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How can analogue health systems open up to transformation in Africa? About 15 African governments have come under increased citizen pressure in recent times because of the cost of living crisis - including food, health care and education. The lack of services has negatively impacted the quality of life and economic stability of the population, prompting demands for real systems change now more than ever. The waves of citizen pressure across Africa demonstrate that the continent has got two major game-changers for real transformation: its vibrant youth and digital technology. With over 60% of the population under 25, these young minds are ready to shake things up. Digitalisation is also supercharging activism and inclusion for change. PharmAccess was a co-organizer of the 3rd African Digital Health Summit in Lagos. Young innovators across Africa interacted with care providers, patient groups, investors and advocates on fostering solutions to drive change in health in Africa. It was not an event of big talks, but rather implementers sharing learnings to build on their efforts for healthcare transformation. Here are some learnings from the summit: •Activism that works makes policy makers uncomfortable to ignore evidence by engaging them with models that deliver better value. •Digital literacy, where policy makers learn from innovators, and allow experiences from innovators to guide policies can foster a culture of collaboration & adoption •Digital identification is key to inclusion by providing opportunities to those who can be recognised. Investments in digital identification are a cost-saver even in poorer settings because it ensures better targeting of services. •Regulatory sandboxes that allow for experimenting with new digital solutions for controlled testing & adaptation is critical in healthcare. Fintech succeeded in Africa because policy makers did not stand in the way of innovators. •The primary value of patients groups lies in the social support that they provide for each other. When the social support is strong, the groups can facilitate adherence to treatment and become better advocates. Africa Digital Health Summit (ADHS) PharmAccess Patients Organisation of Nigeria eHealth Africa National Identification Authority Chika Offor Niyi Osamiluyi Vaccine Network for Disease Control DTH-Lab Team