In April 2025, during the African Union's presentation of its Digital Health Strategy, Dr. Divine Yamulamba outlined five critical barriers that could impede Africa's path toward achieving a robust Universal Health Coverage (UHC) system by 2030. His insights are particularly timely, considering the accelerating momentum across African nations to integrate digital health as a cornerstone of their health reforms. Yet, the structural challenges identified by Dr. Yamulamba reveal that the road ahead is fraught with complexity, requiring concerted, systemic, and sustainable efforts.

In this article, we delve deeper into these five hindrances and discuss how they frame the future of healthcare delivery through digital health across the continent.

1. Infrastructure Challenges

Fundamental infrastructure remains one of Africa’s most persistent and consequential barriers to digital health deployment. Electricity supply is unreliable in many rural and peri-urban areas, with power outages disrupting not only hospital operations but also the functionality of digital health tools and electronic medical records systems. Beyond electricity, internet connectivity is patchy, with vast regions lacking access to stable broadband or mobile networks.

Without consistent electricity and connectivity, even the most sophisticated digital health solutions cannot operate effectively. Consequently, national and regional strategies must prioritize infrastructure development — especially decentralized energy solutions like solar power and satellite internet — as an integral part of any digital health roadmap.

2. Supply and Demand Challenges

A second major hindrance lies in the supply and demand mismatch, particularly in the distribution of medical goods and services. Dr. Yamulamba emphasized the acute transport and logistics issues, especially in remote and underserved regions. Backlogs in pharmaceutical supply chains, a shortage of trained healthcare personnel, and underdeveloped medical transportation networks exacerbate delays in care and widen health disparities.

The transport of vaccines, medical equipment, and even simple pharmaceuticals remains an operational nightmare for many ministries of health. Addressing this requires investment not only in supply chain management systems but also in resilient physical infrastructure like roads and healthcare-specific logistics innovations.

3. Policy Implementation Gaps

While many African countries have adopted forward-looking health policies on paper, a significant gap persists between policy formulation and implementation. Dr. Yamulamba rightly pointed out that political will often dissipates once policies reach the execution stage. Bureaucratic inefficiencies, corruption, lack of trained administrators, and frequent turnover among decision-makers erode policy continuity.

Without strong governance mechanisms and accountability frameworks, national UHC initiatives risk stagnating, despite having clear mandates. Thus, capacity-building at the governmental and institutional levels is essential to translate policies into tangible, scalable action.

4. Financing and Investment Challenges

Africa’s health sector remains heavily dependent on donor financing. While pilot programs often showcase promising results, the sustainability of these initiatives is questionable once donor funding ceases. Dr. Yamulamba highlighted a worrying trend: when funding dries up, critical systems — particularly medical records and digital infrastructures — collapse alongside it.

This exposes a deeper issue: a lack of indigenous, long-term investment in healthcare systems. Moving forward, innovative financing models, public-private partnerships, and domestic resource mobilization must be leveraged to ensure that health system reforms outlive the cycles of external donor support.

5. Research and Development (R&D) Deficits

Finally, the low level of investment in research and development undermines Africa’s ability to tailor health solutions to its specific needs. Without robust R&D ecosystems, African countries remain dependent on imported technologies and health innovations, many of which are not adapted to the continent’s socio-economic realities.

R&D must not be an afterthought but a central pillar of UHC strategies. It is only through local innovation, clinical research, and context-specific technological development that Africa can sustainably improve health outcomes for its populations.

Comparing Africa's Challenges to Other Continents

The obstacles identified by Dr. Yamulamba are not unique to Africa but differ in magnitude and context compared to other continents.

• Infrastructure: In Europe and North America, infrastructure — both in energy and connectivity — is largely taken for granted. Even in rural or underserved areas, redundancy systems ensure stability. In contrast, Asia, particularly Southeast Asia and parts of India, shares similar energy and connectivity challenges, though large-scale infrastructure programs have begun to close the gap.

• Supply and Demand: Latin America faces significant healthcare delivery inequities between urban and rural areas, much like Africa. However, the logistical barriers are often mitigated by better-developed transport systems and a more substantial urban middle class that can drive demand and financing.

• Policy Implementation: Governance challenges are present worldwide but are particularly acute in regions with histories of political instability. In contrast, countries in Scandinavia and Oceania exhibit high levels of policy adherence and operational efficiency, a stark contrast to many African health systems.

• Financing and Investment: Many high-income countries have robust, tax-funded healthcare systems that provide continuity regardless of political change. Emerging economies in Asia have increasingly adopted blended financing models, combining public funding with private investment to reduce reliance on donors — a strategy Africa could emulate more aggressively.

• Research and Development: The global north dominates health R&D, leaving the global south — including Africa and parts of Latin America and Southeast Asia — reliant on external innovation. However, countries like India and Brazil have made significant strides in creating indigenous R&D ecosystems, demonstrating that with the right policies, investment, and incentives, progress is achievable.

  While Africa’s challenges toward achieving UHC by 2030 are profound, they are not insurmountable. Each barrier highlighted by Dr. Yamulamba presents an opportunity for strategic investment, collaboration, and innovation. Learning from the experiences of other continents — adapting what works while forging new paths tailored to Africa's unique context — will be crucial in determining whether the continent meets its health goals within the next five years. The journey toward Universal Health Coverage is not only a moral imperative but also a transformative opportunity for Africa’s sustainable development and global positioning in the 21st century.

  In this evolving landscape, MEDx eHealthCenter has been playing a crucial role in bridging the gap between vision and reality. Across global platforms — including collaborations with the World Health Organization (WHO), the United Nations (UN), the Global Fund, and the Dutch Government — MEDx has been actively supporting governments and private sectors in tackling three of the most persistent barriers: Research and Development (R&D), Infrastructure (with a strong emphasis on Data Sovereignty), and Policy Implementation.

  Through its innovative GOVTECH Solution, MEDx empowers nations to build resilient, sovereign digital infrastructures that ensure healthcare data remains within national jurisdictions while fostering regional interoperability. In the realm of R&D, MEDx assists governments and healthcare ecosystems in designing research frameworks that prioritize local health challenges, encouraging innovation from within rather than depending solely on imported technologies. Moreover, by offering hands-on support in operationalizing digital health strategies, MEDx directly addresses the perennial gap between policy design and effective implementation.

  MEDx's contributions are not merely theoretical; they represent concrete action plans, capacity-building programs, and digital system deployments that enable sustainable, scalable health systems. By positioning itself at the intersection of public sector governance and private sector innovation, MEDx exemplifies how multi-stakeholder partnerships can drive real-world impact — helping countries move steadily closer to the goal of Universal Health Coverage, not only in Africa but worldwide.