As stated earlier, the operating environment of organizations in Africa is transforming itself very rapidly, resulting to rarity of excellent leadership. With diverse emerging issues of ethical nature such as corruption, ethnicity, and xenophobia, among others, Africa needs checks and balances in governance. The evolution of globalization, liberalization, market changes, and technological changes and advancement have forced organizations to redefine their structures, systems, and processes , and have undoubtedly influenced organizational ethics and leadership.
The world has become integrated and interdependent as never before, making globalization one of the most powerful and pervasive influences on work places, communities, and lives of people. Globalization appears to be irreversible and continues to counter the existing local, regional, national, legal and, presumably, cultural boundaries that have been seemingly blocking the material, ideological, and social transformation . No country can afford to ignore an increasingly globalizing world where interdependence is the norm and a new society is being built, a network society or information society with a series of new opportunities and consequent problems of widening inequalities. This directly applies when we consider the availability of medical services and technologies.
Besides the abounding opportunities within different societies as a result of globalization, many other issues exist which raise questions of profound ethical concern and importance to the global community. Furthermore, many countries have liberalized their economies, particularly in the form of deregulation of industries and tariff reductions, to enhance the efficiency of their economies. This liberalization has a strong influence on medical services especially where fake cheap medicines and equipment have become available to patients and practitioners, respectively. Without strict regulations, our ethical stature and being stand to be questioned and scrutinized.
Change and complexity also define the nature of the 20th Century technology. Today, we are confronted with high turnover of technologies related to medicine and other disciplines. We are further witnessing a compression of the time scale by which new technology is introduced, with ever shorter intervals between discovery and application  and the pace of innovation is extremely rapid. This pace of technological change continues to challenge all organizational strategies and affects all individual lives. The availability of facilities such as telemedicine are limited in the developing countries due to their low income per capita and levels of technological advancement. Needless to say, technological change is a sine qua non for not only the survival of an organization but also for maintaining its ethics, competitive edge and growth .
Economic situations usually compel humans to think differently based on the intensity of the crisis and their present feelings. Ethical reflections could be channelled, positively or negatively, towards mitigations of such experiences and encounters. In these hard times, obtaining more returns from ones profession is tempting if not being practised. People tend to suspend all ethical guidelines and their call of duty to make ends meet. With the dwindling resources, medical professionals tend to opt for cheap and/or outdated medicines and revert to other related unorthodox practices. However, it is worth reflecting that success for a practitioner is generally a function of value for others. Indeed, the paradigm of ethical development emphasizes on the maximization of good and the creation of greatest goodness for the greatest number, while at the same time embracing peace, good health, abundance and progress in all their forms. Based on the African community structure, it should also be understood that African ethics is weighed on duty and not on rights, thus placing a great deal of emphasis on human welfare. A morality of duty is one that requires each individual to demonstrate concern for the interests of others, resulting to African morality duties trumping rights, not the other way around. However, this ethical arrangement is being challenged by the enlightenment of peoples' rights and the emergence of human rights groups. Another influence on African leadership and organizational ethics is supererogation, which is an act "beyond the call of duty", an act over and above what a person is required to do as a moral agent. This implies that our African moral sensitivities should be extended to all people, irrespective of their cultures or societies. Furthermore, the interests of all the parties involved in any arrangement ought to be considered in determining how to act ethically and professionally. In this regard, focus on how an organization could act ethically to the internal and external stakeholders should be encouraged. An organization should further take into account all the stakeholders, both individual and collective, with whom it deals . We have to appreciate that health care provider organizations interact with many different groups of stakeholders such as patients and their families, care professionals, other professionals and nonprofessional employees among others. To determine the interests of each of these broad categories, we have to be more specific in their composition and their needs. Nonetheless, it must all the time be remembered that the priority is the patient.