AI with Us, Not for Us: Reflections from the AI in Health Africa Conference 2025

“Artificial Intelligence will only change lives if we build it with the people who need it most.”

This month (November 2025), I had the privilege of attending the AI in Health Africa Conference (AIHAC) 2025 at Makerere University in Kampala.  The theme, “Scaling AI for Sustainable and Inclusive Health Systems in Africa,”couldn’t have been more timely.

From the moment I walked into the buzzing halls of Makerere, surrounded by researchers, AI innovators, civil society leaders, passionate young people, and government representatives, I felt both energised and challenged. As someone working at the intersection of digital health and youth leadership, this conference felt like more than a professional gathering. It was a movement with the ambition of developing AI in Africa for Africans.

It was a chance to learn, connect, and share insights from our ongoing work at the Digital Health and Rights Project (DHRP) and Restless Development, and to contribute to a critical question:

How do we co-create community informed AI solutions?

One message rang loud and clear throughout the conference: Technology  developers  need to shift power, from AI that is built for communities to AI that is co-created with them.

During my panel session on “Co-creating Community-Informed AI Solutions,” I shared reflections from the Digital Health and Rights Project research report titled, Paying the Costs of Connection and highlighted four enablers for truly inclusive AI:

1. Digital Empowerment: From our recently published DHRP report, communities expressed a strong desire to learn about AI, to  understand how AI works and how it affects their rights, data, and opportunities. When communities understand AI, they move from being passive users to active leaders, advocates and creators.
2. Participatory Design: Through Participatory Action Research on the DHRP Project, we trust communities to play meaningful roles in the research cycle. Communities co-lead research, define the challenges, and use the findings to inform advocacy and programming. That, to us, is what co-creation looks like, and such methodologies will give us AI grounded in lived realities, human rights, and community voice. AI should be grounded in lived realities, not distant assumptions.
3. Partnership with Local Innovators: Communities can organise by partnering with and supporting  local innovators, developers, researchers, and institutions. This shifts power back to communities and ensures AI solutions are designed with communities, not imported to them. When African expertise drives innovation, we will build technologies that truly serve the needs, interests and values of the people in Africa.
4. Policy and Advocacy: Communities, especially young people  should play meaningful roles  in national, regional and global AI policy discussions and digital health governance mechanisms. Their presence in these spaces will enable them to  push for accountability standards that reflect local realities.When communities are informed and engaged, they don’t just consume AI,  they shape its ethics, direction, and accountability.

When people understand how AI works, makes decisions, and who controls it,  AI applications stop being a black box and become a shared tool.

Tough Question of Accountability (t/w suicide)

One of the most emotional moments came during  discussions on accountability.

A young woman referred to a  deeply unsettling experience.
When she once asked an AI chatbot for guidance on ending her life, it responded  with a step-by-step guide on how to end her life and even offered to write her a death note.

Imagine if that message had reached someone in deep crisis. So, who is responsible for that? The developer? The platform? Or the user who “chose” to engage with it?

This experience took us to the question on digital health governance. Some argued that developers are responsible , others argued that developers shouldn’t be held accountable because users interact “at their own risk.” Others, myself included, insisted that ethical responsibility cannot be outsourced.When technology can shape life-or-death decisions, accountability cannot end with a disclaimer.

This was a powerful  reminder of what our DHRP research has shown,  young people and communities are already navigating digital spaces where safety, privacy, and wellbeing hang in the balance. Without strong community-informed governance, AI can unintentionally deepen harm rather than deliver safe health care support.We need AI governance frameworks that are grounded in lived experiences of communities, transparent, ethical, and grounded in human rights standards. Frameworks that hold companies and governments accountable to digital harms.

Africa-Centric AI

Another powerful thread throughout the conference was ownership. Speakers repeatedly emphasized that Africa must move from consuming AI to creating it.

Dr. Monica Musenero, Uganda’s Minister of Science and Technology, made it plain:

“AI should drive economic development, not just convenience.”

Uganda’s forthcoming AI policy and national task force, along with plans to build local data centers and train models on Ugandan data, signal a turning point, one that could redefine digital sovereignty in Uganda and across Africa.

She further emphasised that , “AI holds great promise for improving health care in Africa, but we must invest meaningfully in digital  infrastructure if we are to realize its full potential.”

I couldn’t agree more. Findings from the DHRP Costs of Connection report indicate that many young people and communities are  struggling to get online, due to the cost of smartphones and data bundles, lack of Wi-Fi, lack of digital skills, or lack of ability to assess reliable health information. Without serious investment in data quality, ethical frameworks, digital inclusion, and digital empowerment, Africa risks remaining a testing ground for technologies that don’t understand our contexts or our people. Our realities must shape the algorithms, not the other way around.

Conclusion.

As I left the Makerere conference hall after the two days, I felt both proud and hopeful.

• AI is not just about algorithms, apps, or automation. It’s about people!
• It’s about the young people and communities   who find comfort in a chatbot when no one else is available.
• It’s about communities who deserve to trust that the technology guiding their health truly serves them.

If AI is to transform health in Africa, it should  be ethical, transparent, and co-created with communities, not for them.