TGLF’s new Leadership framework is grounded in the experiences of more than 1,300 people who work for health. This unique origins story shapes what it can do for the person using it. This one carries a decade of documented practice behind every level it describes. This article tells you who built it, how, and what they had to prove along the way.
In September 2023, 390 health leaders met online to review a draft open source Manifesto for global health.
Most work for ministries of health in districts and facilities, across more than eighty countries in Asia, Africa, and Latin America.
The Manifesto’s version 1.0 they were reviewing had been written from the testimony of more than 1,000 of their own peers, and it would eventually carry the contributions of around 1,300 health staff primarily from districts and local communities.
Half were government, half were from civil society.
Three years later, The Geneva Learning Foundation (TGLF) is honoured to be launching the first Leadership framework grounded in this Manifesto, building on everything we have learned since.
When we say it is TGLF’s framework, that means we take responsibility and consider ourselves accountable for it.
It belongs to the community whose leaders came together to make it possible.
One detail in the record deserves to be read slowly.
No international consultants, no global health agencies, and no donors were present.
That absence is not a logistical footnote.
It is the founding gesture of the entire framework.
In the ordinary architecture of global health, a competency framework is written by experts in northern capitals and then carried outward to be adapted by the people who do the work.
The room in September 2023 reversed the direction of authority.
The people usually positioned as recipients of knowledge were positioned instead as its authors and validators.
To understand the TGLF Leadership framework, published in July 2026, you have to understand that this reversal is the substance of the thing, not a presentational choice layered on top of it.
What is the TGLF Leadership framework?
The framework defines local leadership as a practice rather than a job title.
It describes the adaptive, cognitive, and social capabilities that allow a nurse, a community health worker, or a district manager to solve complex problems, mobilize scarce resources, and build trust in a particular place.
It is organized into nine interdependent domains, each described across three proficiency levels that run from the practitioner who applies skills in daily tasks, through the collaborator who adapts to context, to the strategist who changes the system.
In technical terms, this is a competency framework, meaning a structured description of what effective performance actually consists of, expressed as observable behaviors and graded by level.
The phrase the framework uses for its own content is worth holding onto.
It calls itself a missing curriculum.
Standard competency models in global health concentrate on clinical skills and bureaucratic compliance, and these remain necessary.
But ten years of listening to frontline staff revealed a body of capability that those models do not name, the adaptive work that local actors do every day and that no one taught them.
Naming the unnamed is never neutral.
When a system declines to name a form of labor, that labor becomes invisible, and invisible labor cannot be recognized, rewarded, or built upon.
The framework is, at its root, an act of making visible.
Why did it take a decade to get to a simple, practical framework grounded in the experiences of people who work for health?
The longer story begins about ten years before publication, in the Foundation’s sustained work with community-based health and humanitarian leaders through large-scale peer learning.
In July 2019, this community built the Impact Accelerator, a new way of thinking and doing implementation work.Learners work on a real challenge they face and document weekly action through a cycle of setting a goal, acting, and reflecting.
The early results were unusual enough to be worth stating: participants progressed about seven times faster toward documented improvements than a comparison group with conventional support, at roughly 90% lower cost. In 2021, working with the Ministry of Health in Côte d’Ivoire and support from Gavi, we tracked a cohort where 82% continued using the TGLF model on their own and 78% explicitly declined further assistance from TGLF.
That last finding is philosophically louder than it first appears.
One outcome of a capacity-building program tends to be continued dependence on the provider.
Here, success was measured the opposite way, by the moment when local actors said they no longer needed the external helper.
This inverts the political economy of technical assistance, in which the expert’s value depends on the recipient’s ongoing need.
A framework that later names self-determination and the move from scarcity toward local asset optimization as competencies did not invent those ideas in 2026.
It had been practicing them for years.
How Teach to Reach made scale a friend rather than an enemy
Teach to Reach is the part of the history that made a framework grounded in thirteen hundred voices possible at all.
It began in January 2021 as a conference on COVID-19 vaccine introduction, growing out of a 2020 immunization training program, and it surprised its own organizers.
At the first event, more than 7,500 generated over 14,000 one-to-one networking meetings across three days.
The organizers – a group of more than 300 government and civil society health leaders from TGLF’s Teach to Reach programme – had built sessions around 55 workshops and plenary presentations.
The participants quietly told them, through their behavior, that what they wanted was each other.
So the model changed to follow the people, and it grew, reaching 24,610 participants by Teach to Reach 11 in December 2024.
The composition of that crowd matters for any claim the framework makes about whose knowledge it carries.
About half work for government and about half for civil society, about half are francophone, two-thirds remote rural areas or the urban poor, more than a third support nomadic and migrant populations, and one in five work for health in the middle of active armed conflict.
Before each event, participants answer Teach to Reach Questions formulated to elicit direct experience rather than opinion, and between fifteen hundred and three thousand experiences are typically shared.
Underneath this sits a quiet but radical pedagogical claim, that scale enhances quality rather than degrading it.
Conventional education treats large numbers as a problem to be managed through standardization, which is precisely how a single competency standard comes to be imposed on wildly different contexts.
The Foundation treats large numbers as the source of quality, because more participants mean more diverse experience brought to bear on a shared problem.
This is an epistemology: how do we come to know?
It says that truth about practice emerges through many situated voices in dialogue rather than through proclamation from a center, which is one of the oldest commitments of liberatory pedagogy and one of the clearest breaks from the colonial model of expertise.
What does servant leadership means when it comes to knowledge, learning, and change?
There is a discipline in how the Foundation handles what the community shares, and it bears directly on the framework’s legitimacy.
