Book review: A handbook of learning for transformation

A cartography of learning for transformation

The Palgrave Handbook of Learning for Transformation offers a sweeping map of the territory of transformative learning. The editors have curated a massive collection of perspectives that stretch the boundaries of the field beyond its traditional roots in the work of Jack Mezirow. The volume is organized not as a linear textbook but as a series of provocations that invite the reader to wander through different passageways of inquiry.

As the editors Nicolaides and Eschenbacher explain, “a passage points to two directions – backward to the space one is leaving, and forward to the space one is approaching”. This orientation is critical because it frames the book not as a final destination but as a movement toward something new.

This structure allows for a rich diversity of voices:

Why should busy practitioners engage with this handbook?

As global health and humanitarian practitioners, we often feel the limitations of the transmission models of training that dominate our sector, yet we sometimes lack the precise vocabulary to explain why they fail in our complex, adaptive environments. This handbook is not a quick or easy read. It is dense, academic, and demanding. It is likely best suited for those of us – program designers, strategists, and technical leads – who are willing to wade through significant theoretical weight to find a more robust way forward. If we are willing to make that effort, this volume offers the intellectual grounding necessary to articulate why linear project cycles fall short in volatile crises and why we are more likely to make progress when we prioritize inquiry-based, networked learning. It equips us to defend the shift away from top-down directives toward approaches that center the frontline worker, helping us design evaluation metrics that measure genuine behavioral change rather than simple compliance.

Insights for networked and complex learning for transformation

Three chapters in this volume stand out for their direct resonance with the work of connecting frontline practitioners to solve complex problems. These contributions offer theoretical grounding that can strengthen practices focused on networked learning and collective intelligence.

Chapter 38: The Interpenetration of Individual and Collective Transformation.

Abigail Lynam and her colleagues present a framework that is vital for understanding how learning scales. They argue that individual and collective development are not separate processes but are deeply intertwined. This mirrors the dynamic we observe in large-scale peer networks where the “We” becomes a powerful engine for the growth of the “I.” They describe how the “subtle We” consists of “the perception of being situated in and arising out of a plurality of contexts” where “the We is not then a specific group of people, but is a relational space, a quality brought to relationships, or a relational field”. Their discussion of “subtle community” and the movement from differentiation to integration provides a useful vocabulary for understanding how digital networks can become spaces of profound connection and shared purpose rather than just channels for information exchange.

Chapter 39: Power of Questions: Transformation in Complex Systems.

Glenda Eoyang’s contribution is essential for any organization operating in volatile and uncertain environments. She argues that in complex systems, traditional answers and linear plans often fail. As she states, “Certainty will never be possible, so it must be replaced with inquiry”. Her approach to “Adaptive Action” – asking What, So what, and Now what – aligns perfectly with the need for iterative, action-oriented learning cycles. She notes that “answers are useful only in limited space and over a short period of time”. This chapter validates the move away from didactic training toward inquiry-based models where learners interrogate their own reality. It reinforces the idea that transformation in complex settings requires the ability to see patterns and adjust actions in real time rather than adhering to rigid protocols.

Chapter 44: Evaluation as a Pathway to Transformation.

Scott Chaplowe and his co-authors tackle the critical challenge of measuring impact in complex systems. They critique the industry’s fixation on metrics, citing Natsios to note an “Obsessive Measurement Disorder” where the production of evidence undermines the very interventions it is supposed to support. They vividly illustrate the problem by quoting Mueller: “the snake of accountability eats its own tail”. They propose a shift toward “transformational evaluation” that supports learning and adaptation. This is crucial for organizations that seek to bridge the gap between learning and performance. It suggests that we must move beyond counting the number of people trained to measuring the actual shifts in behavior and the tangible outcomes that result from learning. This chapter provides a robust theoretical basis for measuring impact through the lens of systems change rather than simple compliance.

How does our work connect to the learning and insights of the handbook?

The handbook offers a rich theoretical map. The approach we take at The Geneva Learning Foundation complements this map by building the vehicle required to traverse this territory at speed and scale. While the handbook often focuses on the intimate or the theoretical, our work demonstrates how these principles can be operationalized for thousands of learners simultaneously.

From theoretical complexity to cognitive quiet

The handbook is dense with academic rigor and complex language. Arguably, this complexity may be necessary for the advancement of theory. TGLF’s approach complements this by translating these high-level concepts into cognitive quiet. We strip away the theoretical noise to focus on the essential loop of analysis, action, and reflection. As Eoyang points out, in complex environments, “one simple intervention sets conditions for multiple, unpredictable transformational changes”. We strive to turn sophisticated ideas from learning theory and embed them into simple, accessible workflows that busy professionals can use immediately. We nourish the handbook’s theories by showing they work not just in the seminar room but in the gritty reality of communities facing multiple, intertwined crises.

From individual reflection to collective intelligence

Many chapters in the handbook focus on the individual or small group as the unit of transformation. We expand this horizon by demonstrating that scale enhances quality. The “We-Space” discussed by Lynam need not be limited to a room of people. It can be a digital network of thousands. Fergal Finnegan, in Chapter 4, warns against the “false dichotomy” between individual and social transformation, noting that “it is a mistake to treat collective agency as a simple scaled-up aggregate version of what happens at an individual level”. Our approach is proving that when you connect vast numbers of peers, you generate a collective intelligence that exceeds the capacity of any single room full of experts. We take the theoretical possibility of collective transformation described in the text and turn it into a practical engine for local actors solving real-world problems.

Producing new learning for transformation

The handbook, by its nature, is a collection of expert knowledge to be consumed by the reader. Our work complements this by inverting the model. We treat the learner not as a consumer of the handbook’s wisdom but as a producer of new knowledge. We operationalize the decolonial and emancipatory themes found in the book by centering the experience of the practitioner as the primary text. As Seehawer and colleagues note in Chapter 26, we must move away from focusing on challenges and toward “recognising our agency as teachers and lifelong learners”. The handbook explains why voice matters. Our platform gives that voice a global megaphone. We operationalize the philosophy contained in these pages by building the digital infrastructure that allows the learners themselves to theorize their practice and lead the transformation of their own systems.

Reference

Nicolaides, A., Eschenbacher, S., Buergelt, P., Gilpin-Jackson, Y., Welch, M. and Misawa, M. (Eds.), (2022). The Palgrave handbook of learning for transformation. Palgrave. 956 pp. $279 USD (hardcover), ISBN: 978-3-030-84693-0. https://doi.org/10.1007/978-3-030-84694-7

5 surprising insights from the science of successful learning

The work of Reda Sadki offers a provocative, often counter-intuitive critique of how we learn, lead, and solve complex problems.

Here are five surprising insights from his body of work.

1. Text is superior to video for learning

In an era where educational technology is obsessed with video content, immersive simulations, and flashy multimedia, Sadki argues for the humble written word.

He asserts that the push for multimedia is often a “deception” that confuses engagement with entertainment.

In Richard Mayer’s research on multimedia for learning actually proves text works better, Sadki re-examines the foundational science of instructional design.

He points out that multimedia often creates “cognitive waste” by forcing the brain to split attention between visual and auditory streams.

He argues that well-structured text is “cognitively quiet” and far better suited for the high-level critical thinking required in complex fields.

He doubles down on this in Against chocolate-covered broccoli: text-based alternatives to expensive multimedia content.

Here, he describes multimedia as an economic dead end.

He argues that text is not only cheaper and easier to update but also creates a more equitable learning environment for professionals in low-bandwidth settings.

2. Gamification is a “disaster” for humanitarian learning

While many organizations rush to “gamify” learning with badges, points, and leaderboards, Sadki calls this trend a “dead end.”

He argues that gamification is simply “lipstick on the pig of behaviorism,” a discredited theory that treats learners like rats in a maze responding to stimuli.

In Why gamification is a disaster for humanitarian learning, he makes a blistering case that games fail to model the complexity of the real world.

He points out that the dominant culture of video games often relies on violence and competition, which are antithetical to humanitarian values.

He argues that professionals facing life-and-death decisions need critical reasoning skills, not the artificial dopamine hits of a game.

3. Low completion rates can be a sign of success, not failure

In the world of online courses, a low completion rate is usually seen as a failure of design.

Sadki flips this metric on its head.

He suggests that in professional settings, “completion” is a vanity metric, part of the legacy of education systems that kept learners in closed environments.

In Online learning completion rates in context: Rethinking success in digital learning networks, he argues that busy professionals often engage with learning to solve a specific problem.

Once they find the solution, they leave.

