Some projects do more than deliver answers. They shift how you think about the problem entirely.

That was the case with the STI Diagnostics Market Assessment, a Gates Foundation–funded project that, over six to seven months, evolved from a structured market review into a deeper exploration of how health innovations move from development into real-world use.

At the centre of the work were diagnostic tools for chlamydia, gonorrhoea, trichomoniasis, and later syphilis, across Kenya, South Africa, Zimbabwe, and Nigeria. But the real question was never only about the products. It was about what happens after innovation.

Because a diagnostic tool only matters if it changes what happens in a clinic. If a pregnant woman in Zimbabwe can be tested and treated in time. If a young woman in Lagos leaves a facility with answers. If a health worker has what they need before a patient walks out the door.

That gap, between having a tool and actually using it, was where this project lived.

“We kept realising the question was bigger than the brief, Elizabeth, the project manager reflected”

For the team, the early phase felt structured and clear. But that clarity quickly expanded.

“At the start, you think you’re doing a market assessment. Then you realise you’re actually trying to understand systems behaviour, access, timing, and constraints all at once,” said the project manager.

The project spanned four countries and multiple population groups, including pregnant women and the broader sexually active population. But each setting revealed distinct realities: different pathways to care, different barriers, and different points at which diagnostics either work or fail.

What emerged was not one market, but many overlapping systems. When the project itself starts to shift. Midway through implementation, the work changed in ways that required constant adjustment.

There were personnel changes across countries, requiring new coordination and continuity planning. A modelling component was removed from the original design and replaced with a deeper market assessment. Later, the scope expanded again to include additional STI diagnostics, widening the focus to include syphilis and the broader diagnostic landscape.

On paper, these were technical adjustments.

In practice, they required rethinking how the work was being done, without stopping the momentum.

“It wasn’t one big pivot. It was a series of small recalibrations where you had to stay steady while things around you shifted, Elizabeth reflected.”

By that stage, a strong working relationship with the client made it possible to navigate changes openly and constructively. Decisions became collaborative rather than reactive, which helped keep the project grounded even as it evolved.

The structure behind the flexibility

What held the project together was not only technical expertise but consistency in how the team worked. Regular check-ins created rhythm across countries and time zones. Shared team norms, agreed at the beginning, provided stability even as people and tasks changed.

These structures became especially important when timelines shifted or availability differed across team members. Coordination challenges were real, and delays happened, but open communication and clear ways of working helped maintain trust and progress.

When “too much data” becomes a lesson, one of the early deliverables- a broad health assessment- became a turning point.

It contained significant information, but lacked the sharp synthesis needed for decision-making. It was a reminder that in complex projects, more information is not always more valuable.

The real need was clarity: what matters most, and what actually informs action.

That experience highlighted an important opportunity for the organisation to strengthen internal knowledge systems, particularly around regulatory environments and country-level context. This would allow future teams to spend less time rebuilding foundational information and more time focusing on analysis and insight.

Why this work matters beyond the project

STI diagnostics is a growing field. New tools are emerging, and investment continues to expand.

But innovation alone is not enough.

Access depends on systems that work in reality, not just in design. It depends on whether a clinic can test, diagnose, and treat in time. It depends on whether a tool reaches the people it was designed for. This project made that gap visible and, more importantly, it reframed it as the central challenge.

For Eureka, the STI Diagnostics Market Assessment strengthened more than technical expertise. It reinforced a way of thinking: start earlier, ask harder questions about fit and feasibility, and stay focused on how evidence translates into real-world action.

In the end, this was not just a project about diagnostics.

It was a project about the space between innovation and impact,  and what it takes to bridge it.

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