When the theme of the 15th African Union Summit in Kampala, Uganda was announced, there was tremendous excitement among the public health community. “Maternal, Infant, and Child Health and Development in Africa” would be a real opportunity to bring to the fore some of the most critical issues in health and development. While specific diseases have gained the attention of world leaders and the global community in recent years, the essential challenge of improving the health status of women and children has often been neglected. This Summit would finally be an opportunity to engage in high-level discussion about how to improve the status of women and children on the African continent. As a Health Officer at the USAID/Uganda Mission, I was looking forward to participating in the conference in support of our U.S. Delegation, anticipating new opportunities to advance the agenda for moms and kids.

And then, two weeks before the opening of the Summit, everything changed. Terrorist bombings tore through Kampala on what should have been a joyful Sunday evening marking the close of the World Cup. Families and friends participating in the global celebration had their lives ended or forever altered by acts of horrendous murder.

Adjusting to our new reality of a terrorist threat in what is usually a safe and relaxed city was quickly overtaken by additional security concerns related to the AU Summit. Ugandans have had to simultaneously mourn while also preparing to welcome the continent’s leaders to their hometown. Grieving for many was cut short.

As I sat in the opening ceremony of the Summit on Sunday, hearing numerous Heads of State and our own Attorney General condemn the unspeakable acts of murder in Kampala, it became clear that the focus of the Summit would be Somalia. As I supported the U.S. delegation’s efforts through the Summit, Somalia and terrorism on the African continent was indeed the central theme of most meetings.

As a public health practitioner, there is of course disappointment that maternal and child health did not gain as much central attention at the Summit as had been hoped for. But the Summit made it clearer to me than ever to me why taking a development approach to advancing health in Africa is so essential. Taking a development approach means working in the real world with the real world problems that conflict, poverty, and even terrorism bring. We need to pay as much credence to applying health interventions to real-world settings as we do to the scientific research that helps us understand what might work in the first place. Conflict, poverty, and terrorism are a real part of women and children’s lives in Africa. While scientific research and innovations remain fundamentally important, we do not have the luxury of applying health interventions in a controlled setting. To advance health status in a sustainable way, we need to be vigilant of the harsh realities that women and children in Africa are facing. For although maternal and child health deserves a great deal of attention in its own right, we cannot separate health interventions that need scale-up from the realities that moms and kids are living in.

So, on the closing day of the AU Summit, I applaud the public health practitioners and advocates who soldiered on during the Summit to maintain some focus on maternal and child health, as it is an issue that deserves the highest levels of attention. But I also challenge us as a public health community to remember that terrorism and conflict are not simply distractions to our goals. This is, unfortunately, the world we are working and living in. These issues shape the lives of the women and children we are working to save. We need to work with local institutions to understand local issues, and transform evidence-based interventions into reality-based interventions. It is only by addressing the reality of conflict, poverty, and now even terrorism that our goals for improving health can be realized. With a development approach to improving health, women and children all over the continent, including Somalia, stand a better chance.