This “drop-off” is actually efficient learning in action.

He warns that optimizing for completion often leads to dumbing down content rather than increasing its impact.

4. The “transparency paradox”: health workers are using AI in secret

One of Sadki’s most startling recent observations comes from his work with frontline health workers.

He reveals that professionals in the Global South are already using advanced Artificial Intelligence (AI) tools, but they are forced to hide this fact.

In Artificial intelligence, accountability, and authenticity: knowledge production and power in global health crisis, he describes a “transparency paradox.”

Global health systems are often punitive.

If a health worker admits to using AI to help draft a report or analyze data, their work is devalued as “inauthentic,” even if the quality is higher.

This forces innovation underground and prevents organizations from learning how to effectively partner with AI.

He expands on the solution in A global health framework for Artificial Intelligence as co-worker to support networked learning and local action, arguing that we must legitimize AI as a “co-worker” rather than a cheat.

5. Cascade training is mathematically doomed to fail

Finally, Sadki uses simple mathematics to dismantle one of the most common methods of training in the world: the “cascade” model, where experts train trainers, who train others.

In Why does cascade training fail?, he demonstrates that information loss at every level of the cascade is inevitable.

He argues that this model persists not because it works, but because it is convenient for hierarchical organizations.

He offers a stark alternative in Calculating the relative effectiveness of expert coaching, peer learning, and cascade training, where he proves that peer learning networks are the only model capable of scaling without losing quality.

The future of hybrid engagement: accelerated action to tackle global threats

How can we use the new physics of digital connections to save lives? What is the future of hybrid engagement?

Mobilization: validating social presence

Analysis: engineering high-bandwidth interaction

Action: from surveillance to accompaniment

The metrics of connection

A new peer learning programme for those leading change across distance

References

• • Lampel, J. and Meyer, A.D. (2008) ‘Field-Configuring Events as Structuring Mechanisms: How Conferences, Ceremonies, and Trade Shows Constitute New Technologies, Industries, and Markets’, Journal of Management Studies, 45(6), pp. 1025–1035. Available at: https://doi.org/10.1111/j.1467-6486.2008.00797.x

• • Lave, J. and Wenger, E. (1991) Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge University Press. Available at: https://doi.org/10.1017/CBO9780511815355

• • Jarvenpaa, S.L. and Leidner, D.E. (1999) ‘Communication and Trust in Global Virtual Teams’, Organization Science, 10(6), pp. 791–815. Available at: https://doi.org/10.1287/orsc.10.6.791

• • Jones I, Sadki R, Brooks A, Gasse F, Mbuh C, Zha M, et al. IA2030 Movement Year 1 report. Consultative engagement through a digitally enabled peer learning platform. The Geneva Learning Foundation; 2022. Available from: https://doi.org/10.5281/zenodo.7119648.

• • Sadki, R., 2024. How can we reliably spread evidence-based practices at the speed and scale modern health challenges demand? https://doi.org/10.59350/cqxmj-3bd96.

• • Sadki, R., 2025. What is The Geneva Learning Foundation’s Impact Accelerator?https://doi.org/10.59350/redasadki.21161.

• • Sadki, R., 2025. PFA Accelerator: across Europe, practitioners learn from each other to strengthen support to children affected by the humanitarian crisis in Ukraine. https://doi.org/10.59350/redasadki.21155.

• • Watkins, K.E., Bhattarai, A., 2019. Analysis of the Impact Accelerator Launch Pad Individual Acceleration Reports in July 2019. University of Georgia at Athens, Athens, United States.

About the installation

What we are learning about diversity in gender and emergencies work

On 18 September 2025, we first announced our new Certificate peer learning programme for gender in emergencies. The first course, a primer on the topic, then launched on 6 October.

As of 21 January 2026, the gender community of The Geneva Learning Foundation (TGLF) now reaches 6,592 practitioners. This amazing growth is the result of the first primer “going viral”, and a testament to the Foundation’s learning communities that responded to the call to action, joined the course, and spread the call for enrollment far and wide.

On 14 October 2025, The Geneva Learning Foundation issued the first call for domain experts to support and guide the programme’s future development.

In humanitarian work, hiring processes are frequently opaque. Specialized topics like gender in emergencies have relied primarily on closed networks led by Global North gatekeepers with impressive credentials and “field” experience. Our thinking was that this excludes or marginalizes practitioners who live every day in the “field” where global humanitarians deploy during emergencies.

Here is what we learned when we opened our roster to both INGO networks that remain concentrated in the Global North and to our own networks that connect over 80,000 health and humanitarian workers, primarily based in local communities of the Global South.

Seeking a guide on the side

The call for applications issued in October 2025 sought a specific type of professional: the “Guide on the side”. This is a facilitator tasked with holding safe and brave spaces for humanitarian practitioners to find solidarity and deepen their analysis.

The Geneva Learning Foundation prioritized several core requirements for this role:

• Deep domain expertise in gender in emergencies, for example in areas like Rapid Gender Analysis or risk mitigation for gender based violence.
• A practice grounded in intersectional, feminist, and decolonial analysis.
• A practice in line with our conviction that practitioners who are there every day hold the essential knowledge required to solve complex problems.
• Full professional fluency in English, French, and other languages to facilitate complex and nuanced discussions across linguistic divides.

Who answered the call: a demographic profile

We received 61 applications from 26 countries, 49% of them from women. The largest concentrations of applicants are found in the Democratic Republic of the Congo and Nigeria, which together account for 41% of the total. However, for the Democratic Republic of the Congo, men represent 67% of the applicants, while Nigeria shows a more balanced split with 55% men and 45% women. Four countries (Spain, Jordan, Morocco, and South Africa) had only female applicants, whereas applicants from three countries (Ethiopia, India, and Senegal) were all men.

Women from the Global North, primarily residing in countries like Spain, Greece, and Switzerland, consistently presented the most extensive institutional pedigrees, citing decades of experience authoring global strategies and leading interagency coordination for major international organizations. In contrast, applications from women in the Global South, although fewer in number, were characterized by grassroots activism and authority derived from personal lived experiences of conflict and displacement. Men from the Global South represented a significant portion of the pool, particularly from the Democratic Republic of the Congo and Nigeria, and their profiles frequently combined technical public health roles with a deep commitment to adapting global guidelines to complex local realities. Notably, no applications were received from men residing in the Global North for this specific call.

Beyond credentials: vague claims versus tangible artefacts

A critical part of our analysis involved distinguishing between vague, unverifiable claims and tangible examples of achievements. Many applicants stated they were “passionate about gender” or “committed to equity” without providing evidence of how this commitment manifested through what they have actually done in their work or life. Passion may be necessary, but it is unlikely to be sufficient without analysis.

Some candidates provided concrete examples. Here are four examples:

• Localized technical tools: One applicant developed culturally relevant glossaries and training materials in Arabic to decolonize the language of gender and protection. Another led the design of a Menstrual Health and Dignity Project that promoted youth leadership and gender justice in partnership with local networks.
• Documented field leadership: Candidates shared evidence of leading national level Rapid Gender Analyses in displacement sites, where they trained local teams and validated results directly with communities.
• Integration of gender into technical sectors: Several health professionals shared how they successfully integrated gender sensitive strategies into outbreak preparedness and large scale immunization campaigns.
• Strategic policy influence: One candidate led the development of a global gender justice strategy that centers decolonial feminist approaches and prioritizes collaboration with women led organizations.

The intersection of professional background and lived experience

A significant dimension shared in many motivation letters was the “why” that informs their practice. For these individuals, expertise is not just a credential. It is a lived reality that is both personal and political.

• Survivors and activists: Several candidates identified as survivors of conflict and displacement. They stated that their commitment to gender equity was not learned from books but was “painfully and personally lived”.
• Identity as expertise: Applicants from the Global South shared how their own multicultural and multilingual identities allow them to navigate power dynamics that Western centric frameworks might miss.
• Commitment to unlearning: Many senior experts explicitly addressed the need for “continued unlearning” to recognize their own privilege and create truly inclusive spaces.

Divergent paths to expertise: local activism versus institutional pedigree

The call for applications revealed a profound bifurcation in the nature of expertise within the humanitarian sector. On one hand, a significant number of applications originated from practitioners rooted in local communities across Africa, Asia, and the Arab World. These candidates presented profiles characterized by grassroots activism and direct advocacy. What was distinct about their applications was the source of their authority: it was not solely academic but was often described as being painfully and personally lived. Some are founders of grassroots initiatives that work on dismantling systems of forced labor and modern slavery. Others are community health supervisors who coordinate responses in health zones facing extreme poverty and armed conflict. Their applications emphasized the importance of psychological liberation and rebuilding agency from within the community rather than through external intervention.

