Images of five thought leaders from around the world over a graphic of the world map. Three of the thought leaders are women. Two are men.
Credit:

Wellcome

Wellcome commissioned these thought leaders to reimagine the global health system. From left to right: Khor Swee Kheng, Catherine Kyobutungi, Kelley Lee, Paola Abril Campos Rivera, Shadi Saleh.

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Bold ideas for a reformed global health system

Discussion papers commissioned by Wellcome bring together bold proposals from five different world regions for a reimagined global health architecture. 

Credit:

Wellcome

Wellcome commissioned these thought leaders to reimagine the global health system. From left to right: Khor Swee Kheng, Catherine Kyobutungi, Kelley Lee, Paola Abril Campos Rivera, Shadi Saleh.

Discussion papers at a glance 

Published:
4 September 2025
Strategic programme:
What's inside:
Bold ideas for global health reform according to five thought leaders from around the world.
Who this is for:
Policy makers, decision-makers in government and the wider global health policy community.
Creative commons:

Summary 

Global health is undergoing significant change with shifts in politics and funding. For example, governments are cutting overseas development aid and focusing more on priorities at home. This presents an unprecedented challenge to global health, but also a unique opportunity to consider the current system and rethink how it can meet the needs of a changing world. 

That’s why we’ve commissioned five thought leaders from different regions around the world to reimagine the global health architecture. By global health architecture, we mean the systems, structures, institutions, rules and processes that collectively guide, coordinate, finance and implement efforts to improve health on a global scale.

Five regional perspectives  

These innovative thought leaders outline ambitious visions for global health reform across five discussion papers, rooted in different regions: 

  • Khor Swee Kheng (Asia and the Pacific)
  • Catherine Kyobutungi (Africa)
  • Kelley Lee (Europe and North America)
  • Paola Abril Campos Rivera (Latin America and the Caribbean)
  • Shadi Saleh (Middle East and Central Asia) 

Emerging themes

The papers offer a diverse and ambitious range of perspectives on an equitable, sustainable future for global health and how to achieve it. Some key themes include: 

  • Shift power to regions and countries most affected by health challenges: how to reform global health governance structures and enable regional and country leadership to make the future system more effective, efficient and equitable in serving the health needs of local communities.
  • Justice and fairness: how to embed fairness in the reformed design of the global health architecture. 
  • Innovation: how global health products, processes and institutions must radically change to fit the challenges of the coming decades. 
  • Coordination across sectors: how to tackle global health, climate change and global financial inequality through joint and mutually reinforcing governance and financing mechanisms. 

What unites all five discussion papers is clarity about the need for substantive global health reforms. They envision significant change to correct failures of the past and present, and to better prepare for challenges of the future. 

These initial proposals are not expected to be representative, or consensus based. Rather, they set an ambitious trajectory for global dialogue based on the perspective of leading experts in the field from different regions of the world. They are a starting point to provoke ambitious and inclusive conversations among a broad range of stakeholders at regional and global levels. 

Key takeaways 

Below are key takeaways lifted directly from each thought leader’s discussion paper, organised by region.

Asia and the Pacific

'Proposing a Global Commons Coordinating Council and A Set of Six Enablers for the Global Health Architecture'

by Khor Swee Kheng

Swee Kheng is the CEO of Angsana Health, which builds integrated digital-first primary care systems in Southeast Asia, Malaysia. He is also a Visiting Assistant Professor at the School of Public Health, The University of Hong Kong.

Africa

'Rethinking the Global Health Architecture in Service of Africa's Needs'

by Catherine Kyobutungi

Catherine is the Executive Director of the African Population and Health Research Center in Kenya. She is also the Co-Director of the Consortium for Advanced Research Training in Africa.

Europe and North America

'A Proposal for Transforming the Global Health Architecture'

by Kelley Lee

Kelley is a Tier 1 Canada Research Chair at the Global Health Governance. She is Professor of Global Public Health for the Faculty of Health Sciences at Simon Fraser University in Canada.

Latin America and the Caribbean

'Rebalancing the Scales: A New Architecture for Global Health Justice'

by Paola Abril Campos Rivera 

Paola is a Research Professor and Director for Evidence and Action for Health Equity School of Government and Public Transformation at the Institute for Obesity Research at Tecnológico de Monterrey in Mexico.

Middle East and Central Asia

'Designing a New Global Health Architecture for the Middle East and Central Asia Region'

by Shadi Saleh

Shadi is Founding Director of the Global Health Institute. He is also a Professor of Health Systems and Financing at the American University of Beirut in Lebanon.

Conclusion 

These ideas are only the beginning. The next step is to have inclusive conversations among regional and global stakeholders.

Wellcome commissioned partners in each of the five regions to lead inclusive regional dialogues on global health reform towards the end of 2025. The above papers, alongside other inputs and processes, should provoke discussion and more ideas from a wide range of stakeholders. They will discuss what is needed to enact changes to the global health system and how this can be made possible on a coherent reform path. 

This will feed into a global dialogue, where the goal will be to encourage agreement and identify actions to take forward.

Downloads 

Download the discussion papers from each region in seven different languages:

  • Arabic
  • Chinese
  • English
  • French
  • Portuguese
  • Russian
  • Spanish

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