I have read about the African Union Summit for years. I have studied its communiqués, tracked its commitments, and followed the annual press conferences on malaria progress with the kind of attention that comes from working in this space. But reading about a room and standing in it are two different things. When I walked into the AU headquarters in Addis Ababa last month for the 39th Ordinary Session of the Assembly, the weight of it was immediate. These are the people (the Heads of State and Government, the commissioners, the ministers) whose decisions determine whether the commitments Africa makes on paper translate into anything real for the people we serve.

AU Summit theme

The theme of the 2026 Summit was water and sanitation: “Assuring Sustainable Water Availability and Safe Sanitation Systems to Achieve the Goals of Agenda 2063.” On the surface, that might seem distant from malaria. It is not. Vector-borne diseases like malaria thrive in environments where water is poorly managed. Neglected tropical diseases increase sharply in communities without access to clean water or basic sanitation. Maternal and newborn deaths remain stubbornly high in areas where health infrastructure is underfunded and fragile. The theme was a provocation, whether intentional or not: how do you talk about water and development without talking about the health systems that sit underneath both? That question followed me through every session I attended.

Malaria high-level press conference

The moment that stayed with me most was the joint high-level press conference on sustainable malaria financing, convened by the African Union Commission and the African Leaders Malaria Alliance (ALMA). Being there not just as an observer but as a member of ALMA’s Youth Advisory Council gave it a different texture. President Advocate Duma Gideon Boko of Botswana, the current ALMA Chair, presented the 2025 Africa Malaria Progress Report to assembled leaders and press. The numbers are not easy to absorb: African Union Member States accounted for 270.8 million malaria cases and nearly 600,000 deaths in 2024. Progress has stalled since 2015. Only five Member States have achieved the 2025 Catalytic Framework targets. And into that already difficult picture, official development assistance for health declined by 21 percent in 2025, as several donor countries reduced or redirected bilateral and multilateral support.

What the report called a “perfect storm” (of funding shortfalls, growing resistance to biological agents, and humanitarian crises disrupting service delivery) landed differently in that room than it does in a report on a screen. Sitting in that space, listening to a Head of State make the case to his fellow leaders that malaria must be treated as a central pillar of health sovereignty, not a line item that shrinks when external funding dries up, I was reminded why political advocacy at this level matters. The data creates the argument. But someone has to stand in the room and make it.

Global Leaders Network for Women’s, Children’s and Adolescents’ Health

The breakfast meeting hosted by the Global Leaders Network for Women’s, Children’s and Adolescents’ Health brought a different but equally urgent conversation. Leaders there were grappling with the same underlying problem: how do you sustain health commitments when external financing is shrinking and domestic fiscal space is constrained? The UNFPA Executive Director’s call for reforms in global health architecture, for local manufacturing of reproductive health commodities, for health systems built on stable domestic foundations rather than donor cycles; it was the same argument being made at the malaria press conference, in different language. Health sovereignity cannot be siloed by disease; the child who dies of a preventable illness sits at the intersection of all of it.

Role of data systems

One theme that cut across everything was accountability, and specifically, the role of data systems in making accountability possible. Strong national scorecards, digitised reporting, and tools like the CARMA Plus campaign for reproductive, maternal, newborn, child and adolescent health are not administrative exercises. They are the mechanism by which political commitments survive contact with reality. A leader can stand at a press conference and commit to increasing health budget allocations. What determines whether that commitment means anything is whether there is a system on the ground to track it, flag it, and enforce it. I left Addis Ababa more convinced than ever that investment in data infrastructure is indeed investment in accountability.

Young people need to be in the room

There is a tendency, in spaces like the AU Summit, to speak about young people as the future. We are mentioned at the close of communiqués. We are invited to speak at side events. And yes, young health workers, community educators, and advocates are doing critical work on the ground across the continent. But what this Summit reinforced for me is that young people need to be in the room where the decisions are made, not just outside it. The commitments that get made, for example, on malaria financing, on health sovereignty, on domestic resource mobilisation, on the architecture of global health, will shape the continent we inherit. I see this as a reason to wait to be invited in, but instead push.

My first AU Summit was many things. It was a masterclass in how continental policy actually moves. It was a reminder that numbers like ‘270 million cases, 600,000 deaths, 21 percent funding decline’ only create change when someone translates them into political will. And it was a confirmation that the work ALMA does, convening leaders, holding them accountable, and now deliberately building a generation of young advocates who understand this landscape, is exactly the kind of work the moment demands.