In contrast, applications from women based in the Global North, particularly from Spain, Switzerland, and Greece, held the most impressive institutional pedigrees. These profiles were marked by decades of experience shaping global policies and leading interagency coordination for major international organizations. They are the authors of global gender justice strategies, senior GenCap advisors who provide technical assistance to United Nations Humanitarian Coordinators, and architects of standardized guidelines for gender-based violence response. Their achievements are measured by the scale of their institutional reach and the creation of universal frameworks intended for deployment across diverse emergency contexts.

From a decolonial feminist lens, these differences illustrate what Ogochukwu Udenigwe and her colleagues describe as “hierarchical knowledge praxis”. In plain language, Global North candidates often function as dispensers of human rights and experts who generate knowledge for others to consume. This reflects the coloniality of power where the West remains the center of production while the rest of the world is positioned as a recipient. 

Conversely, the local activist profiles represent a form of epistemic disobedience. They refuse to be reduced to passive beneficiaries or informants, and assert themselves as knowledge-holders whose firsthand experience is the most critical resource for solving complex challenges. Their applications challenge the saviourism narratives that often characterize international interventions by prioritizing relational accountability and indigenous histories of solidarity.

Solidarity as an act of unlearning and reclaiming

By opening our roster, we are not dismissing institutional expertise but rather creating a site where global strategic knowledge and ‘authentically intelligent’ local experience can meet as equals to solve problems that neither can address alone, to the benefit of both.

In this framework, solidarity does not mean “helping” the Global South from a position of superiority. Instead, it requires a two-way transformation:

• Global North allies can engage in a deliberate process of unlearning positional privilege and recognizing that their “expert” knowledge often excludes the lived realities of those they aim to protect.
• Global South practitioners can reclaim their status as knowledge-holders and experts who are capable of autonomous thought and innovation.
• Both groups benefit from working together to “delink” from Western narratives that pathologize cultures of the Global South and instead value indigenous histories of solidarity, such as the African tradition of “safe spaces”.
• This process fosters “relational accountability,” where the primary responsibility of a consultant is to the community served rather than to a distant donor or state bureaucracy.
• Legitimacy is best defined not only by institutional pedigree but by ‘relational accountability’ to the communities being served and the ability to turn shared insights into concrete action.

By opening the call to everyone with decolonial criteria clearly in mind, we hope to build a bridge across the chasm between “global” and “local” knowledge. True leadership in gender in emergencies requires the humility to listen and the courage to act upon what is heard. As this programme moves forward, our goal is to build an ecosystem where every practitioner, regardless of their geography, identity, or pedigree, can both contribute and benefit.

References

Bian, J., 2022. The racialization of expertise and professional non-equivalence in the humanitarian workplace. Int J Humanitarian Action 7, 3. https://doi.org/10.1186/s41018-021-00112-9

Sadki, R., 2026. Reimagining Rapid Gender Analysis as decolonial practice. https://doi.org/10.59350/rr0d3-3pk55

Sadki, R., 2025. Gender in emergencies: a new peer learning programme from The Geneva Learning Foundation. https://doi.org/10.59350/j3twk-d9x53

Udenigwe, O., Aubel, J., Abimbola, S., 2026. A decolonial feminist perspective on gender equality programming in the Global South. PLOS Glob Public Health 6, e0005556. https://doi.org/10.1371/journal.pgph.0005556

Wenham, C., Davies, S.E., 2022. WHO runs the world – (not) girls: gender neglect during global health emergencies. International Feminist Journal of Politics 24, 415–438. https://doi.org/10.1080/14616742.2021.1921601

Ideas Engine: What is The Geneva Learning Foundation’s insights mechanism?

It’s a cliché to claim that data is the “new oil”, a resource to be mined. We collect it from the field, refine it with experts, and utilize it for decision-making. However, we rarely ask what this extractive model does to the workers and communities that provide the raw materials. This is a summary of how and why we developed the Ideas Engine to collect and share insights.

The flow of data remains largely one-way. We ask local actors to report on vaccination coverage, disease outbreaks, or supply shortages. Yet, all too often, this valuable information travels up the chain without ever returning to the people who generated it in a way they can use.

What if the act of reporting was, in itself, an act of learning? What if the input mechanism was designed not just to feed a database, but to inform the practitioner? What if this recognized the significance of qualitative experiences that are usually dismissed as anecdotes? 

This shift in perspective is the driving force behind The Geneva Learning Foundation’s Ideas Engine, first launched in July 2020 with a group of more than 600 practitioners who designed the COVID-19 Peer Hub with support from the Bill & Melinda Gates Foundation (BMGF).

This mechanism is helping us move beyond the traditional survey model to create a system of reciprocal value. Every piece of data shared becomes a tool for empowerment, connection, and locally-led change.

Ideas Engine: moving beyond mining the frontline

Epidemiologists are trained to dismiss experience as anecdotal, to minimize bias, and to extract clean data. We treat the local actor as a sensor or a passive instrument to measure coverage or disease incidence. But a local actor is not a sensor. She is a professional with the capacity to think, act, and learn. And yet, data reported by local actors are treated with suspicion, generally assumed to be unreliable for multiple reasons.

When we treat a community volunteer or a district medical officer merely as a source of data, we do more than miss the context. We strip them of their agency. We reduce a thinking, adapting professional operating in a complex adaptive system to an anonymous row in a dataset.

This is an epistemic injustice. It assumes that knowledge resides in the center, with experts who analyze the data, while the periphery become an anonymous source or informant.

When we treat people and communities as data sources, we also fail to capture the tacit knowledge that explains the numbers. We miss the story of how a nurse in Kano negotiated with a community leader to allow vaccinators entry. We miss how a district officer in Bihar adapted cold chain logistics during a flood.

The Insights mechanism that led to developing the “Ideas Engine” is not a survey tool designed to extract information for the center. It is a pedagogical pattern designed to build power at the periphery. It supports local actors’ inherent capacity to learn from each other, while offering global actors a rare opportunity: the chance to listen, to act on what they hear, and to question governing assumptions that drive global strategies.

Our Insights mechanism is designed to capture this layer of reality. It operationalizes what learning theorists like Diana Laurillard describe as a conversational framework, but applies it outside classrooms and at a massive scale. Instead of a teacher-student dialogue, we facilitate a peer-to-peer dialogue across borders. This draws on George Siemens’s connectivism, where learning happens by connecting nodes of information across a network. We then add a critical layer of structure to ensure those connections lead to action. This embodies Cope and Kalantzis’s vision of active knowledge production, where the learner is not a consumer of content, but a creator of it. Last but not least, we draw on the insights from the work of Karen E. Watkins and Victoria Marsick to map the capacity for change or “learning culture” that set outer boundaries that local actors operate within.

This mechanism remixes these theoretical frameworks to life on the outer cusp of chaos. It operates in humanitarian emergencies, disasters, war zones, and extreme poverty, engaging tens of thousands of participants where traditional systems fracture. 

Reciprocity as justice, not transaction

In traditional marketing, there is a concept called give-to-get. You give a free resource to get an email address. This is transactional. Our philosophy is different. We believe that giving back is a requirement of justice.

When a health worker in a conflict zone takes thirty minutes to share a story about overcoming vaccine hesitancy, they are performing unpaid labor for the global good. If we do not return that value to them rapidly and in a usable form, we are participating in the same extraction we claim to oppose.

Learn more: Why answer Teach to Reach Questions?

Our Insights mechanism is therefore built on a specific architecture of reciprocity. It cycles value back to the contributor at every stage of the process. This ensures that the mechanism serves the practitioner first, and the hierarchy is positioned in support of the practitioner. This distinct ethical framework is what allows us to maintain high levels of engagement and trust over time.

The architecture of the Ideas Engine: from reflection to action

The mechanism is a complex assembly of pedagogical scripts, technical workflows, and community engagement loops. It functions as the central operating system for our learning programs, feeding both the Teach to Reach events and the Impact Accelerator.

1. The input: reflections, not reporting

Standard data collection asks for statistics. How many children did you vaccinate? This triggers compliance. Our questions ask for narratives. Tell us about a time you faced a challenge. What did you do?

This phrasing is intentional. It forces the user to pause and reflect on their own practice. This is metacognition. It transforms them from a data subject into a knowledge producer.

