The best moments during the United Nations General Assembly (UNGA) week in New York were all about action.
We were proud to be part of a pivotal meeting on innovative health financing in Africa: launching a new multi-country outcomes fund designed to amplify countries’ own health leadership and investments through strategic use of other funding sources.
As Martin Edlund from Health Finance Coalition put it: “You can’t stretch aid dollars any further. You have to multiply them” — by working differently, crowding in diverse funders (from philanthropic to corporate), and paying only for measurable, cost-effective health results at scale.
Here are our key takeaways after this impactful event, moderated by Dr. Prashant Yadav of the Council on Foreign Relations:
1. A New Policy Landscape is Emerging—and It’s Focused on Funding Outcomes
There was much discussion during UNGA week about the newly released US global health strategy—which emphasizes commitment to lifesaving commodities, focus on frontline workforce, and greater engagement with local delivery channels including the private sector and faith-based organizations.
In parallel, our event focused on African countries driving their own solutions. In a video address, Hon. Amobi Godwin Ogah (Chairman of the House Committee on AIDS, Tuberculosis, and Malaria Control in Nigeria’s National Assembly) announced he’s championing legislation to establish results-based financing for AIDS, tuberculosis, and malaria at the national level—all while embracing the private sector as an essential partner. This is about countries like Nigeria taking leadership to mobilize domestic resources and build sustainable health financing on their own terms.
2. The Private and Faith-Based Sectors are Central, Not Peripheral
A recurring theme was the necessity of integrating the private sector, where over 60% of patients in countries like Nigeria first seek care. For example, Dr. Adebobola Bashorun (National Coordinator of Nigeria’s National AIDS, Viral Hepatitis and STIs Control Program) spoke about how HIV care has fundamentally evolved into a manageable chronic condition for most. This opens new opportunities to meet people where they are, including decentralizing certain kinds of HIV services and bringing care closer to communities through pharmacies and local providers… all while maintaining centralized oversight, data systems, and tracking through technology.
This approach is a win-win on multiple fronts. It enhances sustainability: private and faith-based providers represent permanent infrastructure that maintains an independent presence within local health systems, regardless of donor funding cycles. It expands immediate reach by tapping into an already-built network of health facilities across communities. It boosts cost-effectiveness by setting agreed-upon rates per patient at a fraction of traditional costs. And it improves care quality by paying for verified outcomes while meeting patients in the trusted, convenient locations they already prefer.
These providers aren’t on the margins of health systems. They’re a backbone of primary care delivery in much of Africa, and one that can finally be integrated into national health strategies with strong government leadership.
3. Technology is Unlocking Outcomes-Based Models at Scale
As Maisha Meds’ CEO Dr. Jessica Vernon explained, mobile platforms now provide unprecedented, real-time visibility into last-mile service delivery. This allows funders to move from traditional upfront grants to paying for specific, verified health outcomes—like a malaria test followed by appropriate treatment—drastically reducing costs from ~$30 per patient to as low as 10% of that figure.
This isn’t theoretical; the proof is here. Our research-backed malaria program has already reached over a million patients at dramatically lower costs. The model works because our software solves real problems for pharmacy owners, driving organic adoption… while our custom-built backend (incorporating advanced automation, data systems, and AI-enabled auditing with our partner Audere) provides the real-time auditing and transparency needed to pay for outcomes after the work’s been done.
4. A Marketplace for Health Outcomes
Ambassador John Simon of Total Impact Capital framed this compellingly: donors, governments, and local corporations can now simply “buy outcomes” without building cumbersome parallel systems. This model attracts new funders, drives funding to the most effective providers, and generates robust data to inform national health strategies. And Neeta Bhandari from the Gates Foundation emphasized the role philanthropy can play, as well — for example, by de-risking investments from other contributors to the fund, while acting as a catalyst to build and prove effective models.
We’re looking forward to new partnerships with organizations ready to embrace this approach. Ana Ochoa from Catholic Relief Services shared how CRS has successfully implemented outcomes contracts in other sectors like environmental and WASH programs, and is now applying that expertise to health. We came away energized by how outcomes-based financing enables organizations like ours to leverage their unique strengths, creating opportunities to collaborate rather than compete.
A Personal Story That Captures It All
We were honored when Dr. Ahmad Abdulwahab of the Nigeria Governors’ Forum shared how his wife’s pharmacy transformed its operations using our software—leading him to go online asking, “Who are these Maisha guys?”
That’s what this is all about, building solutions that work for everyone: healthcare providers running sustainable businesses, patients accessing affordable and high-quality care, countries mobilizing domestic resources for sustainable health systems, and funders paying only for verified results.
There was a palpable sense at UNGA—and more broadly in the public health space—that we can’t keep doing things the same way. As Hon. Ogah said, ”We’re not starting from scratch.” The models are proven. The tech exists. African governments are leading. Now it’s about bringing together different financing partners (philanthropic, corporate, and domestic) to scale what works and build sustainable health systems for the future.
