Curriculum Reform for Development
By Luchuo Engelbert Bain , MD, PhD, FAAS
Global public health stands at a critical crossroads. Despite unprecedented growth in research outputs, training programs, and the number of global public health graduates—from postgraduate diplomas to master’s degrees and PhDs—the gap between knowledge and real-world impact remains strikingly wide. Recent shocks in the global health financing landscape have exposed deeper structural weaknesses in how the field trains and deploys its talent. Rethinking how we train, reskill, and support global public health professionals is no longer optional—it is an urgent development priority.
Research Fails Society: Why Much Public Health Evidence Remains Unused
Global public health produces an ever-growing volume of research, yet much of it proves weak, unused, or disconnected from real-world change. The problem is rarely a lack of intelligence among researchers. More often, it reflects the ecosystems in which research is produced and rewarded.
One major challenge is the persistent disconnect between researchers and policymakers. Evidence is often generated without meaningful engagement with those responsible for translating it into policy or programs. As a result, research outputs frequently fail to align with the needs, timelines, and realities of decision-makers.
Equally problematic is the exclusion of context – the political economy of research. Research questions are frequently framed in ways that disregard the political, cultural, and institutional realities in which health systems operate. Communities themselves are often treated as passive beneficiaries rather than holders of critical expertise.
The (un)intentional systematic undervaluing of community knowledge and lived experience remains problematic. Local knowledge is often treated as anecdotal or secondary, even though communities possess deep contextual understanding of the problem’s researchers seek to address.
The example of the impact of climate change on community wellbeing is a great example. If communities are still around despite being impacted by climate change over the decades, it means they have at least got something right. Ask them , and they will tell you what happened, how they adapted, the major issues, how they are impacted, how they feel, the issues they face, their expectations, and the solutions that are adapted to the context that will be acceptable, sustainable and scalable.
When research ignores context, excludes communities, and disconnects from policy processes, it risks becoming an academic exercise rather than a tool for development.
Curriculum Reform for Development: Why our training systems are no longer fit for purpose
Many of these challenges originate in how we train researchers and professionals. Academic systems still largely reward specialization, speed, and publication counts while neglecting implementation, political economy, and systems thinking. Across the world—and increasingly across Africa—universities are producing large numbers of global public health graduates, including holders of postgraduate diplomas, master’s degrees, and PhDs. Yet the reality is becoming increasingly difficult to ignore: many of our current curricula are simply not fit for purpose.
The recent global health financing shocks, including the ripple effects following disruptions in major funding streams such as those historically associated with USAID-supported programs, have exposed this fragility. Thousands of highly skilled global health professionals suddenly found themselves out of work.
This moment revealed a structural truth: our systems have largely trained professionals to function as employees within donor-funded ecosystems, rather than as innovators, knowledge entrepreneurs, or builders of resilient knowledge economies.
Africa Needs Better PhDs—Not Just More PhDs
Across Africa there is a legitimate and growing call to produce more PhDs. Indeed, despite bearing over 25% of the world’s disease, Africa produces less than 2% of the global research output. Rethinking overall what we invest on is critical. For instance, Africa wants to produce 60% percent of locally used vaccines by 2040. Investment in fundamental research or drug discovery remains minimal. However, the deeper issue is not simply quantity, but quality and purpose.
Africa does need more doctoral graduates, but above all it needs better PhDs and environments where they can thrive intellectually and professionally. Doctoral training should not merely produce academic credentials. It should produce thinkers capable of driving innovation, development, and societal transformation.
This requires institutions that encourage interdisciplinary thinking, intellectual courage, and curiosity. It requires mentorship systems that allow scholars to explore difficult questions. And it requires academic cultures that value societal impact alongside scholarship. PhDs should be engines of development—not simply markers of academic achievement.
Beyond the Illusion of Interdisciplinarity – transdisciplinarity
In recent years, interdisciplinarity and transdisciplinarity have been widely promoted as solutions to complex or “wicked” problems. While bringing together different disciplines is important, there is often an illusion that merely assembling experts from multiple fields automatically produces better solutions.