2. The immediate return: collections of experiences

Our insights team reads every contribution. The team then does the grueling work of producing a collection of Shared Experiences. This is a compendium with hundreds and sometimes thousands of peer stories. It is filtered only to remove nonsensical or AI-generated content.

We strive to share this back with the community as quickly as possible. This validates tacit knowledge. It tells the health worker that their experience matters enough to be shared with the world rapidly. It is also that a health worker facing a cholera outbreak today is more likely to benefit if the latest experiences are shared when and where they are needed, not on a scholarly publishing calendar that may take months or years. (Our process includes peer feedback, and we posit it actually resolves some of the challenges being faced by academic publishing.)

3. The synthesis: thematic insights reports

While the raw collection is fast, we then use more conventional qualitative research techniques to produce thematic insights reports, also known as “eyewitness reports”. Each report distills dozens, hundreds, or thousands of contributions into short summaries of what we learned from them, on a specific topic or challenge. Written for the community, they identify patterns that no single individual could see on their own. These reports also turn out to be surprisingly relevant and useful for non-local actors.

4. The dialogue: dynamic event-driven knowledge translation

Knowledge in action is dynamic, by definition. The Ideas Engine is about turning knowledge into action. This is why we host Insights Live. These are rapid-fire livestreamed sessions where the data comes alive, with contributors, guides on the side, and anyone else interested joining to discuss how they are putting to use what we are learning together.

We invite the contributors themselves to take the floor as our guests of honor. A lot of what happens in these live session – who speaks, what we learn – we cannot and do not predict in advance. It is emergent. This is more akin to jazz improvisation, rather than the rigid classical music orchestration of presentation webinars. We invite global partners and funders to listen. This reverses the usual power dynamic. We then turn these livestreamed events into podcasts. This ensures that even those with low bandwidth or no time to watch a screen can access the learning.

5. The application: closing the loop

Knowledge is useless if it cannot be shared. This is why we provide tools for dissemination. For example, we prepare short slide decks that contributors can use to present insights to their colleagues and teams.

Crucially, this includes a feedback facility. We track not just who downloaded the deck, but who presented it and what their colleagues said. This allows us to measure the ripple effect of the insight, including actual use and, in some cases, how the use of an insight led to changes in practice and tangible improvements in outcomes.

Does the Ideas Engine actually make a difference?

Does this actually work? Is it better than a survey? The data suggests yes.

In an independent analysis by the University of South Australia’s Centre for Change and Complexity in Learning, researchers examined our Ideas Engine. This was a core component of this mechanism during the COVID-19 Peer Hub. The report revealed the scale of engagement that this proprietary method generates.

• Scholars contributed 1,103 ideas and 3,061 comments. This is an average of 2.77 comments per idea.
• 80.2% of participants reported using the Ideas Engine.
• Of those who used it, 92.9% reported finding ideas that were useful for their work.
• Perhaps most importantly, the analysis of citations showed that two-thirds of the citations in action plans were to ideas from peers working at different levels of the health system.

This proves that the mechanism does not just collect data. It successfully bridges the gap between knowledge and action by connecting practitioners across hierarchies.

Photo: The Geneva Learning Foundation Collection © 2020

This article was updated on 6 January 2026 to reflect what we have learned since 2020.

Implementation science for planetary health

Remarks about implementation science for planetary health by Reda Sadki, Executive Director, The Geneva Learning Foundation at the Centre for Planetary Health’s research corner meeting, London School of Hygiene & Tropical Medicine (LSHTM) on December 17, 2025.

Pauline Paterson (LSHTM): We are really delighted to welcome Reda Sadki. Reda is the Executive Director of the Geneva Learning Foundation, a non-profit research organization developing new epistemological and methodological approaches for complex global health challenges. Welcome, Reda.

Reda Sadki (TGLF): Warm greetings from Geneva, Switzerland. I am very pleased to share with you what we have been learning about climate change and health – in particular, how we can move from ground truth to local action on a global scale.

Since 2021, we have been running an initiative called Teach to Reach, led by community-based health professionals from all over the world. It connects people across countries and job roles, supporting the journey from local insight to global health initiative.

The scale of this network has grown significantly. In March 2021, we started with 2,604 participants. By December 2024, at the eleventh meeting of Teach to Reach, we had 24,610 health workers participating.

Who are they? Most work in health facilities and districts. Half work for government and half for civil society organizations.

Where are they? They serve in the most fragile contexts: 62% work in remote rural areas; 47% with the urban poor; 25% with refugees or internally displaced populations. And one in five work in areas of active armed conflict.

Alongside these individuals, we are nurturing the REACH Network, a coalition of more than 4,000 locally-led organizations. This is the backdrop for how we think about leadership as the key to driving change in climate and health.

The “dark matter” of implementation science

As a community working on climate change and health, we are strong – and getting stronger – on diagnosis. But we must be candid: we are weak on delivery. The science keeps getting better, but there is a gap when it comes to translating science into action.

When it comes to formal research, we see what I call the ”dark matter”, a blind spot around hyperlocal adaptation and how implementation actually happens at the local level.

This dark matter includes environmental, behavioral, and systemic signals that formal research might miss: social and economic disruption, hidden mental health burdens in communities with no formal services, community coping mechanisms, and subtle changes in vector behaviors.

Now, I know that for many of you trained in epidemiology, the word “anecdote” sets off alarm bells. We are taught to devalue it for good reason: it is prone to recall bias, selection bias, and lacks denominators. A nurse in Bangladesh noticing “more heatstroke” is a signal, not a prevalence study. We are not claiming it is.

However, we have two ways to answer the questions these signals raise. We can carry out long-term, rigorous academic studies over decades. Or – given that we are past several climate tipping points – we can recognize that aggregate patterns formed by thousands of these signals offer a speed and granularity that traditional studies cannot match. This functions as a massive, distributed sentinel surveillance system. It may be “imperfect” compared to a controlled trial, but is it riskier than the alternative? The alternative is often waiting years for definitive answers while communities suffer damage that may make those findings moot.

This requires a new epistemology. Our hypothesis is that we can build a system where an anecdote becomes an eyewitness report. A health worker, traditionally seen as a “knowledge recipient” presumed ignorant of climate science, becomes a “knowledge creator”. They know things about local impacts that no one else knows, simply because they are there every day.

In July 2023, Charlotte Mbuh, TGLF’s director who started over a decade ago as a sub-national health worker from Cameroon, stood at COP28 and said:

”What we know, we know because we are here every day. We are already managing the impacts of climate change on health. We are doing the best we can, but we need your support.”

Read Charlotte Mbuh’s full statement at COP28: Climate change is a threat to the health of the communities we serve: health workers speak out at COP28

Turning experience into evidence: the global climate change and health survey

To operationalize this, we built a living laboratory powered by a global human sensor network.

In 2025, in partnership with Grand Challenges Canada and a group of 50 global funders (including Gates, Wellcome, and Rockefeller), we conducted what I have been told is the largest-ever climate and health survey, and the one with the highest level of responses from local communities in the most climate-vulnerable regions

We received responses from 6,436 health workers, primarily from the sub-national level. Because of the trust we have built over years, the Teach to Reach network contributed over 60% of these responses, ensuring we heard from the most climate-vulnerable regions.

https://www.youtube.com/watch?v=C67nYqq-hP0

Most importantly for funders, we asked about barriers to action. The top barriers were not just resource shortages, but structural issues.

Pending their formal publications, I am not yet able to share results.

These findings are signals. They generate hypotheses. Here are three examples of hypotheses grounded in health worker experirences:

• Geh Raphaela Agwa, a midwife from Cameroon, told us: “During this unfavourable weather period, people who can paddle canoes come in and help…”. Could community-led transport solutions improve maternal health access during floods?
• Solace Jewel Morgan, a disease control officer in Ghana, told us: “The dry season… results in dust particles known as harmatan. This leads to a high incidence of respiratory illnesses… encourage… free distribution of personal protective masks.” Could prophylactic mask distribution reduces respiratory morbidity during the harmatan season?
• Victoire Odia, a nurse from the Democratic Republic of Congo (DRC), told us that during extreme weather events, maternity “stays were paid for by the women’s group solidarity fund.” Could micro-financing networks increase facility-based deliveries in climate-vulnerable areas?

Of course, we must distinguish between generating a hypothesis and validating an intervention. We do not claim every local idea is safe or effective immediately. But we do claim that listening is the prerequisite to testing them.

From insight to impact: the Accelerator model for implementation science

We do not just extract data. We give it back to the community to prompt action. Since 2016, we have developed an “Accelerator” system that moves from listening to implementation. It works on a simple rhythm: participants set a specific, practical goal on Monday, and on Friday, they report on what happened, receiving feedback from peers.

