Forging Equitable Healthcare Partnerships between the EU and Africa: featuring Jessica Marzaro

Poornima Suresh

As the world's fastest-growing region, Africa offers attractive opportunities for global partnerships, including in healthcare. Healthcare systems in low- and middle-income African countries are increasingly relying on such partnerships due to a shortage of human, financial, and technological resources. However, are these partnerships truly benefiting the African population or simply serving as an investment opportunity for non-African organizations?

To explore this, we spoke with Jessica Marzaro, a science communicator specialist, about her experience with Medici con l'Africa CUAMM (Doctors with Africa CUAMM), connecting diverse African healthcare communities with European research groups. Jessica worked in the Operational Research Unit of CUAMM, an Italy-based NGO that understands local African systems and develops new, evidence-based practices to improve healthcare in these communities.

Jessica was always passionate about science communication, and after completing her Master's at Scuola Internazionale Superiore di Studi Avanzati (Trieste, Italy), she joined Istituto di Scienze Polari CNR (Venice, Italy) to engage the public with the institute’s work in polar research. This is where she realized polar researchers need to respect indigenous communities in the Arctic Circle and remain mindful of international relations in Antarctica.

She says, “I began asking myself about the impact I want to make as a science communicator. I felt a responsibility not just to explain research but also to bring non-experts into discussions about science.” She clarifies that this does not necessarily mean technical discussions but conversations about how science impacts them. Thus, to further pursue this goal of bridging science and society, Jessica joined Doctors with Africa CUAMM, where she experienced first-hand the strong interdependence between science and society.

How CUAMM supports healthcare in Africa

Most research collaborations between African and Western countries are marked by unequal power dynamics. With Western researchers leading the development of solutions, African partners often do not get any decision-making power. Such projects overlook local challenges and socio-cultural factors, because of which the solutions developed may not strongly benefit African healthcare. For partnerships to have a sustainable impact, solutions must be centered around African perspectives.

CUAMM recognizes this need and initiates partnerships between African healthcare workers and researchers to co-develop community-led solutions. As Jessica points out, CUAMM’s role is to work on the “last mile,” reaching the most vulnerable populations in Angola, the Central African Republic, South Sudan, Uganda, Tanzania, the Ivory Coast, Sierra Leone, Mozambique, and Ethiopia.

There are huge differences between African countries in terms of the political environment, healthcare systems, government support towards healthcare, and culture. For instance, the Central African Republic has a troubled socio-political situation and a fragile healthcare system, whereas Uganda and Tanzania have calmer political environments and governments that are more invested in developing healthcare systems.

CUAMM works upwards from local communities and healthcare centers at the ground level, then connects with hospitals, and finally engages in dialogue with the authorities and policy makers. Jessica explains, “Such decentralized care models are used to develop affordable, long-term programs that address the needs and challenges in specific regions and communities. Furthermore, CUAMM enables these local healthcare systems to be self-reliant by training healthcare workers across all levels.”

For an external organization like CUAMM, partnering with local stakeholders and ensuring sustained investment in hospitals and healthcare networks is essential. Lasting impact requires a genuine, long-term commitment. “That is why we stress the ‘with’ in ‘Doctors with Africa’. We believe you cannot simply enter a country, build projects, and leave. It must be done by partnering with local authorities, ministries, governments, communities, and healthcare personnel. Because funding priorities often shift, our efforts must remain sustainable to preserve long-term progress,” explains Jessica.

Consistent with this vision, CUAMM partners with not just Italian and European universities but also African universities, such as Makerere University in Uganda and Ifakara Health Institute in Tanzania. CUAMM’s Operational Research Unit conducts multi-country studies, encouraging African countries to collaborate for collective growth. Each year, the unit publishes an average of 30 scientific papers and, in 2024 alone, collaborated with more than 60 African research centers, 118 institutions worldwide, and 274 authors.