In reality, disciplines operate with different assumptions, languages, incentives, and ways of knowing. Without deliberate frameworks for collaboration, multidisciplinary teams may simply reproduce fragmentation rather than integration.
Addressing complex problems therefore requires more than assembling diverse expertise. It requires developing best practices for working together across disciplines, sectors, and knowledge systems.
More importantly, it requires building ecosystems that allow genuine epistemic plurality—where different forms of knowledge are valued, and where intellectual humility becomes a foundational principle of collaboration.
From Job Seekers to Knowledge Entrepreneurs
Re-engineering the global public health workforce
The rapid growth of global public health graduates—whether from postgraduate diplomas, master’s programs, or doctoral training—means that many will not find traditional jobs in universities, NGOs, or government agencies. Yet this should not automatically be seen as a failure of the system.
These graduates are essential actors across the knowledge production–utilization value chain. Some will generate evidence, others will translate knowledge for policymakers, some will work in implementation science, while others will build innovative enterprises that bring solutions to scale.
At the same time, many experienced global public health professionals have recently lost jobs as funding landscapes shift and institutions restructure. The USAID-related funding shocks alone revealed how fragile the current global health workforce architecture can be.
These professionals possess an extraordinary wealth of tacit and explicit knowledge. Yet many were trained within systems that programmed them primarily to be employees rather than job creators.
As we reflect on transforming curricula to make them fit for purpose, an equally urgent imperative is investing in best practices to rapidly re-engineer and reskill professionals who have lost jobs.
Reskilling is not merely about helping individuals find employment again. It is about unlocking the immense wealth of knowledge they possess and injecting it back into the knowledge production and utilization value chain through innovation, entrepreneurship, consulting, implementation science, and knowledge translation.
Failing to invest in this re-engineering would represent a profound waste of both hidden and overt expertise accumulated over decades of global health practice.
But this also raises difficult questions. Who should lead this reskilling? Can the same systems that produced these mental models simply retrain the workforce?
Addressing this challenge requires intellectual humility. Public health education must open itself to collaboration with entrepreneurship ecosystems, innovation experts, systems thinkers, and leaders from outside traditional public health training.
The Forgotten Ingredient: Time and Environments for Deep Thinking
Why complex problems require deeper thinking
Another overlooked issue is the absence of protected time for researchers, academics, and professionals to think deeply about their work.
Today’s systems reward speed, constant deliverables, short project cycles, and rapid outputs. Researchers often move from one deadline to another without sufficient time for reflection. Yet meaningful insight rarely emerges from hurried thinking.
Superficial and ad hoc thinking, in many ways, lies at the root of the crises we face in an increasingly complex world.
Complex challenges require deep and rigorous thinking. Yet the goal of such thinking is not necessarily to produce complicated solutions. Often, it is the opposite.
Complex problems frequently require simple solutions—solutions that are elegant, practical, and scalable. Paradoxically, arriving at these simple solutions demands sophisticated thinking, interdisciplinary dialogue, and environments that nurture intellectual exploration.
Institutions must therefore invest not only in projects and outputs, but also in the conditions that allow thinking to flourish: protected time, intellectual freedom, mentorship, and ecosystems where deep thinking, epistemic diversity, and genuine intellectual humility can thrive.
Reimagining Knowledge for Development
If global public health is to meaningfully contribute to development, we must move beyond counting degrees, publications, and projects. What the world urgently needs are thinkers, innovators, and systems builders capable of translating knowledge into action.
This requires courage to reform curricula, humility to rethink how we train professionals, and investment in environments where deep thinking, epistemic plurality, and creativity can flourish.
The future of public health will not be determined by how much knowledge we produce, but by how wisely we cultivate people—from postgraduate diploma holders to master’s graduates and PhDs—who can think deeply, act boldly, and transform knowledge into societal progress.
“Development will not come from producing more degrees, but from cultivating minds capable of turning knowledge into impact.” We need job creators, and not job seekers!