This brings us to a critical tension: the balance between context and content. Critics might argue that prioritizing “context over content” carries risks. What if health workers implement unproven or suboptimal strategies? That is a valid concern. However, we see this mechanism not as a way to bypass evidence, but as the most effective tool to operationalize it.

In The Geneva Learning Foundation’s Accelerator, every participant commits to work toward their countries’ goals, and to do so by using the best available global knowledge.

Learn more: What is The Geneva Learning Foundation’s Impact Accelerator?

This actually supports effective adoption and use of global guidelines, which otherwise may linger on shelves.

In fact, we have shown in the past that this mechanism increases adherence to proven protocols (e.g., WHO guidelines on heat stress or malaria control). That is one important reason why it is a powerful implementation science tool. It transforms adherence from a wish expressed in the capital city into a reality in local communities.

Furthermore, if national planners and international experts are willing to listen, they may hear back ways to improve and strengthen the global standards, as well as gain new insights into the “how” of local implementation that defies easy generalization.

When we compared this model to conventional technical assistance or “cascade training,” the results were stark :

These results give us confidence. We are not starting from zero. We are building on prior work in immunization and other areas of work where supporting implementation led to exactly these kinds of validated outcomes.

Here are two examples of local solutions in action.

• Côte d’Ivoire: Communities identified stagnant water as a malaria risk and organized youth-led cleanup committees to clear gutters. This resulted in a drastic, locally measured drop in malaria cases.
• Cameroon: In response to frequent floods, communities voluntarily cleaned gutters to ensure water did not stagnate, directly impacting disease vectors.

No one in the capital city – and certainly no one in Geneva or Seattle – knew about these initiatives.

This leads to our most ambitious projection. If we can grow this network from 80,000 to 1 million health workers by 2030, we estimate we could save 7 million lives through simple, locally resourced projects, at a cost of less than $2 per life.

I acknowledge this is an aggressive claim. It is a “back-of-the-envelope” calculation based on our pilot data. It assumes that local projects remain effective at scale and that we can attribute outcomes to the network. But I ask you: if there is even a glimmer of a chance that this is true – that we can save lives at a fraction of the cost of traditional interventions – isn’t it worth investing in the rigorous research to find out?

Discussion

Do you think MOOCs (Massive Open Online Courses) are dead?

Reda Sadki: MOOCs have become primarily marketing tools for higher education. From a pedagogical perspective, they remain transmissive, expert to learner. I do not see how that model can deliver against complex problems. We need a two-way street. We need new ways to organize the production and circulation of knowledge.

Thank you, Reda. I noticed in your results that food security is a major concern. Have you identified local actions focusing on food, given the challenges of working with healthcare workers who might not see this as their primary remit?

Reda Sadki: That is a critical question. Food insecurity is one of the most worrying consequences we are tracking. We often see a mismatch where local actors tasked with, say, immunization, do not see nutrition as their lane. However, at the community level, the approach is naturally integrated – the health worker knows the vet, who knows the farmers. Those connections exist.

We are currently preparing a major insights report that includes a specific chapter on food security. We are also designing an accelerator specifically around this topic to bring together the right set of partners, because the consequences we are documenting are dire.

You mentioned that 78% of participants eventually said “no thank you” to further support. Ideally, shouldn’t these peer networks become self-sustaining, bypassing Geneva or London entirely?

Reda Sadki: That is the goal. We have shown that more than half of each cohort stays in touch to continue leading local action. However, as long as resources and decision-making power remain concentrated in global centers, we cannot just “flip a switch”. We need to build bridges that facilitate that transformation. The goal is autonomy, but the reality requires us to actively dismantle the dependencies that current funding structures create.

Are there new capabilities that we in academia need to develop urgently to support this?

Reda Sadki: It is about moving away from being the “sage on the stage” to a “guide on the side”. For example, in our recent work, global partners and experts joined Teach to Reach sessions not to present the latest guidelines, but to listen to the challenges local practitioners faced. They then had to figure out how their expertise could be useful in response to those specific needs.

For researchers inside academic institutions, this can be difficult. It requires starting not with a research question, but with a willingness to listen to the needs of local actors and let the research questions emerge from that reality. We know this challenges the incentive structures of academia, but we are open to partnering with researchers willing to work in this emergent, demand-driven way.

It is a fascinating dilemma – we want to be guided by needs, but funding requires pre-set hypotheses. Reda, this has been truly impressive. Thank you for sharing these refreshing perspectives.

Reda Sadki: Thank you. We look forward to exploring how we can collaborate. Best wishes for the holidays and the new year.

References

Images: The Geneva Learning Foundation Collection © 2025

Subnational tailoring of malaria strategies and interventions: bridging the gap between planning and implementation

The global malaria response is currently navigating a convergence of crises. Epidemiologically, the reduction in mortality has plateaued. Biologically, threats from Anopheles stephensi and partial artemisinin resistance are accelerating. Financially, the 2025 landscape is defined by a severe contraction in foreign assistance, necessitating a radical optimization of resources. In this context, the World Health Organization’s (WHO) new guidance, Subnational tailoring of malaria strategies and interventions (2025), offers a necessary technical framework.

However, the manual relies on an implementation architecture that remains fragile. To succeed, the technical rigor of subnational tailoring (SNT) should be coupled with an operational mechanism capable of mobilizing the workforce in the current context. This article examines how digital peer learning-to-action networks offer a potential mechanism to address the operational deficits of conventional technical assistance and capacity building.

Subnational tailoring of malaria strategies: moving from blanket coverage to allocative efficiency

The rationale for SNT rests on the recognition that transmission heterogeneity – driven by ecology, urbanization, and human behaviour – renders national averages insufficient for operational planning. The WHO guidance codifies a ten-step “Data-to-Action Loop,” designed to be embedded within the National Malaria Strategic Plan (NMSP) cycle. This process moves beyond simple risk mapping to a rigorous cycle of optimization:

• Granular stratification: This involves using composite metrics (combining prevalence, incidence, and mortality) to segment operational units, rather than relying on broad national averages.
• Tailoring and prioritization: This requires developing “ideal scenarios” (what is epidemiologically required) versus “prioritized scenarios” (what is financially feasible). For example, this might involve restricting expensive indoor residual spraying (IRS) to high-burden zones while deploying next-generation nets solely in areas of confirmed pyrethroid resistance.
• Resource optimization: This entails using cost-effectiveness analysis (CEA) to scientifically justify trade-offs, such as cutting lower-impact interventions to preserve life-saving commodities in the face of budget shocks.

The implementation gap: systemic blind spots in subnational tailoring of malaria strategies

While the WHO framework is technically robust, its execution faces systemic “blind spots” that threaten to undermine the strategy:

• The private sector void: In high-burden nations such as Nigeria, the private sector acts as the primary entry point for febrile patients yet remains largely absent from national surveillance data. Without integrating these providers, SNT models risk being built on incomplete datasets, leading to flawed stratification.
• The incentive crisis: The operational culture of many national malaria programmes (NMPs) relies on donor-funded per diems to motivate training and data review. As funding from major donors contracts, this transactional motivation model is fracturing, threatening workforce retention and data quality.
• Centralization of analysis: There is a risk that SNT becomes an extractive process where districts feed data upwards to central planners without retaining analytical ownership. This centralization disempowers the district health teams (DHMTs) expected to execute the tailored strategies.

Operationalizing the subnational tailoring of malaria strategies: the role of digital peer networks

To operationalize SNT in a resource-constrained environment, national malaria programmes require a low-cost mechanism to drive district-level ownership and data quality that goes beyond traditional cascade training. The Geneva Learning Foundation (TGLF) has developed a digital peer-learning model that warrants examination by technical specialists as a complement to standard capacity-building approaches.

