyone’s fault. There is often a gap between what is announced and what actually arrives. We have all watched generous pledges make headlines, only to thin out by the time the work needs cash. Even now, as the continent confronts a serious Ebola outbreak, those leading the response have had to ask plainly where the promised money actually is. It is a sobering reminder that an announcement is not a system, and applause is not a budget. Sustainability is not the press release; it is the faithful follow-through long after the cameras have gone.

None of this is cause for cynicism. Quite the opposite. It is an invitation.

The most useful thing I took from Toronto was not a new idea. It was a renewed conviction that the work now is connection and follow-through, i.e., turning dialogue into partnerships that are named, owned, funded and moving. Not because a signature is the work, but because it is a public commitment to keep doing the work after the room empties.

I have also become more convinced of something the best conversations in Toronto kept returning to – this is not aid. It is two ecosystems that genuinely need each other. Africa offers urgency, talent, and markets moving faster than almost anywhere on earth. Our partners offer decades of hard-won institutional muscle, the standards and systems that turn a clever pilot into a lasting platform. Treated as equals, with honesty on both sides, that is a partnership of real consequence.

So my appeal to everyone who shares these rooms with me – in Lagos, Toronto, Kigali, Abuja, and beyond – is simple. Let us spend a little less energy on the perfect panel and a little more on the corridor. Let us make sure the people closest to the problem are not the ones standing outside the door. And let us measure ourselves not by the quality of our conversations, but by what we are still building together long after they end.

The applause fades quickly. The systems we build, if we are faithful to them, do not.

About the author:

Ota Akhigbe is the Director of Partnerships and Programs at eHealth Africa, where she leads the organisation’s global partnerships and programmes portfolio spanning 21 African countries and its offices in Washington DC, Berlin, and across the Gulf and Asia.