As a development finance practitioner and expert focusing on African countries, Nanziri believes that finance stands central to the success of any initiative or programme. She has served as the director of the African Centre for Development Finance and head of the Postgraduate Diploma in Development Finance at the Stellenbosch Business School. She is also a research fellow at the South African Reserve Bank and a British Academy scholar.

What excites you most about the Africa Centre’s mission and strategic objectives in supporting inclusive health management?

What excites me most is the commitment to ensuring equitable access to healthcare for all individuals, regardless of their backgrounds, through empowerment (enabling everyone to participate in their health decisions), collaboration with diverse stakeholders and designing innovative solutions that adapt to the unique challenges communities face. The potential impact of transforming lives and improving health outcomes across the continent is profoundly inspiring.

What do you think are the most important requirements for and challenges to implementing more inclusive health management practices in an African context?

There are several requirements that must be considered:

• Strong policy frameworks: Developing and enforcing policies that promote equitable access to healthcare services is crucial.
• Community engagement: Involving communities in health decision-making will ensure that services are tailored to their specific needs and cultural contexts.
• Capacity building: Training healthcare professionals and empowering local health systems is essential to sustainable implementation.
• Data collection and analysis: Identifying health disparities and monitoring progress toward inclusive practices require robust data systems.

The following challenges must be addressed:

• Resource limitations: Many regions face financial and infrastructural constraints that hinder the effective delivery of inclusive health services. For instance, the World Health Organisation (WHO) and other organisations have estimated that Africa faces a health financing gap of around $66 billion annually to achieve universal health coverage (UHC), which varies depending on a country’s health infrastructure, population needs and economic conditions.
• Cultural barriers: Variations in beliefs and perceptions about health and wellness can impede the acceptance of inclusive practices, requiring more community engagement, education and awareness, policy advocacy and tailored health services.
• Political instability: In some areas, political challenges have disrupted health systems and hindered collaboration among stakeholders.
• Fragmented health systems: The lack of coordination among different healthcare providers can lead to inefficiencies and gaps in service delivery.

Given your background in development finance, what role do you think innovative financing mechanisms should or can play in contributing to more equitable health systems?

Innovative financing mechanisms – such as social impact bonds, digital health financing, crowdfunding, health insurance schemes, results-based financing, development impact bonds or blended financing – can play a transformative role in contributing to more equitable health systems in many ways.

Firstly, it can unlock new sources of funding, making resources available for underserved regions and populations that traditional financing models often overlook. Secondly, it can promote public-private partnerships that leverage diverse resources and expertise, thereby enhancing service delivery and expanding reach. Thirdly, it can encourage sustainable investment by ensuring that financial returns are aligned with social impact. Fourthly, it can support risk mitigation: Risk-sharing solutions mean healthcare providers can invest in inclusive practices without the fear of financial loss. Fifthly, it can help facilitate the development of innovative healthcare technologies and practices. Lastly, it can improve accountability and performance tracking, ensuring that funds are used effectively to address health disparities.

What are the key lessons from your experience advising on development finance across Africa that you feel will add value to your role as board chair?

The following lessons are relevant to the work of the Africa Centre and can help inform our advisory input as a board:

• Solutions must be tailored to the specific needs and cultural contexts of communities. Engaging with local stakeholders helps ensure that initiatives are relevant and effective.
• Investing in human resources and local institutions is vital for empowering communities to take ownership of their health systems and ensure long-term sustainability.
• Building collaborative partnerships across sectors enhances resource mobilisation and fosters a holistic approach to health management.
• An adaptive approach is critical to responding to emerging challenges and opportunities, particularly in rapidly changing environments.
• Using robust data analytics supports informed decision-making and helps monitor progress toward health objectives, ensuring accountability and transparency.
• Focusing on sustainable financing models ensures that health initiatives can continue to thrive long after initial funding has been exhausted.
• Embracing innovative financing mechanisms and health solutions can drive progress, especially in resource-constrained settings, and help overcome traditional barriers to access.

What would success as the Africa Centre advisory board chair look like for you?

Incorporating the lessons learnt [listed above] would be a key aspect of the board successfully serving the Africa Centre. For example, in terms of collaboration, fostering more partnerships with universities, research institutions, civil society as well as donor community and developmental partners can help integrate academic expertise into health programmes, driving innovation and best practices. Furthermore, robust data systems can contribute to high-quality research that supports health policy and practice. In terms of sustainable financing models, there is room to employ innovative approaches to seeking academic grants and funding opportunities to support innovative research projects.

In addition, providing advice and support in the following focus areas could help enhance the Africa Centre’s impact and influence:

• Promoting research initiatives that inform evidence-based practices, ensuring that health solutions are grounded in robust academic studies.
• Increasing visibility and advocacy by encouraging the publication of research findings in academic journals and other platforms.
• Involving students in community health initiatives as part of their academic curriculum to foster a culture of service and ethical responsibility.
• Establishing mechanisms for academic feedback on health programmes to allow for iterative improvements based on research findings and best practices.