Teresa Clarke, Chair, CEO, and Executive Editor of Africa.com, interviewed Paulin Basinga on advancing public health initiatives in Africa.

In an era where global narratives about Africa often oscillate between despair and paternalism, Dr Paulin Basinga the newly appointed leader of the Bill & Melinda Gates Foundation in Africa, spoke of a vision of philanthropy that prioritizes dignity and partnership over dependency. In an insightful interview with Africa.com, he was clear about his vision: “Africa is not a charity case. It’s a continent full of potential—and our job is to work with others to help unlock it.“

For Basinga, the opening of these offices is not merely symbolic. It signals a long-term commitment to embedding philanthropy into Africa’s local ecosystems in a way that strengthens, rather than substitutes, existing structures. “Philanthropy must catalyze change, not overshadow governments or the private sector,” he explains.

As Africa faces intersecting challenges—from climate change to food insecurity—Basinga acknowledges that philanthropy alone cannot solve them. But he remains hopeful. “Our role is to spark the kind of innovation and collaboration that leads to lasting change,” he says.

Expanding presence for greater impact

With new offices in Senegal and Kenya, Basinga is leading the foundation into a new era of proximity and partnership. This move, he insists, is not about expanding influence but about deepening impact. “We learned over time that proximity to policymakers and local communities makes a significant difference in scaling sustainable solutions,” he says, reflecting on the evolution of the foundation’s strategy.

The recent development in Kenya and Senegal is very important as it enables the Foundation to cover the three main Africa regions, thus creating sub-regional hubs. Basinga said, “Expanding our footprint highlights our commitment to a long-lasting relationship with Africa.”

Building local capacity, not dependence

Basinga’s career has been shaped by his experiences across the continent—from leading health reforms in Rwanda to strengthening health systems in Ethiopia and Nigeria. It’s a perspective that allows him to see both the opportunities and pitfalls of global philanthropy. He’s quick to acknowledge the dangers of dependence on external funding. “We need to ask ourselves: How do we ensure governments and local institutions sustain these efforts when philanthropy steps back?“

The newly opened offices in Senegal and Kenya will deepen partnerships across Africa and work to support local health initiatives while fostering stronger regional collaboration. Central to these efforts is a focus on health system strengthening—what Basinga calls the “bedrock” of sustainable development. “The aim is not to replace government functions but to enhance their capacity to deliver better services,” he explains. This includes everything from supporting data systems that improve vaccine distribution to funding local research institutions that can lead Africa’s health innovations.

Leveraging diverse experience

Basinga’s diverse roles within the foundation have equipped him with a deep understanding of African priorities. From his early work in Rwanda on public health reforms to leading the global policy advocacy team in Seattle, his multifaceted experience spans health system strengthening, human capital development, and economic empowerment. Reflecting on his journey, he says, “Each role allowed me to gain both technical expertise and a deep understanding of African priorities. Now, as I lead our Africa team, I’m applying these experiences to foster a comprehensive approach.”

Health, innovation, and trust

At the heart of Basinga’s mission is a drive to ensure Africa becomes a leader in health innovation. He sees locally-led research and production as essential not just for improving access to medicines but for rebuilding trust in health systems. “If vaccines are researched, produced, and distributed in Africa, they will be trusted more,” he argues.

The foundation is already backing initiatives to make this a reality, from the African Medicines Agency, which will strengthen regulatory frameworks, to the Africa Clinical Trial Network, which is equipping research sites across the continent. “These investments aren’t just about infrastructure. They’re about fostering self-reliance and trust,” he says.

Redefining philanthropy’s role in Africa

Basinga’s vision is not without its critics. As philanthropic organizations like the Gates Foundation expand their footprint, some argue they risk entrenching global power imbalances or setting priorities that don’t align with local needs. But Basinga is adamant that his foundation approach is different.

“Being African shapes how I lead,” he says. With roots in Rwanda and the Democratic Republic of Congo, and fluency in multiple African languages, Basinga sees his identity as a bridge between global expertise and local realities. “We’re not here to impose solutions. Our role is to listen, to respect local knowledge, and to support the changes Africans are already driving.“

This philosophy extends to how the foundation engages the private sector. The foundation has pioneered innovative financing models, such as partnering with banks to lower borrowing costs for smallholder farmers. Yet, Basinga is clear about the limits of philanthropy. “Our return on investment is measured in human impact, not financial gain,” he says. 

Basinga highlighted the importance of conducting vaccine research and production within Africa to build public trust and ensure the availability of effective vaccines. He mentioned, “Engaging African researchers and strengthening the vaccine value chain, from clinical trials to production, is crucial.”  Initiatives like the African Clinical Trial Network and support for local manufacturers such as Revital in Kenya and Institut Pasteur in Dakar are crucial for developing a self-sustaining health ecosystem.

Basinga emphasized the pivotal role of philanthropy in addressing market failures, particularly in health innovation. He explained, “Philanthropy plays a crucial role in development but is most effective when strategically applied.” Initiatives like GAVI have significantly increased vaccine availability by mobilizing funds and enhancing immunization systems. The foundation continues to support early-stage research and innovation, such as developing new tuberculosis vaccines, and enhances government functions through data analysis and support services.

Health, agriculture, and women’s empowerment are priorities

The foundation’s top priorities in Africa include health with a focus on polio eradication, combating infectious diseases, reducing maternal and child mortality, and strengthening health systems. Agriculture is also a priority with a focus on supporting climate adaptation, improving access to seeds and fertilizers to boost sustainable agricultural productivity. The foundation is also in the inclusive finance space enhancing financial access for women and smallholder farmers to promote economic empowerment. The foundation also supports literacy and numeracy in primary schools through evidence-based policies as well as digital public infrastructure that enables countries to safely deliver economic opportunities and social services.

Conclusion

Paulin Basinga’s strategic vision for the Gates Foundation in Africa embodies a commitment to sustainable, impactful development through localized engagement, strategic partnerships, and a deep understanding of the continent’s diverse needs. Basinga, with more than thirteen years of experience within the foundation and wide-ranging experience working in different African countries, feels he is ready to lead the organization to a successful and sustainable future on the continent.