The experiences gathered at Teach to Reach are curated into insights reports and shared experiences, organized by country and theme, and given back to the community.
The Foundation states the logic bluntly.
A data collection firm could gather thousands of health worker experiences and sell them to customers, but here the customer is the community itself, and everything learned is shared back.
This matters because extraction is the characteristic wound of the colonial knowledge relationship.
Raw material, including human testimony, is taken from the periphery, processed at the center, and sold back as finished expertise that the originators must now purchase.
Decolonial scholarship names this pattern precisely, the systematic exclusion of local knowledge systems followed by their repackaging under external authority.
A framework built from community testimony would reproduce that wound if the testimony flowed only one way.
The insistence on returning knowledge to its source is what allows the framework to claim, without irony, that it belongs to the people whose practice it describes.
The conversation that turned testimony into a framework
What converted this body of experience into a structured competency framework was a working dialogue between Reda Sadki, the Foundation’s founder, and his colleague Charlotte Mbuh.
They reasoned together through which capabilities the field actually demands, and they kept colliding with the same gap, that the work peer learning asks of people is not taught anywhere.
Charlotte Mbuh named it directly, observing that much of what people are called to do, such as advocacy at the most local level or finding resources locally for a vaccination campaign, is “not part of the school or a nursing school curriculum”. A worker is told to mobilize resources, but no one ever taught them how to communicate in a way that generates resources.
The dialogue also widened the frame in a way that carries political weight.
It moved from health and humanitarian workers toward local actors in general, because the category community health worker is itself unstable, sometimes a trained nurse, sometimes a volunteer, sometimes a retired teacher or a farmer who spares time for health work.
Recognizing that instability is an act of epistemic humility.
It refuses to let a northern professional taxonomy decide in advance who counts as a legitimate knower.
Decolonial leadership scholarship identifies exactly this move, the centering of community voices and the redefinition of who is considered a credible knower, as a defining feature of decolonized praxis.
The argument hidden inside a vocabulary choice
One exchange in that dialogue is worth dwelling on, because it shows the framework thinking through the politics of its own categories rather than absorbing them unexamined.
Equity was proposed as a core competency, and the question arose of how to frame it.
Sadki observed a strange pattern, that a community framed around equity draws little interest, while the same content framed as gender draws intense interest, and he traced this to a specific genealogy.
He described a strand of feminism shaped by relatively privileged women in Western Europe and North America, operating in individualistic cultures where extended family and community have thinned, who therefore conclude that gender is the single axis that matters, a framing then amplified by wealthy philanthropy.
The decision they reached was to hold equity as a decolonial and intersectional lens, one that encompasses gender rather than being reduced to it.
This is precisely the critique that feminists of color have pressed against what is often called white feminism, that a single-axis analysis centered on gender alone, abstracted from poverty, race, and colonial history, cannot describe the lives of most women in the world.
Intersectionality, born from Black feminist and decolonial thought, insists that oppression operates through several axes at once and cannot be disaggregated into a single variable.
By choosing the broader lens, the framework aligns itself with liberatory traditions articulated from places that endured both slavery and colonization, rather than with the narrower framing exported from places that did not.
That a competency framework reasoned this through, on the record, is itself part of its significance.
Why now
The framework is also a response to a specific moment.
It absorbs a sharp change in the operating environment between 2023 and 2026, including climate, conflict, and artificial intelligence.
It arrives during a contraction in global health financing, when local actors are increasingly expected to mobilize their own resources rather than implement external grants.
A framework that names resource mobilization, bricolage, and the shift from scarcity to local asset optimization as core competencies is a direct answer to that contraction, and it converts a moment of abandonment into an argument for autonomy.
There is also a deeper reason, which the Foundation states plainly.
In an age of knowledge abundance, when reliable information is everywhere and artificial intelligence can answer most questions, what remains scarce and decisive is human connection and the collective intelligence and leadership that grow from it.
If machines can hold and retrieve information, then the distinctive value of education shifts from transmitting content to building the relationships through which situated knowledge is created and adapted.
A framework of leadership for local actors is the natural artifact of that shift, because the capabilities it names, trust, mediation, negotiation, collective sense-making, are exactly the human capacities that abundance cannot supply.
What difference it aims to make
So, at the end of the day, what difference is this framework for?
Its aim is recognition, in a strong and material sense.
It seeks to make visible and assessable a body of leadership that the dominant systems do not name, so that the people who already practice it can have that practice validated, developed, and rewarded.
The practical promise to a frontline worker is that the invisible work of resolving a community refusal, of keeping a service running when the budget failed, of negotiating safe passage in a conflict zone, can finally appear on a job description, in a performance review, and in a path for advancement.
Whether the framework can actually deliver that recognition depends entirely on the history just told, which is why the history is not decoration.
A framework asserting that local knowledge has equal validity to global expertise can only carry weight if it was itself produced that way.
Its authority rests on the thirteen hundred contributors, the decade of practice, the refusal to extract, the validation by practitioners rather than consultants, and the reasoned choice of a decolonial rather than a single-axis lens.
Each of these is a small repair to the broken relationship between center and periphery, and together they are what make the framework’s central claim believable rather than merely aspirational.
The honest caution belongs here too.
The framework rests on self-selected testimony, so it maps the range of relevant competencies rather than their prevalence, and it still requires formal validation of its indicators, a step its authors name openly.
Recognition encoded in a document is not the same as recognition delivered in a salary, a promotion, or a seat at the table where strategy is set.
The framework is a bid for that recognition, grounded in a way of working that has tried, for ten years, to practice the thing it now describes.
The next article asks what that bid means for the institutions that set global norms, and how the framework completes rather than competes with them.