Rethinking the future of global health

The global health system is collapsing. Major shifts in geopolitics and funding have put increasing strain on an already fragmented and overly complex system. 

Aid cuts are directly impacting people’s health, especially in the world’s poorest countries. Plugging funding gaps may limit this damage, but it’s not a long-term solution. 

The old global health system has not been working for some time now. Despite many initiatives and institutions improving health and saving lives, half the world – around 4.6 billion people – still don’t have access to basic health services. 

This needs to change. To improve health for everyone, we must rethink the global health system. 

Global health reform cannot and should not be decided solely by any one person or organisation. It must centre the communities most affected by health challenges – particularly in the Global South – whose perspectives are too often marginalised. 

While the specifics of global health reform will need to be collectively and inclusively defined, some things are already clear.

Overseas development assistance will continue to be important, especially for those countries and communities with the greatest needs, but it mustn’t drive dependence.

A new system should involve more regional and national accountability and less dependence on the priorities of donors from high-income countries. 

There is also a growing desire globally for countries and regions to have more agency and autonomy to improve the health of their citizens. The current global health system does not align with the needs and wants of individual countries. 

And ultimately, reform must lead to a sustainable, equitable global health system that meets the needs of our changing world – and secures a healthier future for everyone. 

At Wellcome, we believe our role is to kickstart discussions to rethink the future of global health. 

We are bringing together a wide range of voices to participate in inclusive conversations about what a new global health system should look like. 

We commissioned five thought leaders from across the world to share their visions for global health and kickstart the conversation. These ambitious ideas were outlined in five discussion papers, which were used as the starting point for regional dialogues among stakeholders, such as: 

• national government stakeholders from ministries of health and finance
• regional public organisations
• regional thought leaders
• civil society organisations and community representatives
• health and development partners at regional and national levels

These conversations have worked towards proposals for global health reform. The proposals go beyond the discussion papers and include emerging consensus around more specific changes and how to implement them. The next step will be to encourage agreement and identify actions to take forward. 

Wellcome will then work with governments and organisations across the global health system to support this shift. 

To ensure a healthier future for everyone, it’s time to rebalance power to the people most impacted by health challenges.