• Shifting from incentives to intrinsic motivation: Traditional training workshops often rely on per diems to ensure attendance. In contrast, the TGLF model connects health workers in digital cohorts to share problem-solving strategies without extrinsic financial incentives. Empirical data from recent cohorts involving 1,715 health workers indicate that participants report high levels of practice application (rated 5.13 on a 6-point scale) based purely on professional recognition and peer accountability. This suggests that intrinsic motivation can be sustained digitally, a critical finding as external funding for operational costs diminishes.
• Validating granular data through ground-level intelligence: SNT models depend entirely on the quality of input data. Digital peer networks can serve as a listening mechanism to surface “tacit knowledge” from the frontline that quantitative surveillance misses. For instance, during recent Teach to Reach sessions, health workers provided over 400 narrative accounts of specific local barriers – such as cultural resistance to bed nets due to associations with burial shrouds – that would not appear in DHIS2 reports. This qualitative intelligence provides a necessary layer of validation for stratification maps.
• Devolving analytical capacity to the district: True SNT requires districts to function as data users, not merely data collectors. The peer-learning platform employs a structured “Impact Accelerator” methodology, which guides frontline staff to conduct their own root-cause analyses (for example, using the “Five Whys” technique) rather than receiving top-down instruction. In Nigeria, working with UNICEF and NPHCDA, The Geneva Learning Foundation supported 4,300 health workers to identify and resolve local bottlenecks in a matter of weeks, effectively decentralizing the “tailoring” process to the community level.
• Cost-efficiency and sustainability: Traditional face-to-face training and supervision are resource-intensive. Comparative data suggests the peer-learning model delivers capacity building at approximately 90% lower cost than traditional technical assistance methods. This is primarily by virtue of scalability: costs very little whether there are 10 or 1,000 participants. Furthermore, in a country-specific study, 82% of a cohort reported using TGLF’s peer learning model for their own needs, and 78% said they needed no further assistance from TGLF. More than half of participants stay in touch because they want to. This aligns with both the value for money and sustainability mandates of malaria partners.

We need more than technical precision to overcome operational inertia

The WHO’s Subnational tailoring of malaria strategies and interventions guidance provides the necessary technical standards, stratification algorithms, and modeling tools for the next phase of malaria control. However, technical precision alone cannot overcome operational inertia.

TGLF’s peer-learning model demonstrates that it is possible to shift from top-down instruction to lateral learning, and from extrinsic financial incentives to intrinsic professional motivation. For technical partners and epidemiologists, integrating these two approaches – rigorous technical stratification coupled with broad-based workforce mobilization – could provide an innovative path to sustaining gains in a fragile funding landscape.

Image: “Contours of Local Knowledge”, The Geneva Learning Foundation Collection © 2025. This installation stretches organic planes across a web of taut, intersecting lines, echoing how malaria responses must adapt to the distinct shapes of local realities. The tension between each form –sometimes pulling apart, sometimes holding together – mirrors the work of tailoring strategies to varied terrains, communities, and transmission patterns. By revealing strength in flexibility and coherence in diversity, the piece evokes a central truth of subnational action: health systems become most effective when they align with the textures of the places and people they serve.

References

#globalHealth #guideline #implementationGap #learningStrategy2 #malaria #peerLearning #snt #theGenevaLearningFoundation #worldHealthOrganization

Retrouver les enfants congolais non-vaccinés: des acteurs de tout le pays lancent le premier Accélérateur zéro-dose pour renforcer la mise en oeuvre et le suivi

«Si je réussis mon projet de terrain, je m’attends à avoir au moins vacciné 345 enfants».

Cet engagement n’a pas été pris par un ministre dans la capitale, mais par Jérémie Mpata Lumpungu, infirmier titulaire dans la province du Kasaï.

Il n’était pas seul.

Lundi 10 novembre 2025, un appel a résonné à travers la République démocratique du Congo.

Depuis Kinshasa, le Dr Josaphat-Francois WETSHIKOY, épidémiologiste, a détaillé son objectif pour les 21 prochains jours: «récupérer 30 % des enfants» non vaccinés dans sa zone cible de 230 000.

Barthélemy Daké Saoromou, préparant une stratégie mobile, vise «plus de 500 enfants zéro dose».

Cette détermination palpable, venue de praticiens de tout le pays, a marqué le lancement de l’«Accélérateur d’impact zéro-dose».

Il ne s’agit pas d’une formation ou d’un atelier de plus.

C’est une nouvelle phase d’action, un «système de soutien» pour la mise en oeuvre et le suivi, conçu par la Fondation Apprendre Genève (TGLF), en partenariat avec l’UNICEF, avec le soutien de Gavi, et sous l’égide du Programme Élargi de Vaccination (PEV) de la RDC. En savoir plus…

Vous souhaitez rejoindre la prochaine séance de l’Accélérateur? Suivez ce lien.

C’est, pour ses participants, un «baptême du feu».

Du constat à l’action

Ce nouvel élan pour la vaccination n’est pas né de rien.

Il s’appuie sur les leçons d’un vaste exercice d’apprentissage par les pairs qui a mobilisé plus de 1 600 praticiens congolais pour développer 385 projets de terrain.

Les résultats de cette analyse, présentés au lancement, ont été sans concession.

La découverte la plus importante: le problème des enfants zéro dose en RDC est avant tout «un problème de gestion et de relation».

Les praticiens ont affinée l’explication officielle inscrite dans le plan Mashako, selon laquelle le principal obstacle est que «la mère est trop occupée».

Pour eux, la «véritable cause, la cause racine, c’est un échec du système de santé», c’est-à-dire un système qui «ne réussit pas à adapter ses services […] à la vie réelle et au travail des parents».

Leurs analyses ont aussi pointé un problème de gestion des Relais Communautaires (RECO), qui se sentent «ignorés ou exclus de la planification», et une méfiance qui naît «en réaction à des échecs précis du système de santé», comme la mauvaise gestion des effets secondaires des vaccins.

Une cohorte du niveau national à l’aire de santé

Les voix qui portent ces engagements ne sont pas anonymes.

La force de l’Accélérateur réside dans la diversité de sa cohorte.

Les participants sont des médecins (comme le Dr Derrick Ngoyi MALOBO au Centre de santé de Kenge), des infirmiers et infirmières (comme Marlène KAPINGA MULUMBA au niveau national ou Jérémie Mpata Lumpungu au niveau local), des agents de santé publique (comme Bonnet Leteta en province) et, surtout, un grand nombre d’agents de santé communautaire (comme Martine YOWA NDAYE ou David BINWA dans leurs Aires de santé).

Ils représentent tous les échelons du système: du niveau National à Kinshasa jusqu’au Centre de santé le plus reculé, en passant par la Province et la Zone de santé.

Ils proviennent du Gouvernement (la majorité des participants), mais aussi de la Société civile (ONG) et du Secteur privé.

C’est cette alliance de praticiens, du sommet à la base, qui est maintenant mise en action.

L’action avant vendredi

Le mécanisme de l’Accélérateur est conçu pour être radicalement concret, transformant les constats de terrain en action immédiate.

D’abord, chaque participant doit fixer un «objectif à 30 jours».

Il doit répondre à cinq questions: quelle communauté aider; combien d’enfants zéro dose s’y trouvent; quelles acteurs impliquer; quel est l’obstacle principal; et quel résultat mesurable atteindre en un mois.

Ensuite, et c’est le cœur du réacteur, chaque lundi, le participant doit définir une «action spécifique et réalisable» qu’il s’engage à accomplir avant le vendredi de la même semaine.

Lors du lancement, les engagements pour la semaine à venir étaient tangibles.

Pour Noëlly Zola Watusadisi, médecin dans la zone de santé de Bombay qui gère 12 îlots fluviaux, son action pour la semaine n’est pas de tout faire, mais de commencer: «entrer en contact avec les infirmiers de chaque îlot» et appeler les chefs de quartier pour préparer la sensibilisation.

David Binwa, du Nord-Kivu, a un plan similaire.

Son action d’ici vendredi: tenir une activité avec les RECO d’ici jeudi afin d’«identifier les vrais problèmes» avant de lancer une sensibilisation de masse.

Le rendez-vous: la redevabilité entre pairs

L’efficacité de l’Accélérateur repose sur un dernier pilier: la redevabilité (accountability) entre pairs.

Ce vendredi, chaque participant devra répondre à un formulaire de suivi de trois questions.

La première: «Avez-vous vacciné des enfants à zéro dose cette semaine?»

La seconde: «Dans quelle mesure avez-vous progressé dans la réalisation de votre action de la semaine?».

Mais le véritable test aura lieu lundi prochain, lors de la prochaine assemblée de la cohorte.

«Lundi prochain à l’Assemblée, déjà, vos collègues vont rechercher, est-ce qu’il est là, celui qui avait déclaré qu’il allait faire telle ou telle chose la semaine dernière», a prévenu Charlotte Mbuh, qui accompagne le groupe. «Et si vous n’êtes pas là, ils vont en faire le constat, mais si vous êtes là, ils vont vous demander est-ce que vous l’avez fait?».

Cette pression n’est pas conçue comme une punition.

