A hard truth is emerging in global health innovation: Some solutions reach scale, but few last. Equipment goes dark. Dashboards fade. Paper charts return. And the status quo—marked by health care inequities and the digital divide—persists. The foreign aid contractions of 2025 forced a long overdue shift: Government partnership is now front and center. Yet, after 15 years of ministries of health working with our organization, Nexleaf Analytics, we’ve learned that partnership—while necessary—is not sufficient. To achieve scale that lasts, innovators must move from managing government partnerships to catalyzing country ownership of solutions. And while highly intuitive natural language interfaces enabled by AI may be able to leapfrog useless paper charts and unusable dashboards, the core challenges to sustaining digital health remain the same, demonstrating the importance of presenting a roadmap to scaling global health.

Much has been written about the importance of government partnership in scaling digital tools. Experienced practitioners such as Rakesh Rajani and Tim Hanstad note that NGOs and philanthropies often overlook “the most effective pathway to scale solutions to our planet's biggest challenges—partnering with government.” Others focus on solution affordability and government willingness to pay, often measured by whether an innovation earns a budget line in the national plan. As one Kenyan county official put it, successful innovation requires “cost effectiveness, ability to solve the problem, and the budget line needed to sustain the innovation.”

Yet a government’s willingness to pay does not guarantee that a system will survive leadership turnover, procurement delays, or shifting donor priorities. Too often, roadmaps to scaling global health development fade once the initial partnership ends, because countries rarely sustain what they don’t truly own.

Partnership in practice can operate more like permission. A ministry may allow a solution to be deployed within its health system, but it’s not fully integrated into daily workflows. Ministries may work with dozens of “partners” at once, each running projects in parallel, creating operational noise rather than lasting change. Strong partnership is an enabler of ownership, but not sufficient.

Ownership means country agency. It means the country retains decision-making authority, control over data, the ability to adapt tools without external approval, allocations of budget and staff time, and processes and operations that rely on the solution to function effectively.

Read the full article about global health development by Nithya Ramanathan, Nelima Otipa, and Hosea Kintu at Stanford Social Innovation Review.