Moving Faster Means Building the Road, Not Just Stepping on the Gas
Why Africa’s maternal and child health gains depend on fixing how countries prioritize and introduce health products
A recent Devex special edition on “moving mother and child health into the fast lane” highlights an uncomfortable truth: despite decades of progress, momentum in maternal, newborn, and child health has stalled. Financing constraints, workforce shortages, fragile health systems, and overlapping global crises have left too many countries in Africa struggling to sustain—and extend—hard-won gains.
Calls for urgency are justified. But urgency alone is unlikely to accelerate outcomes for women and children in Africa. Improving health outcomes is not simply about “moving into the fast lane,” it is about how effectively systems are designed to prioritize, introduce, integrate, and scale innovation. Without robust innovation introduction systems, even the most promising innovations may be delayed, unevenly adopted, or fail to reach those most in need.
If we want to improve maternal, newborn, and child health at a far more rapid pace, we need to focus not just on stepping harder on the gas, but also on building and maintaining the road (road = the systems that enable progress).
Speed Is a Systems Outcome
Reporting from the International Maternal Newborn Health Conference (IMNHC) in Nairobi, Devex’s Sara Jerving underscores a central paradox: at a time when tools, technologies, and delivery innovations are abundantly available, improvements in MNCH outcomes have plateaued. The challenge is no longer innovation scarcity, but system readiness and capacity.
Health products—medicines, diagnostics, devices, and vaccines—do not move from regulatory authorization to impact on their own. Their journey is shaped by how effectively and efficiently countries can:
Assess evidence and contextual relevance
Set priorities across competing health needs
Align financing, procurement and service delivery systems
Coordinate actors across government and markets
When introduction systems are fragmented, even well-funded products can take years to reach frontline providers — some products taking nearly 30 years to scale-up. When those introduction systems are institutionalized and reliable, progress can accelerate without compromising sustainability.
From Political Will to Whole-of-Government Action
A growing chorus of stakeholders rightly points to renewed political commitment as a prerequisite to regaining momentum in maternal, newborn, and child health. But political will translates into results only when supported by whole-of-government coordination.
Decisions about what to introduce, how to pay for it, and how to deliver it involve ministries of health, finance, and others, as well as procurement agencies and regulators. When these actors work sequentially — or in silos — delays and duplications are inevitable.
Whole-of-government coordination creates shared ownership of introduction decisions. It helps governments:
Align maternal, newborn, and child health priorities with budget cycles
Reduce duplicative reviews and approvals
Clarify institutional roles and accountabilities early
In practice, coordination allows urgency to translate into action. Without it, fast lanes become bottlenecks.
Market Intelligence: Fast Doesn’t Mean Everything, Everywhere
The maternal, newborn, and child health landscape is crowded with both new and existing products and pilots, each with a compelling case for attention. But speed cannot mean introducing everything at once. As Dr. Owen Chikhwaza, director of reproductive health for Malawi’s Ministry of Health, points out in the article, “Resources will never be enough. The first thing is to get the interventions right.”
This is where market intelligence becomes essential. Structured, decision-relevant data—on disease burden, costs, supplier pipelines, and delivery feasibility—allows countries to make deliberate choices about what to fast-track and how to sequence all of the new technologies that are accessible.
Market intelligence supports tough but necessary questions:
Which innovations can offer the greatest impact in the near future?
Where do new tools improve or complement, rather than complicate, existing programs?
What are the long-term costs and system implications of introduction today?
In an era of constrained resources, choosing well is as important as choosing quickly.
Whole-of-Market Engagement: Avoiding the Pilot Trap
IMNHC delegates commented on the need to reduce the constant ‘piloting’ of products with donors, and instead focus on transitioning the right products into routine, nationally financed programs.
This gap frequently reflects weak whole-of-market engagement. When manufacturers, donors, procurers, and governments engage late or ineffectively, countries are left to reconcile policy ambition with market realities after key decisions have already been made.
Whole-of-market engagement earlier in the introduction pathway allows governments to:
Understand supplier readiness and pricing trajectories
Plan for transitioning from external donor financing to domestic funding
Send clearer demand signals that support sustainable supply
For maternal, newborn, and child health interventions in particular, where continuity and trust are critical, this coordination helps ensure that speed does not come at the cost of reliability.
Portfolio Thinking: Accelerating Without Overloading Systems
The call to “move faster” raises an important risk: acceleration that overwhelms already stretched health systems. Introducing multiple products independently — each with its own training, guidelines, and reporting requirements — can slow and compromise delivery rather than fast-track it.
Portfolio-based planning offers a way through this tension. Instead of evaluating innovations one by one, countries consider groups of interventions together, assessing how they interact and where they share delivery platforms.
A portfolio lens allows governments to:
Sequence introductions to match system capacity
Bundle training, procurement, and rollout strategies
Make trade-offs explicit rather than implicit
For maternal and child health, portfolio approaches can help ensure that acceleration is strategic, aligned, and manageable.
Building the Fast Lane
The world cannot afford incremental progress for maternal and child health. But impact will not come from urgency alone. It will come from systems that make urgency actionable.
Rooting innovations in efficient and effective product introduction systems, like what the ALIGN Consortium is doing, is what turns commitment into reality. Whole-of-government coordination, market intelligence, whole-of-market engagement, and portfolio-based planning are not administrative niceties—they are the infrastructure of speed, scale, and sustainability.
If we want a fast lane for mothers and children, we need to keep building and maintaining the road.