Can Africa host its way to inclusion?

When this year’s International AIDS Conference opened in Kigali, Rwanda, it was impossible to miss the difference: African scientists, activists, and students filled the halls — traveling by plane, bus, and sheer determination. The International AIDS Society told Devex that nearly 50% of the roughly 4,000 participants at IAS 2025 were from Africa, a stark contrast to IAS 2023 in Australia, where just 26% of the 5,335 attendees came from central, eastern, southern, or western Africa. Despite decades of pledges around equity and inclusion, systemic barriers still block African voices from the very global health conversations that most affect their communities. For African researchers, civil society leaders, and early-career scientists, visas are expensive and denials are rampant. Even when invited to speak or present work, many are denied entry to conferences tackling the very challenges their communities face. IAS 2025’s location was no accident. After the 2022 Montreal AIDS Conference sparked outrage when dozens of African delegates were denied Canadian visas, IAS was under pressure to act. Rwanda, with its political stability, growing scientific infrastructure, and visa-on-arrival policy for most African nations, offered a solution. “More than ever, this is the moment for us to be in Africa,” IAS President Beatriz Grinsztejn told Devex at a pre-conference press briefing. “Rwanda has a very good visa policy,” added IAS President-elect Kenneth Ngure. “It enabled Africans who couldn’t get scholarships to still pay their way and attend.” The difference was visible. In the bustling halls of the Kigali Convention Centre, Ngure took in the sight of African scientists, activists, students, advocates, and journalists mingling. “It almost feels like a family reunion,” said Ngure, who is also a professor of public health at Jomo Kenyatta University in Kenya. “People came by bus from Uganda and Kenya. The mood is celebratory, but also reflective.” But as the applause fades and the booths are packed away, a harder question lingers: Does relocating global health conferences to Africa truly make them more inclusive? Or does it simply move the epicenter of exclusion? Others caution that simply shifting locations won’t fix deeper inequities in how global health operates. Loice Ombajo, a senior lecturer and infectious disease specialist at the University of Nairobi, warned that hosting alone isn’t enough. “It makes sense to hold conferences here. But we must ensure that it’s not just symbolic. True access means that local scientists can present, publish, and implement,” she said. For many attendees, just getting through the door also required personal sacrifice. "Even with the Kigali location, many paid out of pocket to attend,” Obi Chima, a health informatics manager with the Society for Family Health Nigeria, said. “That’s not sustainable." Organizers told Devex that the IAS 2023 conference awarded 327 in-person and virtual scholarships to participants from 63 countries and half of all scholarships were awarded to people in central, eastern, southern and western Africa. For IAS 2025, there were 247 scholarship recipients — 64% were African. Locked out of the continent IAS isn’t the only group that has moved its event from the global north to Africa. Women Deliver did the same, shifting its 2023 conference from Canada to Rwanda. WD2023 saw 24% of attendees from Africa — a marked improvement in regional representation compared to around 15.3% in the previous edition. Though WD2019 in Vancouver had more political visibility and donor commitments, including 1.4 billion Canadian dollars in Canadian government pledges, WD2023 was hailed as the most inclusive edition to date. While hosting global health conferences in Africa is being pitched as a step toward inclusivity, the reality is that not all parts of the continent are equally accessible to all Africans. Regional visa restrictions, costly flights, and limited institutional support often mean that even when events are held on the continent, participation remains a challenge. Despite years of pledges to dismantle internal borders through the African Union's Protocol on Free Movement of Persons, nearly half of all African travellers still need a visa before visiting another African country, according to the 2024 Africa Visa Openness Index. While 39 countries have improved their openness since 2016, progress has stalled in many regions, with eight countries sliding backward over the past year. The report highlights both innovation and inertia: e-visas and reciprocal agreements are expanding, yet inconsistencies and high travel costs continue to hinder mobility. Scholars from countries facing economic or political instability and those with so-called “weaker” passports said they still encounter the same hurdles they would if the event were in Europe or North America. The irony is not lost on African researchers who were denied entry to conferences held on their own continent. Ifeanyi Omah, a Nigerian virologist and doctoral candidate at the University of Edinburgh, whose research focuses on genomic surveillance of infectious diseases, said attending regional conferences has been an uphill battle because of the limitations of his Nigerian passport. Omah recounted how he once missed a pivotal conference in South Africa — the Virus Evolution and Molecular Epidemiology meeting — not because he lacked funding or credentials, but because his visa application was inexplicably denied. He had assumed, like many others, that attending a conference on African soil would be easier for an African researcher. “I told my lab members (in the U.K.), ‘No stress, this one will go through,’” he told Devex. “But I (the African) was the only one left behind.” He also failed to honor an invitation from the Africa Centres for Disease Control and Prevention for a high-level meeting in Ethiopia. Despite applying for a visa well in advance, he said he found himself stranded in Istanbul, Turkey, when airline officials refused to let him board. His visa “wasn’t approved,” he was told, even though colleagues traveling on similar missions had theirs cleared. “That was the moment I realized the African Union is a paper tiger,” he said, his voice thick with frustration. “If I face this much trouble entering Europe or America, I might understand. But to face it within Africa as an African? That’s heartbreaking.” Hope on the horizon? But there are signs that change may finally be coming, albeit at a glacial pace. In a landmark move, Kenya recently scrapped visa requirements for citizens of all African Union member states, with the exception of Libya and Somalia, allowing African travelers to enter without lengthy paperwork or fees. For public health leaders such as Yap Boum II, deputy lead of the Africa CDC incident management support team, Kenya’s decision offers a rare glimpse of what an accessible continent could look like. “Just show up with your African passport,” he said, applauding Kenya’s leadership. While the broader system of free movement across Africa remains uneven, Kenya’s decision signals growing momentum toward a more mobile, connected continent, one where the ability to share knowledge and respond to crises is no longer determined by visa stamps. “This is definitely an opportunity to remind us of this important advocacy piece,” Boum added, calling for renewed urgency in removing the very barriers that prevent Africa’s public health experts from contributing to both regional and global solutions. Kenya now offers an alternative to Rwanda for international conference organizers seeking African destinations without visa restrictions for African attendees. However, both countries also face scrutiny over governance and rights. Rwanda’s reputation as an efficient organizer is tempered by criticism of President Paul Kagame’s tight control, restrictions on opposition and civil society, and allegations of repression of dissent. Kenya, while more open politically, has also drawn concern over recent crackdowns on protests, shrinking civic space and questions around how its human rights record might affect United Nations operations relocating to Nairobi. While Kigali has demonstrated its reliability as a host, it remains uncertain whether logistical access alone will lead to more meaningful inclusion of the continent most affected by global health challenges. That’s the shift advocates such as Ngure said must come next. “We’ve proved we can host, now we must prove we can lead,” he said.