In this opinion piece, Shreya Bhatt and Andra Blaj share key takeaways from their first Skoll World Forum as Medic Co-Executive Directors.
This year’s Skoll World Forum was special – it was our first time attending as Medic’s Co-Executive Directors.
We arrived open and curious, with many questions on our minds:
- How are peers navigating change?
- What does responsible AI look like for last-mile communities?
- And, what does it mean to share power and to lead more collaboratively in a sector that’s still figuring out what that looks like?
Here’s what stayed with us:
No one does this alone.
This is certainly not a new concept in our ecosystem, but it landed differently last week. Maybe because the world feels less stable. Or perhaps because there is a shared sense of fatigue, and therefore a need for regrounding in the collective.
What we heard, again and again, was a real doubling down on community and collaboration as the unit of change. Not one individual organization, program, or platform. Not even a single funder. From emerging funding collaboratives to advocacy groups like Community Health Impact Coalition, we are seeing the power of partnership drive impact in ways that are otherwise simply impossible.
One of the most resonant moments for us came from Ana Lucia Ixchiu Hernandez, indigenous activist and documentary film-maker, who shared that in Mayan philosophy, the number 1 doesn’t mean singular. It means unity. A oneness that includes all others. In a moment where many of us are navigating disruption and regeneration, that reframe felt like a gift.
At Medic, our belief in the power of the collective has shaped our work since the beginning. We work alongside 47 partners and hundreds of thousands of community health workers across 24 countries to build open-source technology for last-mile care, together. Our multi-squad model brings together representatives across Community Health Toolkit (CHT) adopters to build solutions for shared needs, and it’s unlocking new and critical functionalities for community health workers at unprecedented speed. More importantly, it’s proving something important: that collaboratively building open-source technology—with the people closest to the problem—actually works.
We didn’t design the CHT as a community-led platform by accident. We built it this way because no single organization could reach everyone who needed care. It’s a conscious choice; a statement of our values. And Skoll reminded us why this matters more than ever.
Scale comes from how you build, not what.
At the Forum, the question of ‘scale’ comes up fast. But the conversations in Oxford reaffirmed something we’ve known for a long time: technology alone is not a guarantee of scale, let alone of impact.
When we look at the CHT, now supporting 182,000 community health workers (CHWs), what made it work wasn’t just technology itself. It was the choices behind it. Meeting people where they are—through the devices in their hands, in the languages they speak, and in the realities of how care actually happens. Open by design, user-centered. Built to be locally owned from the start.
Moreover, the technology only scales in political environments willing to invest in local ownership, assert sovereignty over their own health systems, and treat CHWs as a genuine and valued pillar of the system rather than an afterthought. When it comes to durable systems at scale, we’ve seen time and again that the socio-political conditions matter as much as, if not more than, the code.
That’s what made the CHT travel and have impact. And the Forum confirmed it: as governments around the world increasingly reclaim ownership of their digital systems, it’s clear that the case for open, sovereign, locally-rooted systems has never been stronger.
This is what local leadership unlocks: the agency to set your own pace, choose your own tools, and build systems that last. As Michelle Adeniyi from Crown Family Philanthropies reflected about the CHU4UHC consortium in Kenya, “What excited us most was the alignment: government leading with the vision, joined by civil society and philanthropy all uniting to advance universal health coverage.”
That alignment is the model we believe will shape the next decade of community health: open, led from within, and built by the people who deliver care. That’s how we get to health for all.
Paranoid optimism around AI is the need of the hour.
It was no surprise that AI took center stage at the Forum. Flagship Pioneering Founder and CEO Noubar Afeyan’s opening plenary put a name to something many of us have been feeling. Not naive optimism, which ignores the risks from AI or pretends they aren’t real. Nor paralyzing caution, which uses those risks as an excuse to stand still. But rather paranoid optimism: staying clear-eyed about challenges while refusing to let them become an excuse for inaction.
This is where we are with AI at Medic. We’re actively building, supporting CHWs to smartly plan their days to provide timely care, exploring multi-agent systems to accelerate relevant innovation, and strengthening the foundations of the CHT for the AI era. But we’re also taking the time to ask ourselves: in a world where AI can build anything, are we building the right things?
It’s a question that generates a whole host of further considerations.
Will it reach the people who need it most, in their daily lived realities? In places where electricity is intermittent, data is expensive, and CHWs largely work offline on low-cost devices.
Will it address what actually limits care? Clinical decision-making is the growing focus of many early-stage AI innovations, but we know this accounts for only a fraction of a CHW’s day. The administrative and logistical realities of their work need equal attention. We need to ensure AI makes existing tools smarter and doesn’t deepen existing challenges.
Whose voices shape these innovations? Maureen Wauda, a CHW from Migori County, Kenya, said it best: “We need to be involved in the designing of AI. AI cannot replace me.” We believe the people closest to the problem hold the deepest knowledge, and that real innovation means lowering the barriers that restrict their agency to develop their own solutions.
For us at Medic, paranoid optimism is not just a feeling, but a daily practice. We’re curious and ambitious about what AI can unlock for CHWs. And we’re equally willing to slow down, ask hard questions, and say “no” to innovation without purpose.
The reality is that funding is shifting, the pressure to move fast is constant, and the gap between AI’s promise and its responsible application in last-mile settings is still wide. But Medic has walked this path for 15 years, championing open-source to unlock collective innovation, building a diverse community of dedicated experts, and continuously pushing the frontier of what’s possible.
We may not have ended the week with all of the answers, but we came away with something more durable: a healthy dose of paranoid optimism, conviction in the path we’re on, and gratitude for the peers, partners, and donors who accompany us.