This piece draws on four years of comparative ethnographic research in Ghana and Malawi, between 2020 and 2024. I want to make three connected arguments for the people who shape African health governance: ministries, regulators, and the advisory bodies behind them. First, medical drones do not bypass infrastructure. They reassemble it. Second, Ghana and Malawi have taken divergent paths, and this divergence shows that "leapfrogging" is not a single pathway. It is a set of pol