Letter from the CEO

Dear friends,

What began as a year of deep uncertainty became something unexpected: a moment of clarity.

That clarity didn’t come easily, or all at once. Like many organizations, we faced hard choices, uncertain timelines, and the loss of committed funding. But we kept moving because we knew this was when our work mattered most. The model we’d spent years building, without fully knowing what it would be tested against, turned out to answer the question: "What does global health look like when the old models stop working?"

This wasn’t a hypothetical. At the end of January, we received a call from Kenya’s Ministry of Health when its system for distributing HIV medicines to community pharmacies went offline. In an instant, people lost a critical access point for life-saving treatment. In response, our team built something that would normally have taken months to implement—within seven days.

Meanwhile, global health leaders were focused on what approaches could endure beyond the immediate response to funding cuts. In those early months, Maisha Meds was recognized by both Project Resource Optimization and the Foreign Aid Bridge Fund, which sought to identify “urgent and vetted” organizations that are high-impact, cost-effective, and ready to deliver.

And the question about what could endure wasn’t hypothetical for us, either. Our malaria program in Lagos State continued uninterrupted—thanks to a strong partnership with the state government, which funds the program directly. In a year when so much felt uncertain, we watched something remarkable unfold: a full transition from a donor-supported intervention to one that was government-financed and led. This relationship started before 2025, but last year brought it into even sharper focus.

The success of that program led to a dedicated budget line in Lagos State going forward; sparked plans to expand the model at the national level; and unfolded alongside a legislative effort championing results-based financing for malaria, HIV, and TB with the private sector as a core partner. More broadly, what began as a state-level initiative is now a practical blueprint for how governments across Africa can integrate private-sector care into sustainable, country-led health programs.

This trust was years in the making, and last year it opened new doors. One such door opened when the Ugandan government selected Maisha Meds over more than twenty other organizations to expand malaria care and HIV prevention through private pharmacies, drug shops, and clinics nationwide—supported by our first Global Fund award. It was a milestone we’d been working toward for years, and a sign that governments are increasingly ready to lead this shift.

Of course, trust and partnership are based not on goodwill alone, but strong evidence of impact and cost-effectiveness. Our randomized trials, our live dashboards, and our best-in-class auditing and claims processing platforms are all powered by data systems that keep everything transparent, accountable, and running. And last year, we put that data infrastructure to even bigger use. We launched Africa’s largest tool to track malaria drugs, giving decision-makers in government, industry, and global health visibility into the private sector that never existed before.

We’re also investing in what comes next. This means harnessing AI in ways that strengthen our work and benefit the communities we serve. It means preparing our model to address emerging challenges that will define the coming years: antimalarial drug resistance that threatens hard-won progress, injectable and long-acting HIV prevention that could transform care if delivery systems exist to support it, and lower-cost TB tests that make private pharmacies and clinics an ideal entry point for earlier diagnosis and stronger disease surveillance.

When I think about what made this year possible, I keep coming back to the people. The partners, governments, and funders who’ve backed this work—many of whom took early risks on us and have stayed alongside us as we’ve grown. The thousands of pharmacies and clinics who trust us with their business and their patients every day, and the communities who rely on them. And, on a very personal note, the people I get to work with every day at Maisha Meds.

There’s so much about working here that doesn’t usually make it into an annual report, but I want to try. This year brought moments that tested us in ways we hadn’t experienced before. When challenges arose, like restoring community access to HIV medicines in Kenya, people were working around the clock, often without an initial guarantee of funding to do this work. These are people who continued showing up for providers, patients, and each other. Some volunteered to take pay cuts and temporary leave to avoid having to let go of their teammates. We supported each other and kept our focus on what mattered. And what we know now is that it was very much worth it. We’re stronger than ever, and we’re bringing this resilience to challenges bigger than any we’ve faced—many sooner than we thought.

Instead of writing large checks upfront with no receipts, governments and funders increasingly want to pay for results—to finance cost-effective health services after they’ve been delivered and verified. And that means doing so in ways that leverage technology and existing private-sector infrastructure to expand coverage, drive down costs, invite a range of innovative organizations to participate, and build a path for country co-investment and ownership from the start.

The hard part has always been making that work in practice—building supply chain and data systems that can track services in real time, prevent fraud, process claims, and reimburse providers accurately at scale.

Over the past several years, we built these systems because we had to; our own model and funding depended on it. But in the end, we hadn’t just built health programs. We built new infrastructure that makes pay-for-results possible in practice. And we’re excited to share our learnings and platform in ways that others can plug into and benefit from.

Which is all to say: We don’t intend to let this defining moment pass. The pressures facing global health are real, but so is the opportunity to build systems that are more effective, accountable, and sustainable. And so we’re going to keep moving—solving immediate problems while designing for the future. And we’re grateful to everyone who’s moving alongside us.

With deep gratitude,
Jessica Vernon, MD