L’objectif est de «nourrir l’entraide, de nourrir la solidarité».

Pour soutenir ce «Mouvement congolais pour la vaccination à l’horizon 2030», 167 ambassadeurs de la Fondation ont été intronisés lors de la cérémonie.

Ce sont eux, des praticiens de terrain, qui aideront à animer cette entraide.

L’Accélérateur est lancé.

Les premiers engagements sont pris.

Le compte à rebours avant lundi prochain a commencé.

Image: Collection de la Fondation Apprendre Genève © 2025. L’image «Échos du soin» fait émerger deux visages comme des souvenirs partagés, fragiles mais tenaces. Les formes simples et les couleurs mêlées disent la tendresse, la fatigue, et la force discrète du geste de soin, qui marque durablement celles et ceux qui donnent comme celles et ceux qui reçoivent.

#enfantsZeroDose #equite #francophone #globalHealth #impactAccelerator #laFondationApprendreGeneve #peerLearning #rdc #republiqueDemocratiqueDuCongo #theGenevaLearningFoundation #unicef #vaccination

Development is adaptation: Bill Gates’s shift is actually about linking climate change and health

Bill Gates’ latest public memo marks a significant shift in how the world’s most influential philanthropist frames the challenge of climate change. He sees a future in which responding to climate threats and promoting well-being become two sides of the same mission, declaring, “development is adaptation.”

Gates argues that the principal metric for climate action should not be global temperature or near-term emission reductions alone, but measured improvement in the lives of the world’s most vulnerable populations.

He argues that the focus of climate action should be on the “greatest possible impact for the most vulnerable people.”

The suffering of poor communities must take priority, since, in his view, “climate change, disease, and poverty are all major problems. We should deal with them in proportion to the suffering they cause.”

Climate change is about the health of the most vulnerable

This position resonates with a core message that has emerged across global health over the past several years: climate change is about health.

New data from the 2025 Lancet Countdown draw a stark picture:

• Heat-related mortality has risen 63 percent since the 1990s.
• Deaths from wildfire smoke and air pollution caused by fossil fuels continue to climb.
• Food insecurity, driven by erratic weather, is destabilizing health and economies at once.
• Thirteen out of twenty key health indicators linked to climate impacts now signal urgent action is needed.

Health professionals, policy coalitions, scientists, and patient advocates have succeeded in bringing this nexus between climate and health squarely to the global agenda, culminating in recent summits where health finally shared the main stage with energy and economics.

Yet just as the science and advocacy align, political attention risks fragmenting.

Despite sweeping reports, evidence, and high-level declarations, momentum can ebb.

There is now a risk that the transformative potential embedded in the climate-health linkage may not be fully realized.

Here, Gates’s pivot could actually be the inflection point that the field needs.

The case for health workforce-centered adaptation

For nearly a decade, The Geneva Learning Foundation (TGLF) has been advocating and demonstrating that meeting complex humanitarian, health, and development challenges requires strengthening not just technical capacities or disease programs, but the underlying connective tissue of the health system: its workforce.

TGLF’s digital peer-learning platform now connects over 70,000 health workers across more than 130 countries.

These practitioners – mostly in government service, often in low-resource or crisis-affected settings – are the first to observe, and often the first to respond to, the local impacts of climate change on health.

Their reports show that health impacts are immediate and multi-faceted: rising malnutrition from crop failures, increases in waterborne diseases following floods, new burdens from air pollution and heat, and psychological distress from repeated disasters.

What sets this approach apart is its systemic focus.

Climate change is not a threat that can be “verticalized”.

It demands responses that are adaptive, distributed, and coordinated across all levels of the health system.

TGLF’s innovation lies in harnessing a distributed network to surface and scale locally-grounded solutions:

• Peer learning accelerates uptake of proven local adaptations – health workers share and adapt practices in near real time.
• Digital networks enable early warning and rapid, cost-effective dissemination of context-appropriate strategies, even in remote settings.
• The workforce is not merely the channel for external solutions but is positioned as a community of problem-solvers and trusted communicators, leaders in building and sustaining resilience.

Data from these initiatives demonstrate that such networked learning delivers results at scale, often with return on investment superior to parallel vertical programs, and increases system resilience and flexibility.

Development is adaptation: the need for human capital investment

The urgency and logic of these approaches are reinforced by ongoing policy developments ahead of COP30:

• WHO’s Global Action Plan on Climate Change and Health, adopted at the World Health Assembly in May 2025, recognizes that without context-sensitive system strengthening, existing approaches are insufficient, and positions knowledge and workforce mobilization as strategic imperatives.
• The COP30 Belem Health Action Plan establishes adaptation of the health sector to climate change as an international priority, calling for holistic, cross-sectoral strategies, and “community engagement and participation as foundational to implementation.”

Without empowered and connected health workers, no global action plan will reach those most at risk or maintain public trust.

A strategic investment imperative: why the next breakthrough must be human-centered

The philanthropic search for cost-effective, scalable, and measurable impact has built immense legacies in reducing child mortality and combating infectious disease.

Gates’ own approach of pioneering “vertical” innovations, optimizing delivery through metrics, and prioritizing technical solutions has been transformative, especially at the intersection of science and delivery.

However, emerging science show the limits of technical “magic bullets” absent robust, interconnected local systems.

Trust, legitimacy, and action flow from the relationships health workers build in – and with – their communities.

If development is adaptation, what does this mean for the next phase in climate-health philanthropy?

If the measure of climate action’s value is the scale and speed at which lives are improved and disasters averted, investing in the human infrastructure of the health system is the most evidence-based, cost-effective, and legacy-ensuring play available.

Without these bridges, even the best technology or policies will fail to gain a durable footprint at community level, especially as climate impacts deepen.

Health is where climate change action matters most

The world is waking to the reality that technical solutions alone cannot future-proof health against climate risks.

We need to focus on the highest-value levers.

This starts with a distributed, networked workforce at the coalface of the crisis, empowered to adapt, share, and lead.

In a world of accelerating climate shocks and retreating political will, the boldest, most rational bet for sustained global impact is to go “horizontal” – to invest in the people and the systems that connect them.

By helping build adaptive, digitally connected networks of health professionals, philanthropy can reinforce the foundation upon which all high-impact innovation rests.

This is not a departure from the pursuit of technology-driven change, but rather the necessary evolution to ensure every breakthrough finds its mark – and that trust in science and public health stays strong under pressure.

If ever there was a time for rigorous, data-driven engagement that bridges technology, health, and community resilience, this is it.

Every indicator – scientific, economic, social – suggests that communities will confront more climate disruptions in the coming years.

Investing in the people who translate science into health, who stand with their communities in crisis, is the most robust, scalable, and sustainable bet that any philanthropist or society can make.

By focusing on these vital human connections, the world can ensure that innovation works where it matters most – and that the next chapter of climate action measures true success by the health, security, and opportunity it delivers for all.

History will honor those whose support creates not only tools and policies, but the living networks of trust and craft upon which community resilience depends.

That is the climate breakthrough waiting to happen.

References

#billGates #climateAndHealth #climateChangeAndHealth #development #humanCapitalInvestment #lancetCountdown #peerLearning #theGenevaLearningFoundation #workforce

The great unlearning: notes on the Empower Learners for the Age of AI conference

Artificial intelligence is forcing a reckoning not just in our schools, but in how we solve the world’s most complex problems. 

When ChatGPT exploded into public consciousness, the immediate fear that rippled through our institutions was singular: the corruption of process.

The specter of students, professionals, and even leaders outsourcing their intellectual labor to a machine seemed to threaten the very foundation of competence and accountability.

In response, a predictable arsenal was deployed: detection software, outright bans, and policies hastily drafted to contain the threat.

Three years later, a more profound and unsettling truth is emerging.

The Empowering Learners AI 2025 global conference (7-10 October 2025) was a fascinating location to observe how academics – albeit mostly white men from the Global North centers that concentrate resources for research – are navigating these troubled waters.

The impacts of AI in education matter because, as the OECD’s Stefan Vincent-Lancrin explained: “performance in education is the learning, whereas in many other businesses, the performance is performing the task that you’re supposed to do.” 

The problem is not that AI will do our work for us.

The problem is that in doing so, it may cause us to forget how to think.

This is not a distant, dystopian fear.

It is happening now.

A landmark study presented by Vincent-Lancrin delivered a startling verdict: students who used a generic, answer-providing chatbot to study for a math exam performed significantly worse than those who used no AI at all.

The tool, designed for efficiency, had become a shortcut around the very cognitive struggle that builds lasting knowledge.

