When health is not for all: Confronting bias in global healthcare (1 May 2025)

# When health is not for all: Confronting bias in global healthcare Learn more and request your invitation: https://www.learning.foundation/bias “In Cameroon’s Northwest, the crisis has left facilities with no staff—just community health workers doing what they can. Many children are not vaccinated,” explains Morine Fuen, a district health worker. In South Africa, Sonia Botha reports, “Without Gavi support, we rely on provincial budgets that are not ring-fenced. Our children in marginalized communities miss out on resources.” These are not isolated cases but represent structural inequities determining who receives care across the global health landscape. ## The power of shared experiences When 4,700 health practitioners from 72 countries responded to the Geneva Learning Foundation’s (TGLF) call in April 2025, something remarkable happened. This event created a space for authentic exchange—no lectures, but practitioners sharing experiences of bias. Results were striking. Measured using TGLF’s evidence-based scale, participants reported 48% stronger worldview changes and 40% greater practice impact compared to global baselines from larger programs. “I became aware of the deep inequalities around me, even in contexts I thought I knew,” shared a physician from DR Congo—one of 76% reporting enhanced awareness of systemic biases. More compelling was what followed: 62% committed to implementing concrete changes in their practices. A Bulgarian health worker explained, “I am no longer passive. I actively work toward shifting systems that create inequity.” ## Beyond awareness to action Three weeks later, participants reconvened to co-design a Certificate peer learning programme focused on equity. The consultation revealed practitioners’ primary motivations: career advancement (40.8%), addressing workplace challenges (23%), and accessing expertise (21%). While early participants have come primarily from low- and middle-income countries, the programme aims to connect practitioners, researchers, and policymakers globally. “My primary reason for participating is to contribute to understanding inequality, share my experience, and learn from colleagues how they are coping,” explained Umar Pella Abdulrahman, a Nigerian NGO health worker. “In some areas, one nurse attends to 50 patients and one doctor serves 150 clients. Some rural communities hardly see a doctor.” ## Countering the “improvement paradox” This peer learning represents a paradigm shift in global health. Unlike traditional approaches where expertise flows downward from global experts, TGLF’s model creates lateral connections, allowing solutions developed in one context to rapidly spread to others facing similar challenges. What distinguishes this approach is its effectiveness in translating knowledge into action. By connecting over 60,000 health practitioners across 137 countries, TGLF has created channels for experiential knowledge to flow across borders, job roles, rank, and other hierarchies. This approach responds to the “improvement paradox” that has long plagued global health—where significant investments yield disappointing results. By focusing on intrinsic motivation, peer support, and contextual learning rather than prescriptive solutions, TGLF’s model has demonstrated remarkable success in bridging the persistent gap between knowing and doing. ## From fragmentation to collective power For Eunice Musembi at UNICEF Kenya, the timing is critical: “Equity is a key contributor to zero-dose immunization challenges. This certificate will help shape policies so healthcare workers and policymakers understand the critical role of equity in ensuring everyone receives quality care.” With 95% of participants from low- and middle-income countries requiring financial assistance, sustainable funding mechanisms are essential. TGLF is calling for funding partners to support the new programme, with a flexible pricing model combining tiered pricing by country income level and needs-based scholarships to ensure accessibility. Partners are also needed to include Global North funders, researchers, and policy makers in shared learning and action. In a health landscape fragmented by specialty, geography, and hierarchy, this initiative offers a rare opportunity for diverse practitioners to unite around a common purpose—ensuring health systems serve everyone, regardless of who they are or where they live. The question now is whether global health funders will recognize the power of this practitioner-led approach. Early evidence suggests that in the battle against systemic bias in health, our most powerful asset might be the collective wisdom of those closest to the problems—and to the solutions. The inaugural cohort will start on 9 June 2025. To receive the call for applications: https://www.learning.foundation/bias *All participants quoted speak in their personal capacity, not representing official positions of their organizations or governments.*