Rethinking the future of global health

Sixteen countries (with more to come) in 2025 partnered with the World Bank to develop national health compacts, five-year roadmaps designed to expand access to quality, affordable health care and create millions of jobs. The compacts serve as strategic roadmaps to align resources across domestic and external sources, including the private sector, galvanize political leadership, and promote accountability for delivering results.

At the global level, several processes kicked off during 2025 – 2026 to reimagine the future of the global health architecture. They include:

Accra Reset

Launched by the President of Ghana, H.E. John Mahama, in the sidelines of the 80th United Nations General Assembly, the Accra Reset is an Africa-led initiative calling for a reimagined global health order that empowers nations to lead resilient and self-sustaining health responses. A Global Presidential Council – a coalition of heads of state and government from around the world – will provide political leadership to drive the Accra Reset’s agenda. The Accra Reset builds on the outcomes of the 5 August Africa Health Sovereignty Summit hosted by President Mahama in Accra that agreed that Africa must move from aid dependency to self-determination and fleshed out a process for reimagining a global health governance architecture in which Africa shares power and accountability.

European Union/Like-minded Donors Reflection Process

This European Commission-led process aims by the end of the end of 2025 to:

support donors to strengthen alignment around a clear vision for global health and development priorities, roles and responsibilities, and opportunities and risks associated with reforming the current health architecture, and,
produce an options paper to help EU/like-minded donors reflect on how to advance global health reform and participate constructively as a group in the wider global dialogue.

The process is guided by a reference group and expert group and includes key information interviews, consultation panels and an on-line survey and will eventually be brought to a more political level to consider the appetite for change and how to take the options forward.

HEAR CSO (Health Architecture Reimagined – Civil Society Organizations)

A civil society consortium led by WACI Health that includes the NCD Alliance, UHC2030 CSEM, ITPC, GNP+, StopAIDS UK and GFAN aims by July 2026 to ensure that civil society and communities are supported to develop and articulate their visions for the future of the global health ecosystem, including through existing and new processes looking at reforming the global health ecosystem to become more inclusive, equitable, and responsive to their needs. The process includes global, regional and national consultations as well as mapping and analysis of existing literature.

Check the HEAR CSO website for updates.

Sevilla Platform for Action – Global Health

A part of the Sevilla Platform for Action (SPA) launched at the IV International Conference on Financing for Development (FFD4), the initiative “Towards a Renewed Global Health Ecosystem: Navigating Challenges and Opportunities for Financing Inclusive, Resilient, and Sustainable Health Systems” aims to reform the global health architecture to be more cohesive, country-led, and aligned with sustainable financing strategies. This initiative, which builds on the Lusaka Agenda and ongoing reform dialogues, proposes a shared roadmap to strengthen health system resilience and equity without creating new mechanisms or institutions.

The initiative is structured around two key areas of action:

Inviting relevant organizations and global health initiatives to propose concrete ideas of reform aimed at improving coherence, agility, efficiency, maximizing impact, strengthening collaboration, avoiding overlapping and fragmentation and supporting partner countries leadership with a view to presenting a joint reform roadmap by early 2026 with an accountability mechanism to the Boards.
Renewing countries’ intention to support a restructured, more agile and coordinated global health ecosystem, with an emphasis on promoting universal health coverage through inclusive, resilient and sustainable national health systems.

Wellcome

During the second half of 2025 Wellcome supported organisations in five regions to lead dialogues to identify global health reform priorities, and the pathways to get us there, that are grounded in the perspectives and expertise of stakeholders from around the world. This builds on the Wellcome-commissioned proposals to reimagine the global health architecture launched in September.

Each dialogue included a consultation phase and an in-person convening, both of which saw strong engagement across stakeholder groups, actively bringing together governments, civil society, and other actors from over 114 countries. The outcomes of these dialogues are captured in five reports released on 12 December 2025: Latin America and Caribbean, Asia and Pacific, Africa, Europe and North America and Middle East and Central Asia .

While the dialogues started by reflecting on the current global health architecture, their main focus was forward-looking—exploring what the future global health architecture should look like and which reforms could make that vision possible.

Looking ahead, the insights from the five dialogues will be consolidated into a global synthesis paper in early 2026, and inform Wellcome’s plans for a global convening that will bring together key stakeholders from across all five regions, to drive consensus on joint global health reform priorities. It is hoped that the insights from these dialogues will complement and inform other ongoing conversations on GHA reform, including the EC-led reflection process and Accra Reset, to catalyse collective thinking and coordinated action on reform. At regional level, stakeholders involved in the dialogues are also exploring ways to advance these recommendations.

WHO and UN80 Initiative

In February 2026, the Executive Board of the World Health Organization requested the Director-General, in close collaboration with, and under the direction of, Member States, in a transparent and inclusive manner, to design a proposal on a joint, WHO-hosted process that brings together and complements current global health architecture and UN80 discussions to facilitate convergence and consensus-building, in order to support the transformation of the current global health architecture, enhance coordination and leverage the comparative advantages of diverse actors, while being responsive to country needs and realities.

WHO was requested to submit the proposal for the consideration of the World Health Assembly in May 2026.

Read the full decision here: Reform of the global health architecture and the UN80 Initiative