Jason Lodge of the University of Queensland captured the paradox with a simple analogy.

“It’s like an e-bike,” he explained. “An e-bike will help you get to a destination… But if you’re using an e-bike to get fit, then getting the e-bike to do all the work is not going to get you fit. And ultimately our job… is to help our students be fit in their minds”.

This phenomenon, dubbed “cognitive offloading,” is creating what Professor Dragan Gasevic of Monash University calls an epidemic of “metacognitive laziness”.

Metacognition – the ability to think about our own thinking – is the engine of critical inquiry.

Yet, generative AI is masterfully engineered to disarm it.

By producing content that is articulate, confident, and authoritative, it exploits a fundamental human bias known as “processing fluency,” our tendency to be less critical of information that is presented cleanly. 

“Generative AI articulates content… that basically sounds really good, and that can potentially disarm us as the users of such content,” Gasevic warned.

The risk is not merely that a health worker will use AI to draft a report, but that they will trust its conclusions without the rigorous, critical validation that prevents catastrophic errors.

Empower Learners for the Age of AI: the human algorithm

If AI is taking over the work of assembling and synthesizing information, what, then, is left for us to learn and to do?

This question has triggered a profound re-evaluation of our priorities.

The consensus emerging is a radical shift away from what can be automated and toward what makes us uniquely human.

The urgency of this shift is not just philosophical.

It is economic.

Matt Sigelman, president of The Burning Glass Institute, presented sobering data showing that AI is already automating the routine tasks that constitute the first few rungs of a professional career ladder.

“The problem is that if AI overlaps with… those humble tasks… then employers tend to say, well, gee, why am I hiring people at the entry level?” Sigelman explained.

The result is a shrinking number of entry-level jobs, forcing us to cultivate judgment and adaptive skills from day one.

This new reality demands a focus on what machines cannot replicate.

For Pinar Demirdag, an artist and co-founder of the creative AI company Cuebric, this means a focus on the “5 Cs”: Creativity, Curiosity, Critical Thinking, Collective Care, and Consciousness.

She argues that true creativity remains an exclusively human domain. “I don’t believe any machine can ever be creative because it doesn’t lie in their nature,” she asserted.

She believes that AI is confined to recombining what is already in its data, while human creativity stems from presence and a capacity to break patterns.

This sentiment was echoed by Rob English, a creative director who sees AI not as a threat, but as a catalyst for a deeper humanity.

“It creates an opportunity for us to sort of have to amplify the things that make us more human,” he argued.

For English, the future of learning lies in transforming it from a transactional task into a “lifestyle,” a mode of being grounded in identity and personal meaning.

He believes that as the value of simply aggregating information diminishes, what becomes more valuable is our ability “to dissect… to interpret or to infer”.

In this new landscape, the purpose of learning – whether for a student or a seasoned professional – shifts from knowledge transmission to the cultivation of human-centric capabilities.

It is no longer enough to know things.

The premium is on judgment, contextual wisdom, ethical reasoning, and the ability to connect with others – skills forged through the very intellectual and social struggles that generic AI helps us avoid.

Empower Learners for the Age of AI: Collaborate or be colonized

While the pedagogical challenge is profound, the institutional one may be even greater.

For all the talk of disruptive change, the current state in many of our organizations is one of inertia, indecision, and a dangerous passivity.

As George Siemens lamented after investing several years in trying to move the needle at higher education institutions, leadership has been “too passive,” risking a repeat of the era when institutions outsourced online learning to corporations known as “OPMs” (online programme managers) that did not share their values: “I’m worried that we’re going to do the same thing with AI, that we’re just going to sit on our hands, leadership’s going to be too passive… and the end result is we’re going to be reliant down the road on handing off the visioning and the capabilities of AI to external partners.”

The presidents of two of the largest nonprofit universities in the United States, Dr. Mark Milliron of National University and Dr. Lisa Marsh Ryerson, president of Southern New Hampshire University, offered a candid diagnosis of the problem.

Ryerson set the stage: “We don’t see it as a tool. We see it as a true framework redesign for learning for the future.” 

However, before any institution can deploy sophisticated AI, it must first undertake the unglamorous, foundational work of fixing its own data infrastructure.

“A lot of universities aren’t willing to take two steps back before they take three steps forward on this,” Dr. Milliron stated. “They want to jump to the advanced AI… when they actually need to go back and really… get the basics done”.

This failure to fix the “plumbing” leaves organizations vulnerable, unable to build their own strategic capabilities.

Such a dynamic is creating what keynote speaker Howard Brodsky termed a new form of “digital colonialism,” where a handful of powerful tech companies dictate the future of critical public goods like health and education.

His proposed solution is for institutions to form a cooperative, a model that has proven successful for over a billion people globally.

“I don’t believe at the current that universities have a seat at the table,” Brodsky argued. “And the only way you get a seat at the table is scale. And it’s to have a large voice”.

A cooperative would give organizations the collective power to negotiate with tech giants and co-shape an AI ecosystem that serves public interest, not just commercial agendas.

Without such collective action, the fear is that our health systems and educational institutions will become mere consumers of technologies designed without their input, ceding their agency and their future to Silicon Valley.

The choice is stark: either become intentional builders of our own solutions, or become passive subjects of a transformation orchestrated by others.

The engine of equity

Amid these profound challenges, a powerfully optimistic vision for AI’s role is also taking shape.

If harnessed intentionally, AI could become one of the greatest engines for equity in our history.

The key lies in recognizing the invisible advantages that have long propped up success.

As Dr. Mark Milliron explained in a moment of striking clarity: “I actually think AI has the potential to level the playing field… second, third, fourth generation higher ed students have always had AI. They were extended families… who came in and helped them navigate higher education because they had a knowing about it.”

For generations, those from privileged backgrounds have had access to a human support network that functions as a sophisticated guidance system.

First-generation students and professionals in under-resourced settings are often left to fend for themselves.

AI offers the possibility of democratizing that support system.

A personalized AI companion can serve as that navigational guide for everyone, answering logistical questions, reducing administrative friction, and connecting them with the right human support at the right time.

This is not about replacing human mentors.

It is about ensuring that every learner and every practitioner has the foundational scaffolding needed to thrive.

As Dr. Lisa Marsh Ryerson put it, the goal is to use AI to “serve more learners, more equitably, with equitable outcomes, and more humanely”.

This vision recasts AI not as a threat to be managed, but as a moral imperative to be embraced.

It suggests that the technology’s most profound impact may not be in how it changes our interaction with knowledge, but in how it changes our access to opportunity.

Technology as culture

The debates from the conference make one thing clear.

The AI revolution is not, at its core, a technological event.

Read the article: Why learning technologists are obsolete

It is a pedagogical, ethical, and institutional one.

It forces us to ask what we believe the purpose of learning is, what skills are foundational to a flourishing human life, and what kind of world we want to build.

The technology will not provide the answers.

It will only amplify the choices we make.

As we stand at this inflection point, the most critical task is not to integrate AI, but to become more intentional about our own humanity.

The future of our collective ability to solve the world’s most pressing challenges depends on it.

Do you work in health?

As AI capabilities advance rapidly, health leaders need to prepare, learn, and adapt. The Geneva Learning Foundation’s new AI4Health Framework equips you to harness AI’s potential while protecting what matters most—human experience, local leadership, and health equity. Learn more: https://www.learning.foundation/ai.

References

• Sadki, R. (2025). Why peer learning is critical to survive the Age of Artificial Intelligence. https://doi.org/10.59350/redasadki.21123
• Sadki, R. (2025). A global health framework for Artificial Intelligence as co-worker to support networked learning and local action. https://doi.org/10.59350/gr56c-cdd51
• Sadki, R. (2025). What does AI reasoning mean for global health?. https://doi.org/10.59350/redasadki.21102
• Sadki, R. (2025). The crisis in scientific publishing: from AI fraud to epistemic justice. https://doi.org/10.59350/532vk-hq503
• Sadki, R. (2025). The agentic AI revolution: what does it mean for workforce development?. https://doi.org/10.59350/redasadki.21092
• Sadki, R. (2025). Language as AI’s universal interface: What it means and why it matters. https://doi.org/10.59350/redasadki.21088
• Sadki, R. (2025). Eric Schmidt’s San Francisco Consensus about the impact of artificial intelligence. https://doi.org/10.59350/redasadki.21109
• Sadki, R. (2019). The next big thing in learning. https://doi.org/10.59350/fp6zp-zpj84

Image: The Geneva Learning Foundation Collection © 2025

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