Good morning. And welcome to Ibadan.

Some of you got in late last night. Some of you are running on jollof and three hours of sleep. Some of you have been here before, and some of you are setting foot in this city for the very first time. Whichever camp you fall into, on behalf of SRHIN, on behalf of the University of Ibadan that is hosting us, on behalf of every person who has been working behind the scenes for months to put this room together, you are welcome.

This is the first and oldest university in Nigeria. The first. So if anyone tries to convince you over the next three days that the gen has affected your brain, just remember that you are sitting in a room that has produced presidents, professors, Nobel laureates, and at least three people in this very hall who will not stop reminding you they went to UI. You are in good company.

Now, to the work.

The theme of this year's Nexus is Bold Moves, Big Impact. And I want to spend a few minutes with you on why those four words matter, especially in the space we have all chosen to give our lives to, which is public health.

Public health, more than any other field I can think of, punishes timidity. You cannot half-step into a community outbreak. You cannot half-step into a policy room. You cannot half-step a maternal mortality figure that has stayed the same for ten years and expect a different number next year. The field demands that you decide, that you move, and that you stand by the move even when the data comes back and tells you it did not go the way you hoped.

That is a hard ask. Especially for those of us who are young, who are early in our careers, who are still being told to wait our turn. We have been trained, very politely, to be cautious. To pilot before we scale. To write the concept note before we ship the intervention. To get the buy-in before we get the boldness.

And look, some of that caution is good. Some of it has saved lives. But some of it, if we are honest with ourselves, has just delayed the lives that we should have already been saving.

Bold moves are not loud moves. I want us to be clear about that. A bold move is not a press release. A bold move is not a tweet thread. A bold move is the decision, often quiet, often unrecognised, to do the thing that everyone in the room agrees needs to be done but no one wants to be the first to start.

It is the community health worker who keeps showing up to the same household even after the door is shut in her face the first three visits. It is the medical student who sees a gap in the curriculum and decides to fill it with a peer-led seminar instead of just complaining in the WhatsApp group. It is the researcher who chooses to investigate a question that does not have funding attached to it yet, because the question matters more than the cheque.

Bold moves are made by people who have decided that the discomfort of acting is smaller than the discomfort of watching.

And then there is the second half of the theme. Big impact.

Now, big impact is a phrase that we have to be careful with, because in our space, it gets thrown around a lot. Everybody wants impact. Every proposal promises impact. Every annual report shows impact. So let me try to be specific about what big impact actually is, and what it is not.

Big impact is not the size of your audience. It is the depth of the change. A clinic that retrained twelve nurses on respectful maternity care, properly, with follow-up over six months, has more impact than a webinar that reached six thousand people who closed the tab after eight minutes.

Big impact is not the size of the budget. Some of the biggest changes I have seen in this field were made by people working with money that would not pay a single consultant in another sector. What they had instead was patience, focus, and the refusal to spread themselves thin.

Big impact is not the size of the brand. There are organisations doing extraordinary work in this country that you will never see in a newspaper. And there are organisations that get written about every week whose actual programmes, if you go to the field, are not there. You will have to learn the difference. The earlier you learn it, the better off your career will be.

Big impact is what is still standing five years after you have moved on. That is the only honest definition.

So here is my charge to you over the next three days.

Find the bold move you have been putting off. The proposal you have been editing for six months that you should just send. The conversation with that mentor you keep meaning to have. The pilot project in your community that you keep saying you will start next semester. Find that thing this week. While you are surrounded by people who will hold you to it.

And then think about the impact. Not the impressive version. The honest version. What can you actually do, with the resources you actually have, that will still be standing five years from now? That is the question worth bringing into every session you sit in, every conversation you have at lunch, every late-night argument in the hostel that I know some of you are about to start having.

One last thing, and I will let you get on with your morning.

The reason we keep coming back to this work, year after year, is because we believe that the public health future of this continent is not going to be handed to us. It is not going to be flown in from anywhere. It is going to be built by people who look like you, sound like you, and are sitting in rooms like this one. That is not a slogan. That is just the math.

So make the bold move. Chase the real impact. And if you remember nothing else from what I have said this morning, remember this. The work is yours. Nobody else is coming.

Thank you. And welcome, properly, to HEAL Nexus 2025.