How CUAMM uses operational research for greater community impact

In public health programs, implementation and operational research help monitor the work in practice, identify problems, and develop solutions, thus improving healthcare delivery. For example, in rural Tanzania, CUAMM observed that people are less likely to follow up on treatments for non-communicable diseases when hospitals are located far away. However, when local health centers started providing care for these diseases, the number of patients returning for follow-ups more than doubled.

“We believe implementing research adds real value by helping us do our job better, with more awareness of the challenges we face,” says Jessica, “It also creates a bridge between the Western world and the African world, enabling researchers to work together.” Such collaboration can be a part of scientific diplomacy, which involves knowledge building and fostering of research relationships on an international level.

Within such a collaborative network, Jessica’s main role is to share CUAMM’s research through institutional materials and fact sheets; manage the organization’s magazine Health and Development; collect experiences, lessons, and feedback from their African partners; and organize outreach events to share the research with the public. Jessica reflects, “The challenge is not just to say, ‘I discovered this, and it’s important because of X,’ but to explain why the research was needed, how it connects to other needs, and the process behind it. That’s where storytelling becomes essential to embed scientific content in a narrative people can follow.”

Decolonizing Science and amplifying local voices

“CUAMM has a well-structured presence in the countries where we work,” explains Jessica, “In every country, we have a local representative who maintains institutional relationships with authorities, ministries, and governments.” Her team maintains daily communication with CUAMM’s offices and with healthcare workers in hospitals and health centers to stay connected with the ground realities.

Jessica’s favorite part of her job is speaking directly with the doctors and researchers in the field to understand their perspective. Jessica says, “We are not just conveying scientific content. We are contributing to decolonize science by giving the microphone to people whose voices are often overlooked.” Decolonization of science , a growing global movement, is indeed important for forming equitable partnerships, as it challenges Eurocentric norms and power structures in the scientific community and looks to include diverse perspectives from communities that were oppressed by colonialism.

Although Africa represents almost 19% of the world’s population, it produces less than 1% of the world’s research. To address this gap, CUAMM creates space for African researchers and doctors on a global platform. For example, at CUAMM’s research event in Milan this year, in May 2025, the organization supported African researchers to take part in a roundtable discussion along with European researchers. Jessica recalls a particularly fulfilling moment when she supported an obstetrician from rural Tanzania with her presentation. Despite her initial nervousness, the obstetrician confidently presented the challenges her team faced in managing birth and delivery complications. Through her talk, she brought her lived experiences to the European audience unfamiliar with the realities of African healthcare, a significant step towards an equitable scientific partnership.

Lessons learnt in navigating cultural differences

Connecting European and African perspectives, although a rewarding task, came with its share of challenges for Jessica. She remarks that communication with her African colleagues was initially difficult because of cultural differences and communication gaps. However, viewing this as a learning opportunity instead of an obstacle, she has learnt to step back, listen more, and maintain a dialogue to understand their perspective first. She emphasizes, “The key is humility, that is, recognizing that you may know nothing about their context, asking them to explain it so you can truly understand and not having inherent biases play a role. In my case, it is about bringing the African point of view into a European framework, which is important, and that’s a challenge I embrace.”

The value of creativity and flexibility is another key lesson Jessica has gleaned from her African colleagues, who devise innovative and frugal solutions to problems such as data-collection challenges. By embracing this perspective, Jessica is now looking beyond familiar approaches such as rigid work plans and timelines and using alternative methods to improve outcomes, thus enriching both her professional and personal life.

These learning opportunities have increased her respect and appreciation for her African colleagues. Her experience shows that research collaborations between Africa and the Global North do not have to solely revolve around deficits in African countries; they can be a two-way street, with both partners learning strategies and gaining perspectives from each other.

Jessica’s journey does signify that science communication needs to be the cornerstone of scientific diplomacy and public health. Looking at the larger picture, it demonstrates how allyship between the Global North and Global South can help spotlight research from underrepresented countries and support decolonization. Nevertheless, although decolonization is an important movement, it should be led by those who were colonized. Hence, when fostering scientific diplomacy in former European colonies, science communicators and organizations from other countries must be ready to listen, learn, and support, rather than take on the role of “saviors.”